Leucovorin in 2026: What's the Current Shortage Situation?

If you or a loved one depends on Leucovorin for cancer treatment or methotrexate rescue, you've likely been affected by the ongoing shortage. Leucovorin Calcium — a critical medication used alongside chemotherapy drugs like 5-Fluorouracil (5-FU) and as a rescue agent after high-dose methotrexate — has been difficult to find for years. Here's where things stand in 2026.

Is Leucovorin Still in Shortage?

Yes. As of early 2026, Leucovorin remains in an active shortage, particularly the injectable formulation. According to ASHP (American Society of Health-System Pharmacists), the Leucovorin Calcium injection 500 mg vials continue to be on back order from multiple manufacturers, with some companies unable to estimate release dates.

The oral tablet form has also experienced intermittent supply disruptions. The FDA has taken the unusual step of allowing temporary importation of Leucovorin (Calcium Folinate) 5 mg tablets from Canada, manufactured by Farmasierra in Spain for Pfizer. This speaks to the severity of the domestic supply problem.

Why Is Leucovorin So Hard to Find?

The Leucovorin shortage is not new — it's a recurring problem that has plagued the U.S. drug supply since 2008. Here are the main reasons:

• Limited manufacturers: Only a small number of companies make generic Leucovorin. When any one of them halts production, the ripple effect is significant.
• Manufacturing complexity: Producing sterile injectable medications requires specialized facilities. Quality control issues or facility upgrades can sideline production for months.
• Rising demand: Colorectal cancer is the third most common cause of cancer death in the U.S. Leucovorin-containing regimens like FOLFOX and FOLFIRI remain standard of care, sustaining high demand.
• Supply chain fragility: Global supply chain disruptions affecting raw materials and shipping have compounded the problem.

For more background, read our detailed explainer on why Leucovorin is so hard to find.

How Much Does Leucovorin Cost in 2026?

The cost of Leucovorin varies depending on the formulation and where you fill your prescription:

• Oral tablets (5 mg, 12 tablets): Cash price averages around $36, though discount cards from GoodRx and SingleCare can bring the price down to approximately $24-$25.
• Injectable formulations: Prices for injection vials range widely from $30 to over $500 depending on the vial size and supplier. Hospital and clinic pricing may differ from retail.
• Brand Wellcovorin: Significantly more expensive than generic. Prescription Hope offers it for $70/month through their patient assistance program.

If cost is a concern, check out our full guide on how to save money on Leucovorin.

Are There New Options Available?

The most important alternative remains Levoleucovorin (brand names Fusilev and Khapzory). This medication is the active isomer of Leucovorin and can be used at half the dose for the same indications. It was FDA-approved in 2008 specifically because of Leucovorin shortages, and it remains a viable substitute in 2026.

The FDA's temporary importation program for Leucovorin tablets from Canada is also helping fill gaps in the oral tablet supply. Your pharmacy may carry the imported product (labeled as Lederle Leucovorin or Calcium Folinate).

Read our comparison of Leucovorin alternatives for more details.

How to Find Leucovorin in Stock

Even during a shortage, Leucovorin can still be found. Here are your best strategies:

1. Search on Medfinder: Check real-time pharmacy availability in your area.
2. Try independent and specialty pharmacies: They may have access to different distributors.
3. Contact your oncologist or infusion center: Hospital-based supply chains often have stock that retail pharmacies don't.
4. Ask about Levoleucovorin: Your doctor can write a new prescription for this interchangeable alternative.
5. Check for FDA-imported supply: Ask your pharmacy if they carry the imported Leucovorin tablets from Pfizer/Farmasierra.

For a complete guide, see our post on how to find Leucovorin in stock near you.

Final Thoughts

The Leucovorin shortage in 2026 is a continuation of a problem that has persisted for over 15 years. While systemic solutions require changes in manufacturing capacity and policy, there are concrete steps you can take today to find your medication and stay on track with your treatment. Use Medfinder to search for availability, talk to your doctor about alternatives, and don't hesitate to explore patient assistance programs if cost is a barrier.

For provider-focused information, see our Leucovorin shortage guide for providers.