Hydrocortisone Shortage Update: What Patients Need to Know in 2026

For patients who depend on hydrocortisone daily — whether for Addison's disease, congenital adrenal hyperplasia (CAH), or another condition — access to this medication is not optional. It is essential. And yet, the hydrocortisone shortage that began in 2020 has continued to cause disruptions into 2026.

This guide gives you the most current picture of the hydrocortisone shortage situation, explains what's driving it, and outlines practical steps you can take today.

Current Shortage Status (2026)

As of 2026, hydrocortisone oral tablets remain on the FDA's official drug shortage database, where they were first listed on April 2, 2020. The shortage affects the 5 mg, 10 mg, and 20 mg tablet presentations.

The injectable form (Solu-Cortef) experienced a separate shortage in 2023 related to a manufacturing delay at Pfizer. That injectable shortage was largely resolved by late 2025, with Pfizer reporting all Solu-Cortef presentations available. However, patients should confirm availability with their specific pharmacy or hospital.

How Did the Hydrocortisone Shortage Begin?

The shortage has roots going back to early 2020, when Amneal Pharmaceuticals — one of the primary generic manufacturers — discontinued its entire line of hydrocortisone tablets. This decision removed a significant portion of supply from the market almost overnight.

Simultaneously, the COVID-19 pandemic disrupted global pharmaceutical supply chains and increased demand for corticosteroids in healthcare settings. Greenstone, Pfizer's generic subsidiary, was placed on allocation — meaning pharmacies could only order a limited quantity per month. Pfizer's branded Cortef remained more available but became harder to access due to cost and insurance restrictions.

Key Shortage Events Timeline

April 2020: FDA first lists hydrocortisone tablets as "Currently in Shortage."

Mid-2020: Amneal discontinues all hydrocortisone tablet presentations. Greenstone goes on allocation.

2021: Greenstone 5 mg tablets go on backorder. Pfizer/Cortef remains available for direct ordering by pharmacies.

2023: Solu-Cortef (injectable) experiences separate shortage due to manufacturing delays. Pfizer implements emergency distribution for healthcare providers.

Late 2025: Solu-Cortef injectable shortage largely resolved. Oral tablet shortage continues.

2026: Hydrocortisone oral tablets remain on FDA shortage list. Availability varies regionally and by pharmacy. Brand-name Cortef remains more available but costlier.

Why Doesn't the FDA Just Fix the Shortage?

The FDA has limited tools to compel manufacturers to produce specific drugs. The agency can fast-track review of new generic applications and can encourage manufacturers to voluntarily increase production, but it cannot order a company to make a drug it has chosen not to produce.

The fundamental economics are challenging: hydrocortisone is an old, off-patent drug that sells for very little. The profit margin for manufacturers is thin, meaning there is little financial incentive to invest in expanded production capacity. This same dynamic drives shortages across many older generic drugs.

What Are Patients Doing to Cope?

Patients who have successfully navigated the shortage share several common strategies:

Switching to brand-name Cortef when generics are unavailable and working with their doctor to appeal insurance restrictions

Using compounding pharmacies for precisely dosed capsules, especially for children with CAH

Asking doctors to prescribe a 90-day supply (or mail-order pharmacy) when stock is available, to reduce refill frequency

Connecting with patient advocacy organizations like the National Adrenal Diseases Foundation (NADF) for community tips and advocacy updates

Using medfinder to quickly identify pharmacies with current stock without spending hours on hold

Questions to Ask Your Doctor Right Now

Can you write my prescription for brand-name Cortef and include a note about the shortage to help with insurance coverage?

Should I maintain an emergency buffer supply, and how large should it be?

Do I have an emergency hydrocortisone injection kit and do I know how to use it?

If hydrocortisone becomes completely unavailable, what alternative would you prescribe and at what dose?

When you're ready to search for hydrocortisone near you, medfinder can help you identify pharmacies with stock quickly and without the frustrating phone calls. See also our guide on

how to find hydrocortisone in stock near you.