Provider Briefing: Proctofoam HC Availability in 2026

If your patients have been reporting difficulty filling Proctofoam HC prescriptions, they're experiencing a real and ongoing supply problem. This briefing covers the current state of Proctofoam HC availability, the factors driving the shortage, prescribing implications, and practical tools to help your patients access treatment.

Background: What Is Proctofoam HC?

Proctofoam HC (Hydrocortisone Acetate 1% / Pramoxine Hydrochloride 1%) is a topical aerosol foam indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses of the anal region. The combination of a low-potency corticosteroid with a local anesthetic in a foam vehicle makes it a preferred choice for many patients with hemorrhoids, anal fissures, and pruritus ani.

The foam formulation offers advantages over creams and suppositories: improved mucosal adherence, even distribution, and generally higher patient acceptance and compliance.

Timeline: How We Got Here

The Proctofoam HC supply issue is not a sudden event but a gradual decline:

• 2000s-2010s: Schwarz Pharma manufactured brand-name Proctofoam HC. UCB acquired Schwarz Pharma in 2008.
• Mid-2010s: Brand-name production was significantly scaled back. UCB shifted focus to its core neurology and immunology portfolio.
• 2018-2022: Generic manufacturers intermittently produced Hydrocortisone-Pramoxine foam, but supply remained inconsistent due to the specialized nature of aerosol foam manufacturing.
• 2023-2026: Availability continues to be sporadic. The product is not formally listed on the FDA Drug Shortage Database as of early 2026, but real-world availability remains severely limited.

Prescribing Implications

The shortage has several practical implications for prescribers:

Prescription Fulfillment Failures

Patients are frequently reporting that pharmacies cannot fill Proctofoam prescriptions. This leads to treatment gaps, worsening symptoms, and patient frustration. Providers should proactively discuss availability with patients before prescribing.

Therapeutic Substitution Considerations

When Proctofoam is unavailable, the following substitutions should be considered based on clinical presentation:

• Pramosone Cream/Lotion (Hydrocortisone 1% / Pramoxine 1%): Same active ingredients in a cream or lotion vehicle. Most direct therapeutic equivalent. Generics are more widely available.
• Hydrocortisone Rectal Cream 2.5% (Anusol-HC generic): Higher corticosteroid concentration without the anesthetic component. Appropriate when inflammation is the primary concern.
• Compounded Hydrocortisone-Pramoxine preparations: Compounding pharmacies can prepare custom formulations. Consider this for patients who specifically need both active ingredients.
• Epifoam (Hydrocortisone 1% / Pramoxine 1% topical foam): Same ingredients in foam form, though labeled for dermatologic rather than rectal use. Off-label prescribing may be appropriate.

Prior Authorization and Coverage

Insurance coverage for Proctofoam HC varies significantly:

• Some plans cover brand or generic with standard copays ($20-$50)
• Others require prior authorization or step therapy (typically requiring trial of OTC Hydrocortisone first)
• Some plans have removed Proctofoam from formulary entirely due to availability issues

Prescribing generic "Hydrocortisone-Pramoxine rectal foam" rather than brand-name Proctofoam HC may improve insurance coverage and pharmacy fulfillment rates.

Current Availability Picture

As of early 2026, Proctofoam HC availability is best characterized as "intermittently available with significant regional variation." Key observations:

• Chain pharmacies (CVS, Walgreens) frequently report out-of-stock status
• Independent pharmacies with diverse wholesaler relationships may have better success sourcing the product
• Mail-order and specialty pharmacies occasionally have inventory
• The product is not consistently available through any single distributor

Cost and Access Considerations

Pricing for Proctofoam HC remains elevated due to limited competition:

• Brand-name: $200-$500+ per 10 g canister (cash price)
• Generic foam: $50-$150 per canister with discount card
• Alternative cream formulations: $15-$80 for generic Pramosone or Hydrocortisone rectal cream

For patients facing cost barriers, discount programs (GoodRx, SingleCare) and patient assistance programs (NeedyMeds, RxAssist) may help. Direct patients to: How to Save Money on Proctofoam.

Tools and Resources for Your Practice

Medfinder for Providers offers real-time pharmacy availability data that can help you and your staff:

• Check Proctofoam stock at pharmacies near your patients before writing prescriptions
• Direct patients to specific pharmacies that currently have stock
• Reduce prescription fulfillment failures and patient callbacks

Additional resources:

• FDA Drug Shortage Database: accessdata.fda.gov/scripts/drugshortages — check for formal shortage listings
• ASHP Drug Shortage Resource Center: Provides updates on medication shortages affecting hospital and community pharmacy
• Compounding pharmacy directories: PCCA (Professional Compounding Centers of America) can help locate compounding pharmacies in your area

Looking Ahead

There are no announced plans for new manufacturers to enter the Hydrocortisone-Pramoxine foam market in the near term. The specialized manufacturing requirements continue to limit competition. However:

• Generic cream formulations remain reliably available and represent the most practical alternative for most patients
• Compounding options continue to expand as more pharmacies develop rectal preparation capabilities
• Real-time pharmacy search tools like Medfinder make it easier to locate available stock when it does appear

Final Thoughts

The Proctofoam HC shortage requires a proactive approach from prescribers. Consider discussing availability upfront with patients, have alternative prescribing strategies ready, and leverage tools like Medfinder for Providers to streamline the process.

For a patient-facing version of this information to share with your patients, see: Proctofoam Shortage Update: What Patients Need to Know in 2026.

For a step-by-step workflow guide, read: How to Help Your Patients Find Proctofoam in Stock.