Your Patients Can't Find Their Isotretinoin — Here's How You Can Help

You prescribed Isotretinoin because your patient's acne warrants it. Now they're calling your office because the pharmacy can't fill it. This scenario has become increasingly common as generic Isotretinoin supply remains uneven across the country.

As a prescriber, you're in a unique position to help patients navigate these supply challenges. This guide provides a practical workflow for ensuring your patients can find Claravis — or an equivalent Isotretinoin brand — and stay on therapy.

Current Availability: What You Need to Know

Generic Isotretinoin (Claravis, Amnesteem, Myorisan, Zenatane) has experienced intermittent supply disruptions since 2022. As of 2026:

• No manufacturer has reported a complete production halt
• Spot shortages are common, particularly for 20 mg and 40 mg strengths
• Availability varies significantly by pharmacy, region, and wholesaler
• Brand Absorica (Sun Pharma) has had more consistent supply but at significantly higher cost

For a full timeline and analysis, see our provider shortage briefing.

Why Patients Can't Find It

Understanding the bottlenecks helps you guide patients more effectively:

1. Pharmacy stocking gaps: Many pharmacies — especially chains — don't stock Isotretinoin consistently due to iPLEDGE requirements and limited demand per location
2. iPLEDGE timing: The 7-day dispensing window means patients can't easily "shop around" once their window opens
3. Single-wholesaler contracts: Chain pharmacies may be unable to source from alternative distributors when their primary wholesaler is backordered
4. Strength-specific shortages: One strength may be unavailable while others are in stock, but patients don't know to ask about alternatives

What Providers Can Do: 5 Practical Steps

Step 1: Write Brand-Flexible Prescriptions

Prescribe "Isotretinoin" rather than a specific brand name. This allows the pharmacy to dispense whichever generic is in stock — Claravis, Amnesteem, Myorisan, or Zenatane. Ensure "substitution permitted" is indicated on the prescription.

If a patient has commercial insurance and supply is consistently problematic, consider prescribing Absorica with the manufacturer savings card, which can reduce copays to as low as $10/month.

Step 2: Offer Dose Flexibility

When a specific strength is unavailable, alternative dosing can maintain treatment continuity:

• 40 mg unavailable → prescribe two 20 mg capsules
• 30 mg unavailable → prescribe one 20 mg + one 10 mg capsule
• Consider slight dose adjustments within the therapeutic range (0.5–1 mg/kg/day) based on available strengths

Document the rationale for any dose modifications and counsel patients to take the medication with a fatty meal regardless of strength.

Step 3: Direct Patients to Medfinder

Medfinder provides real-time pharmacy stock searches for Isotretinoin. You can:

• Share the link directly with patients at the time of prescribing
• Have your office staff check availability before sending the prescription
• Include Medfinder in your printed patient instructions for Isotretinoin therapy

This single step can eliminate the frustrating cycle of patients calling multiple pharmacies and then calling your office when they can't find it.

Step 4: Build Pharmacy Relationships

Identify two to three pharmacies in your area that reliably stock Isotretinoin:

• Include at least one independent pharmacy — they typically have access to multiple wholesalers and can source more flexibly
• Confirm the pharmacy is iPLEDGE-registered and experienced with Isotretinoin dispensing
• Establish a communication channel (direct phone number, fax) for supply-related questions
• Consider developing a preferred pharmacy list for your Isotretinoin patients

Step 5: Educate Patients Proactively

At the start of therapy, set expectations about potential supply challenges:

• Advise patients to begin looking for their refill at least one week before running out
• Explain the importance of verifying pharmacy stock before confirming in iPLEDGE
• Share resources: finding Claravis in stock, brand alternatives
• Encourage patients to notify your office immediately if they anticipate a gap in therapy

Therapeutic Alternatives When Isotretinoin Is Unavailable

In rare cases where no Isotretinoin brand can be sourced within a clinically acceptable timeframe, consider bridging strategies:

• Oral antibiotics (Doxycycline 100 mg BID or Minocycline 100 mg BID) as a bridge — understanding this doesn't replace Isotretinoin's mechanism but can manage flares
• High-potency topical retinoids (Tazarotene 0.1%) combined with benzoyl peroxide as a temporary regimen
• Hormonal therapy (Spironolactone, oral contraceptives) for appropriate female patients

These are not equivalent substitutes for Isotretinoin in severe nodular acne but can help maintain some disease control during unavoidable treatment gaps. Plan to resume Isotretinoin as soon as supply is available and adjust the cumulative dose target accordingly.

Workflow Tips for Your Practice

Integrating these steps into your standard Isotretinoin workflow:

1. Initial visit: Discuss potential supply challenges; provide Medfinder link and pharmacy recommendations
2. Pre-prescription: Check or have staff check Isotretinoin availability at preferred pharmacies before sending the Rx
3. Monthly visits: Ask patients about any fill difficulties; adjust brand or strength proactively
4. Refill reminders: If your EHR supports automated patient messaging, include a reminder to check pharmacy stock one week before the expected refill date
5. Staff training: Ensure front desk and nursing staff know how to direct patients to Medfinder and can explain brand substitution options

Final Thoughts

Supply disruptions for Isotretinoin are frustrating for patients and providers alike, but they're manageable with proactive planning. By writing flexible prescriptions, leveraging real-time stock tools like Medfinder, and educating patients upfront, you can significantly reduce treatment gaps and improve outcomes.

For the clinical and supply background, see our Claravis shortage briefing for providers. For cost reduction strategies, see how to help patients save money on Claravis.