Provider Briefing: Cepastat Sore Throat & Cough Availability in 2026

Patients are increasingly reporting difficulty finding Cepastat Sore Throat & Cough lozenges — a combination OTC product containing benzocaine (6 mg), dextromethorphan HBr (5 mg), and menthol (10 mg). While this is an over-the-counter product that does not require a prescription, providers should be aware of the availability challenges as patients may seek guidance on alternatives and symptom management.

This briefing provides an overview of the current supply situation, therapeutic alternatives, and practical tools you can use to support your patients.

Timeline: How We Got Here

Cepastat Sore Throat & Cough, manufactured by Insight Pharmaceuticals LLC, has experienced declining retail availability over the past several years. Key milestones include:

• 2020-2022: Product remained available at most major chain pharmacies but with decreasing shelf presence as retailers consolidated OTC sore throat product selections.
• 2023-2024: Reports of difficulty finding the product increased significantly. Major retailers began prioritizing larger brands (Cepacol, Chloraseptic) over Cepastat.
• 2025-2026: The product has become very difficult to locate at retail pharmacies. Online availability is intermittent. No official discontinuation announcement has been made by Insight Pharmaceuticals.

Unlike prescription drug shortages tracked by the FDA, OTC product availability issues do not receive the same level of regulatory monitoring, making it harder to provide patients with definitive information.

Prescribing Implications

Since Cepastat Sore Throat & Cough is an OTC product, there are no prescribing implications in the traditional sense. However, providers should be prepared for the following scenarios:

Patient Inquiries

Patients who relied on Cepastat Sore Throat & Cough may ask for recommendations on equivalent products. The most clinically relevant equivalents include:

• Chloraseptic Total Sore Throat + Cough Lozenges — identical active ingredient profile (benzocaine 6 mg, DXM 5 mg, menthol 10 mg)
• Cepacol Extra Strength Sore Throat & Cough — benzocaine 7.5 mg + DXM 5 mg (slightly higher benzocaine, no menthol as active ingredient)

Clinical Considerations

When recommending alternatives, providers should keep in mind:

• Benzocaine allergy: Patients with known sensitivity to local anesthetics of the ester class (procaine, butacaine, benzocaine) should avoid all benzocaine-containing products.
• Methemoglobinemia risk: The FDA has issued warnings about benzocaine-associated methemoglobinemia, particularly in children under 2 years of age. While Cepastat is not indicated for children under 6, providers should ensure patients understand age restrictions.
• MAOI interactions: The dextromethorphan component is contraindicated with MAOIs and should be used with caution in patients taking SSRIs or SNRIs due to serotonin syndrome risk.
• Chronic cough evaluation: Products containing DXM are not appropriate for persistent or chronic cough associated with smoking, asthma, or emphysema. Patients reporting chronic cough should receive appropriate workup rather than OTC cough suppression.

Current Availability Picture

As of early 2026, the availability of Cepastat Sore Throat & Cough is severely limited:

• Major chain pharmacies (CVS, Walgreens, Rite Aid): Generally not stocking the product
• Mass retailers (Walmart, Target): Inconsistent availability, often not in stock
• Independent pharmacies: Occasionally available; may be able to order from distributors
• Online retailers: Intermittent availability on Amazon, eBay, and specialty health retailers, sometimes at inflated prices

The equivalent product Chloraseptic Total Sore Throat + Cough remains widely available and can be recommended as a direct substitute.

Cost and Access Considerations

For patients concerned about cost:

• Cepastat Sore Throat & Cough (when available): $5 to $10 for 18 lozenges
• Chloraseptic Total: Approximately $8 for 15 lozenges
• Cepacol Extra Strength Cough: $4 to $7 per package
• Store-brand alternatives: $3 to $6 for benzocaine/menthol lozenges

As OTC products, these are generally not covered by insurance. Patients should be reminded that FSA and HSA funds can typically be used for OTC medication purchases.

Tools and Resources for Providers

Several tools can help you and your patients navigate availability challenges:

• Medfinder for Providers — Search real-time medication availability at pharmacies in your patients' areas. This is particularly useful for identifying which nearby pharmacies have stock.
• DailyMed — For complete product labeling and ingredient information on Cepastat and equivalent products.
• FDA Drug Shortage Database — While OTC products are not typically listed, this remains a valuable resource for monitoring prescription medication shortages that may affect your clinical decisions.

Looking Ahead

The long-term outlook for Cepastat Sore Throat & Cough availability is uncertain. Providers should be prepared to:

• Transition patients to equivalent OTC products as needed
• Monitor for any official announcements from Insight Pharmaceuticals regarding discontinuation
• Evaluate patients with persistent sore throat or cough symptoms for underlying conditions rather than relying solely on OTC symptom management

Final Thoughts

While the Cepastat Sore Throat & Cough shortage is unlikely to significantly impact clinical practice — given the availability of equivalent OTC products — it's important to be aware of the issue when patients ask questions. Direct patients to Medfinder for Providers and recommend clinically equivalent alternatives like Chloraseptic Total or Cepacol Extra Strength.

For a patient-facing resource you can share, see our patient shortage update for Cepastat Sore Throat & Cough.