Relador Shortage Update: What Patients Need to Know in 2026

Patients who rely on Relador — the lidocaine 2.5%/prilocaine 2.5% topical anesthetic cream — have been facing increasing difficulty filling prescriptions in recent years. Here is the most current information available for 2026, including which products are affected, the root causes of the shortage, and what you can do as a patient.

What Is Relador and Who Uses It?

Relador is a brand-name topical anesthetic cream made by Accelis Pharma. It contains lidocaine 2.5% and prilocaine 2.5% — the same combination as the original EMLA cream. It is applied to the skin 45–60 minutes before a procedure to provide numbness for IV placements, blood draws, minor dermatologic surgeries, laser treatments, and other procedures. It is not a controlled substance and does not require any special DEA prescription requirements.

Current Shortage Status in 2026

As of early 2026, lidocaine-containing medications remain on active shortage lists. Key facts:

Injectable lidocaine: Remains on the ASHP drug shortage list continuously since June 2012. As of early 2026, Pfizer has 0.5% flip-top vials and 2% emergency Ansyr syringes on back order. The Abboject LifeShield pre-filled syringes were discontinued in mid-2025.

Lidocaine viscous 2% oral solution: Actively listed on the ASHP shortage list, with Hikma having 100 mL bottles on allocation as of December 2025. ASHP first created this listing on April 12, 2023.

Relador / lidocaine-prilocaine topical cream: Not directly listed on the FDA shortage database as a separate product, but supply is impacted by API-level constraints. Localized stockouts are reported at individual pharmacies across many regions.

Why Is Lidocaine Still in Shortage in 2026?

The lidocaine shortage is a structural problem that has persisted for over a decade. Here's why it remains unresolved:

Manufacturing duopoly: Only two major US manufacturers make injectable lidocaine — Pfizer and Fresenius Kabi USA. When either faces delays, the entire market is disrupted. Eugia US also had multiple formulations discontinued in the first half of 2026.

No domestic API production: The active pharmaceutical ingredient (lidocaine) has no domestic US suppliers registered with the FDA, creating total dependence on overseas supply chains.

Low profitability: Lidocaine is a decades-old generic. Thin margins discourage manufacturers from investing in expanded or redundant production capacity.

Rising demand: An aging US population, more outpatient procedures, and a post-pandemic rebound in elective surgeries have driven demand for local anesthetics to record levels.

How Does This Affect Patients Using Relador?

If you use Relador for topical anesthesia before procedures, the shortage may affect you in these specific ways:

Your pharmacy may be completely out of stock or have very limited quantities

Your pharmacy may carry the generic (lidocaine-prilocaine cream) but not the brand Relador Pak kit

Prices may be higher at some pharmacies due to supply constraints

Your procedure may need to be rescheduled if anesthetic cannot be sourced in time

What's Being Done to Address the Shortage?

Several steps are underway at the manufacturer and regulatory level:

The FDA has implemented expedited review processes for new lidocaine manufacturer approvals

Smaller alternative manufacturers (Sintetica, Avenacy, Afaxys Pharma, Amphastar) have been building inventory through major distributors

Pfizer targeted recovery of the 0.5% 50 mL vials in March 2026 and the 2% emergency syringes in April–May 2026

Medical societies including the AAD (American Academy of Dermatology) have advocated to the FDA for prioritizing lidocaine supply restoration

What You Can Do Right Now

Start your search early — 5–7 days before your procedure, not the day before

Ask your prescriber about generic lidocaine-prilocaine 2.5%/2.5% cream as a substitute — it is therapeutically equivalent and more available

Call multiple pharmacy types: major chains and independent pharmacies may have different stock

Use medfinder to check which pharmacies near you currently have your medication — medfinder is a paid service that calls pharmacies on your behalf and texts you results

Ask your prescriber about alternative topical anesthetics (benzocaine, LMX 4) if Relador and its generics are not available

For a deeper look at your options, see our guide to alternatives to Relador. And if you need help locating Relador at a pharmacy near you, medfinder is here to help.