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

Vazalore (aspirin, liquid-filled capsule) has become a preferred formulation for many cardiovascular patients due to its favorable pharmacokinetic profile — offering the rapid platelet inhibition of immediate-release aspirin while limiting direct gastric mucosal contact. However, clinicians who recommend Vazalore are increasingly encountering a supply problem: their patients can't find it at the pharmacy.

This post provides a clinician-focused overview of the current supply situation, the clinical implications of switching patients to alternative formulations, and practical guidance for managing your patient panel.

Current Supply Status: What Clinicians Need to Know

As of 2026, Vazalore is not on the FDA's formal drug shortage list. However, the product is experiencing persistent logistical availability issues at the retail level. The root cause traces back to April 2023, when PLx Pharma filed for Chapter 11 bankruptcy and subsequently sold Vazalore and all related assets to Greenwood Brands, LLC.

Key supply facts for 2026:

Vazalore 81 mg is more consistently available than 325 mg nationally

Online retail (Amazon, Walmart.com) often has stock when brick-and-mortar pharmacies do not

Geographic variability is high — major metro areas generally have better access than rural markets

No generic equivalent exists for the PLxGuard liquid-filled formulation

Clinical Background: Why Providers Choose Vazalore

Vazalore's clinical rationale rests on a well-documented problem with enteric-coated aspirin: variable and often incomplete absorption. Multiple studies have demonstrated that enteric coating significantly delays and reduces aspirin bioavailability, which can lead to incomplete platelet inhibition — a concern particularly relevant for high-risk patients following ACS, PCI, or CABG.

Vazalore's PLxGuard technology uses a phospholipid-aspirin complex that is released in the duodenum rather than the stomach. Clinical pharmacokinetic studies demonstrated that Vazalore 81 mg provided potent and early inhibition of platelet aggregation, with faster antiplatelet effect than enteric-coated aspirin and bioequivalence to immediate-release aspirin. This profile makes it particularly attractive for patients who:

Have a history of aspirin-related GI events (ulcers, erosions, bleeding)

Are on dual antiplatelet therapy following ACS or PCI where absorption reliability is critical

Have diabetes or obesity, where enteric-coated aspirin absorption may be particularly erratic

Clinical Implications of Switching Away from Vazalore

For most stable patients on long-term aspirin maintenance therapy, a temporary switch to enteric-coated aspirin is clinically acceptable. The risk of incomplete absorption is a concern, but in a clinically stable patient, it is generally manageable.

Higher-risk clinical scenarios where the switch requires closer consideration:

Recent ACS or PCI (within 12 months): Patients on dual antiplatelet therapy require the most reliable aspirin absorption possible. If switching from Vazalore, consider immediate-release aspirin (taken with food) rather than enteric-coated.

Patients with prior GI bleeding: If switching to IR aspirin, adding a PPI (omeprazole 20 mg daily) is strongly recommended. Enteric-coated aspirin is a reasonable alternative but does not eliminate GI risk entirely.

Aspirin-intolerant patients: For patients who truly cannot tolerate any aspirin formulation, clopidogrel (75 mg daily) is the standard alternative for secondary prevention.

Recommended Protocol When Patients Report Vazalore Unavailability

Assess the patient's cardiovascular risk tier and proximity to last cardiac event or procedure

For stable patients: Bridge to enteric-coated aspirin 81 mg with counseling to continue aspirin therapy without interruption

For high-risk patients (recent ACS/PCI): Consider IR aspirin + PPI; document clinical rationale

Advise patients to use medfinder or online retailers to find remaining Vazalore supply

Document any formulation change in the medical record for continuity of care

How medfinder Can Help Your Patients

Rather than telling patients to call 15 pharmacies themselves, consider referring them to medfinder. medfinder calls pharmacies near the patient's location and texts them back with results — taking the friction out of finding hard-to-stock medications. Providers who use medfinder report fewer medication adherence gaps due to supply-related barriers.

Key Takeaways for Clinicians

Vazalore is not on the FDA shortage list but remains intermittently unavailable at retail pharmacies nationwide in 2026

For stable patients, enteric-coated aspirin 81 mg is an acceptable bridge; for recent ACS/PCI patients, IR aspirin + PPI is preferred

Never advise patients to simply stop aspirin therapy — the thromboembolic risk is significant

Online retailers often have Vazalore in stock when local pharmacies do not; patients should be directed to check Amazon and Walmart.com

See our companion post: How to Help Your Patients Find Vazalore in Stock: A Provider's Guide