Colistin Shortage Update: What Patients Need to Know in 2026

Colistin Shortage in 2026: The Latest Update

If you or someone you love depends on Colistin — a critical last-resort antibiotic — you need up-to-date information on whether it's available. The short answer: Colistin (Colistimethate Sodium) continues to face supply constraints in 2026, though the situation varies by region and facility.

In this update, we'll cover the current shortage status, explain why supply remains tight, share what Colistin costs in 2026, and give you actionable steps to find it.

Is Colistin Still in Shortage?

Yes, Colistin remains on the ASHP drug shortage watch list as of early 2026. While it's not continuously unavailable everywhere, supply is intermittent. Some hospitals have adequate stock while others report significant gaps. The pattern has been consistent for several years: brief periods of adequate supply followed by weeks or months of scarcity.

Colistimethate Sodium for injection (150 mg colistin base activity per vial) is the formulation most affected. The primary manufacturers — Xellia Pharmaceuticals, Par Pharmaceutical, and Hikma Pharmaceuticals — have all experienced production or distribution disruptions at various points.

Why Is Colistin Hard to Find?

The shortage has multiple causes that compound each other:

• Limited manufacturers: Only 2-3 companies produce Colistimethate Sodium for the U.S. market, leaving no buffer when one has problems.
• Rising demand: Multidrug-resistant gram-negative infections are increasing globally. The WHO lists carbapenem-resistant bacteria as a "critical" threat, and Colistin is often the last option.
• Complex manufacturing: Colistin production uses fermentation-based processes that are harder to scale quickly compared to chemical synthesis.
• Low profitability: At roughly $31 to $44 per vial wholesale, there's little financial incentive for new manufacturers to enter the market.
• Supply chain fragility: The active ingredient supply chain is highly concentrated, with limited redundancy.

For a deeper dive, see Why Is Colistin So Hard to Find? [Explained for 2026].

What Does Colistin Cost in 2026?

Colistin pricing varies significantly based on how you access it:

• Average retail price: Approximately $1,306 for 30 vials (150 mg each) without insurance
• With a discount coupon: As low as $207 to $265 for 30 vials through programs like SingleCare
• Per vial (generic): Roughly $31 to $44 at wholesale
• Brand name (Coly-Mycin M): Starting around $186 for 6 vials

Because Colistin is usually administered in a hospital, the cost is typically billed under your medical benefit, not your pharmacy benefit. This means your hospital stay or outpatient infusion center charges will include the drug cost. For tips on reducing costs, see our guide: How to Save Money on Colistin.

Are There New Options in 2026?

While no new formulations of Colistin have been approved, the landscape for treating multidrug-resistant infections has improved somewhat:

• Ceftazidime-Avibactam (Avycaz): Effective against many carbapenem-resistant Enterobacteriaceae, sometimes reducing the need for Colistin.
• Cefiderocol (Fetroja): A newer siderophore cephalosporin with activity against multidrug-resistant gram-negative bacteria, including some that are resistant to Colistin.
• Imipenem-Cilastatin-Relebactam (Recarbrio): Another option for certain carbapenem-resistant infections.

These newer antibiotics are significantly more expensive than Colistin but may be more readily available. Your infectious disease specialist can determine if any of these options are appropriate for your specific infection. For more details, see Alternatives to Colistin.

How to Find Colistin in Stock

Here's your action plan:

1. Search on Medfinder: Use Medfinder to find pharmacies with Colistin in stock near you.
2. Contact your hospital pharmacy: Hospital pharmacists have access to specialty distributors and group purchasing organizations.
3. Ask about emergency allocations: In critical cases, manufacturers may provide emergency supply through hospital pharmacy channels.
4. Check multiple hospital systems: Stock levels can vary between hospital networks in the same city.
5. Consider alternatives: Work with your doctor to determine if alternatives like Polymyxin B could work for your infection.

For a complete guide, read How to Find Colistin in Stock Near You.

Final Thoughts

The Colistin shortage in 2026 is real but manageable with the right approach. Stay informed, work closely with your medical team, and use tools like Medfinder to track availability. Colistin is a critical life-saving antibiotic, and while supply remains tight, patients who are persistent and proactive can still access the treatment they need.

We'll continue to update this page as new information becomes available. Bookmark it and check back regularly for the latest on Colistin availability.