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

Prescribers seeing patients who use Pandel (hydrocortisone probutate 0.1% cream) are increasingly encountering a familiar problem: the prescription gets written, and then the patient can't fill it. Understanding the underlying reasons — and having a prepared clinical response — helps you manage this efficiently for your patients.

Current Availability Status of Pandel in 2026

Pandel is not listed on the FDA's official drug shortage database as of 2026. The product continues to be manufactured and distributed by ANI Pharmaceuticals. However, pharmacists and patients report consistent difficulty finding it on pharmacy shelves — particularly at smaller community pharmacies and in rural areas. This is a structural availability issue driven by three key factors:

No generic equivalent: Hydrocortisone probutate has no FDA-approved generic. Every prescription requires the ANI Pharmaceuticals brand product.

Limited routine stocking: Pharmacies optimize shelf space around the highest-volume generics. Pandel's relatively low prescription volume means many pharmacies stock it inconsistently or only on a per-order basis.

Formulary barriers: As a brand-name drug, Pandel is Tier 3 or higher on many commercial formularies and may require prior authorization, step therapy, or fail-first requirements.

Clinical Profile: What Makes Pandel Clinically Distinct?

Pandel contains hydrocortisone probutate, a synthetic double ester of hydrocortisone (specifically, hydrocortisone 17-butyrate 21-propionate). Vasoconstrictor assay data confirm it falls in the medium potency range among topical corticosteroids. It is formulated as a cream with a propylene glycol and petrolatum base, which provides a cosmetically acceptable vehicle for use on inflammatory and pruritic dermatoses.

FDA-approved indications include atopic dermatitis, contact dermatitis, seborrheic dermatitis, plaque psoriasis, lichen simplex chronicus, and other corticosteroid-responsive dermatoses in patients 18 years of age or older. Pandel is applied once or twice daily as a thin film, with therapy discontinued when control is achieved.

HPA Axis Suppression: Key Clinical Consideration

In a 2017 FDA-reviewed open-label HPA axis suppression study, 19 adult subjects with atopic dermatitis or plaque psoriasis covering more than 20% body surface area (BSA) were treated with Pandel twice daily for 21 days. At baseline, mean disease BSA was 36%. Of the 15 evaluable subjects, 1 of 15 (6.7%) showed HPA axis suppression, defined as a serum cortisol level ≤18 mcg/dL at 30 minutes post-cosyntropin stimulation. This is consistent with medium-potency topical corticosteroid behavior.

Factors predisposing to HPA axis suppression with any topical corticosteroid include: large BSA treatment, prolonged duration, occlusive dressings, altered skin barrier, hepatic impairment, and younger age. Periodic evaluation with ACTH stimulation testing is recommended when these risk factors are present.

Appropriate Alternative Prescribing When Pandel Is Unavailable

When Pandel is unavailable or not covered, consider these evidence-based alternatives at a comparable potency level:

Hydrocortisone butyrate 0.1% (Locoid): Chemically most similar to Pandel. Generic available. Widely stocked.

Triamcinolone acetonide 0.1% cream: Medium potency. Generic, inexpensive, widely available. Appropriate for body (not face/folds).

Mometasone furoate 0.1% cream: Medium potency. Generic available. Once-daily dosing favorable for adherence.

Desonide 0.05% cream: Lower potency. Appropriate for face, folds, and sensitive areas. Generic available.

Tacrolimus ointment (Protopic) 0.1%: Non-steroidal calcineurin inhibitor. Appropriate for atopic dermatitis, especially face/flexures. No skin thinning risk.

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Documenting Medical Necessity for Prior Authorization

If you are prescribing Pandel and your patient's insurance requires prior authorization, document the following in your PA request:

Specific indication and ICD-10 code

Failure or intolerance to specific named generics (triamcinolone, mometasone), if applicable

Clinical rationale for choosing hydrocortisone probutate's specific vehicle/potency combination

Treatment site considerations (sensitive skin locations, barrier dysfunction)

How medfinder Supports Your Patients' Access to Pandel

medfinder for providers is a tool you can recommend to patients who are struggling to locate Pandel at their pharmacy. medfinder calls pharmacies in the patient's area, checks which ones can fill the prescription, and texts the patient the results. This removes the burden of pharmacy hunting from both the patient and your staff, and ensures your patients can quickly locate a pharmacy that has the medication before their condition worsens.

Skip the calls, skip the stress.

Find Pandel In Stock Today →

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Summary for Prescribers

Pandel is not in a declared shortage, but its brand-only status and limited routine stocking create access challenges for patients. When writing for Pandel, consider alerting patients that they may need to call ahead or use a pharmacy search service. If prior authorization is required, document fail-first requirements thoroughly. When a clinical equivalent is appropriate, hydrocortisone butyrate 0.1% (Locoid) is the most structurally similar generic alternative. For more information patients can share with their pharmacy, see Pandel shortage update for patients.