Your Patients Are Struggling to Fill Cosopt — Here's How You Can Help

As an eye care provider, you know that treatment adherence is critical in glaucoma management. But adherence becomes impossible when patients can't find their medication. Cosopt (Dorzolamide/Timolol) — one of the most widely prescribed combination drops for open-angle glaucoma and ocular hypertension — has experienced intermittent supply challenges that directly affect your patients' ability to stay on therapy.

This guide provides actionable steps your practice can take to help patients navigate Cosopt availability issues, reduce treatment gaps, and maintain IOP control.

Current Availability: What You Need to Know

As of early 2026, generic Dorzolamide/Timolol is being manufactured by several companies, including Sandoz, Bausch Health, and Apotex. The medication is not on the FDA Drug Shortage List. However, retail pharmacy stock continues to vary by region and wholesaler.

Key factors affecting current availability:

• Reduced generic manufacturer base: Akorn's 2023 bankruptcy removed a major source of ophthalmic generics. While other manufacturers have partially filled the gap, the overall number of suppliers remains lower than pre-2023 levels.
• Wholesaler allocation: Large pharmacy chains often receive priority allocation during tight supply periods, while independent pharmacies and smaller chains may face longer wait times.
• Formulation differences: Standard multi-dose Cosopt (with preservative) and Cosopt PF (preservative-free single-use vials) are sourced differently. One may be available when the other isn't.

Why Patients Can't Find Cosopt

Understanding the patient experience helps you intervene more effectively:

• Single-pharmacy reliance: Most patients fill all prescriptions at one pharmacy. If that location is out of stock, the patient may not think to try elsewhere.
• Reluctance to contact the prescriber: Many patients feel they're "bothering" their doctor if they call about a refill problem. They may ration drops instead.
• Cost confusion: Some patients are told the brand isn't available but don't realize the generic is identical and potentially in stock. Others assume a generic substitution requires a new prescription.
• Timing: Patients who try to refill on the day they run out leave no buffer for stock-outs.

What Providers Can Do: 5 Practical Steps

Step 1: Screen for Refill Difficulties at Every Visit

Add a simple question to your intake workflow: "Have you had any trouble filling your eye drop prescriptions recently?" Patients rarely volunteer this information. Normalizing the question uncovers problems early.

Train technicians to ask about medication access during pre-exam workups. Document any reported issues in the patient chart.

Step 2: Prescribe Generics by Default with Clear Substitution Language

Write prescriptions for "Dorzolamide 2%/Timolol 0.5% ophthalmic solution" rather than "Cosopt." Include explicit generic substitution language. This gives pharmacies maximum flexibility to dispense whatever NDC they have in stock.

If the standard formulation is unavailable, the preservative-free version (Cosopt PF) may be in stock. Consider noting "preservative-free acceptable" on the prescription when clinically appropriate.

Step 3: Use Medfinder to Locate Available Pharmacies

Medfinder for providers enables your staff to check real-time pharmacy inventory for Cosopt and generic Dorzolamide/Timolol by zip code. When a patient reports a stock-out, your team can identify a nearby pharmacy with the medication in stock — often while the patient is still in the office or on the phone.

Bookmark medfinder.com/providers on your practice workstations for quick access.

Step 4: Document a Backup Regimen in Every Patient's Chart

For every patient on Cosopt, document a pre-approved alternative regimen in their chart. This might be:

• Dorzolamide 2% TID + Timolol 0.5% BID (component separation)
• Combigan (Brimonidine/Timolol) BID
• Simbrinza (Brinzolamide/Brimonidine) TID (for patients who cannot use beta-blockers)

With a documented backup, your front desk or triage staff can issue a new prescription quickly when a patient calls about a stock-out — without requiring a physician callback or appointment.

Step 5: Educate Patients Proactively

Give patients the tools to help themselves:

• Direct them to Medfinder to check pharmacy stock independently
• Explain that generic Dorzolamide/Timolol is identical to brand Cosopt
• Encourage them to refill 5-7 days before running out to build a buffer
• Advise trying independent pharmacies if chains are out of stock
• Share our patient guides: How to find Cosopt in stock and How to save money on Cosopt

Alternative Medications to Consider

When Cosopt is genuinely unavailable and an alternative is needed, consider:

• Combigan (Brimonidine 0.2%/Timolol 0.5%): BID dosing, maintains the beta-blocker component. May cause more ocular surface irritation in some patients.
• Simbrinza (Brinzolamide 1%/Brimonidine 0.2%): TID dosing, beta-blocker-free. Ideal for patients with respiratory or cardiac contraindications to beta-blockers.
• Latanoprost 0.005%: QHS dosing. A prostaglandin analog for patients who may benefit from a different drug class entirely.
• Rocklatan (Netarsudil 0.02%/Latanoprost 0.005%): QHS dosing. A newer combination with robust IOP-lowering efficacy. Brand-only, higher cost.

For a full clinical comparison, see our article: Alternatives to Cosopt.

Workflow Tips for Your Practice

• Batch check: At the start of each week, have staff check Medfinder for availability of commonly shorted ophthalmic medications. Post a brief update for the clinical team.
• Prior authorization templates: Have PA templates ready for alternative medications in case a switch is needed and the alternative requires authorization.
• Sample inventory: If your practice maintains samples, keep a small supply of alternative combination drops (Combigan, Simbrinza) for bridging patients through short-term stock-outs.
• Patient handout: Create a one-page handout explaining what to do when eye drops are unavailable. Include Medfinder, your office phone number, and instructions to never stop treatment without consulting their provider.

Final Thoughts

Cosopt supply challenges are a manageable reality in 2026. By building medication access screening into your workflow, using tools like Medfinder, and having documented backup regimens ready, your practice can minimize treatment disruptions and protect your patients' vision.

For the clinical overview of current shortage status and prescribing implications, see our companion article: Cosopt shortage: What providers and prescribers need to know in 2026.