Arazlo Shortage: What Providers and Prescribers Need to Know in 2026

Arazlo (tazarotene 0.045% lotion) has become a preferred topical retinoid option for many dermatologists treating moderate to severe acne. However, a growing number of patients are reporting difficulty filling their Arazlo prescriptions in 2026. This briefing covers the current supply picture, clinical alternatives, prior authorization strategies, and tools to help your patients maintain continuity of care.

Current Arazlo Supply Status (2026)

Arazlo is not on the FDA's official Drug Shortage Database as of 2026. However, real-world availability is inconsistent. The challenges are structural rather than reflecting a formal manufacturing crisis:

• Single-source product: Arazlo is manufactured exclusively by Bausch Health / Ortho Dermatologics. No generic equivalent exists for the 0.045% lotion formulation.
• Pharmacy stocking: Chain pharmacies with automated ordering systems frequently do not carry Arazlo because dispensing volume is lower than common generics. Independent and specialty pharmacies tend to stock it more reliably.
• Insurance-driven access barriers: Multiple payers, including UnitedHealthcare, require prior authorization and step therapy for Arazlo. Some plans exclude it from formulary entirely. Medicare Part D plans typically list tazarotene on Tier 3 with PA requirements.

Prescribing Considerations in 2026

Before prescribing Arazlo, a few practical considerations can help avoid access issues for your patients:

1. Check formulary status before prescribing. Use your EHR's formulary check or contact the patient's payer to verify whether Arazlo is covered. If it requires PA, begin the process at the time of the appointment to minimize delays.
2. Document step therapy failures proactively. Many plans require documented trials of adapalene or tretinoin before approving Arazlo. Document any prior retinoid use, reason for discontinuation (e.g., intolerance, inadequate response), and clinical rationale for Arazlo in your chart notes.
3. Direct patients to the manufacturer savings card. The Ortho Rx Access program offers a $0 copay card for commercially insured patients, and an uninsured pricing program. Point patients to the program before they encounter sticker shock at the pharmacy ($564–$683 retail per 45g tube).
4. Know which local pharmacies stock Arazlo. Your staff can build a short list of independent pharmacies or specialty pharmacies in your area that reliably carry Arazlo. Alternatively, direct patients to medfinder to check current stock.

Evidence-Based Clinical Alternatives When Arazlo Is Unavailable

When Arazlo is unavailable or cost-prohibitive for a patient, the following evidence-based alternatives are appropriate for acne vulgaris:

• Tretinoin 0.025%–0.1% (cream, gel, microsphere) — extensive evidence base, widely available as a generic, approximately $15–$60 per tube; first-line option for most patients
• Adapalene 0.1%–0.3% (gel, cream, lotion) — 0.1% available OTC; best-tolerated retinoid; appropriate starting point for patients who cannot tolerate tazarotene or tretinoin
• Trifarotene 0.005% cream (Aklief) — selective RAR-gamma agonist; uniquely indicated for both facial and truncal acne; brand-only; appropriate for patients with body acne as well as facial involvement
• Generic tazarotene 0.1% cream or gel — same active ingredient at higher concentration; approximately $40–$150 cash price; note the different vehicle and higher concentration may increase irritation; start with lower application frequency if substituting

Prior Authorization Strategy for Arazlo

If your patient's plan requires PA for Arazlo, the following documentation strategy improves approval rates:

• Document prior topical retinoid use (adapalene, tretinoin) with dates, concentrations, duration, and reason for discontinuation
• Specify acne severity (moderate to severe), lesion count, and Evaluator Global Severity Score (EGSS) if documented
• Cite Arazlo's clinical data: two Phase 3 trials in 1,614 patients demonstrating statistically significant superiority (p<0.001) over vehicle at 12 weeks, with 55–60% reduction in inflammatory lesions
• Note clinical rationale for tazarotene's lower irritation profile via the polymeric emulsion vehicle — particularly relevant for patients who failed higher-concentration tazarotene (Tazorac) due to intolerance

Patient Access Tool: medfinder

When patients report difficulty locating Arazlo, medfinder offers a practical solution. Patients enter their medication and location; medfinder contacts nearby pharmacies to check current stock and texts the results. This eliminates the time burden from patients calling multiple pharmacies and avoids wasted trips to locations without stock.

You can incorporate medfinder into your practice workflow by providing the URL (medfinder.com) as part of your standard prescription instructions for medications that are commonly difficult to find, including Arazlo, tazarotene generics, and other specialty dermatology products.

Summary for Prescribers

Arazlo remains a clinically valuable option for moderate to severe acne, offering strong efficacy with improved tolerability compared to legacy tazarotene formulations. The primary access challenges in 2026 are structural — driven by brand exclusivity, insurance barriers, and pharmacy stocking practices rather than a formal manufacturing shortage. Proactive PA management, patient education about savings programs, and tools like medfinder can help your patients maintain continuity of care.