Baclofen Shortage: A Provider Briefing for 2026

Baclofen — one of the most widely prescribed skeletal muscle relaxants in the United States — has experienced intermittent supply disruptions since 2023. For providers managing patients with spasticity from multiple sclerosis, spinal cord injuries, traumatic brain injury, and other neurological conditions, these shortages present real clinical challenges.

This article provides an up-to-date overview of the Baclofen shortage landscape, prescribing considerations, alternative therapy options, and practical tools to help your patients maintain medication access.

Shortage Timeline

Baclofen supply issues have evolved over the past several years:

• 2020–2022: Periodic shortages of intrathecal Baclofen (Gablofen) were reported, primarily affecting patients with implanted pumps for severe spasticity. Oral formulations were generally stable.
• 2023: Manufacturing disruptions at key generic producers led to the first widespread oral Baclofen tablet shortages. The FDA's drug shortage database began tracking the issue.
• 2024: Supply improved somewhat but remained inconsistent, with regional variation. Some wholesalers reported difficulty fulfilling orders for all three tablet strengths (5 mg, 10 mg, 20 mg).
• 2025–2026: Availability continues to fluctuate. The oral solution (Ozobax, 5 mg/5 mL) has remained more consistently available but at higher cost. Intrathecal formulation shortages have recurred periodically.

Prescribing Implications

The intermittent nature of Baclofen shortages creates several clinical concerns for prescribers:

Withdrawal Risk

Baclofen withdrawal is a well-documented and potentially life-threatening condition. Abrupt discontinuation — whether from a missed refill or a pharmacy stockout — can cause:

• Severe rebound spasticity
• Seizures
• Hallucinations and altered mental status
• Hyperpyrexia
• Rhabdomyolysis (particularly with intrathecal withdrawal)
• Multi-organ system failure in severe cases

The FDA's boxed warning for intrathecal Baclofen specifically addresses the risk of abrupt withdrawal. However, oral Baclofen withdrawal — while generally less severe — can still produce significant morbidity, particularly in patients on high doses (60–80 mg/day) or those with comorbid seizure disorders.

Dose Titration Challenges

When patients switch pharmacies or receive partial fills during shortages, there's a risk of inadvertent dose changes. Ensure patients understand their exact dosing regimen and have written instructions. Baclofen's half-life of 2–6 hours necessitates three-times-daily dosing for consistent effect.

Off-Label Use Considerations

If you prescribe Baclofen off-label (e.g., for alcohol use disorder, trigeminal neuralgia, or GERD), be aware that insurance coverage may be more challenging during shortage periods when pharmacies face scrutiny over allocation. Prior authorization for off-label indications may add delays.

Current Availability Picture

As of early 2026, Baclofen availability varies significantly by region, pharmacy type, and formulation:

• Oral tablets (generic): Intermittently available. Chain pharmacies report more frequent stockouts than independent pharmacies in many regions.
• Oral solution (Ozobax): Generally more available than tablets, but at significantly higher cost ($50–$150+ per month vs. $5–$58 for tablets).
• Intrathecal (Gablofen): Periodic shortages continue. Patients with implanted pumps should be monitored closely and refill schedules adhered to strictly.

For real-time pharmacy-level availability data, Medfinder for Providers offers inventory search tools that can help your team locate Baclofen for patients quickly.

Cost and Access Considerations

Baclofen remains an affordable generic medication, which helps with access even during shortages:

• Generic oral tablets: $15–$58 retail cash price for 30 tablets (10 mg); as low as $4.80 with discount coupons (SingleCare, GoodRx)
• Insurance coverage: Covered by virtually all commercial and government plans as a Tier 1 or Tier 2 generic. Prior authorization is typically not required for oral tablets.
• Patient assistance: NeedyMeds and RxAssist list programs for patients who cannot afford their medications. State Medicaid programs cover Baclofen without restriction.

Cost is rarely the barrier to Baclofen access — physical availability is the primary challenge during shortage periods.

Alternative Therapy Options

When Baclofen is unavailable, the following alternatives may be considered based on the patient's underlying condition and clinical profile:

Tizanidine (Zanaflex)

The most direct alternative. Alpha-2 adrenergic agonist FDA-approved for spasticity from MS and spinal cord injury. Shorter duration of action (3–6 hours). Requires liver function monitoring. May produce less muscle weakness than Baclofen. Generic cost: $8–$25/month.

Dantrolene (Dantrium)

Direct-acting skeletal muscle relaxant that works peripherally on muscle fibers. FDA-approved for spasticity from upper motor neuron conditions. Hepatotoxicity risk requires baseline and periodic LFTs. May be preferred when CNS side effects are a concern. Generic cost: $30–$80/month.

Diazepam (Valium)

Benzodiazepine with muscle relaxant properties. Useful as a bridge therapy but carries dependence risk (Schedule IV). Provides additional anxiolytic benefit. Not ideal for long-term spasticity management. Generic cost: $4–$20/month.

Intrathecal Baclofen Pump

For patients with severe spasticity who cannot access oral Baclofen consistently, intrathecal delivery via an implanted pump may offer more reliable drug administration — though this option has its own supply considerations and requires surgical implantation and ongoing management.

For a patient-facing overview of alternatives, see our article on alternatives to Baclofen.

Tools and Resources for Providers

Several tools can help you and your clinical team manage Baclofen access for patients:

• Medfinder for Providers: Real-time pharmacy inventory search. Direct patients to pharmacies with confirmed stock.
• FDA Drug Shortage Database: Official shortage status and manufacturer updates at accessdata.fda.gov
• ASHP Drug Shortage Resource Center: Clinical guidance and alternative therapy recommendations
• Discount card referrals: Recommend SingleCare or GoodRx to patients paying cash — Baclofen can cost as little as $4.80

Looking Ahead

The Baclofen supply situation is expected to remain variable through 2026. Key factors to watch include:

• FDA enforcement actions at generic manufacturing facilities
• API (active pharmaceutical ingredient) supply from global sources
• Potential new generic approvals that could increase manufacturer diversity
• Evolving off-label prescribing patterns, particularly for alcohol use disorder

Proactive management — including early refills, alternative pharmacy sourcing, and pre-identified backup therapy plans — remains the most effective strategy for ensuring continuity of care.

Final Thoughts

Baclofen shortages are an ongoing challenge, but they're manageable with planning. Ensure your patients understand the risks of abrupt discontinuation, have a backup plan for pharmacy sourcing, and know about affordable access options. Tools like Medfinder for Providers can streamline the process of locating Baclofen in stock.

For a practical workflow on helping patients navigate shortages, see our companion article: How to Help Your Patients Find Baclofen in Stock.

Disclaimer: This article is for informational purposes only and does not constitute clinical guidelines. Always exercise clinical judgment when managing individual patients.