Cefpodoxime Shortage: A Briefing for Providers

Cefpodoxime proxetil — the third-generation oral cephalosporin once marketed as Vantin — has been subject to intermittent supply disruptions that continue to affect patient access in 2026. While the shortage primarily impacts the oral suspension formulation, its downstream effects on prescribing decisions, patient adherence, and clinical workflows are significant. This article provides a comprehensive overview for prescribers and clinical pharmacists navigating the current landscape.

Shortage Timeline

The cefpodoxime supply chain has faced recurring challenges:

• 2018–2020: Initial reports of oral suspension shortages emerge, driven by manufacturing quality issues and limited supplier base.
• 2021–2022: Aurobindo Pharma discontinues its cefpodoxime oral suspension product, removing a significant source of supply from the U.S. market.
• 2023–2024: Intermittent shortages of the oral suspension continue to appear on the ASHP drug shortage database. Tablet formulations remain largely unaffected.
• 2025–2026: The oral suspension remains on the ASHP watch list with periodic availability gaps. Tablet supply is generally stable, though seasonal demand spikes during respiratory illness season can create localized shortages.

The ASHP has confirmed that cefpodoxime tablets are not currently affected by the formal shortage designation, which applies specifically to the oral suspension.

Prescribing Implications

The shortage primarily affects pediatric prescribing, where the oral suspension is the standard formulation. Key considerations include:

Pediatric Patients

• Children under 12 who cannot swallow tablets depend on the oral suspension (50 mg/5 mL or 100 mg/5 mL).
• When the suspension is unavailable, consider cefdinir suspension (125 mg/5 mL or 250 mg/5 mL) as the most direct therapeutic substitute for otitis media, sinusitis, and pharyngitis.
• Compounding pharmacies can prepare cefpodoxime suspensions from tablets, though this requires verification of stability data and appropriate beyond-use dating.

Adult Patients

• Tablets (100 mg and 200 mg) remain available for most adult indications.
• Standard adult dosing: 200 mg every 12 hours for most infections; 100 mg every 12 hours for uncomplicated UTIs; 200 mg single dose for uncomplicated gonorrhea.
• Remind patients to take tablets with food to maximize bioavailability.

Renal Impairment

Dose adjustment is required for patients with CrCl <30 mL/min — extend the dosing interval from every 12 hours to every 24 hours. For hemodialysis patients, administer three times weekly after dialysis.

Current Availability Picture

As of early 2026, the availability landscape breaks down as follows:

• Tablets: Generally available through major wholesalers (McKesson, Cardinal Health, AmerisourceBergen). Generic manufacturers include Sandoz, Lupin, and Teva.
• Oral Suspension: Intermittently available. Supply may vary by distributor and region. Some pharmacies may need to source from secondary wholesalers.

Providers can direct patients to Medfinder for Providers to check real-time stock at pharmacies near the patient's location before writing a prescription.

Cost and Access Considerations

Cefpodoxime is a generic medication and is generally affordable, but prices can vary:

• Retail cash price: $50–$175 for a standard tablet course (14–20 tablets of 200 mg).
• With discount cards: $15–$30 through programs like GoodRx and SingleCare.
• Insurance: Covered as Tier 1 or Tier 2 on most formularies. Prior authorization is generally not required.

No manufacturer savings programs exist for cefpodoxime (as it is generic-only). Patients without insurance can be referred to NeedyMeds or RxAssist for additional assistance.

Therapeutic Alternatives

When cefpodoxime is unavailable, the following alternatives should be considered based on indication and patient factors:

• Cefdinir 300 mg BID or 600 mg QD — Most direct substitute; comparable spectrum; available as capsule and suspension.
• Cefixime 400 mg QD — Once-daily dosing advantage; useful for UTIs and gonorrhea.
• Cefuroxime axetil 250–500 mg BID — Second-generation; broader gram-positive coverage; useful for Lyme disease.
• Amoxicillin-clavulanate 875/125 mg BID — Non-cephalosporin option; first-line for sinusitis and otitis media in many guidelines. Contraindicated in penicillin-allergic patients.

For detailed alternative analysis, see our clinical comparison: Alternatives to cefpodoxime.

Tools and Resources for Providers

• Medfinder for Providers — Real-time pharmacy stock search. Help patients find cefpodoxime before they leave the office.
• ASHP Drug Shortage Database — Official shortage tracking with manufacturer updates.
• FDA Drug Shortage Database — Federal-level shortage reporting and expected resolution dates.

For a step-by-step workflow on integrating availability checks into your practice, see How to help your patients find cefpodoxime in stock.

Looking Ahead

The cefpodoxime oral suspension shortage reflects a broader vulnerability in the generic antibiotic market: thin manufacturer bases, overseas API sourcing, and limited economic incentives for companies to produce low-margin generic products. While no new branded products are expected, additional generic approvals and manufacturing capacity expansions may improve supply over time.

In the meantime, proactive prescribing — checking availability before writing, having backup alternatives ready, and directing patients to real-time tools — can minimize disruptions to patient care.

Final Thoughts

Cefpodoxime remains an effective and well-tolerated antibiotic when it's available. The current shortage, concentrated in the oral suspension, requires prescribers to stay informed and flexible. By leveraging real-time availability tools like Medfinder, maintaining familiarity with therapeutic alternatives, and communicating proactively with patients, providers can navigate the shortage without compromising outcomes.