Scopolamine Shortage: What Providers and Prescribers Need to Know in 2026

The ongoing scopolamine transdermal patch shortage has created real workflow challenges for clinicians across travel medicine, anesthesiology, surgery, and primary care. With Padagis exiting the market in October 2025 and Teva reporting back orders through early 2026, many practices are finding it difficult to prescribe this medication with confidence that patients will be able to fill it. This guide summarizes the clinical landscape, shortage details, alternative protocols, and patient communication strategies.

Current Shortage Status (ASHP, Updated 2026)

The ASHP Drug Shortage Resource Center lists scopolamine transdermal patches as an active shortage. Key details by manufacturer:

Padagis: Discontinued in October 2025 — permanently out of market.

Teva: 10-count and 24-count back ordered, estimated release early March 2026. No disclosed reason.

Currently available: Rhodes (4, 10, 24 ct), Viatris/Mylan (4, 24 ct), Zydus (4, 10, 24 ct), Baxter/Transderm Scop (10, 24 ct). Availability varies by distributor and pharmacy.

FDA Drug Safety Communication: Hyperthermia Risk (June 2025)

On June 18, 2025, the FDA issued a Drug Safety Communication regarding serious hyperthermia events — including fatal cases — associated with scopolamine transdermal use. Anticholinergic agents including scopolamine reduce sweating and can impair thermoregulation. The majority of reported cases involved pediatric patients (under 17) and older adults (over 60).

Clinical implications for providers:

Counsel all patients about the hyperthermia risk; document this counseling.

Instruct patients to avoid external heat sources (heating pads, electric blankets) while wearing the patch.

Exercise additional caution or consider alternatives for patients under 17 or over 60.

Advise patients that symptoms of hyperthermia can persist after patch removal due to residual drug in skin layers.

Remind patients about the aluminum content — patches must be removed before MRI to prevent skin burns.

Clinical Contraindications to Confirm Before Prescribing

The FDA lists two absolute contraindications for scopolamine transdermal:

Hypersensitivity to belladonna alkaloids or any component of the formulation.

Angle-closure glaucoma. Scopolamine's mydriatic effect can precipitate acute angle closure; monitor IOP in patients with open-angle glaucoma.

Use with heightened caution in patients with: prostatic hypertrophy or bladder neck obstruction (urinary retention risk), pyloric obstruction, any patient on concurrent anticholinergics, psychiatric history (scopolamine has been reported to exacerbate psychosis), hepatic or renal impairment (altered clearance), severe preeclampsia (seizure risk with IV/IM forms; avoid transdermal as well).

Evidence-Based Alternatives During Shortage

ASHP notes that meclizine and diphenhydramine may be used for motion sickness prevention but are generally not as effective as scopolamine transdermal. Clinical context should guide selection:

For Motion Sickness Prevention

Meclizine (Antivert) 25–50 mg PO, taken 1 hour before travel, then q24h as needed. OTC 25 mg available; Rx 50 mg available. Less effective than scopolamine for severe motion sickness.

Dimenhydrinate (Dramamine) 50–100 mg PO q4–6h. More sedating than meclizine.

Promethazine 25 mg PO/PR q4–6h. Effective but significantly sedating; suppository form useful when nausea is already present. Contraindicated in children under 2.

For PONV Prevention

Per the Fourth Consensus Guidelines for PONV Management (Gan et al., Anesth Analg 2020), multimodal PONV prophylaxis is preferred for high-risk patients. Alternatives to scopolamine in the surgical setting include:

Ondansetron 4 mg IV at end of surgery (5-HT3 antagonist — different mechanism, highly effective).

Dexamethasone 4–8 mg IV at surgery start (synergistic with ondansetron).

Droperidol 0.625–1.25 mg IV (note QTc monitoring requirements).

Aprepitant 40 mg PO (NK1 antagonist) for high-risk patients.

Helping Patients Find Scopolamine During Shortage

When scopolamine is clinically appropriate and the patient is willing to search for it, direct them to medfinder.com/providers. medfinder calls pharmacies near the patient to check which ones have the medication in stock, then texts the patient the results. This saves patients hours of frustrating phone calls and may prevent them from giving up and going without treatment.

Additionally, advise patients that prescriptions written for Transderm Scop (brand) can usually be filled with any FDA-approved generic (Rhodes, Viatris, Zydus). Encourage them to call pharmacies and ask which manufacturer's product is in stock, then request your office to contact the pharmacy with substitution authorization if needed.

For a provider-specific workflow guide, see: How to Help Your Patients Find Scopolamine in Stock: A Provider's Guide