Your Patient Needs Prednisolone — and Their Pharmacy Is Out

You've prescribed Prednisolone oral solution for a child with an asthma exacerbation, a patient with a lupus flare, or someone recovering from an allergic reaction. An hour later, your office gets a call: the pharmacy doesn't have it. Can you send a new prescription somewhere else? Can they take something different?

This scenario has become increasingly common. Prednisolone oral solution — particularly the 15 mg/5 mL concentration — has been subject to intermittent shortages since 2020, and the supply situation in 2026 remains inconsistent. As a prescriber, you're often the first person patients turn to when they can't fill their prescription.

This guide provides a practical, step-by-step framework for helping patients navigate Prednisolone availability challenges efficiently.

Current Prednisolone Availability

Before diving into solutions, here's a snapshot of the supply landscape:

• Oral solution (15 mg/5 mL): Most affected by shortages. Availability varies by region and pharmacy.
• Oral solution (5 mg/5 mL): More reliably available, though spot shortages occur.
• Tablets (5 mg): Generally available at most pharmacies.
• Orapred ODT (brand): Available but expensive ($200-$600+) and may require prior authorization.

For a full background on the shortage drivers, see our provider shortage briefing for 2026.

Why Patients Can't Find Prednisolone

Understanding the barriers your patients face helps you address them proactively:

• Limited manufacturer base: Only a few companies produce generic Prednisolone liquid, making supply fragile.
• Wholesaler allocation: During shortages, wholesalers may limit how much each pharmacy can order, creating uneven distribution.
• Seasonal demand: Respiratory illness seasons (October-March) spike demand for pediatric Prednisolone liquid.
• Patient search fatigue: Many patients call 2-3 pharmacies, get told "no," and then call your office feeling stuck.

What Providers Can Do: 5 Actionable Steps

Step 1: Verify Availability Before the Patient Leaves

The single most impactful thing you can do is check availability before prescribing. This prevents the scenario where a patient drives to the pharmacy only to be told the medication isn't in stock.

Medfinder for Providers allows you to search for Prednisolone availability at pharmacies in your area in real time. Checking takes under a minute and can be incorporated into the prescribing workflow by clinical staff.

If your EHR allows it, consider adding a brief note in your Prednisolone order set: "Verify pharmacy stock via Medfinder before sending prescription."

Step 2: Prescribe the Most Available Formulation

If the 15 mg/5 mL concentration is unavailable, consider these options:

• 5 mg/5 mL oral solution: Same drug, lower concentration. The patient takes a larger volume. Adjust the prescribed volume accordingly (e.g., 15 mL of 5 mg/5 mL = 15 mg dose).
• Prednisolone 5 mg tablets: Appropriate for children old enough to swallow small tablets (typically age 6+) and for all adults. Tablets are rarely in shortage.
• Compounded Prednisolone solution: A compounding pharmacy can prepare the liquid from bulk ingredients. Write the prescription specifying "compounding" and include the desired concentration and flavoring if relevant.

Step 3: Have a Go-To Alternative Protocol Ready

When Prednisolone itself is unavailable in any form, have a documented alternative protocol that your team can implement quickly:

For acute pediatric conditions (croup, asthma flare):

• Dexamethasone oral solution — 0.6 mg/kg (max 16 mg) as a single dose for croup; 0.6 mg/kg/day for 1-2 days for mild-moderate asthma exacerbations. Evidence supports comparable efficacy with improved adherence due to shorter duration and better taste.

For adults and older children who can take tablets:

• Prednisone tablets — Equivalent dosing (1 mg Prednisone ≈ 1 mg Prednisolone for practical purposes). Widely available, rarely in shortage. First-line tablet alternative.
• Methylprednisolone (Medrol Dose Pack) — Convenient pre-packaged 6-day taper. 4 mg Methylprednisolone ≈ 5 mg Prednisolone.

For patients with liver disease:

• Prednisolone is preferred because it doesn't require hepatic conversion. If Prednisolone is unavailable, Dexamethasone or Methylprednisolone (both active forms) are better alternatives than Prednisone for these patients.

Step 4: Direct Patients to the Right Pharmacy

When you do identify a pharmacy with stock, send the prescription there directly. Provide the patient with:

• The pharmacy name, address, and phone number
• Confirmation that stock was verified
• Instruction to fill promptly (stock can change quickly during shortages)

If no local pharmacy has stock, consider these referral pathways:

• Independent pharmacies: Maintain a list of 2-3 reliable independents in your area that tend to have better access during shortages.
• Compounding pharmacies: Identify at least one compounding pharmacy your practice can refer to. Compounded Prednisolone liquid typically costs $30-$80 and can be ready same-day or next-day.
• Mail-order pharmacies: For non-urgent needs, mail-order services may have stock. Turnaround is typically 1-3 business days.

Step 5: Empower Patients with Self-Service Tools

Equip patients to help themselves by sharing these resources:

• Medfinder — Patients can search pharmacy availability themselves and find stock without calling your office.
• How to Find Prednisolone in Stock — Our patient-facing guide with step-by-step tips.
• Alternatives to Prednisolone — A plain-language guide patients can review to understand their options before calling your office.

Sharing these resources upfront reduces callbacks and empowers patients to act quickly.

Alternatives at a Glance

Quick reference for common Prednisolone substitutions:

• Prednisone: 1:1 dosing with Prednisolone. Tablets widely available. Requires hepatic conversion. Not ideal for liver disease.
• Dexamethasone: ~6-7x more potent. Much lower doses needed. Liquid available. Longer duration (may reduce total treatment days).
• Methylprednisolone: ~1.25x more potent than Prednisolone. Tablets only (no liquid). Medrol Dose Pack widely available.
• Hydrocortisone: ~0.25x the potency of Prednisolone. Higher doses needed. Best suited for adrenal replacement, not acute anti-inflammatory use.

Workflow Tips for Your Practice

Incorporating shortage awareness into daily operations can significantly reduce patient friction:

1. Morning stock check: Have a staff member check Medfinder for current Prednisolone availability at your top 3-5 pharmacies at the start of each day.
2. Pre-written alternative prescriptions: Create templates in your EHR for Dexamethasone and Prednisone alternatives so switching is a one-click process.
3. After-visit summary language: Include a standard note: "If your pharmacy cannot fill your Prednisolone prescription, please visit medfinder.com to search for availability nearby, or call our office for an alternative prescription."
4. Staff training: Ensure clinical staff understand the shortage situation and can triage patient callbacks efficiently — many can be resolved by sending a new prescription to a pharmacy with stock, without requiring a provider call.
5. Compounding pharmacy relationship: Establish a standing relationship with a local compounding pharmacy. Share their contact information with patients proactively.

Final Thoughts

Drug shortages are a system-level problem, but the impact lands on individual patients and the providers trying to help them. By building shortage awareness into your prescribing workflow, maintaining familiarity with alternatives, and leveraging real-time availability tools like Medfinder for Providers, you can minimize disruption to patient care.

The Prednisolone supply situation will likely remain inconsistent through 2026. Preparation and proactive communication are your best tools for navigating it.

For the full supply timeline and clinical context, see our Prednisolone shortage briefing for providers. For cost guidance to share with patients, see how to save money on Prednisolone.