Provider Briefing: Prednisolone Supply in 2026

Prednisolone oral solution has been one of the more persistent drug shortage stories in recent years, and the disruption hasn't fully resolved. For providers who routinely prescribe this corticosteroid — particularly pediatricians, allergists, pulmonologists, and primary care clinicians — the supply situation continues to affect clinical workflows and patient outcomes.

This article provides a concise, evidence-informed overview of where things stand with Prednisolone supply in 2026, what it means for your prescribing, and what tools are available to help your patients.

Shortage Timeline

Prednisolone sodium phosphate oral solution shortages first appeared prominently on the FDA Drug Shortage Database around 2020, coinciding with broader pharmaceutical supply chain disruptions. Key milestones:

• 2020-2021: Initial shortages reported, primarily affecting the 15 mg/5 mL oral solution. COVID-19 pandemic disrupted manufacturing and distribution chains globally.
• 2022-2023: Shortages intensified, particularly during respiratory illness seasons. Multiple manufacturers reported production delays, including Hi-Tech Pharmacal and Pharmaceutical Associates.
• 2024: Partial recovery, with improved (but not fully stable) supply. Some concentrations remained on the FDA shortage list intermittently.
• 2025-2026: Supply remains inconsistent. The 15 mg/5 mL oral solution continues to be the most frequently affected formulation. Tablets and the 5 mg/5 mL solution have fared better.

Prescribing Implications

The ongoing supply instability creates several clinical considerations:

Formulation Awareness

When writing Prednisolone prescriptions, be aware that not all formulations are equally available:

• 15 mg/5 mL oral solution: Most frequently in shortage. If prescribing this concentration, verify availability before the patient leaves the office.
• 5 mg/5 mL oral solution: Generally more available, though patients will need to take a larger volume for equivalent dosing.
• Prednisolone tablets (5 mg): Usually available. Appropriate for patients who can swallow tablets.
• Orapred ODT: Available but cost-prohibitive for many patients ($200-$600+ without insurance).

Alternative Corticosteroid Protocols

Given supply uncertainty, having established alternative protocols is essential. Evidence-supported alternatives include:

• Prednisone: Equivalent efficacy for most patients with normal hepatic function. Widely available in tablet form. Prednisone oral solution exists but is less commonly stocked. Consider Prednisone as the first-line alternative for patients who can take tablets.
• Dexamethasone oral solution: Well-supported for pediatric croup (single dose of 0.6 mg/kg) and increasingly used for acute asthma exacerbations (0.6 mg/kg/day for 1-2 days). Has the advantage of being available as an oral liquid and having a longer duration of action, potentially reducing total treatment days.
• Methylprednisolone (Medrol Dose Pack): Useful for adult patients needing short-course oral steroid therapy. No liquid form available.

For a patient-facing summary of alternatives, you can direct patients to our article on alternatives to Prednisolone.

Documentation and Prior Authorization

If switching to a brand-name formulation or non-formulary alternative, document the medical necessity and shortage circumstances. Many insurance plans have shortage override protocols that expedite prior authorization when a preferred drug is unavailable. Including reference to the FDA Drug Shortage Database listing can strengthen these requests.

Current Availability Picture

Availability varies significantly by geography, pharmacy type, and wholesaler relationships:

• Chain pharmacies (CVS, Walgreens, Rite Aid) may have allocation limits from their primary wholesalers during shortage periods.
• Independent pharmacies often have access to secondary wholesalers and may have stock when chains don't.
• Compounding pharmacies can prepare Prednisolone oral solution from bulk ingredients — a reliable fallback that more providers are utilizing.
• Hospital pharmacies typically maintain some buffer stock but may restrict outpatient dispensing during acute shortages.

Real-time availability data is accessible through Medfinder for Providers, which allows you to check pharmacy stock in your area before prescribing.

Cost and Access Considerations

Cost remains relatively low for generic Prednisolone, but the landscape varies:

• Generic oral solution: $10-$50 (cash price, typical course)
• Generic tablets: $5-$20
• Orapred ODT (brand): $200-$600+ — often requires prior authorization and may not be covered
• Compounded solution: $30-$80

Generic Prednisolone is typically covered as Tier 1 on most formularies, with minimal copay. However, when shortage-driven switches push patients to brand-name or non-preferred alternatives, out-of-pocket costs can increase substantially.

For patients struggling with costs, prescription discount cards (GoodRx, SingleCare, RxSaver) can reduce cash prices for generic Prednisolone by 20-60%. Patient assistance programs through NeedyMeds and RxAssist may also help uninsured or underinsured patients. Our patient-facing article on saving money on Prednisolone provides detailed guidance you can share.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder offers real-time pharmacy stock checking that can be integrated into your prescribing workflow. Before sending a prescription, verify that the pharmacy has Prednisolone available. This reduces patient frustration and avoids unnecessary delays in treatment initiation.

FDA Drug Shortage Database

The FDA Drug Shortage Database provides official shortage status, affected NDCs, and estimated resolution dates when available. Check periodically to stay current on the supply status of Prednisolone and other commonly prescribed medications.

ASHP Drug Shortage Resource Center

The American Society of Health-System Pharmacists maintains a Drug Shortage Resource Center with clinical recommendations and alternative therapy guidance during shortages.

Practice Workflow Suggestions

• Maintain an updated list of 2-3 pharmacies (including at least one independent and one compounding pharmacy) known to stock Prednisolone liquid
• Include shortage-aware language in after-visit summaries: "If your pharmacy is unable to fill this prescription, please call our office and we can provide an alternative."
• Consider adding a clinical decision support alert for Prednisolone that prompts availability verification
• For pediatric practices: stock a small quantity of Prednisolone oral solution for first-dose dispensing during acute visits when outpatient availability is uncertain

Looking Ahead

The fundamental drivers of Prednisolone oral solution shortages — limited manufacturer base, low profit margins, complex liquid formulation manufacturing, and seasonal demand variability — are structural issues unlikely to resolve quickly. Providers should plan for continued intermittent supply disruptions through at least 2026-2027.

Advocacy through professional organizations for improved generic drug supply chain resilience, support for FDA initiatives to streamline generic approvals, and engagement with pharmacy benefit managers on shortage override policies can all contribute to longer-term improvements.

Final Thoughts

Prednisolone remains an essential medication across multiple specialties and patient populations. While the supply picture in 2026 is better than the worst periods of 2022-2023, it's not yet stable enough for providers to prescribe without considering availability.

Building shortage awareness into your prescribing workflow, maintaining familiarity with alternative protocols, and leveraging tools like Medfinder for Providers will help ensure your patients get the treatment they need — even when their first-choice medication isn't on the shelf.

For a step-by-step guide on helping patients navigate availability challenges, see our companion article: How to Help Your Patients Find Prednisolone in Stock. For the patient perspective on the shortage, share our patient-facing shortage update.