How to Help Your Patients Find Proctofoam-Hc in Stock

Proctofoam-Hc (Hydrocortisone Acetate 1%/Pramoxine HCl 1% aerosol foam) is a highly effective anorectal preparation that many patients rely on for hemorrhoid and anal fissure relief. Unfortunately, it's also one of the more difficult prescriptions for patients to fill in 2026.

As a prescriber, you can take proactive steps to reduce patient frustration, minimize prescription abandonment, and ensure continuity of care. This guide provides a practical framework for your practice.

Current Availability Landscape

Proctofoam-Hc is manufactured exclusively by Pharmasol Corporation for Viatris (formerly Mylan Specialty L.P.). It is not on the FDA's formal drug shortage list, but availability at the pharmacy level remains inconsistent due to:

• Single-source aerosol foam manufacturing with no generic foam equivalent
• Lingering effects of the January 2022 voluntary recall of four batches
• Low pharmacy stocking rates driven by high unit cost ($190–$235) and limited insurance coverage
• Inconsistent formulary placement across commercial, Medicare, and Medicaid plans

The result: patients often visit multiple pharmacies or wait days for special orders, leading to delayed treatment and increased appointment callbacks.

Why Patients Can't Find Proctofoam-Hc

Understanding the root causes helps you set patient expectations and plan accordingly:

High Cost, Low Stocking Priority

At $190–$235 per 10g canister (providing only 3–5 days of treatment), Proctofoam-Hc is expensive relative to its short duration. Pharmacies with limited shelf space prioritize higher-volume, lower-cost medications. Many chain pharmacies have removed Proctofoam-Hc from their auto-replenishment lists.

Insurance Barriers Reduce Demand

When insurance doesn't cover a medication or requires prior authorization, fewer patients fill the prescription. This reduced demand further discourages pharmacies from stocking it, creating a self-reinforcing cycle of low availability.

No Generic Foam Competition

While generic Hydrocortisone/Pramoxine is available in cream and ointment forms, no manufacturer produces a generic aerosol foam. This means there's no lower-cost foam alternative that pharmacies could stock instead.

What Providers Can Do: 5 Practical Steps

Step 1: Verify Availability Before the Patient Leaves

Before sending a patient to the pharmacy, take 60 seconds to check availability. Direct your staff to use Medfinder for Providers to check real-time pharmacy stock in your area. This simple step can prevent the frustrating experience of a patient arriving at a pharmacy only to find the medication isn't in stock.

Step 2: Prescribe a Generic Alternative as a Backup

Consider writing two prescriptions: one for Proctofoam-Hc and one for generic Hydrocortisone/Pramoxine cream. This gives the patient a backup option if the foam is unavailable. Make sure to explain the difference:

• Proctofoam-Hc (foam): Delivered via applicator for intra-anal use; preferred for internal hemorrhoids and fissures
• Generic Hydrocortisone/Pramoxine cream: Applied topically or with finger/applicator; effective for perianal symptoms; starts at ~$41 with coupon

Document your clinical rationale for the foam formulation if prior authorization is needed.

Step 3: Direct Patients to Independent Pharmacies

If you know of independent pharmacies in your area that reliably stock or can quickly order Proctofoam-Hc, share that information with patients. Independent pharmacies often work with multiple wholesalers and are more flexible about special orders than large chains.

Step 4: Connect Patients with Cost-Saving Resources

Many patients abandon Proctofoam-Hc prescriptions due to cost shock. Proactively share these resources:

• GoodRx / SingleCare: Can reduce the cash price to $160–$210
• Viatris Patient Assistance Program: Free medication for qualifying uninsured/underinsured patients (apply at viatris.com)
• NeedyMeds (needymeds.org): Comprehensive assistance program database

You can also share our patient guide: How to Save Money on Proctofoam-Hc.

Step 5: Set Realistic Expectations

Let patients know upfront that Proctofoam-Hc may require a special order and could take 1–3 business days to arrive. This prevents unnecessary anxiety and repeated calls to your office. Recommend they call the pharmacy before visiting and suggest trying early in the week when wholesale orders are typically placed.

Therapeutic Alternatives at a Glance

When Proctofoam-Hc is unavailable or cost-prohibitive, consider these evidence-based alternatives:

• Generic Hydrocortisone/Pramoxine cream (Analpram HC, Pramosone): Same active ingredients; ~$41 with coupon; best first-line substitute
• Hydrocortisone rectal suppositories (Anusol-HC, generic): For internal hemorrhoid inflammation; $15–$40 generic
• OTC Hydrocortisone 1% cream: For mild perianal symptoms; $8–$15; no prescription needed
• Rectiv (Nitroglycerin 0.4%): For chronic anal fissures unresponsive to corticosteroids; $500–$700; different MOA

For a detailed comparison, see: Alternatives to Proctofoam-Hc.

Workflow Tips for Your Practice

Integrating these steps into your existing workflow doesn't have to be complicated:

• Add a standard note to Proctofoam-Hc prescriptions: Include a note to the pharmacist such as "If unavailable, may substitute generic HC/pramoxine cream" (if clinically appropriate and permitted in your state).
• Create a patient handout: A one-page sheet with pharmacy search tips (including medfinder.com/providers), savings resources, and alternative medication options. Hand this to every patient receiving a Proctofoam-Hc prescription.
• Flag the medication in your EHR: Add an alert or note for Proctofoam-Hc reminding prescribers about availability issues and the recommended backup alternative.
• Follow up proactively: For patients with acute hemorrhoid or fissure symptoms, a 48-hour follow-up call or message to confirm they were able to fill their prescription can catch access problems early.

Final Thoughts

Proctofoam-Hc availability challenges in 2026 are driven by structural market factors that are unlikely to resolve soon. However, by verifying availability before prescribing, offering generic alternatives, connecting patients with savings resources, and building these steps into your workflow, you can significantly reduce treatment delays and patient frustration.

Visit Medfinder for Providers to check real-time medication availability and streamline your prescribing workflow.

For the clinical shortage briefing, see: Proctofoam-Hc Shortage: What Providers Need to Know. For cost-saving strategies to share with patients, see: How to Help Patients Save Money on Proctofoam-Hc.