Promethazine Shortage Update: What Patients Need to Know in 2026

If you've heard that promethazine is in shortage and you're wondering whether your prescription is affected, the answer depends on the form your doctor prescribed. The shortage in 2026 primarily impacts the injectable form of promethazine — used in hospitals and surgical centers — not the oral tablets, syrup, or suppositories that most outpatients use.

Here's everything you need to know about the 2026 promethazine shortage, including what's causing it, what's still available, and what your options are.

2026 Promethazine Shortage: What's Actually Happening?

According to the American Society of Health-System Pharmacists (ASHP), promethazine hydrochloride injection is listed as an active shortage. Specifically:

• Promethazine 25 mg/mL, 1 mL ampules: On back order with an estimated release date of late January 2026
• Promethazine 50 mg/mL, 1 mL ampules (X-Gen): On back order with no estimated release date

These injectable forms are used almost exclusively in clinical settings — emergency departments, operating rooms, and procedure suites. They are not dispensed at retail pharmacies. So if you fill a prescription at CVS, Walgreens, Walmart, or an independent pharmacy, you are getting oral tablets, syrup, or suppositories — and those are NOT affected by the current shortage.

What Forms of Promethazine Are Still Available?

The following promethazine forms remain available in 2026:

• Oral tablets (12.5 mg, 25 mg, 50 mg): Widely available at most pharmacies. Most patients take this form.
• Oral syrup (6.25 mg/5 mL): Generally available, may need to be ordered at some smaller pharmacies.
• Rectal suppositories (12.5 mg, 25 mg): Available but stocked less commonly. Call ahead or ask your pharmacist to order.

Why Is the Injectable Form in Shortage?

Sterile injectable medications are among the most technically challenging drugs to manufacture. They require aseptic (germ-free) production facilities, precise quality control, and complex packaging. When a manufacturing line experiences quality issues, or a key supplier falls behind, the resulting shortage can ripple for months.

Contributing factors to the current promethazine injection shortage include:

• Manufacturing back orders from key suppliers including X-Gen Pharmaceuticals
• Limited number of manufacturers producing sterile injectable promethazine
• Low profit margins on old generic injectables, reducing incentives to maintain large production buffers
• Supply chain fragility — API components often sourced internationally

How Does This Shortage Affect Patients at Home?

For most patients who take promethazine at home, the injectable shortage has little direct impact. If you take oral tablets or suppositories, your pharmacy supply is generally not affected.

Where patients may feel the impact indirectly:

• If you had surgery and expected IV promethazine for postoperative nausea, your care team may substitute ondansetron or another antiemetic
• If you visited an emergency department and expected injectable promethazine for severe nausea, your provider may have used a different IV antiemetic

These substitutions are clinically appropriate and should not significantly affect your care. If you have concerns about a specific treatment substitution you received, ask your care team to explain the reasoning.

What Should Patients Do If They Can't Find Promethazine Tablets?

If you're having trouble filling a promethazine tablet or suppository prescription, the issue is most likely a localized stocking problem at your specific pharmacy, not a national shortage of oral forms. Here's what to do:

1. Call 2-3 other pharmacies in your area and ask if they have your specific form and dose in stock
2. Ask your pharmacist to check their wholesaler's expected delivery date
3. Use medfinder to find pharmacies with promethazine in stock near you
4. If unavailable anywhere, ask your doctor if ondansetron or another antiemetic can be prescribed temporarily

How to Stay Informed About the Promethazine Shortage

The most reliable sources to track the promethazine injection shortage are the ASHP Drug Shortage Database and the FDA Drug Shortage Database at fda.gov. Both are updated as new information becomes available from manufacturers.

Bottom Line

The promethazine shortage in 2026 primarily affects the injectable form used in hospitals — not the oral tablets most patients take at home. If you're struggling to fill an oral promethazine prescription, use medfinder.com to locate it at a nearby pharmacy, or talk to your doctor about promethazine alternatives in the meantime.