Anucort-HC Shortage: What Providers and Prescribers Need to Know in 2026

Patients presenting with prescriptions for Anucort-HC are increasingly encountering availability challenges at retail pharmacies. While no formal FDA or ASHP shortage declaration is in effect for this product as of 2026, providers are fielding growing numbers of callbacks from patients who cannot fill their prescriptions. This guide is designed to help prescribers navigate the current situation, identify appropriate alternatives, and streamline the prescribing process for patients with rectal inflammatory conditions.

Current Availability Status

Anucort-HC (hydrocortisone acetate 25 mg rectal suppository, Cosette Pharmaceuticals) is not listed on the FDA's Drug Shortage Database or the ASHP shortage list as of 2026. However, the product's availability is limited by its single-manufacturer status, relatively low pharmacy stocking volumes, and regional distributor variability. Patients are experiencing localized stock gaps — particularly in rural areas and smaller pharmacy chains — that can persist for days to weeks.

The generic formulation (hydrocortisone acetate 25 mg rectal suppository, various manufacturers) is more widely available but may also experience intermittent stocking variability at the pharmacy level.

Pharmacology Reminder: What Does Anucort-HC Treat?

Anucort-HC is indicated for use in inflamed hemorrhoids, post-irradiation (factitial) proctitis, as an adjunct in the treatment of chronic ulcerative colitis, cryptitis, and other inflammatory conditions of the anorectum and pruritus ani. The drug's mechanism involves local anti-inflammatory, anti-pruritic, and vasoconstrictive action. Approximately 26% of the dose is absorbed systemically when applied rectally.

Dosing: 1 suppository rectally twice daily for 2 weeks for nonspecific proctitis; 1 suppository three times daily or 2 suppositories twice daily for severe cases; 6-8 weeks for factitial proctitis, based on individual response.

Therapeutic Alternatives by Indication

When Anucort-HC is unavailable, the appropriate alternative depends on the patient's specific diagnosis:

Inflamed Hemorrhoids

First alternative: Generic hydrocortisone acetate 25 mg rectal suppository (bioequivalent; write prescription generically to maximize pharmacy dispensing flexibility)

Other branded equivalents: Anusol-HC, Proctosol-HC, Hemmorex-HC, Proctocort, Proctozone HC — all contain hydrocortisone acetate 25 mg

Alternative formulation: Cortifoam (hydrocortisone acetate rectal foam) if the patient has difficulty retaining suppositories

Ulcerative Proctitis

Preferred alternative: Mesalamine 1 g suppository (Canasa) once nightly — AGA guidelines recommend mesalamine suppositories as first-line therapy for ulcerative proctitis due to superior remission rates versus rectal corticosteroids alone

Extended disease: Mesalamine enema 4 g (Rowasa) nightly for proctosigmoiditis; combination oral + topical mesalamine for more extensive disease

Post-Irradiation (Factitial) Proctitis

Alternative: Other hydrocortisone acetate suppository brands (same class, same mechanism); discuss case-by-case with radiation oncology or gastroenterology for complex cases

Prescribing Recommendations to Minimize Access Barriers

Write prescriptions generically where appropriate. Prescribing "hydrocortisone acetate 25 mg rectal suppository" rather than "Anucort-HC" gives the pharmacist more flexibility to dispense whatever equivalent is in stock, reducing callback rates significantly.

Enable DAW-0 (Dispense As Written: generic allowed) when possible. This allows pharmacists to substitute a generic without a new authorization, streamlining access for the patient.

Consider prior authorization lead time. Insurers with step therapy requirements (including some Cigna plans) may require prior authorization for brand-name Anucort-HC. Initiating this early or prescribing the generic first can shorten time to therapy.

Direct patients to medfinder.

Rather than managing patient callbacks manually, providers can direct patients to medfinder — a service that contacts pharmacies near the patient to locate which ones can fill their prescription. This significantly reduces the burden on your staff and helps patients get their medication faster.

Key Takeaways for Prescribers

No national shortage — localized stocking gaps are the primary issue

Generic hydrocortisone acetate 25 mg suppository is bioequivalent and more widely available

For ulcerative proctitis: mesalamine 1 g suppository is preferred first-line per AGA guidelines

Writing prescriptions generically minimizes access barriers for patients

medfinder can help patients find the nearest pharmacy with stock, reducing your staff's callback burden