Provider Briefing: Lorazepam Supply Disruptions in 2026

If your patients have been reporting difficulty filling Lorazepam prescriptions, the issue is real and ongoing. Supply of Lorazepam (Ativan) — both oral and injectable formulations — has been inconsistent across the United States, and the situation remains fluid heading into 2026.

This briefing covers the current state of Lorazepam availability, the factors driving supply constraints, clinical implications for prescribers, and practical tools to help your patients access their medication.

Timeline: How We Got Here

Lorazepam supply disruptions didn't begin overnight. Here's a brief timeline:

• 2016–2020: Lorazepam injection enters the FDA Drug Shortage Database intermittently, driven by manufacturing issues at key producers including Pfizer/Hospira and Akorn. Oral formulations remained largely unaffected.
• 2020–2022: The COVID-19 pandemic triggers a significant increase in benzodiazepine prescribing as anxiety and insomnia rates surge nationwide. DEA manufacturing quotas, set based on historical prescribing data, begin to lag behind actual demand.
• 2023–2024: Tighter supply of multiple benzodiazepines, including Lorazepam oral tablets, becomes apparent. Patients and pharmacists report spot shortages, particularly of certain strengths (notably 1 mg and 2 mg tablets).
• 2025–2026: Supply remains inconsistent. Lorazepam is being manufactured by multiple generic companies, but uneven distribution, quota limitations, and raw material constraints create localized shortages that vary by region and pharmacy.

Prescribing Implications

The supply situation creates several practical challenges for prescribers:

Patient Anxiety About Access

Patients who depend on Lorazepam for daily anxiety management are understandably distressed when they can't fill their prescriptions. This anxiety about medication access compounds their underlying condition. Proactive communication is key — let patients know you're aware of the supply situation and have a plan.

Risk of Abrupt Discontinuation

The most significant clinical concern is unplanned withdrawal. Patients who run out of Lorazepam without a refill are at risk for benzodiazepine withdrawal syndrome, which can include rebound anxiety, insomnia, tremors, autonomic instability, and in severe cases, seizures.

Consider proactive strategies:

• Prescribe slightly ahead of schedule when possible to maintain a small buffer supply
• Ensure patients have a documented taper plan if discontinuation becomes necessary
• Provide a "bridge" prescription or alternative if the primary pharmacy is out of stock

Dose and Strength Flexibility

When a specific strength is unavailable, consider prescribing an alternative strength combination. For example:

• If 2 mg tablets are unavailable: prescribe 1 mg tablets with instructions to take two tablets per dose
• If 1 mg tablets are unavailable: prescribe 0.5 mg tablets with adjusted quantity
• The oral concentrate (Lorazepam Intensol, 2 mg/mL) is another option, though it's less commonly stocked in retail pharmacies

Current Availability Picture

As of early 2026, Lorazepam oral tablets continue to be manufactured by multiple generic companies including Teva, Mylan (Viatris), Leading Pharma, and others. The drug is not formally listed as unavailable by the FDA for oral formulations.

However, real-world availability varies significantly:

• Chain pharmacies (CVS, Walgreens, Rite Aid) may have limited stock due to automated ordering systems and controlled substance inventory management
• Independent pharmacies often have better luck sourcing through regional wholesalers
• Hospital pharmacies face separate challenges with injectable Lorazepam, which has been on the FDA shortage list intermittently

The pattern is one of uneven distribution rather than complete unavailability — the drug exists in the supply chain, but it's not consistently reaching all points of dispensing.

Cost and Access Considerations

From a cost perspective, Lorazepam remains one of the more affordable benzodiazepines:

• Generic cash price: $8–$30 for a 30-day supply (retail); as low as $3–$10 with discount cards
• Insurance coverage: Typically Tier 1 preferred generic on most commercial and Medicare Part D plans, with copays of $0–$10
• Prior authorization: Generally not required, though some plans impose quantity limits (e.g., 60–90 tablets per 30 days)

Cost is rarely the barrier for Lorazepam patients — availability is the primary issue. When counseling patients, emphasize that the challenge is finding stock, not affording the medication.

Tools and Resources for Providers

Several resources can help you and your patients navigate the current supply environment:

Medfinder for Providers

Medfinder offers real-time pharmacy stock data that can help your team direct patients to pharmacies with Lorazepam in stock. Rather than having patients call pharmacy after pharmacy, you can recommend they check Medfinder first.

FDA Drug Shortage Database

The FDA Drug Shortage Database (accessdata.fda.gov/scripts/drugshortages) provides official shortage listings and manufacturer updates. Note that oral Lorazepam may not always appear on this list even during periods of tight supply, as the FDA tracks formal shortages reported by manufacturers rather than localized distribution issues.

ASHP Drug Shortage Resource Center

The American Society of Health-System Pharmacists (ASHP) maintains a drug shortage resource that can be useful for institutional settings dealing with injectable Lorazepam shortages.

Therapeutic Alternatives

When Lorazepam is unavailable, the following alternatives may be appropriate depending on the clinical indication:

• Clonazepam (Klonopin): Longer-acting benzodiazepine; good for patients needing sustained anxiolysis. Approximate equivalence: Lorazepam 1 mg ≈ Clonazepam 0.5 mg.
• Diazepam (Valium): Very long-acting; useful for taper protocols. Approximate equivalence: Lorazepam 1 mg ≈ Diazepam 5 mg.
• Alprazolam (Xanax): Shorter-acting; may be appropriate for panic disorder. Approximate equivalence: Lorazepam 1 mg ≈ Alprazolam 0.5 mg. Note higher abuse potential.
• Hydroxyzine (Vistaril): Non-benzodiazepine option for mild-moderate anxiety; no controlled substance concerns. Not equivalent in potency but appropriate for some patients.

For patients on Lorazepam for seizure management, consult neurology before making substitutions. Anticonvulsant equivalence requires careful clinical judgment.

Looking Ahead

The benzodiazepine supply situation is unlikely to resolve overnight. DEA quota adjustments take time, manufacturer capacity increases require investment, and global supply chain challenges persist.

As a prescriber, the most impactful steps you can take are:

1. Communicate proactively with patients about potential supply issues
2. Build flexibility into prescriptions (consider alternative strengths or short-term alternatives)
3. Direct patients to resources like Medfinder for finding available stock
4. Document taper plans in case of unavoidable discontinuation
5. Monitor for withdrawal in patients who report difficulty obtaining refills

Final Thoughts

Lorazepam remains a valuable and widely prescribed medication for anxiety and related conditions. The current supply challenges require prescribers to be more engaged in the logistics of medication access than we'd ideally like — but with the right tools and awareness, we can help ensure our patients maintain continuity of care.

For real-time availability tools and provider resources, visit medfinder.com/providers. For the patient perspective, you may also want to review our patient-facing shortage update so you know what your patients are reading.