Your Patients Can't Find Muro 128 — Here's How You Can Help

You prescribe Muro 128 (Sodium Chloride 5% Ophthalmic) for a reason — it works. But when your patients call back saying they can't fill the prescription, it creates a clinical and logistical headache for everyone. The good news: there are concrete steps your practice can take to improve access for patients, even during supply disruptions.

This guide is designed for ophthalmologists, optometrists, and any provider who prescribes Muro 128. It covers the current availability landscape, why patients are struggling, and a practical five-step approach to solving the problem.

Current Availability

As of early 2026, Muro 128 supply remains inconsistent:

• 5% Drops: Moderately available. Pharmacies can usually order them, but they're not always in stock on the shelf.
• 5% Ointment: The most constrained formulation. Many pharmacies experience prolonged gaps in supply.
• 2% Drops: Relatively available, but prescribed less frequently.
• Generics: Multiple generic Sodium Chloride 5% products exist and may be available when brand-name Muro 128 is not.

For the full shortage background, see our provider shortage briefing.

Why Patients Can't Find It

Understanding the patient's experience helps you intervene effectively:

• Chain pharmacies may not stock it: Muro 128 is a relatively low-volume product. Many chain pharmacy locations don't carry it routinely and may not order it without a specific prescription in hand.
• Patients don't know about generics: Many patients believe "Muro 128" is the only option and don't realize that generic Sodium Chloride 5% is therapeutically equivalent.
• The ointment is genuinely scarce: For patients who specifically need the ointment (e.g., bedtime use for Fuchs' dystrophy), there may truly be no commercial product available in their area.
• Cost concerns: Some patients find the medication but can't afford it, especially if their insurance doesn't cover it or classifies it as OTC.

What Providers Can Do: 5 Steps

Step 1: Prescribe Generically

Write prescriptions as "Sodium Chloride 5% Ophthalmic Solution" or "Sodium Chloride 5% Ophthalmic Ointment" rather than specifying "Muro 128" by brand name. This gives the pharmacist flexibility to dispense any available equivalent product. Make sure the prescription does not restrict substitution.

Step 2: Check Availability Before Prescribing

Use Medfinder for Providers to check real-time pharmacy stock before sending a prescription. You can identify which pharmacies near your patient currently have the product in stock, then route the prescription accordingly. This simple step can prevent the frustrating cycle of rejected fills and pharmacy callbacks.

Step 3: Build Compounding Pharmacy Relationships

Identify one or two compounding pharmacies in your area that can prepare sterile Sodium Chloride 5% ophthalmic drops or ointment. Having this as a standing backup means you always have a fallback option for patients who can't find commercial products. Key considerations:

• Verify the pharmacy follows USP <797> sterile compounding standards
• Confirm turnaround time (many can prepare within 24-48 hours)
• Discuss pricing with the pharmacy so you can counsel patients on expected costs ($20-$50 typical range)

Step 4: Equip Your Staff

Train your front desk and clinical staff to handle Muro 128 availability calls efficiently:

• Have a standard script for patients who call saying they can't find it
• Keep a list of pharmacies that frequently stock Sodium Chloride 5% products
• Know which compounding pharmacies to recommend
• Have patient-facing resources ready to share (see links below)

Step 5: Proactively Counsel Patients at the Visit

Don't wait for the phone call. When prescribing Muro 128 or Sodium Chloride 5%, proactively tell patients:

• "This medication can sometimes be hard to find. If your pharmacy doesn't have it, the generic version works the same way."
• "Try checking Medfinder to see which pharmacies near you have it in stock."
• "Call us if you can't find it anywhere — we have backup options."

This sets expectations and reduces patient anxiety.

Alternatives to Recommend

When Muro 128 is unavailable, these are your primary alternatives:

1. Generic Sodium Chloride 5% Ophthalmic Solution: Direct equivalent to Muro 128 drops. Multiple manufacturers. Typically $10-$25.
2. Generic Sodium Chloride 5% Ophthalmic Ointment: Direct equivalent to Muro 128 ointment. Availability varies but may be better than brand-name.
3. Sochlor (Sodium Chloride 5%): Another branded option that may be available when Muro 128 is not.
4. Compounded Sodium Chloride 5%: Custom-prepared by a compounding pharmacy. Always available on demand. $20-$50.

For a patient-friendly overview of alternatives, share this resource: Alternatives to Muro 128.

Workflow Tips

Here are some practical workflow suggestions to minimize the impact of Muro 128 shortages on your practice:

• Template your prescriptions: Create e-prescribing templates for both generic Sodium Chloride 5% drops and ointment so you can quickly send alternatives.
• Batch availability checks: At the start of each day, have a staff member check Medfinder for current Muro 128 availability at major pharmacies in your area. This gives you real-time data during patient visits.
• Document alternatives in the chart: When prescribing, note in the patient's chart that generic substitution is acceptable and list your preferred compounding pharmacy as a backup. This makes it easier for staff to respond when patients call.
• Consider a "shortage protocol": Create a simple flowchart for your practice: (1) Try generic at patient's preferred pharmacy → (2) Check Medfinder for nearby stock → (3) Refer to compounding pharmacy. This standardizes the response and saves time.

Patient Resources to Share

These articles can be shared directly with patients who are struggling to find Muro 128:

• How to Find Muro 128 in Stock Near You (Tools + Tips)
• Alternatives to Muro 128
• How to Save Money on Muro 128
• Muro 128 Shortage Update for 2026

Final Thoughts

The Muro 128 shortage is frustrating, but it's manageable with the right systems in place. Prescribe generically, check availability before sending prescriptions, maintain compounding pharmacy relationships, and equip your team with the tools and information they need. Your patients will appreciate the proactive approach — and you'll spend less time fielding "I can't find it" phone calls.

Visit Medfinder for Providers to start checking Muro 128 availability in your area.