Your Patients Are Struggling to Find Loreev XR — Here's How to Help

You prescribed Loreev XR for good clinical reasons: simplified once-daily dosing, improved adherence, more consistent symptom control for your anxiety patients. But now those patients are calling back, frustrated because their pharmacy doesn't carry it, can't order it, or quoted an out-of-pocket price that's out of reach.

This guide provides actionable steps your practice can take to help patients find and access Loreev XR, along with contingency plans for when the medication remains unavailable.

Current Availability: What's Happening at the Pharmacy Level

Loreev XR is not in a manufacturing shortage — Almatica Pharma has not reported supply disruptions to the FDA. The problem is at the pharmacy stocking level:

• Most chain pharmacies (CVS, Walgreens, Rite Aid) don't routinely stock Loreev XR due to low prescription volume
• The medication is available through major pharmaceutical wholesalers, but pharmacies must proactively order it
• No generic equivalent exists (patent expires January 2034), so pharmacies can't substitute
• Controlled substance (Schedule IV) classification adds ordering friction

The result: patients often visit multiple pharmacies before finding one that has it — or give up entirely. This creates treatment disruption risk, particularly concerning with a benzodiazepine where abrupt discontinuation poses serious safety implications.

Why Patients Can't Find It: The Full Picture

Understanding the barriers helps you anticipate problems and counsel patients proactively:

Insurance Barriers

Many commercial and Medicare Part D plans require prior authorization for Loreev XR. Some impose step therapy, requiring documented failure of or inability to use IR lorazepam. When PA requests are denied or delayed, prescriptions go unfilled, and pharmacies see even less reason to stock the product.

Cost Barriers

Retail cash price for Loreev XR ranges from $430 to $565 for 30 capsules. Even with insurance, patients may face significant copays for this non-formulary brand product. For context, generic IR lorazepam costs $5 to $29 for a 30-day supply.

Awareness Gaps

Some pharmacists may be unfamiliar with Loreev XR, particularly if it hasn't been dispensed at their location before. This can lead to incorrect information being given to patients, including being told the drug "doesn't exist" or "has been discontinued."

5 Steps Providers Can Take to Help Patients Access Loreev XR

Step 1: Use Medfinder for Providers to Locate Stock

Medfinder for Providers allows your practice to search for pharmacies with Loreev XR in stock in real time. Consider integrating this tool into your prescribing workflow:

• Before sending the prescription, check Medfinder for a stocking pharmacy near the patient
• Send the prescription directly to a pharmacy confirmed to have stock
• Share the Medfinder link with patients so they can check availability for future refills

Step 2: Build Relationships With Independent Pharmacies

Independent pharmacies are significantly more likely to accommodate special orders for Loreev XR. Consider identifying 1-2 independent pharmacies in your area that are willing to stock or order the medication, and build that into your referral pattern. Many independent pharmacies can receive the medication from their wholesaler within 1-2 business days.

Step 3: Submit Proactive Prior Authorizations

Don't wait for the pharmacy to reject the claim. When prescribing Loreev XR, submit the prior authorization request simultaneously. Key documentation to include:

• Patient's stable TID IR lorazepam regimen (dose and duration)
• Clinical rationale for switching to extended-release (adherence, simplification, consistent plasma levels)
• Documentation that the patient is not benzodiazepine-naive

Step 4: Educate Patients About Cost Savings

Make sure patients know about the Almatica copay savings card before they get to the pharmacy:

• Commercially insured patients: as low as $20/month
• Uninsured patients: $90 for 30 capsules
• Information available at loreevxr.com or by calling 1-877-447-7979

You can also direct patients to our patient savings guide for Loreev XR for additional discount card options.

Step 5: Have a Transition Plan Ready

If a patient cannot access Loreev XR despite best efforts, have a clear plan to transition them back to IR lorazepam safely:

• Calculate the equivalent TID dose (Loreev XR total daily dose ÷ 3)
• Begin IR lorazepam the day after the last Loreev XR dose
• Monitor for any differences in clinical response or side effect profile
• Document the reason for the switch and plan to reassess at follow-up

Alternative Medications to Consider

When Loreev XR isn't available and IR lorazepam isn't the right fit, consider these alternatives based on clinical presentation:

• Clonazepam (Klonopin): Longer half-life benzodiazepine, BID dosing, generic available ($5-$20/month). Good option for patients who need fewer daily doses but are appropriate for continued benzodiazepine therapy.
• Buspirone: Non-benzodiazepine anxiolytic for GAD. Non-controlled. Takes 2-4 weeks for full efficacy. Best suited for patients where benzodiazepine tapering is clinically appropriate.
• Hydroxyzine (Vistaril): Non-controlled antihistamine with anxiolytic properties. Rapid onset, useful for situational or breakthrough anxiety. Can be sedating.
• SSRIs/SNRIs: First-line for generalized anxiety disorder. Consider if the clinical goal includes moving away from benzodiazepine therapy long-term.

For a patient-facing resource, share our article on alternatives to Loreev XR.

Workflow Tips for Your Practice

• Flag Loreev XR patients in your EHR — set reminders to check in about access at each visit
• Create a pharmacy quick-reference list of local pharmacies that stock or will order Loreev XR
• Keep the manufacturer's contact info accessible for staff: Almatica Pharma, 1-877-447-7979
• Bookmark Medfinder for Providers as a practice resource
• Consider same-day PA submission whenever prescribing Loreev XR to minimize delays

Final Thoughts

Helping patients access Loreev XR requires a more proactive approach than most prescribing workflows, but the tools exist to make it manageable. By using Medfinder for Providers, building pharmacy relationships, submitting preemptive prior authorizations, and having alternative protocols ready, you can minimize treatment disruptions and keep your patients on track.

For the clinical perspective on availability trends and prescribing considerations, see our Loreev XR shortage briefing for providers. For information on helping patients manage costs, see our provider's guide to saving patients money on Loreev XR.