How to Help Your Patients Find Lentocilin in Stock: A Provider's Guide

One of the most common calls and messages providers are receiving in 2026 goes something like this: "My pharmacy says they don't have Lentocilin. What do I do?" With Bicillin L-A still in shortage and Lentocilin supply intermittent, the burden of helping patients navigate access has fallen heavily on prescribing providers. This guide gives you practical, actionable strategies to help your patients get the treatment they need.

Know Your Sourcing Channels

The first step in helping patients is making sure you — and your office staff — know exactly where Lentocilin can be ordered and what the current availability looks like. There are four main channels:

1. TopRx (Authorized U.S. Distributor)

TopRx is the primary authorized distributor of Lentocilin in the United States. Healthcare facilities and pharmacy directors can place orders directly:

Phone: 800-542-8677

Email: STDmeds@toprx.com

Check availability proactively — don't wait until you're out of stock. When Lentocilin is available, maintain a small buffer supply rather than ordering just-in-time.

2. Cost Plus Drug Company Marketplace

Mark Cuban Cost Plus Drug Company distributes Lentocilin to healthcare businesses through its online marketplace. When Lentocilin was first imported in 2024, Cost Plus priced it at approximately $15 per dose — compared to $500+ for brand Bicillin L-A. Healthcare businesses can register at costplusdrugs.com. For questions, contact their quality team: 682-428-8081 or dtc_quality@costplusdrugs.com.

3. Local or State Public Health Departments

State and local health departments often maintain emergency stockpiles of penicillin G benzathine with priority allocation for high-risk patients. If you have a pregnant patient with syphilis who cannot be treated at your facility due to supply issues, your state STD control program should be your immediate contact. Many states have established specific protocols and helplines for exactly this situation.

4. Pfizer Medical Request Process (Congenital Syphilis Cases)

For confirmed congenital syphilis cases or women at risk for congenital syphilis, Pfizer maintains a medical request process for Bicillin L-A:

The treating provider or pharmacy director must complete the medical request form

Submit by email to: PISupplyContinuity@pfizer.com

Pfizer will review on a per-patient basis for confirmed or at-risk congenital syphilis

Direct Patients to medfinder

For outpatient patients who need to find a facility that carries Lentocilin and can administer it, medfinder for providers offers a service that contacts pharmacies and healthcare facilities on the patient's behalf to identify who has the medication in stock. Rather than your staff spending 30 minutes calling clinics across town, medfinder can do this legwork and text the results directly to the patient.

This is especially useful for patients who live in areas where availability varies significantly across facilities — and for your office staff who are already stretched thin managing shortage-related calls.

Patient Communication Strategies

Patients are anxious and confused when their medication is unavailable. Clear, empathetic communication makes a big difference. Here are scripts and talking points that work:

For Pregnant Patients With Syphilis

"This medication is in short supply nationally, but it's our top priority for you. I'm actively working to get it — here are the steps we're taking right now. Please don't worry; we will make sure you and your baby receive treatment before delivery. I've already contacted [state health department / sourcing channel] and will call you as soon as we have a plan."

For Non-Pregnant Adults With Syphilis

"Lentocilin is the preferred treatment, but there's a national shortage right now. The good news is that doxycycline, a tablet you take twice a day, is an effective alternative that the CDC recommends for people in your situation. If you're able to take it reliably for 14 days, that's a strong option. I can prescribe it now, and we'll continue to look for the injectable if you'd prefer that approach."

For Patients on Rheumatic Fever Prophylaxis

"Your monthly Lentocilin injection is temporarily harder to obtain due to a national shortage. In the meantime, I'm prescribing an oral antibiotic [Penicillin V] that you'll take twice daily. It's not quite as convenient as the monthly shot, but it provides reliable protection against strep. We'll return to the injection as soon as supply allows."

Setting Up a System in Your Practice

Rather than handling each shortage inquiry ad hoc, consider implementing a simple system:

Designate one staff member as the Lentocilin shortage coordinator who maintains vendor contacts and monitors supply weekly

Create a standing order for doxycycline as a backup for eligible non-pregnant syphilis patients

Flag pregnant patients with syphilis in your EHR with a shortage alert so they receive priority outreach when supply arrives

Subscribe to state health department shortage alerts so your practice receives real-time updates on availability

Recommend medfinder to patients as a resource to locate Lentocilin in their area, reducing the burden on your office staff

When to Escalate

Some situations require escalation beyond the typical sourcing steps:

A pregnant patient cannot access penicillin G benzathine despite contacting the health department → consult infectious disease, consider in-hospital management and desensitization if patient is allergic

A patient on rheumatic fever prophylaxis misses multiple monthly doses → consider cardiology consultation to assess risk and adjust prophylaxis strategy

Multiple patients reporting shortage at local pharmacies → notify your state health department's STD control program and CDC at stdshortages@cdc.gov