Your Patient Needs Orapred — and Can't Find It

It's a scenario playing out in clinics across the country: you write a prescription for Orapred or generic Prednisolone oral solution, and your patient calls back an hour later saying their pharmacy doesn't have it. Then the next pharmacy doesn't either. Now a parent is stressed, a child is symptomatic, and you're fielding phone calls that pull you away from other patients.

The Prednisolone oral solution shortage isn't your fault, but it does land on your desk. This guide offers practical strategies for helping your patients locate Orapred, along with workflow adjustments that can reduce the disruption to your practice.

Current Availability: What You Need to Know

As of early 2026, Prednisolone Sodium Phosphate oral solution remains intermittently available. The key patterns:

• Seasonal: Supply is tightest from October through March during respiratory illness season. Availability generally improves in spring and summer.
• Geographic: Shortages are more pronounced in some regions than others, often correlating with respiratory illness severity and local pharmacy stocking patterns.
• Pharmacy type: Large chain pharmacies (CVS, Walgreens, Rite Aid) are more frequently affected than independent pharmacies, which typically source from multiple wholesalers.
• Formulation-specific: The liquid solution is most affected. Prednisolone and Prednisone tablets remain widely available. Orapred ODT is generally available but at significantly higher cost ($200-$500+).

Why Patients Can't Find It

Understanding the root causes helps you set expectations with patients and families:

• Limited manufacturing base: Few companies produce Prednisolone oral solution. Liquid formulations require specialized equipment and have shorter shelf lives than tablets.
• Demand concentration: Prescribing is heavily weighted toward pediatrics during respiratory season, creating sharp demand peaks.
• Pharmacy stocking decisions: Pharmacies with thin margins on generic liquids may not maintain large buffer stocks, leading to faster stock-outs.
• Wholesaler allocation: During shortages, wholesalers may limit orders to prevent hoarding, which can leave individual pharmacies with less than they need.

For more background, see our provider shortage briefing.

What Providers Can Do: 5 Practical Steps

Step 1: Recommend Medfinder to Patients

Medfinder allows patients to check which pharmacies near them have a specific medication in stock. Instead of asking patients to call pharmacy after pharmacy, direct them to medfinder.com/providers to find availability quickly.

Consider adding Medfinder to your discharge instructions or patient handouts for conditions that commonly require Prednisolone (asthma exacerbations, croup, allergic reactions).

Step 2: Write Backup Prescriptions

When prescribing Prednisolone liquid, consider also providing a backup prescription for an alternative corticosteroid. Good options include:

• Dexamethasone oral solution (0.6 mg/kg/day, max 16 mg, for 1-2 days) — particularly useful for croup and mild-to-moderate asthma exacerbations
• Prednisone tablets (can be crushed for older children who can tolerate it)
• Prednisone oral solution (if available)

Clearly label the backup prescription as an alternative to use only if Prednisolone is unavailable, and include dosing instructions for the equivalent dose.

Step 3: Proactively Discuss the Shortage

For patients with recurrent conditions requiring corticosteroid bursts (e.g., intermittent asthma, recurrent croup-prone children), bring up the shortage proactively during visits:

• Explain that Prednisolone liquid may be difficult to find at times
• Discuss alternative formulations and medications they could use
• Encourage them to fill prescriptions when available rather than waiting for an acute episode
• Set expectations that they may need to check multiple pharmacies

Step 4: Suggest Independent and Compounding Pharmacies

When patients report that chain pharmacies are out of stock, recommend:

• Independent pharmacies: These often have relationships with multiple wholesalers and may have better access to shortage-affected medications. Maintain a short list of reliable independent pharmacies in your area to recommend.
• Compounding pharmacies: Can prepare Prednisolone oral solutions from active pharmaceutical ingredients when commercial products are unavailable. Ensure the compounding pharmacy is accredited and follows USP standards.

Step 5: Coordinate with Your Pharmacy Partners

Build relationships with pharmacies you frequently send prescriptions to:

• Alert pharmacies to anticipated Prednisolone prescriptions so they can hold or order stock
• Ask pharmacies to notify your office when they receive shipments of Prednisolone liquid
• Discuss therapeutic substitution protocols so pharmacists can make appropriate switches without requiring a new prescription (where state laws permit)

Alternative Medications: Quick Reference

When Prednisolone liquid is unavailable, these are the most appropriate alternatives:

Dexamethasone

• 6-7x more potent than Prednisolone
• Available as oral solution
• Shorter course (1-2 days vs. 3-5 days)
• Well-studied in pediatric asthma and croup
• Cash price: $5-$25

Prednisone

• Equivalent potency (converted to Prednisolone by the liver)
• Tablets widely available ($4-$10)
• Liquid form may also face shortages
• Tablets can be crushed for older children

Methylprednisolone

• 1.25x more potent than Prednisolone
• Tablets only (no commercial liquid)
• Good option for adults and older children
• Cash price: $10-$30

Refer to our alternatives guide for detailed patient-facing information you can share.

Workflow Tips for Your Practice

Small workflow changes can significantly reduce the burden of shortage management:

• Create a shortage handout: Develop a patient-friendly handout explaining the Prednisolone shortage, listing alternative medications, and recommending tools like Medfinder. Hand this out when writing Prednisolone prescriptions.
• Update your EHR templates: Add alternative corticosteroid options to your prescribing templates so you can quickly generate backup prescriptions.
• Train front desk staff: Ensure your team knows what to tell patients who call about not being able to fill Prednisolone prescriptions — including directing them to Medfinder and scheduling a quick provider call if an alternative is needed.
• Monitor shortage alerts: Subscribe to ASHP drug shortage alerts and FDA shortage notifications for Prednisolone so you're aware of supply changes before patients start calling.
• Batch prescription reviews: During peak season, set aside time to review patients with active Prednisolone prescriptions and proactively reach out about alternatives if supply tightens.

Final Thoughts

The Prednisolone oral solution shortage adds an unwelcome layer of complexity to routine prescribing. But with proactive communication, smart use of alternatives, and tools like Medfinder, you can minimize the impact on your patients and your practice.

The patients who struggle most are those who don't know about the shortage until they're standing at a pharmacy counter with a sick child. By addressing it proactively, you give them the information and tools they need to get treatment quickly — even when the supply chain falls short.

For the clinical details on the shortage, see our provider shortage briefing. For cost-saving resources to share with patients, see how to help patients save money on Orapred.