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

When a patient calls your office to say their pharmacy can't fill their Vancomycin prescription, the clock is ticking. Whether they need oral Vancomycin for a C. difficile infection or were discharged from the hospital expecting outpatient IV Vancomycin therapy, supply disruptions can turn a clinical plan into a patient crisis.

This guide provides a practical, step-by-step approach for providers to help patients locate Vancomycin during the ongoing 2026 shortage — and what to do when it truly can't be found.

Current Availability Snapshot

As of February 2026:

• IV Vancomycin injection: Active shortage per ASHP. Institutional supply chains (hospitals, infusion centers) generally have better access than retail pharmacies. Manufacturer allocations are in effect
• Oral Vancomycin capsules (125 mg, 250 mg): Available at most pharmacies, but stock may be inconsistent. Multiple generic manufacturers producing
• Firvanq oral solution (Azurity): Generally available by prescription. Cash price $122-$593 for 150 mL
• Compounded oral solution: Available through compounding pharmacies using IV vancomycin powder

Why Patients Can't Find It

Understanding the barriers helps you troubleshoot more effectively:

• Distributor allocation: During shortages, wholesalers limit quantities per pharmacy, leaving some locations with zero stock
• Chain pharmacy limitations: Large chains have centralized purchasing and may not be able to source from secondary distributors
• Cost confusion: Some patients find Vancomycin available but unaffordable. Brand Vancocin capsules can cost over $4,400 without a coupon, while generic with discount is $39-$120
• Form confusion: Patients may not know that oral solution or compounded preparations are alternatives to capsules
• IV access barriers: Outpatient IV Vancomycin requires infusion center access, home infusion services, or PICC line management — not always easily arranged

What Providers Can Do: 5 Steps

Step 1: Direct Patients to Medfinder

The most efficient first step is pointing patients to Medfinder. This tool searches real-time pharmacy availability by zip code, saving patients hours of phone calls.

You can also use Medfinder yourself during the appointment to identify pharmacies with stock and send the prescription directly there.

Step 2: Prescribe Flexibly

Build flexibility into the prescription:

• Allow substitution: Write for "Vancomycin" rather than "Vancocin" to allow generic dispensing
• Include oral solution as an option: Some patients have trouble with capsules. Firvanq or compounded solution may be easier to find
• Send to multiple pharmacies: If your EHR allows, send the prescription to a backup pharmacy in case the primary is out of stock
• E-prescribe with DAW 0: Ensure the prescription allows any generic manufacturer

Step 3: Consider Compounding

For oral Vancomycin, compounding is a reliable backup during the capsule shortage:

• IV Vancomycin powder can be reconstituted and prepared as an oral solution by compounding pharmacies
• The taste is unpleasant, so pharmacies often add flavoring
• Ensure the patient understands proper storage and dosing of the compounded product
• Contact local compounding pharmacies proactively to establish this as an available option for your practice

Step 4: Coordinate With Hospital/Infusion Services

For patients needing IV Vancomycin:

• Hospital outpatient pharmacies often have access to institutional supply chains
• Home infusion companies (e.g., Option Care Health, BioScrip/PharMerica) may have dedicated Vancomycin supply
• If transitioning from inpatient to outpatient, coordinate with the discharge pharmacy to ensure supply continuity
• Consider whether the patient can complete therapy in the hospital before discharge if outpatient supply is uncertain

Step 5: Use Discount Programs to Address Cost Barriers

If the patient finds Vancomycin but can't afford it:

• GoodRx or SingleCare coupons: Can reduce generic oral Vancomycin from $500+ to as low as $39
• NeedyMeds and RxAssist: Patient assistance program databases
• Hospital charity care: May cover IV Vancomycin administered in facility settings
• Azurity copay assistance: May be available for brand Firvanq

See our detailed guide: How to help patients save money on Vancomycin.

When to Consider Alternatives

If Vancomycin truly cannot be located or afforded, consider switching based on the indication:

For C. Difficile Infections

• Fidaxomicin (Dificid): Preferred by IDSA/SHEA guidelines for initial and recurrent C. diff. Lower recurrence rates than Vancomycin. Cost is high but manufacturer programs exist
• Metronidazole (Flagyl): Less effective than Vancomycin for C. diff per current guidelines, but still used for mild initial episodes when Vancomycin is unavailable

For MRSA and Gram-Positive Infections

• Daptomycin (Cubicin): MRSA bacteremia, skin infections, right-sided endocarditis. Not for pneumonia
• Linezolid (Zyvox): MRSA pneumonia, skin infections, osteomyelitis. Oral and IV. Monitor platelets
• Telavancin (Vibativ): Hospital-acquired pneumonia, complicated skin infections
• TMP-SMX: Uncomplicated MRSA skin infections (oral option)

For complete details, see alternatives to Vancomycin.

Workflow Tips

To streamline shortage management across your practice:

• Create a shortage protocol: Document alternative agents and compounding options so any provider in your group can act quickly
• Bookmark Medfinder for Providers: Check availability before sending prescriptions to avoid patient callbacks
• Maintain a compounding pharmacy contact list: Know 2-3 local compounding pharmacies that can prepare oral Vancomycin
• Train front office staff: Give staff a script for handling "I can't find my medication" calls, including directing patients to Medfinder
• Monitor ASHP updates: Check the ASHP drug shortage database monthly for status changes

Final Thoughts

The Vancomycin shortage adds complexity to an already challenging clinical landscape, but with proactive planning and the right tools, you can help patients get the treatment they need. Start with Medfinder for Providers to check real-time availability, build flexibility into prescriptions, and maintain familiarity with alternative agents.

For the broader shortage context, see our provider briefing: Vancomycin shortage: what providers and prescribers need to know in 2026.