Sodium Phosphate Shortage Update: What Patients Need to Know in 2026

If you've recently been prescribed OsmoPrep (sodium phosphate, dibasic/sodium phosphate, monobasic) for colonoscopy prep and had trouble filling it, you're not alone. Many patients report difficulty finding this medication at their local pharmacy — even though OsmoPrep is not on the FDA's official national shortage list. Here's what's actually going on in 2026 and what you can do about it.

Is Sodium Phosphate (OsmoPrep) Officially in Shortage in 2026?

As of 2026, oral sodium phosphate (OsmoPrep) is NOT listed as a current drug shortage on the FDA's Drug Shortage Database. This means the FDA has not received formal shortage notifications from manufacturers that would trigger official shortage status.

However, the absence of an official shortage doesn't mean OsmoPrep is easy to find everywhere. The drug is a niche, brand-name, prescription-only medication used for a single procedure — and many pharmacies simply don't keep it on their regular shelves. The result is a situation that feels like a shortage to patients but is more accurately described as a distribution and stocking challenge.

What About the IV Form of Sodium Phosphate?

The injectable form of sodium phosphate — used in hospitals for hypophosphatemia treatment and TPN (total parenteral nutrition) formulations — has experienced supply disruptions in the past, particularly when manufacturing capacity was strained. These hospital-focused supply issues do not directly affect the availability of OsmoPrep tablets at retail pharmacies, as they have separate supply chains. Patients receiving IV sodium phosphate in a hospital setting should speak with their care team about any supply concerns.

Why Does It Feel Like a Shortage if It Isn't One?

Several structural factors make OsmoPrep feel like it's perpetually in short supply:

It's a one-time-use medication. Unlike blood pressure or diabetes medications that patients refill monthly, OsmoPrep is used once per colonoscopy. Pharmacies have little financial incentive to keep large quantities in stock.

Colonoscopy demand clusters. Demand for colonoscopy prep spikes at certain times of year — particularly at year-end as patients rush to use their insurance deductibles. This seasonal clustering can temporarily exhaust local pharmacy stock.

Brand-name only. While generic versions of sodium phosphate tablets are technically available, the market is dominated by OsmoPrep, and stock isn't always consistent across pharmacy networks.

Insurance coverage varies. Some plans don't cover OsmoPrep, leading patients to shop for the best cash price across pharmacies — which can create localized demand spikes and stock outs at certain locations.

Historical Context: Sodium Phosphate and the 2008 FDA Action

It's worth understanding how sodium phosphate went from a widely available OTC product to a prescription-only medication. Before 2008, Fleet Phospho-Soda — an oral sodium phosphate solution — was available OTC and used extensively for colonoscopy prep. In December 2008, the FDA issued a safety communication requiring a boxed warning on all prescription sodium phosphate products after reports of acute phosphate nephropathy (serious and sometimes permanent kidney damage). The OTC Fleet Phospho-Soda solution was subsequently recalled. Visicol tablets were discontinued in 2012. Today, OsmoPrep remains the primary prescription oral sodium phosphate tablet on the market.

What Should Patients Do Right Now?

If you've been prescribed OsmoPrep and are having trouble finding it, here are your action steps:

Fill your prescription early — as soon as you receive it, not the day before your prep.

Ask your GI office which pharmacy they prefer for colonoscopy preps — they know who stocks it.

Use medfinder to have pharmacies called on your behalf to check stock.

Ask your doctor about switching to GoLYTELY, SUTAB, or MoviPrep if OsmoPrep remains unavailable.

Do not delay your colonoscopy — cancer screening is time-sensitive. A different prep is always better than postponing.

Should You Wait for OsmoPrep to Come Back in Stock?

In most cases, no. Unless you have a specific medical reason to prefer OsmoPrep over other colonoscopy preps (which your doctor can clarify), the alternative preps are equally effective and often easier to find. Colonoscopy is a critical cancer screening — missing or delaying it to wait for a specific brand of prep is rarely worth it.

If you still need to find OsmoPrep near you, medfinder can call pharmacies near you to locate it quickly. Or, if you're ready to explore other options, read our guide to alternatives to sodium phosphate.