Provider Briefing: Benzoyl Peroxide/Erythromycin Availability in 2026

Benzoyl Peroxide/Erythromycin (brand: Benzamycin) remains FDA-approved and in production, but many providers are fielding patient calls about difficulty filling prescriptions. While there is no official FDA-listed shortage as of early 2026, real-world availability is inconsistent across pharmacy networks.

This briefing covers the current supply landscape, prescribing implications, cost considerations, and tools to help your patients access their medications more efficiently.

Timeline and Background

Benzoyl Peroxide/Erythromycin (3%/5% topical gel) was first approved in 1984 under the brand name Benzamycin by Valeant International (now Bausch Health). A generic version from Rising Pharmaceuticals was approved by the FDA in September 2015.

Over the past decade, prescribing patterns for topical acne treatments have shifted significantly. Combination products containing Clindamycin/Benzoyl Peroxide (BenzaClin, Duac, Onexton) and Adapalene/Benzoyl Peroxide (Epiduo) have become the preferred first-line options in most clinical guidelines. This shift has reduced demand for Erythromycin-based topical combinations, leading to decreased pharmacy stocking.

Key milestones:

• 1984: Benzamycin (Erythromycin 3%/Benzoyl Peroxide 5%) FDA-approved
• 2015: Generic version approved (Rising Pharmaceuticals)
• 2020–2026: Gradual decline in prescriptions as Clindamycin-based combinations become dominant
• 2026: No FDA shortage listed; availability challenges persist due to market dynamics

Prescribing Implications

For providers who continue to prescribe Benzoyl Peroxide/Erythromycin, several factors are worth considering:

Antibiotic Stewardship

Current dermatology guidelines from the American Academy of Dermatology (AAD) recommend limiting the duration of topical antibiotic use and always combining antibiotics with Benzoyl Peroxide to reduce resistance. Benzoyl Peroxide/Erythromycin inherently meets this recommendation, as both components are combined in a single product.

However, growing Erythromycin resistance among Cutibacterium acnes strains has been documented. Some studies suggest that Clindamycin-based combinations may offer better antimicrobial coverage in certain patient populations, though resistance patterns vary by region.

Patient Compliance

Benzoyl Peroxide/Erythromycin requires twice-daily application and refrigeration after dispensing. These requirements may affect adherence, particularly in younger patients. Alternatives like Adapalene/Benzoyl Peroxide (once-daily application, room-temperature storage) may offer compliance advantages.

When Benzoyl Peroxide/Erythromycin Remains Appropriate

Despite the availability challenges, Benzoyl Peroxide/Erythromycin may still be the right choice for:

• Patients with documented Clindamycin sensitivity or allergy
• Patients who have responded well to this specific combination historically
• Cases where formulary restrictions favor Erythromycin-based products
• Patients who cannot tolerate retinoid-containing products

Current Availability Picture

The availability challenge is not a manufacturing shortage but rather a distribution and stocking issue:

• Brand Benzamycin (Bausch Health): Still manufactured; available through distributors but not routinely stocked at many chain pharmacies
• Generic (Rising Pharmaceuticals): FDA-approved and available; stocking varies by pharmacy and region
• Refrigeration requirement: Benzamycin Gel requires refrigerated storage and has a 3-month expiration after dispensing, which limits pharmacy willingness to stock

Independent pharmacies and specialty dermatology-focused pharmacies are more likely to stock or order this product. Compounding pharmacies can also prepare custom Erythromycin/Benzoyl Peroxide formulations.

Cost and Access Considerations

Understanding cost barriers helps providers support patients in accessing treatment:

• Brand Benzamycin: $140–$315 retail for a 46.6g jar
• Generic: $31–$45 with a discount card (GoodRx, SingleCare); approximately $140 retail without a coupon
• Insurance coverage: Generic is typically covered as a Tier 1 or Tier 2 medication; brand may require prior authorization
• Patient assistance: Bausch Health Patient Assistance Program for eligible uninsured patients; Prescription Hope offers the medication for $70/month

When writing prescriptions, specifying "generic Erythromycin/Benzoyl Peroxide" and allowing substitution gives pharmacies maximum flexibility in sourcing.

Tools and Resources for Providers

Several resources can help streamline patient access to Benzoyl Peroxide/Erythromycin:

Medfinder for Providers

Medfinder offers a provider-facing tool that shows real-time pharmacy availability for medications including Benzoyl Peroxide/Erythromycin. You or your staff can check which pharmacies near your patient have the medication in stock before sending the prescription.

This is particularly useful for:

• Directing e-prescriptions to pharmacies with confirmed stock
• Reducing patient callbacks about unfilled prescriptions
• Supporting patients who have been unable to locate the medication on their own

Prescribing Tips

• Write for generic Erythromycin/Benzoyl Peroxide 3%/5% gel unless there's a clinical reason for brand-only
• Specify the 46.6g jar size for better value (the 23.3g jar costs nearly the same per unit)
• Inform patients that the gel requires refrigeration and has a 3-month post-dispensing shelf life
• Consider e-prescribing directly to a pharmacy confirmed to have stock via Medfinder

Looking Ahead

The topical acne treatment market continues to evolve. While Benzoyl Peroxide/Erythromycin is unlikely to regain its previous market share, it remains a viable option for appropriate patients. Providers should be aware of the availability landscape and prepared to discuss alternatives when this product cannot be sourced.

For patients who are candidates for a switch, the following alternatives have strong evidence bases:

• Clindamycin/Benzoyl Peroxide — closest pharmacological substitute; widely available
• Adapalene/Benzoyl Peroxide — retinoid-based; strong efficacy data; once-daily dosing
• Adapalene alone (Differin) — available OTC; no antibiotic resistance concerns

For a patient-facing comparison, you can share our guide on alternatives to Benzoyl Peroxide/Erythromycin with your patients.

Final Thoughts

Benzoyl Peroxide/Erythromycin remains an effective acne treatment, but real-world access is constrained by market dynamics rather than a true supply shortage. Providers can support patient access by prescribing generically, directing prescriptions to pharmacies with confirmed stock, and being prepared to recommend alternatives when needed.

Medfinder for Providers is a free tool that can help your practice reduce prescription fill failures and improve patient satisfaction. Consider integrating it into your prescribing workflow for all hard-to-find medications.