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

Moxifloxacin tablets have been listed on the ASHP Drug Shortage Database since December 2023. The listing was most recently updated December 15, 2025, with no resolution date provided. While the drug remains available from select manufacturers, the shortage has created real-world access challenges for patients at pharmacies that primarily stock Teva or Aurobindo moxifloxacin. This briefing provides prescribers with the current supply picture, evidence-based alternative recommendations, and practical strategies for managing patient access in 2026.

Current Supply Status by Manufacturer

As of the most recent ASHP update (December 15, 2025):

Teva Pharmaceuticals: 400 mg tablets, 30-count (NDC 00093-7387-56) — shortage, no reason provided

Aurobindo Pharma: Refused to provide availability information — status unknown

Major Pharmaceuticals: Available

Rising Pharmaceuticals: Available

The oral tablet shortage is manufacturer-specific, not a total market withdrawal. IV moxifloxacin (400 mg/250 mL) has experienced intermittent hospital-level availability issues. Ophthalmic formulations (Vigamox, Moxeza, generics) are generally available and not significantly affected.

Moxifloxacin's Place in the Current Antimicrobial Landscape

Moxifloxacin remains a clinically important 4th-generation fluoroquinolone with a distinct niche:

Enhanced gram-positive and anaerobic activity compared to ciprofloxacin and levofloxacin

Once-daily dosing (400 mg PO/IV) with no renal dose adjustment required

Equivalent bioavailability oral vs IV — seamless oral step-down without dose adjustment

Active component of multi-drug TB regimens (fluoroquinolone-containing regimens for MDR-TB and as alternative to isoniazid when intolerance/resistance present)

Note: not suitable for UTIs due to inadequate urinary concentrations from primary hepatic metabolism

Evidence-Based Alternatives by Indication

When moxifloxacin is unavailable, the following alternatives are supported by current guidelines:

Community-Acquired Pneumonia (CAP)

Respiratory fluoroquinolone monotherapy: Levofloxacin 750 mg PO/IV daily x 5-7 days (IDSA/ATS guideline-recommended; class equivalent for typical and atypical coverage)

Beta-lactam + macrolide combination: Amoxicillin/clavulanate or amoxicillin 1 g TID + azithromycin 500 mg daily (outpatient, mild-to-moderate, no fluoroquinolone contraindication)

Doxycycline: 100 mg BID as monotherapy for outpatient non-severe CAP in patients with no significant comorbidities and low local macrolide resistance

37,665+ patients found their medications in stock

37K+

Find Moxifloxacin In Stock Today →

Acute Bacterial Sinusitis (ABS)

First-line: Amoxicillin-clavulanate 875/125 mg BID x 5-7 days (current IDSA first-line recommendation)

Penicillin allergy: Levofloxacin 500 mg daily x 5 days or doxycycline 100 mg BID x 5-7 days

Note: Per FDA labeling, moxifloxacin (and other fluoroquinolones) should be reserved for ABS only when no alternative treatment options exist, given the risk-benefit profile of the drug class for this indication.

Complicated Skin and Skin Structure Infections (cSSSI)

Beta-lactam options: Amoxicillin-clavulanate, dicloxacillin, or cephalexin for mild infections without MRSA concern

MRSA coverage needed: TMP-SMX or doxycycline for outpatient; vancomycin or linezolid for inpatient

Fluoroquinolone alternative: Levofloxacin 750 mg daily for appropriate outpatient cSSSI cases

Skip the calls, skip the stress.

Find Moxifloxacin In Stock Today →

50K+

Medications
Found

99%

Success
Rate

6+

Hours saved
on average

Complicated Intra-Abdominal Infections (cIAI)

Combination regimens: Ciprofloxacin + metronidazole, levofloxacin + metronidazole, or ertapenem monotherapy are common substitutes

Consider severity: Severe or healthcare-associated infections may require broader coverage with piperacillin-tazobactam or carbapenems per IDSA/SIS guidelines

FDA-Updated Fluoroquinolone Prescribing Guidance

A key regulatory context for any fluoroquinolone prescribing decision: in 2016, the FDA issued updated guidance restricting fluoroquinolone use for uncomplicated infections (acute sinusitis, acute bronchitis, uncomplicated UTIs) to situations where no alternative treatment options exist, due to the risk of serious, potentially irreversible adverse effects including tendinopathy, peripheral neuropathy, and CNS reactions. Additionally, the FDA added warnings for aortic aneurysm and dissection risk in 2018.

When switching from moxifloxacin to another fluoroquinolone due to shortage, inform patients that the same boxed warning risks apply to levofloxacin and ciprofloxacin.

Supporting Patient Access: Practical Tools

When prescribing moxifloxacin during the current shortage, proactively guide patients toward locating their medication. medfinder for Providers helps prescribers support patient access by contacting pharmacies to check real-time availability. This can reduce treatment delays and unnecessary callbacks asking for alternative prescriptions.

Monitor ASHP Drug Shortage Resource Center for the latest moxifloxacin bulletin updates

Advise patients to ask their pharmacist about ordering from Major or Rising Pharmaceuticals if their usual supplier is out of stock

Have a second prescription ready (e.g., levofloxacin) to avoid treatment delays if moxifloxacin cannot be located in the patient's area within 24 hours

See also: How to Help Your Patients Find Moxifloxacin in Stock: A Provider's Guide