How to Help Your Patients Find Zilxi in Stock

As a dermatologist or prescriber, you may find that one of the biggest challenges with Zilxi (Minocycline topical foam, 1.5%) isn't the clinical decision to prescribe it — it's making sure your patient can actually fill the prescription. This guide provides a practical, step-by-step approach to helping your patients navigate the availability challenges that come with this specialty rosacea treatment in 2026.

Current Availability Landscape

Zilxi is not in an official drug shortage as of early 2026. However, the practical reality is that many pharmacies do not stock it. This is driven by:

• Single-source supply — Journey Medical Corporation is the sole manufacturer; no generics exist
• Low retail pharmacy stocking — Many chain pharmacies don't carry Zilxi due to low prescription volume
• Cost barriers — At $400-$600 per canister (cash price), pharmacies with uncertain demand may not invest in inventory
• Insurance gatekeeping — Step therapy and prior authorization requirements reduce filled prescription volume

Why Patients Can't Find Zilxi

Your patients may report these common scenarios:

1. "My pharmacy says they don't carry it" — The most common experience. Chain pharmacies with automated ordering systems may not pull a specialty item without an active prescription driving demand.
2. "They said they'd order it, but it's been a week" — Distribution delays can occur when a pharmacy's wholesaler doesn't carry the product or has limited allocation.
3. "My insurance won't cover it" — Prior authorization denials or step therapy requirements send patients back to your office, delaying treatment.
4. "I can't afford the copay" — Even with insurance, specialty tier copays can be $100+ without the manufacturer savings card.

What Providers Can Do: 5 Practical Steps

Step 1: Check Availability Before the Patient Leaves

Use Medfinder for Providers to check which pharmacies near your patient's home or workplace currently have Zilxi in stock. This takes seconds and can save your patient days of frustration calling pharmacies.

Consider making this a standard part of your workflow when prescribing Zilxi or any other specialty medication.

Step 2: Send the Prescription to a Pharmacy With Confirmed Stock

Rather than sending the prescription to the patient's default pharmacy, direct it to a pharmacy where you've confirmed availability. If the patient uses a specific pharmacy for insurance reasons, call ahead or have your staff verify stock before sending.

Step 3: Complete Prior Authorization Proactively

Don't wait for the pharmacy to trigger the PA process. If you know the patient's insurer requires prior authorization for Zilxi:

• Submit the PA request at the time of prescribing
• Document previous treatment failures clearly (specific agents, dates, outcomes)
• Include supporting clinical rationale for why Zilxi is medically necessary
• Use payer-specific forms when available to reduce back-and-forth

Proactive PA submission can cut days off the time to fill.

Step 4: Activate the Manufacturer Savings Card

For commercially insured patients, the Zilxi Savings Card can reduce copays to as little as $25 per prescription. Help patients enroll during their visit or direct them to zilxi.com to sign up. Note: the savings card is not valid for patients with government insurance (Medicare, Medicaid, Tricare).

Step 5: Have a Backup Plan Ready

When prescribing Zilxi, consider also discussing backup options with your patient in case of access delays. Prescribing a bridge therapy — such as topical Metronidazole or Azelaic Acid — can prevent treatment gaps while the Zilxi prescription is being filled.

Alternative Treatments to Discuss

When Zilxi simply isn't accessible for a patient, evidence-based alternatives include:

• Metronidazole 0.75%-1% gel/cream — Available as generic; widely stocked; first-line per most guidelines
• Ivermectin 1% cream (Soolantra) — Once-daily application; effective for papulopustular rosacea; generic availability expanding
• Azelaic Acid 15% gel (Finacea) — Good for both inflammatory lesions and background erythema; generic available
• Doxycycline 40mg MR (Oracea) — Oral option for moderate-to-severe cases; sub-antimicrobial dose minimizes resistance concerns; generic Doxycycline available at low cost

For patient-facing information on alternatives, you can share this resource: Alternatives to Zilxi.

Workflow Tips for Your Practice

Incorporating these habits into your practice can reduce Zilxi access friction for patients:

Designate a Pharmacy Point Person

Assign one staff member to handle specialty medication logistics — checking stock, submitting PAs, and coordinating with pharmacies. This concentrates expertise and creates a smoother process.

Build a Pharmacy Network

Identify 2-3 pharmacies in your area that reliably stock or quickly order Zilxi. Maintain these relationships so you always have a go-to recommendation for patients. Independent and specialty pharmacies tend to be the most responsive.

Use Medfinder as a Standard Tool

Bookmark Medfinder for Providers on your office workstations. Train your MA or nursing staff to check availability as part of the prescription workflow.

Keep Samples When Available

If your Journey Medical representative provides Zilxi samples, maintain a supply for patients who are navigating PA delays or pharmacy availability issues. Even a 1-2 week supply can bridge the gap.

Document Everything

Thorough documentation of treatment history (prior agents tried, duration, response, adverse effects) makes PA submissions faster and more likely to succeed. Create a templated note section for rosacea treatment history to standardize this across your practice.

Final Thoughts

Zilxi is a clinically differentiated treatment for inflammatory rosacea, and your patients deserve access to it when it's the right choice. By proactively checking availability with Medfinder, streamlining the prior authorization process, and maintaining backup strategies, you can significantly reduce the access challenges your patients face.

For the latest on Zilxi availability and shortage status, see our provider shortage briefing. For help navigating costs, read our provider's guide to helping patients save money on Zilxi.