Istalol Shortage Update: What Patients Need to Know in 2026

If you take Istalol (timolol maleate ophthalmic solution 0.5%) for glaucoma or ocular hypertension and you've had trouble filling your prescription, you're not imagining it. Availability of brand-name Istalol and related timolol products has been inconsistent at pharmacies across the country. Here is the current status as of 2026 and what you can do to protect your vision.

Is Istalol Officially in Shortage?

Istalol brand (Bausch + Lomb) is not currently listed on the FDA's Drug Shortage Database. However, patients are experiencing real-world availability issues for several reasons:

• Pharmacy stocking decisions: Many pharmacies have shifted to stocking the FDA-approved generic timolol maleate once-daily 0.5% (approved July 2024) instead of brand-name Istalol, since the generic is therapeutically equivalent and far cheaper.
• Related timolol product shortages: Timolol gel-forming solution (generic Timoptic-XE) has been in shortage, with Sandoz reporting back-ordered supply and no estimated release date. This affects patients who specifically use that formulation.
• Combination product disruptions: Dorzolamide/timolol (generic Cosopt) has faced manufacturing delays from Bausch Health, affecting patients who rely on this combination therapy.

Why Do Timolol Product Shortages Happen?

Ophthalmic solutions like Istalol face unique manufacturing challenges that contribute to supply disruptions:

1. Sterile manufacturing complexity: Eye drops must be manufactured in sterile environments with strict quality controls. Any facility issue, equipment failure, or FDA inspection concern can halt production for extended periods.
2. Concentrated manufacturing: A limited number of companies manufacture generic timolol ophthalmic products. If one major manufacturer experiences delays, it can ripple across the entire market.
3. Rising demand: The CDC estimates approximately 3 million Americans have glaucoma, and this number is growing as the U.S. population ages. Increased demand strains supply chains.
4. Raw material sourcing: Disruptions to active pharmaceutical ingredient (API) suppliers can slow production even when manufacturing facilities are fully operational.

Current Availability of Timolol Products in 2026

Here's a summary of availability by formulation:

• Istalol 0.5% (brand) and generic equivalent: Findable with effort; not at every pharmacy. Call ahead or use a medication finder service.
• Generic timolol 0.5% standard solution (twice daily): More widely available through multiple manufacturers (Apotex and others).
• Timolol gel-forming solution (generic Timoptic-XE): Still in shortage from Sandoz with no estimated release date.
• Timoptic in Ocudose (preservative-free): Available but expensive, ranging from $69 to $285 depending on pharmacy and insurance.

What Should Patients Do Right Now?

Here are the most important steps to protect your access to glaucoma medication:

1. Don't wait until you run out. Start looking for your next refill 2-3 weeks before you run out. Shortage situations can require multiple calls and extra lead time.
2. Ask about the generic. Generic timolol maleate once-daily 0.5% is equivalent to Istalol and costs as little as $6.99 with GoodRx. Most pharmacies that don't stock the Istalol brand will have the generic.
3. Use medfinder to find pharmacies with Istalol in stock. medfinder calls pharmacies in your area and texts you which ones have your medication available.
4. Talk to your ophthalmologist. If you cannot find Istalol or its equivalent, ask your doctor about switching to a widely available alternative like latanoprost or brimonidine.
5. Request a 90-day supply. If your doctor can prescribe a 90-day supply and your insurance allows it, this gives you a larger buffer and reduces how often you need to search for the medication.

How medfinder Helps During Shortages

When pharmacies are inconsistently stocked, spending hours calling around is exhausting. medfinder takes that burden off your shoulders — enter your medication details and location and medfinder calls pharmacies on your behalf, then texts you which ones have it in stock. For a full breakdown of strategies, see our guide: How to find Istalol in stock near you