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

Eprontia (Topiramate oral solution, 25 mg/mL) is the first and only FDA-approved ready-to-use liquid formulation of Topiramate. Since its approval in November 2021, it has become an important option for patients who require or prefer a liquid anticonvulsant — particularly pediatric patients, those with dysphagia, and individuals on feeding tubes.

However, many providers have encountered patient complaints about difficulty filling Eprontia prescriptions. This briefing covers the current supply landscape, prescribing considerations, cost and access factors, and practical tools to support your patients.

Current Supply Timeline

Eprontia is not currently listed on the FDA Drug Shortage Database as of early 2026. Unlike some anticonvulsants that have experienced manufacturing-related shortages, Eprontia's availability challenges are structural rather than supply-driven:

• November 2021: FDA approval of Eprontia (NDA 214679) by Azurity Pharmaceuticals
• 2022–2023: Market launch and gradual uptake; pharmacy stocking remained limited
• 2024–2025: Steady production by Azurity; supplemental NDA approvals for labeling updates (including s007 revision in 2024)
• 2026: No formal shortage reported; limited retail availability persists due to low pharmacy stocking rates

The core issue is not a manufacturing shortfall but rather limited distribution to retail pharmacies, driven by the product's niche demand and cost profile.

Prescribing Implications

When prescribing Eprontia, consider the following clinical and logistical factors:

Indications

Eprontia carries the same indications as other Topiramate formulations:

• Initial monotherapy or adjunctive therapy for partial-onset seizures, primary generalized tonic-clonic seizures, and Lennox-Gastaut syndrome in patients ≥2 years
• Preventive treatment of migraine in patients ≥12 years

When Eprontia Is Clinically Preferred

• Pediatric patients (ages 2–5) who cannot reliably swallow tablets or capsules
• Patients with dysphagia or oropharyngeal dysfunction
• Patients on nasogastric or gastrostomy tubes
• Dose titration requiring precise milligram adjustments (the 25 mg/mL concentration allows flexible dosing)
• Patients who have been receiving compounded Topiramate solutions — Eprontia provides an FDA-approved, standardized alternative

Fetal Risk Considerations

Topiramate carries significant reproductive safety concerns. Data show a 2- to 5-fold increase in the risk of oral clefts (cleft lip/palate) in infants exposed to Topiramate during the first trimester. Additionally, infants may be born small for gestational age (SGA). Women of childbearing potential should use effective contraception while taking any Topiramate formulation, including Eprontia.

Key Drug Interactions

Providers should be aware of significant interactions, detailed further in our drug interactions guide:

• Valproic acid: Risk of hyperammonemia, hypothermia, and encephalopathy — monitor ammonia levels
• Other carbonic anhydrase inhibitors (Zonisamide, Acetazolamide): Increased metabolic acidosis and nephrolithiasis risk
• Oral contraceptives: Reduced efficacy of estrogen-containing contraceptives at doses ≥200 mg/day
• Phenytoin, Carbamazepine: May decrease Topiramate serum levels; Topiramate may increase Phenytoin levels

Availability Picture

The reality on the ground is that most retail pharmacies do not stock Eprontia. Key factors include:

• Single manufacturer: Azurity Pharmaceuticals is the sole producer
• No approved generic Eprontia: A generic Topiramate oral solution has appeared in some wholesaler catalogs (~$260/120 mL), but availability is inconsistent
• Pharmacy economics: With a retail price of $250–$334 per 120 mL, pharmacies face inventory cost risk for a low-volume product
• Insurance friction: Many plans require prior authorization or step therapy (generic tablets first), which reduces fill rates and further disincentivizes stocking

Cost and Access Landscape

Understanding the cost picture helps when counseling patients:

• Eprontia retail price: $250–$334 for 120 mL
• With discount coupons: $85–$116 for 120 mL
• Generic Topiramate tablets: As low as $2–$15 for a 30-day supply
• Azurity co-pay program: eVoucherRx/Voucher on Demand for commercially insured patients
• Bridge Program: Azurity offers temporary coverage if insurance approval takes >48 hours
• Patient assistance: NeedyMeds, RxAssist, and RxHope may offer additional resources for uninsured patients

Tools and Resources for Providers

To help your patients access Eprontia efficiently:

1. Medfinder for Providers: Check real-time pharmacy availability of Eprontia. Direct patients to pharmacies that actually have it in stock, saving time and reducing treatment gaps.
2. Azurity Solutions Portal: Access co-pay savings enrollment, Bridge Program details, and prescribing resources at eprontia.azuritysolutions.com
3. Specify "DAW" when appropriate: If Eprontia (liquid) is medically necessary, write "Dispense As Written" to prevent substitution with tablets
4. Include clinical justification: Note the medical necessity for liquid formulation on the prescription or prior authorization form (e.g., "patient cannot swallow solid oral dosage forms")
5. Recommend independent pharmacies: Independent and specialty pharmacies are more likely to stock or quickly order Eprontia

Looking Ahead

Several developments may improve Eprontia access over the coming years:

• Generic Topiramate oral solution: Early market entries suggest a generic liquid may become more widely available, potentially reducing cost barriers
• Expanded insurance coverage: As awareness of Eprontia grows, more plans may add it to formularies without stringent prior authorization
• Pharmacy awareness: Continued prescribing and patient demand should gradually increase stocking at retail pharmacies

In the meantime, providers can help by educating patients about availability tools, cost-saving programs, and — when Eprontia is unavailable — appropriate alternative formulations.

Final Thoughts

Eprontia fills an important clinical niche as the only FDA-approved liquid Topiramate. While it is not in a formal shortage, practical availability remains limited. By understanding the supply dynamics, leveraging tools like Medfinder for Providers, and connecting patients with savings programs, you can minimize treatment interruptions and ensure continuity of care.

For patient-facing resources, refer patients to: How to Find Eprontia in Stock Near You and How to Save Money on Eprontia.