Locoid Shortage: What Providers and Prescribers Need to Know in 2026

Provider Briefing: Locoid Supply and Availability in 2026

If your patients are reporting difficulty filling Locoid (Hydrocortisone Butyrate 0.1%) prescriptions, you're hearing a real and recurring concern. While Locoid is not currently listed on the FDA's formal drug shortage database, brand-name supply — particularly Locoid Lipocream — has been inconsistent across retail pharmacy channels.

This briefing covers the current availability landscape, prescribing considerations, therapeutic alternatives, and tools you can recommend to help patients access their medication.

Timeline: How We Got Here

Locoid, manufactured by Bausch Health (formerly Valeant Pharmaceuticals), has faced intermittent supply challenges over the past several years. Key factors include:

• Manufacturer production variability: Bausch Health's production and distribution of Locoid — especially the Lipocream formulation — has not consistently met retail demand in all markets.
• Formulary and payer shifts: Increasing use of prior authorization and step therapy protocols by insurance plans has reduced routine pharmacy ordering of Locoid, creating a feedback loop where lower demand leads to lower stocking levels.
• Limited generic landscape: While generic Hydrocortisone Butyrate 0.1% is available in cream and ointment forms, the Lipocream vehicle has limited generic competition, constraining supply for patients specifically prescribed that formulation.

Unlike acute drug shortages driven by manufacturing defects or raw material disruptions, the Locoid situation is better characterized as a chronic, low-grade accessibility issue driven by market dynamics.

Prescribing Implications

The intermittent availability of Locoid has several practical implications for prescribers:

Formulary Position

Locoid is typically classified as a Tier 2 or Tier 3 medication on most commercial formularies. Many payers require:

• Step therapy: Trial of a lower-cost mid-potency topical steroid (usually Triamcinolone Acetonide) before approving Locoid
• Prior authorization: Documentation of clinical necessity for the specific formulation
• Quantity limits: Restrictions on tube size or number of tubes per fill

Generic Substitution

When writing prescriptions for Hydrocortisone Butyrate, consider the following:

• Prescriptions written for "Hydrocortisone Butyrate 0.1% cream" or "ointment" can typically be filled with any available generic, improving fill rates.
• Prescriptions specifying "Locoid Lipocream" with "Dispense As Written" (DAW) significantly limit pharmacy options. Unless there's a clinical reason for the Lipocream vehicle specifically, allowing generic substitution improves patient access.
• If the Lipocream vehicle is clinically important (e.g., patient preference, tolerability, specific skin condition), document this in the chart to support prior authorization if needed.

Therapeutic Alternatives

When Hydrocortisone Butyrate is unavailable in any form, the following alternatives offer comparable efficacy for corticosteroid-responsive dermatoses:

• Triamcinolone Acetonide 0.1% cream/ointment — Mid-potency (Group IV-V), widely available, very low cost ($5-$20 generic). First-line alternative for most patients.
• Mometasone Furoate 0.1% cream/ointment — Mid-to-high potency (Group IV), once-daily dosing, good generic availability ($15-$40).
• Betamethasone Valerate 0.1% cream/ointment — Mid-to-high potency (Group III-V depending on vehicle), widely stocked, affordable ($10-$30 generic).
• Desonide 0.05% cream/ointment/lotion — Low potency (Group VI), suitable step-down option for sensitive areas or pediatric patients ($15-$50 generic).

Potency selection should account for the treatment site, condition severity, patient age, and duration of therapy. For detailed patient-facing information on alternatives, see Alternatives to Locoid.

Current Availability Picture

Based on pharmacy-level data and patient reports:

• Generic Hydrocortisone Butyrate 0.1% cream: Generally available at most retail pharmacies
• Generic Hydrocortisone Butyrate 0.1% ointment: Generally available, though stocking is less universal than cream
• Brand-name Locoid Cream/Ointment: Intermittently available; not stocked at all locations
• Brand-name Locoid Lipocream: Most difficult to find; limited stocking at retail pharmacies
• Locoid Solution 0.1%: Least commonly stocked; may require special ordering

We assign Locoid a findability score of 70 out of 100 — indicating it's findable with some effort, but patients may need to check multiple pharmacies or accept generic substitution.

Cost and Access Considerations

Cost remains a barrier for some patients, particularly those without insurance or with high-deductible plans:

• Brand-name cash price: $150-$400+ (varies by formulation and quantity)
• Generic cash price: $30-$80 (15-45g tube)
• With insurance: Typical copay ranges from $5-$75 depending on tier and plan type
• Discount programs: Pharmacy discount cards can reduce generic costs to approximately $20-$50

Bausch Health has periodically offered copay assistance for brand-name Locoid. The Bausch Health Patient Assistance Program may also be available for eligible uninsured patients. Direct patients to our savings guide for current options.

Tools and Resources for Your Practice

Several resources can help you and your patients navigate the Locoid availability challenge:

Medfinder for Providers

Medfinder for Providers offers real-time pharmacy inventory data that you can use to direct patients to pharmacies with confirmed Locoid stock. This reduces call-backs from patients who can't fill their prescriptions and improves first-fill success rates.

Prescribing Best Practices

• Write for "Hydrocortisone Butyrate 0.1%" rather than "Locoid" to allow generic substitution unless there's a specific clinical reason for the brand.
• Include alternative medications on the prescription or in the patient's chart so the pharmacist can contact you quickly if the first choice is unavailable.
• Consider e-prescribing to pharmacies that show stock via real-time inventory tools.

Patient Education

Directing patients to reliable information resources can reduce anxiety and phone calls to your office. Consider sharing:

• How to Find Locoid in Stock Near You
• Locoid Shortage Update for Patients
• What Is Locoid: Uses, Dosage, and What You Need to Know

Looking Ahead

The Locoid availability situation is unlikely to change dramatically in the near term absent new generic entries for the Lipocream formulation or changes in Bausch Health's manufacturing strategy. Prescribers who proactively address availability with patients — through generic substitution, alternative medications, and inventory tools — will see fewer fill failures and better treatment adherence.

We will continue to update this page as new information becomes available. For the latest provider-specific resources, visit Medfinder for Providers.

Final Thoughts

Locoid remains an effective mid-potency topical corticosteroid with a role in managing inflammatory dermatoses. However, its current availability profile requires prescribers to be proactive — allowing generic substitution, having alternative agents in mind, and leveraging real-time inventory tools to support patient access.

By taking these steps, you can minimize the impact of supply disruptions on your patients' care and ensure continuity of treatment for their skin conditions.