Proctofoam-Hc Shortage: A Provider Briefing for 2026

If your patients have been reporting difficulty filling Proctofoam-Hc prescriptions, this article provides the clinical and logistical context you need. While Proctofoam-Hc (Hydrocortisone Acetate 1%/Pramoxine HCl 1% aerosol foam) is not on the FDA's formal drug shortage list, real-world access remains inconsistent in 2026.

This briefing covers the availability timeline, prescribing implications, cost considerations, and practical tools to help your patients access treatment.

Timeline of Availability Issues

Proctofoam-Hc has experienced intermittent supply disruptions over the past several years:

• January 2022: Mylan Specialty L.P. (Viatris) initiated a voluntary retail-level recall of four batches manufactured by Pharmasol Corporation due to quality concerns. This removed significant inventory from pharmacy shelves.
• 2022–2024: Post-recall supply recovery was gradual. The single-source manufacturing arrangement (Pharmasol for Viatris) created a bottleneck in replenishing stock.
• 2024–2025: While production resumed, distribution remained limited. Many chain pharmacies did not restock Proctofoam-Hc as a routine inventory item, particularly given its high cost and relatively narrow patient population.
• 2026 (current): Proctofoam-Hc is technically available through pharmaceutical wholesalers but is frequently not in stock at individual pharmacy locations. Patients report needing to visit multiple pharmacies or wait for special orders.

In Canada, Proctofoam-Hc has been the subject of multiple drug shortage reports filed with the Drug Shortages Canada database, further indicating that supply chain fragility is not limited to the U.S. market.

Prescribing Implications

Proctofoam-Hc remains indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses of the anal region, including hemorrhoids, anal fissures, proctitis, and cryptitis.

Key prescribing considerations in the current environment:

• Verify availability before prescribing. Given inconsistent stocking, consider directing patients to check availability via Medfinder for Providers or advising them to call ahead to their pharmacy.
• Consider generic alternatives proactively. Generic Hydrocortisone/Pramoxine is available in cream, ointment, and lotion formulations. While the delivery mechanism differs (cream vs. aerosol foam), the active ingredients and concentrations are identical.
• Document therapeutic rationale if foam is preferred. For patients with internal hemorrhoids or anal fissures where the foam applicator provides superior intra-anal delivery, documenting the clinical rationale may support prior authorization requests if the insurance plan requires it.
• Be aware of the cost barrier. At $190–$235 per 10g canister (3–5 days of treatment at recommended dosing), Proctofoam-Hc represents a significant out-of-pocket expense for uninsured or underinsured patients.

Current Availability Picture

Proctofoam-Hc's availability challenges stem from structural factors rather than a temporary manufacturing disruption:

• Single-source manufacturing: Pharmasol Corporation is the sole manufacturer of the aerosol foam product for Viatris. No other manufacturer produces a generic or competing aerosol foam formulation of hydrocortisone/pramoxine.
• Limited pharmacy stocking: Due to the high unit cost, relatively low prescription volume, and limited insurance coverage, many pharmacies do not maintain Proctofoam-Hc in regular inventory.
• No generic foam alternative: While generic hydrocortisone/pramoxine is available in cream and ointment forms, no generic aerosol foam equivalent exists on the U.S. market.

Cost and Access Considerations

Understanding the cost landscape helps when counseling patients:

• Brand Proctofoam-Hc: $190–$235 per 10g canister (cash price)
• With discount cards (GoodRx, SingleCare): $160–$210
• Generic Hydrocortisone/Pramoxine cream: From approximately $41 with coupon
• OTC Hydrocortisone cream (1%): $8–$15
• Generic Hydrocortisone suppositories (25mg): $15–$40

Insurance coverage: Many commercial plans, Medicare Part D, and Medicaid plans either exclude Proctofoam-Hc or place it on higher copay tiers. Prior authorization may be required. Generic hydrocortisone/pramoxine cream is more likely to be on formulary.

Patient assistance: Viatris offers a Patient Assistance Program that covers Proctofoam-Hc for qualifying uninsured or underinsured patients. Applications are available at viatris.com or through RxAssist and NeedyMeds.

Tools and Resources for Your Practice

Several resources can help you and your patients navigate Proctofoam-Hc availability:

• Medfinder for Providers — Check real-time pharmacy availability for Proctofoam-Hc and other medications. Integrates into clinical workflows to reduce prescription abandonment.
• Viatris Patient Assistance Program — For uninsured patients meeting income criteria. Apply at viatris.com.
• GoodRx / SingleCare — Discount cards that can reduce the cash price by $25–$50 per canister.
• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs and discount resources.

Therapeutic Alternatives to Consider

When Proctofoam-Hc is unavailable or unaffordable, the following alternatives may be appropriate depending on the clinical scenario:

1. Generic Hydrocortisone/Pramoxine cream (Analpram HC, Pramosone) — Same active ingredients; widely available; significantly less expensive. Best first-line alternative for most patients.
2. Hydrocortisone rectal suppositories — For internal hemorrhoid inflammation. Generic options available at $15–$40.
3. OTC Hydrocortisone 1% cream — Adequate for mild perianal symptoms. No prescription needed.
4. Rectiv (Nitroglycerin 0.4%) — For anal fissures not responding to corticosteroid therapy. Different mechanism of action; significantly more expensive ($500–$700).

For patient-facing information on alternatives, you can share: Alternatives to Proctofoam-Hc.

Looking Ahead

The structural factors driving Proctofoam-Hc's availability challenges — single-source manufacturing, specialized aerosol formulation, limited insurance coverage, and high unit cost — are unlikely to resolve quickly. No new generic aerosol foam competitors are currently in the FDA approval pipeline.

Providers should plan for continued intermittent availability and consider establishing a standard workflow for patients who report difficulty filling their Proctofoam-Hc prescriptions. Having a preferred generic alternative and patient assistance resources readily available can significantly reduce patient frustration and treatment delays.

Final Thoughts

Proctofoam-Hc remains a clinically effective anorectal preparation, but its practical accessibility in 2026 is limited by supply chain and economic factors. By proactively considering generic alternatives, verifying pharmacy availability through Medfinder, and connecting patients with savings resources, you can help ensure your patients get the anorectal relief they need without unnecessary delays.

For additional provider resources, see our companion article: How to Help Your Patients Find Proctofoam-Hc in Stock.