How to Help Your Patients Find Pentasa XR in Stock: A Provider's Guide

When a commonly prescribed medication goes into shortage, the burden falls heavily on providers to help patients navigate the gap. With Pentasa XR (mesalamine extended-release capsules) facing an active shortage in 2026, gastroenterologists, PCPs, and their care teams are fielding an increasing number of calls from patients unable to fill their prescriptions. This guide provides concrete, actionable steps you and your staff can take to support affected patients.

Step 1: Confirm the Shortage Is Real and Document It

Verify the shortage using the ASHP Drug Shortage Database (ashp.org/drug-shortages) or the FDA Drug Shortages database. As of March 2026, the ASHP bulletin confirms mesalamine ER capsules are in active shortage. Document this in your practice management system. When you formally document a shortage, prior authorization requests become easier to approve, and your clinical staff can more efficiently manage incoming patient inquiries.

Step 2: Recommend medfinder to Patients

One of the fastest ways to help your patients is to direct them to medfinder.com. medfinder calls pharmacies near the patient to check which ones have their specific medication and dosage in stock — saving patients hours of frustrating phone calls. Results are texted directly to the patient.

You can add medfinder to your patient education materials, your after-visit summary, or your practice's shortage resource page. During an active shortage like the one currently affecting Pentasa XR, having a reliable tool for patients to find in-stock pharmacies reduces callback volume to your office and prevents patients from going without medication.

Step 3: Update Your Prescribing Workflow for the Shortage

Consider implementing these workflow changes while the shortage persists:

• Send to multiple pharmacies: When writing new Pentasa XR prescriptions, ask patients which pharmacies to try (chain and independent), and e-prescribe to multiple locations simultaneously.
• Specify 250 mg as an alternative strength: The 250 mg capsule may be available when the 500 mg is not. Write the prescription to allow dispensing of four 250 mg capsules as a substitute for two 500 mg capsules per dose.
• Include therapeutic substitution authorization: For patients where a switch to Lialda, Delzicol, or another formulation is acceptable, include a note on the prescription or in a standing order authorizing the pharmacist to substitute if Pentasa XR is unavailable.
• Establish a 90-day supply protocol: When a patient secures Pentasa XR, request a 90-day supply to reduce the frequency of refill searches during the shortage.

Step 4: Proactive Outreach to Affected Patients

Consider running a report from your EHR for all patients currently prescribed Pentasa XR or mesalamine ER and sending a proactive patient message via your portal. A brief message explaining the shortage, recommending patients contact you before they run out, and providing a pharmacy-finding resource like medfinder can prevent a flurry of urgent calls and avoid patients going without medication.

Step 5: Know Your Clinical Substitution Options

When patients cannot find Pentasa XR in any form, the following substitutions are clinically reasonable for most UC patients:

• Lialda 2.4–4.8 g once daily: Preferred for patients who want simpler, once-daily dosing. Takes with food. Generic widely available.
• Delzicol 800 mg TID (active) or 1.6 g daily divided (maintenance): Targets terminal ileum and colon. Approved for children ≥5 years.
• Sulfasalazine 500 mg tablets (generic): Very inexpensive; appropriate for sulfa-tolerant patients. Typical dose 3–4 g daily in divided doses.

Step 6: Managing Insurance for the Brand or Alternatives

Insurance plans that require generic mesalamine ER before covering brand Pentasa will need a prior authorization citing the shortage. For alternative formulations, insurance coverage depends on the patient's formulary — verify before prescribing to avoid surprise copays that lead to non-adherence. Most generic mesalamine formulations (Lialda generic, Delzicol generic) are Tier 1–2 on most commercial and Medicare Part D plans.

For a more detailed clinical overview of the shortage and substitution guidance, read: Pentasa XR shortage: what providers need to know in 2026