Helping Your Patients Find Azasite in Stock

When you prescribe Azasite (Azithromycin ophthalmic solution 1%) in 2026, there's a reasonable chance your patient will call back to say their pharmacy doesn't have it. The ongoing Azasite shortage means that writing the prescription is only half the job — helping patients actually fill it requires a proactive approach.

This guide provides five practical steps your practice can take to improve patient access to Azasite, along with alternative prescribing strategies and workflow tips to reduce the administrative burden on your team.

Current Availability: What You're Working With

As of early 2026, Azasite remains on the FDA drug shortage list. Key facts:

• Sole manufacturer: Thea Pharma (acquired the NDA from bankrupt Akorn in 2023)
• No generic: No FDA-approved generic version exists
• Formulation: 1% ophthalmic solution in 2.5 mL bottles only
• Price: $205-$260 per bottle (cash price)
• Distribution: Available through standard pharmaceutical wholesalers, but quantities are allocated and inventory is inconsistent

The shortage is exacerbated by the erythromycin ophthalmic ointment shortage, which has redirected prescribing volume toward Azasite — a product with limited manufacturing capacity.

Why Patients Can't Find Azasite

Understanding the patient experience helps frame your response:

• Major chain pharmacies (CVS, Walgreens, Rite Aid) deplete their allocated stock quickly due to high patient volume.
• Patients don't know to look elsewhere. Most patients default to their usual pharmacy and give up if it's out of stock.
• Phone-based searching is inefficient. Patients calling pharmacies one by one often get discouraged after 3-4 calls.
• Cost surprises. Even when patients find Azasite, the $205-$260 price tag can be a shock, especially if insurance requires prior authorization.
• Confusion with oral Azithromycin. Patients sometimes arrive at the pharmacy asking for "Azithromycin" and are given the oral form (Z-Pack) instead.

5 Steps Your Practice Can Take

Step 1: Check Availability Before the Patient Leaves

The most impactful intervention is simple: check if a pharmacy near the patient has Azasite before they leave your office.

Use Medfinder for Providers to search real-time pharmacy inventory. This takes 30 seconds and can save the patient hours of frustration. If you find a pharmacy with stock, send the prescription directly there.

Step 2: Prescribe to Specific Pharmacies

If your EHR allows pharmacy selection at the point of prescribing, take advantage of it. Rather than defaulting to the patient's usual pharmacy, e-prescribe to a pharmacy you know has Azasite in stock or is more likely to carry specialty medications.

Good candidates include:

• Independent pharmacies with ophthalmic or specialty focus
• Hospital outpatient pharmacies
• Pharmacies attached to ophthalmology or optometry practices

Step 3: Provide a Backup Prescription

Consider writing two prescriptions: one for Azasite and one for an alternative (such as Moxifloxacin or Tobramycin). Tell the patient: "Try to fill the Azasite first. If they don't have it, fill the backup." This prevents a delay in treatment while the patient searches.

For blepharitis and MGD patients, you might pair the Azasite prescription with a plan for oral Doxycycline or Azithromycin as the fallback, along with lid hygiene instructions.

Step 4: Proactively Address Insurance and Cost

Azasite's brand-only status means many insurance plans require prior authorization or step therapy. Getting ahead of this:

• Submit prior authorization at the time of prescribing rather than waiting for a pharmacy rejection.
• Mention discount cards — GoodRx and SingleCare can bring the price down to approximately $190-$220. Patients can use these even with insurance if the discount price is lower than their copay.
• Document clinical necessity clearly in your notes, especially for off-label blepharitis/MGD use. This supports prior authorization appeals.

For cost-saving details to share with patients, direct them to our guide on saving money on Azasite.

Step 5: Educate Patients on the Shortage

Patients who understand the shortage are more resilient when faced with pharmacy stockouts. Consider providing:

• A brief verbal explanation: "Azasite is currently in shortage because there's only one manufacturer and no generic. It may take some extra effort to find."
• Written resources you can hand out or email, such as the patient shortage update
• Clear guidance on what to do if they can't find it — including when to call your office for an alternative

Alternative Prescribing Strategies

Having alternative protocols ready reduces prescribing delays:

For Bacterial Conjunctivitis

For Blepharitis/MGD

Workflow Tips for Your Practice

• Create a shortage protocol: Document your practice's preferred alternatives for Azasite so any provider in your group can prescribe consistently when Azasite is unavailable.
• Bookmark Medfinder for Providers on your staff's browsers so availability checks take seconds.
• Build PA templates: Prepare prior authorization letter templates for Azasite that include standard clinical rationale language, especially for off-label blepharitis/MGD use.
• Track patient outcomes: If you switch patients from Azasite to alternatives frequently, consider tracking clinical outcomes to inform your protocol.
• Set up drug shortage alerts: The ASHP Drug Shortage Resource Center and FDA Drug Shortage Database both offer email alerts for specific medications.

Final Thoughts

The Azasite shortage adds friction to prescribing, but a little proactive effort goes a long way. Checking availability before the patient leaves, having backup prescriptions ready, and educating patients about the shortage can transform a frustrating experience into a manageable one.

Tools like Medfinder for Providers are designed to make this process as painless as possible — for both your staff and your patients.

For the broader provider perspective on this shortage, see our companion briefing: Azasite shortage: what providers need to know in 2026. For the provider's guide to helping patients save money, see how to help patients save money on Azasite.