Azasite Shortage Update for 2026

If you rely on Azasite for bacterial conjunctivitis or blepharitis, you've probably noticed it's been hard to find — and 2026 hasn't changed that. Azasite (Azithromycin ophthalmic solution 1%) has been on and off the FDA's drug shortage list for years, and many patients are still struggling to fill their prescriptions.

Here's everything you need to know about the Azasite shortage right now, including why it's happening, what it costs, and what you can do to get the treatment you need.

Is Azasite Still in Shortage?

Yes. As of early 2026, Azasite remains in limited supply. The FDA has listed Azithromycin ophthalmic solution 1% as currently in shortage. While some pharmacies have intermittent stock, availability is inconsistent across the country.

Thea Pharma, the current manufacturer, has been working to maintain production since acquiring the product in 2023, but demand continues to outpace supply. The situation is further complicated by the ongoing erythromycin ophthalmic ointment shortage, which has pushed more patients and prescribers toward Azasite as an alternative.

Why Is Azasite Hard to Find?

Several factors have combined to create the current shortage:

No Generic Competition

There is no FDA-approved generic version of Azasite. This means one manufacturer — Thea Pharma — is responsible for the entire U.S. supply. Any disruption in their production directly impacts every patient who needs the drug.

Complicated Manufacturing

Azasite uses a proprietary DuraSite delivery system — a polycarbophil-based polymer that extends the drug's contact time on the eye. This specialized formulation requires specific manufacturing equipment and processes that can't easily be scaled up or transferred to other facilities.

Ownership Changes and Bankruptcy

Azasite has been passed from Inspire Pharmaceuticals to Merck to Akorn. When Akorn went bankrupt in 2022, production stopped entirely. Thea Pharma revived the product in 2023, but rebuilding the supply chain from scratch takes time. For a deeper dive, read our article on why Azasite is so hard to find.

Erythromycin Shortage Ripple Effect

Erythromycin ophthalmic ointment — a cheap, widely used antibiotic for eye infections — has been in shortage since the mid-2020s. The FDA, CDC, and American Academy of Ophthalmology have all recommended using Azasite as an alternative for superficial ocular infections. This guidance, while helpful for patients who can't get erythromycin, has dramatically increased demand for an already scarce product.

How Much Does Azasite Cost in 2026?

Without insurance, Azasite costs approximately $205 to $260 per 2.5 mL bottle. That's for a single treatment course (7 days). Because there is no generic, prices remain high.

Here's how costs break down:

• Cash price without insurance: $205 to $260
• With insurance: Varies widely. Some plans cover it with a specialty copay of $50-$75. Others may require prior authorization or step therapy with cheaper alternatives first.
• With discount card (GoodRx, SingleCare): May reduce the price to around $190 to $220, depending on the pharmacy

For detailed savings strategies, see our guide on how to save money on Azasite in 2026.

Are There New Options or Developments?

While no generic has been approved, there are some developments worth knowing about:

• Thea Pharma production expansion: The company has been working to increase manufacturing capacity since acquiring the product. Supply has improved from the darkest days of the Akorn bankruptcy, but shortages persist.
• Erythromycin supply recovery: If erythromycin production stabilizes, some of the overflow demand for Azasite may ease.
• Alternative treatments: Ophthalmologists continue to develop protocols for managing blepharitis and MGD without Azasite, including warm compresses, lid hygiene, oral antibiotics, and in-office procedures like intense pulsed light therapy.

For information on alternative medications, read our article on alternatives to Azasite.

How to Find Azasite in Stock

Despite the shortage, Azasite is available at some pharmacies — you just need to know where to look.

Step 1: Use Medfinder

Medfinder helps you search for pharmacies near you that have Azasite in stock right now. It's the fastest way to skip the frustrating cycle of calling pharmacy after pharmacy.

Step 2: Expand Your Search

Try independent pharmacies, specialty pharmacies, and hospital outpatient pharmacies. These often have different supply chains from the major retail chains.

Step 3: Ask for a Special Order

If your pharmacy is out, ask them to check with their wholesaler and place a special order. It may take a few days, but supply does trickle in.

Step 4: Plan Ahead

If you use Azasite regularly for a chronic condition like blepharitis, don't wait until your bottle runs out. Start looking for a refill at least a week early.

For a complete walkthrough, see our guide on how to find Azasite in stock near you. You can also learn how to check if a pharmacy has Azasite before making the trip.

Final Thoughts

The Azasite shortage is real, frustrating, and ongoing in 2026. But it's not hopeless. Understanding why the shortage exists helps you plan ahead, and knowing your options — from pharmacy search tools like Medfinder to alternative medications — puts you in control.

If you're struggling to find Azasite, talk to your eye doctor. They can help you explore alternatives, adjust your treatment plan, or try different strategies for getting the medication. And keep checking — supply does come and go, and persistence often pays off.

For more information about this medication, visit our complete guide on what Azasite is and what you need to know.