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

Provider Briefing: Bonjesta Availability in 2026

If your patients are reporting difficulty filling Bonjesta prescriptions, they're reflecting a real and ongoing access challenge. While Bonjesta is not listed on the FDA Drug Shortage database or ASHP shortage list as of March 2026, limited pharmacy stocking continues to create de facto access barriers for many pregnant patients seeking treatment for nausea and vomiting of pregnancy (NVP).

This briefing provides an overview of the current situation, practical prescribing considerations, and tools available to help your patients access Bonjesta or appropriate alternatives.

Background and Timeline

Bonjesta (doxylamine succinate 20 mg/pyridoxine hydrochloride 20 mg extended-release tablets) was approved by the FDA on November 7, 2016, and is manufactured by Duchesnay USA. It is indicated for NVP in women who do not respond to conservative management.

Key milestones:

• 2013: Diclegis (doxylamine/pyridoxine delayed-release 10 mg/10 mg) approved — the first FDA-approved NVP medication in the U.S. since Bendectin was withdrawn in 1983
• 2016: Bonjesta approved as an extended-release formulation with dual immediate/delayed-release technology, allowing a maximum of 2 tablets/day vs. Diclegis's 4
• 2020s: Generic Diclegis becomes available, further reducing prescriber and payer incentive to choose brand-name Bonjesta
• 2026: Bonjesta remains brand-name only; patents extend through 2033

Prescribing Implications

Several factors should inform your prescribing decisions around Bonjesta:

Insurance and Prior Authorization

Most commercial and managed care plans require prior authorization for Bonjesta. Many also impose step therapy, requiring documented failure of:

• OTC pyridoxine (vitamin B6) alone
• Generic doxylamine/pyridoxine (Diclegis generic)
• Brand-name Diclegis (in some plans)

UnitedHealthcare, for example, has specific medical necessity criteria that require a trial and failure of generic alternatives before approving Bonjesta. Documenting the clinical rationale — such as inadequate symptom control, adherence challenges with 4x/day dosing, or adverse effects — in the patient's chart strengthens prior authorization requests.

Patient Adherence Considerations

Bonjesta's 1-2 tablet/day dosing (vs. Diclegis's up to 4/day) can be a meaningful clinical differentiator for patients who struggle with adherence, have difficulty swallowing multiple tablets, or experience timing-related breakthrough symptoms. If stepping through Diclegis first, document adherence-related reasons for switching to Bonjesta.

Cost Considerations

The financial landscape for Bonjesta:

• Cash price: $481–$490 for 30 tablets
• GoodRx coupon: Starting at approximately $180
• Manufacturer copay card: As low as $35–$40 for commercially insured patients
• Bonjesta At Home (mail order): $60 for 30 tablets or $99 for 60 tablets for uninsured patients
• Generic Diclegis comparison: $30–$80 for 60 tablets

Current Availability Picture

Bonjesta is not in a formal supply shortage. Duchesnay continues to manufacture and distribute the medication through standard wholesale channels. The access challenge is at the pharmacy stocking level:

• Many chain pharmacies (CVS, Walgreens, Rite Aid) do not routinely stock Bonjesta due to high wholesale cost and low prescription volume
• Independent pharmacies are often more willing to special-order but may also not carry it routinely
• Specialty pharmacies and the Bonjesta At Home mail-order program provide the most reliable access

Cost and Access Solutions

When prescribing Bonjesta, proactively connect patients with cost-reduction programs:

• Bonjesta CoPay Savings Card: Reduces out-of-pocket cost to as low as $35–$40 for commercially insured patients. Available at bonjesta.com/bonjesta-savings
• Bonjesta At Home: Mail-order program offering $60/30 tablets or $99/60 tablets with free delivery and pharmacist support. Particularly valuable for uninsured patients. Call 1-800-835-0755
• Discount cards: GoodRx and SingleCare coupons can reduce the cash price significantly

Tools and Resources

The following tools can help streamline the process for your practice and patients:

• Medfinder for Providers — Identify pharmacies with Bonjesta in stock near your patients' locations. This is especially helpful when patients report multiple pharmacy calls without success.
• Duchesnay support line: 1-800-835-0755 — For questions about the savings program, Bonjesta At Home, and insurance support.
• Prior authorization templates: Document the clinical rationale for Bonjesta specifically (e.g., adherence issues with 4x/day Diclegis dosing, inadequate symptom control with generic alternatives).

Looking Ahead

Several developments may affect the Bonjesta access landscape in the coming years:

• Patent expiration in 2033: Generic Bonjesta could become available after this date, though the extended-release formulation may present generic development challenges
• Evolving payer policies: As more data accumulates on adherence benefits of simplified dosing, some plans may become more receptive to Bonjesta coverage
• Telehealth expansion: Remote prescribing paired with Bonjesta At Home delivery may improve access for patients in areas with limited pharmacy options

Final Thoughts

Bonjesta remains a clinically valuable option for NVP management, particularly for patients who benefit from simplified dosing. While the medication is not in formal shortage, the combination of brand-name exclusivity, high cost, and low pharmacy stocking creates a real barrier for patients.

As prescribers, the most impactful actions are: documenting clinical rationale thoroughly, proactively connecting patients with savings programs, and utilizing tools like Medfinder for Providers to identify available pharmacies. For a patient-facing version of this update, see our Bonjesta shortage update for patients.

For guidance on helping patients find Bonjesta specifically, see our provider's guide to helping patients find Bonjesta in stock.