A practical guide for providers to help patients locate Marplan (Isocarboxazid) during the ongoing shortage. Steps, tools, and alternative strategies.
As a prescriber, you've done the clinical work: evaluated your patient, tried first-line treatments, and determined that Marplan (Isocarboxazid) is the right medication. But in 2026, writing the prescription is only half the battle. Your patient now has to actually find a pharmacy that has it in stock — and for a sole-source, brand-only MAOI with ongoing supply issues, that's far from guaranteed.
This guide gives you concrete, actionable steps to help your patients find and maintain access to Marplan.
Marplan's availability in 2026 can be described as intermittent and unpredictable:
For the most current picture, check Medfinder for Providers.
Understanding the supply chain helps you counsel patients more effectively:
Before your patient walks out the door with a new prescription, take 60 seconds to check availability. Use Medfinder for Providers to see which pharmacies near the patient currently have Marplan in stock. This single step can save your patient days of frustration and phone calls.
If Marplan isn't available nearby, you can adjust the plan in real time — either choosing a pharmacy in a broader radius or discussing an alternative medication before the patient has a failed fill attempt.
Once you've identified a pharmacy with Marplan in stock, send the prescription directly there. Avoid sending it to the patient's "usual" pharmacy if that pharmacy doesn't carry Marplan — this creates unnecessary delays and transfers.
If the patient's insurance requires a specific pharmacy network, work with the patient to identify an in-network pharmacy that has stock.
When Marplan is available, maximizing the supply duration reduces the frequency of the search process. If the patient's insurance and state regulations allow it, prescribe a 90-day supply. This gives the patient a 3-month buffer and reduces the risk of a gap in therapy.
Even if insurance only covers 30-day fills, discuss with the patient whether paying cash for a 90-day supply might be worth the peace of mind — particularly if they've had difficulty finding Marplan before.
Identify 2-3 independent or specialty pharmacies in your area that reliably source hard-to-find medications. Over time, building a relationship with these pharmacies benefits all of your patients on niche medications — not just those on Marplan.
Some specialty pharmacies will proactively notify your office when supply of a specific medication becomes available or runs low.
For every patient on Marplan, document a backup medication plan in the chart. This should include:
Having this plan documented means you can act quickly if supply is interrupted, rather than starting the clinical decision-making process from scratch under time pressure.
When Marplan is unavailable, the three primary MAOI alternatives are:
For a patient-facing comparison, share our article on alternatives to Marplan.
The Marplan shortage is a structural problem that won't resolve overnight. But providers who are proactive — verifying stock before prescribing, building pharmacy relationships, maintaining contingency plans, and leveraging tools like Medfinder for Providers — can significantly reduce the burden on their patients.
For the clinical perspective on the shortage itself, see our provider shortage briefing. For patient-facing resources you can share, check out How to find Marplan in stock near you.
You focus on staying healthy. We'll handle the rest.
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