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

You prescribed Locoid (Hydrocortisone Butyrate 0.1%) for a patient's eczema or dermatitis, and now they're calling your office because the pharmacy doesn't have it. It's a scenario that dermatologists, family physicians, and pediatricians are encountering with increasing frequency.

While Locoid isn't in a formal FDA-listed shortage, brand-name supply — especially the Lipocream formulation — has been inconsistent. This guide provides actionable steps you can take to help patients access their medication with minimal disruption to their care.

Current Availability Overview

Here's the availability landscape for Locoid and its generic equivalents as of early 2026:

• Generic Hydrocortisone Butyrate 0.1% cream: Broadly available at most retail and mail-order pharmacies
• Generic Hydrocortisone Butyrate 0.1% ointment: Available at most pharmacies, though less universally stocked than cream
• Brand-name Locoid (cream/ointment): Intermittently available; not routinely stocked at all retail locations
• Brand-name Locoid Lipocream: The most difficult formulation to find; limited retail distribution
• Locoid Solution 0.1%: Rarely stocked; typically requires special ordering

Overall findability: 70/100 — patients can usually find the generic with moderate effort, but the brand name may require checking multiple pharmacies.

Why Patients Can't Find It

Understanding the root causes helps you counsel patients more effectively:

1. Pharmacy stocking economics: Locoid isn't a high-volume dispensing item. Pharmacies allocate shelf space based on demand, and topical steroids like Triamcinolone move much faster. Many pharmacies simply don't keep Locoid on hand.
2. Insurance-driven demand shifts: Step therapy requirements and prior authorization have pushed many patients toward Triamcinolone or other cheaper alternatives. As fewer prescriptions are written for Locoid, pharmacies order less of it.
3. Formulation-specific issues: The Lipocream vehicle has limited generic competition, creating a supply bottleneck that doesn't exist for cream and ointment formulations.
4. Wholesaler allocation: When supply is tight, wholesalers may allocate limited quantities to pharmacies based on historical ordering patterns, making it harder for pharmacies that don't regularly stock Locoid to obtain it on short notice.

What Providers Can Do: 5 Actionable Steps

Step 1: Write for the Generic When Possible

The single most impactful change you can make is prescribing "Hydrocortisone Butyrate 0.1% cream" or "ointment" rather than brand-name "Locoid." This allows the pharmacy to fill with any available manufacturer's generic, dramatically increasing fill success rates.

Reserve brand-specific prescriptions for cases where the vehicle truly matters — for example, if a patient has documented intolerance to the inactive ingredients in available generics, or if the Lipocream vehicle's cosmetic properties are clinically relevant for adherence.

Step 2: Include Backup Alternatives in Your Workflow

When prescribing Hydrocortisone Butyrate, consider noting an alternative on the prescription or in your EHR so the pharmacy can reach you quickly if the first choice is unavailable. Common alternatives include:

• Triamcinolone Acetonide 0.1% cream/ointment — most direct mid-potency substitute, $5-$20 generic
• Mometasone Furoate 0.1% cream/ointment — slightly more potent, once-daily, $15-$40 generic
• Betamethasone Valerate 0.1% cream — mid-potency, widely available, $10-$30 generic
• Desonide 0.05% — lower potency, good for sensitive areas and pediatric patients, $15-$50 generic

For a comprehensive comparison, see Alternatives to Locoid.

Step 3: Direct Patients to Real-Time Inventory Tools

Rather than having patients call pharmacy after pharmacy, direct them to Medfinder for Providers. You can also use it in your office to check stock before sending the prescription.

Workflow tip: Have your medical assistant or front desk check Medfinder before the patient leaves the office. Send the e-prescription to a pharmacy that shows confirmed stock. This eliminates the frustrating callback cycle entirely.

Step 4: Educate Patients Proactively

When prescribing Locoid, take 30 seconds to set expectations:

• "This medication can sometimes be tricky to find in stock. If your pharmacy doesn't have it, ask them to check for the generic — Hydrocortisone Butyrate."
• "You can also check medfinder.com to find pharmacies near you that have it."
• "If you can't find it at all, call our office and we'll prescribe an alternative."

This proactive communication reduces patient anxiety and phone calls to your office.

Step 5: Leverage E-Prescribing Strategically

If your EHR system supports real-time benefit checks or pharmacy inventory visibility, use those features when selecting the receiving pharmacy. Sending a prescription to a pharmacy that doesn't stock Locoid wastes everyone's time.

If your system doesn't offer this, consider:

• E-prescribing to larger pharmacies that are more likely to stock a wider range of topical steroids
• Suggesting patients use specialty or independent pharmacies that may have different supply access
• For brand-name Locoid, recommending mail-order pharmacies that may have better stock consistency

Alternatives at a Glance

Quick reference for therapeutic substitution when Locoid is unavailable:

• Mild inflammation / sensitive areas / pediatric: Desonide 0.05% cream or ointment
• Moderate inflammation / most body sites: Triamcinolone Acetonide 0.1% cream or ointment
• Moderate-severe inflammation / once-daily preferred: Mometasone Furoate 0.1% cream or ointment
• Moderate inflammation / thick plaques: Betamethasone Valerate 0.1% ointment

Always consider patient factors including treatment site, prior responses, and duration of therapy when selecting alternatives.

Workflow Tips for Your Practice

• Create a topical steroid formulary card for your practice listing preferred agents by potency class, with availability and cost notes. Update quarterly.
• Set up EHR order sets that include both primary and alternative topical steroids, making it easy to pivot if the first choice is unavailable.
• Track fill failures: If your EHR captures pharmacy callbacks for stock-outs, monitor these to identify which medications are routinely problematic and adjust prescribing patterns accordingly.
• Bookmark Medfinder for Providers for quick real-time availability checks during patient visits.

Final Thoughts

The Locoid availability challenge is manageable with proactive prescribing practices. By writing for generics when possible, having alternatives ready, and directing patients to real-time inventory tools, you can minimize fill failures and maintain treatment continuity.

Your patients' skin conditions don't wait for supply chains to sort themselves out. With the right workflow, neither should their treatment.

For the latest supply information and provider resources, visit Medfinder for Providers. For background on the current supply situation, see our provider briefing on Locoid availability.