Provider Briefing: Amitiza Availability in 2026

Lubiprostone, marketed as Amitiza, remains a cornerstone treatment for chronic idiopathic constipation (CIC), irritable bowel syndrome with constipation (IBS-C), and opioid-induced constipation (OIC). However, prescribers across the country have noted that patients are increasingly reporting difficulty filling their Lubiprostone prescriptions. This article provides an evidence-based overview of the current supply landscape, prescribing implications, and actionable resources for your practice.

Current Shortage Status and Timeline

As of early 2026, Lubiprostone is not listed on the FDA's drug shortage database. There is no officially declared shortage at the national level.

However, the practical reality for patients is more nuanced. Intermittent availability issues persist at the pharmacy level, creating what can be characterized as a "distribution-level soft shortage." Key milestones in the recent timeline include:

• 2006: FDA approval of Amitiza (brand) for CIC
• 2008: Additional indication for IBS-C in women
• 2013: OIC indication added
• 2024-2025: Patent expiration and entry of generic Lubiprostone
• 2026: Generic availability increasing, but manufacturer base remains limited

The transition from brand-only to a mixed brand/generic market has introduced some supply chain variability. While overall production has increased, the limited number of generic manufacturers means localized shortages can still occur when demand fluctuates or distribution channels are disrupted.

Prescribing Implications

The availability landscape has several practical implications for prescribers:

Generic Substitution

Generic Lubiprostone is therapeutically equivalent to brand-name Amitiza. Unless there is a specific clinical reason to maintain brand-name therapy, prescribing generically or allowing generic substitution can improve your patient's ability to fill their prescription and reduce out-of-pocket costs significantly.

• Brand Amitiza: $400-$530 for 60 capsules (30-day CIC/OIC supply)
• Generic Lubiprostone: $60-$150 for 60 capsules

Prior Authorization Considerations

Most commercial and Medicaid plans require prior authorization for Lubiprostone. Common step therapy requirements include documented failure of:

• Dietary and lifestyle modifications
• Over-the-counter osmotic laxatives (polyethylene glycol)
• Stool softeners (docusate)

Proactively documenting these trials in your patient's chart can expedite the prior authorization process and reduce treatment delays.

Dosing Reminders

For reference, the FDA-approved dosing is:

• CIC: 24 mcg twice daily with food and water
• IBS-C (women ≥18): 8 mcg twice daily with food and water
• OIC: 24 mcg twice daily with food and water
• Hepatic impairment (CIC): Start at 16 mcg twice daily for moderate impairment; 8 mcg twice daily for severe (Child-Pugh Class C)

Pregnancy is a consideration — Lubiprostone is Pregnancy Category C with evidence of fetal loss in animal studies. Women of childbearing potential should have a negative pregnancy test before starting therapy and use effective contraception.

Availability Picture

The availability landscape varies by pharmacy type and region:

• Chain pharmacies (CVS, Walgreens, Rite Aid): Variable stock — many locations carry generic Lubiprostone but may not maintain consistent inventory for the 8 mcg strength
• Independent pharmacies: Often have better access through multiple wholesaler relationships and can special-order within 1-2 business days
• Mail-order pharmacies: Generally more reliable for maintaining 90-day supplies
• Specialty pharmacies: May carry both brand and generic for patients whose plans require a specific formulation

Cost and Access Considerations

Cost remains a significant barrier for many patients, particularly those with high-deductible plans or inadequate coverage:

• Uninsured patients: Generic Lubiprostone at $60-$150/month is substantially more accessible than brand at $400-$530/month
• Discount programs: Pharmacy discount cards (GoodRx, SingleCare) can reduce generic costs to $50-$100 range
• Patient assistance: Mallinckrodt Patient Assistance Program may be available for qualifying patients. NeedyMeds and RxAssist can help identify additional programs
• Manufacturer savings: Takeda has historically offered copay assistance cards for brand Amitiza, though current availability may vary

For a comprehensive overview of savings options to share with patients, see: How to Save Money on Amitiza in 2026. For provider-specific cost guidance, see: How to Help Patients Save Money on Amitiza: A Provider's Guide.

Tools and Resources for Your Practice

Several tools can help you and your patients navigate availability challenges:

Medfinder for Providers

Medfinder for Providers allows you to check real-time pharmacy stock for Lubiprostone in your patient's area. You can incorporate this into your workflow by checking availability at the point of prescribing, helping patients avoid the frustration of being turned away at the pharmacy.

Alternative Medication Reference

When Lubiprostone is unavailable, the following alternatives can be considered:

• Linzess (Linaclotide): GC-C agonist for CIC and IBS-C; once daily dosing; generally well-stocked
• Trulance (Plecanatide): GC-C agonist for CIC and IBS-C; once daily; can be taken with or without food
• Motegrity (Prucalopride): 5-HT4 agonist for CIC; once daily; different mechanism — useful when secretagogues are ineffective
• Movantik (Naloxegol) / Symproic (Naldemedine): PAMORAs for OIC specifically

See the patient-facing alternatives guide: Alternatives to Amitiza.

Drug Interaction Awareness

While Lubiprostone has a relatively clean interaction profile (no CYP450 involvement), note that diphenylheptane opioids (e.g., Methadone) may reduce its efficacy by blocking ClC-2 activation. Lubiprostone's effectiveness has not been established in patients taking Methadone. For details, see: Amitiza Drug Interactions: What to Avoid.

Looking Ahead

The Lubiprostone supply situation is expected to gradually stabilize as the generic market matures. Key trends to watch:

• Potential entry of additional generic manufacturers improving competition and supply reliability
• Continued expansion of telehealth prescribing, improving access for patients in underserved areas
• Evolution of payer coverage policies as generics become the standard

Staying informed about availability trends and having a ready list of therapeutic alternatives will help you maintain continuity of care for your constipation patients.

Final Thoughts

While there is no formal Amitiza shortage in 2026, the real-world experience for patients and prescribers involves navigating distribution gaps, insurance hurdles, and cost concerns. Prescribing generically when appropriate, proactively documenting step therapy requirements, and leveraging tools like Medfinder for Providers can help ensure your patients get the treatment they need. When Lubiprostone is unavailable, having evidence-based alternatives at the ready keeps your patients from going without effective therapy.