Comprehensive medication guide to Klisyri including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$25 copay for commercially insured patients using the Almirall Advantage program at an in-network pharmacy. Standard specialty tier copay of $30–$100 may apply with other commercial plans after prior authorization is approved. Medicare coverage varies by Part D plan; manufacturer copay card not usable with Medicare.
Estimated Cash Pricing
Retail price is approximately $1,959–$1,967 for a 5-packet course. With a GoodRx coupon, price drops to as low as $280.79. Through the Almirall Advantage Network pharmacy (cash-pay, no insurance), eligible patients pay as low as $95 per fill.
Medfinder Findability Score
55/100
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Klisyri is the brand name for tirbanibulin 1% ointment, a prescription topical medication approved by the FDA on December 14, 2020. It is manufactured by Almirall, LLC (Malvern, PA) and is indicated for the topical field treatment of actinic keratosis (AK) on the face or scalp in adults. Actinic keratosis is a precancerous skin condition caused by chronic UV radiation exposure that affects an estimated 40 million Americans annually.
Klisyri is classified as a first-in-class dual inhibitor of tubulin polymerization and Src kinase signaling. It is applied once daily for just 5 consecutive days — the shortest treatment course of any topical AK medication. In June 2024, the FDA expanded the approved treatment area from 25 cm² to up to 100 cm², making Klisyri useful for patients with more widespread facial or scalp AK.
Klisyri comes in unit-dose packets: 250 mg packets (2.5 mg tirbanibulin) for smaller areas and 350 mg packets (3.5 mg tirbanibulin) for the larger 100 cm² area. Each carton contains 5 single-use packets — one for each day of the treatment course.
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Klisyri (tirbanibulin) works through a unique dual mechanism of action that distinguishes it from all other topical AK treatments. First, it inhibits tubulin polymerization by binding to the colchicine-binding site of beta-tubulin protein. This blocks the formation of microtubules — the protein scaffolds cells need to divide. Without functional microtubules, rapidly dividing precancerous keratinocytes cannot complete cell division and are triggered to undergo apoptosis (programmed cell death).
Second, tirbanibulin inhibits Src tyrosine kinase signaling pathways. Src kinases act as survival and growth signals inside cells. In AK lesions, Src signaling is often overactivated — helping abnormal cells resist death. By suppressing Src kinase activity, Klisyri further reduces the viability of precancerous cells while leaving healthy, non-dividing skin cells relatively unaffected.
Although the exact mechanism of action in human actinic keratosis is not fully established (as noted in the FDA prescribing information), the dual-action approach of tirbanibulin enables meaningful clearance with just 5 days of application. Clinical trials demonstrated 44–54% complete clearance at day 57, with 68–76% of patients achieving at least 75% lesion reduction.
1% (2.5 mg / 250 mg packet) — ointment
Original packet size for treatment areas up to 25 cm²; 1 packet per day for 5 consecutive days
1% (3.5 mg / 350 mg packet) — ointment
Larger packet for treatment areas up to 100 cm² (approved June 2024); 1 packet per day for 5 consecutive days
Klisyri is not on the FDA's official drug shortage list, meaning the manufacturer's supply is intact. However, pharmacy availability is inconsistent nationwide. Because Klisyri is a brand-name-only medication with a retail price exceeding $1,900 and no generic equivalent, many retail pharmacies choose not to stock it routinely. Step therapy requirements from major insurers also limit prescription volume, further reducing the incentive for pharmacies to carry it on the shelf.
Patients looking for Klisyri in stock have the best luck at Almirall Advantage Network pharmacies, large chain pharmacies near dermatology offices, or mail-order specialty pharmacies. medfinder can call local pharmacies on your behalf to find which ones can fill your Klisyri prescription — saving you hours on hold.
Klisyri's findability score reflects the reality that it is available and in production, but requires more effort to locate than widely-stocked generic medications. Pharmacies that specialize in dermatology or are part of the Almirall network are reliably stocked.
Klisyri (tirbanibulin) is not a controlled substance, so it can be prescribed by any licensed prescriber without special DEA authorization. It requires a standard prescription due to the need for professional diagnosis of actinic keratosis and medically supervised application.
Prescriber types who commonly order Klisyri:
Dermatologists — most common prescribers; actinic keratosis is one of dermatology's most frequent diagnoses
Primary care physicians (PCPs, family medicine, internal medicine)
Nurse practitioners (NPs) — can independently prescribe in most U.S. states
Physician assistants (PAs) — can prescribe in most U.S. states
Mohs surgeons and surgical dermatologists — often prescribe field treatment before or after surgical procedures
Klisyri can also be prescribed via telehealth in many cases, as actinic keratosis is a visual diagnosis. Platforms like Teladoc, MDLive, and dermatology-specific telehealth services can prescribe Klisyri after virtual evaluation. Some states may require an in-person initial visit for a first-time AK diagnosis.
No. Klisyri (tirbanibulin) is not a controlled substance and is not scheduled under the DEA's Controlled Substances Act. There are no special DEA prescribing requirements for Klisyri — any licensed healthcare provider (physician, NP, PA) can prescribe it without a special license or registration beyond a standard DEA number for non-controlled prescriptions.
Klisyri is a prescription-only medication, meaning it requires a written prescription from a licensed provider. It cannot be purchased over the counter. The prescription requirement exists because actinic keratosis requires professional diagnosis and because the drug must be applied properly to a defined treatment field under medical guidance.
Patients should be aware that Klisyri is for topical use only — it is not for oral ingestion or ophthalmic use. There is no abuse potential, and no refill restrictions associated with controlled substance status apply to Klisyri prescriptions.
Local skin reactions are common and expected with Klisyri — they are a sign the drug is working on precancerous cells. In clinical trials (incidence ≥2%):
Erythema (redness) — 91% of patients
Flaking or scaling — 82% of patients
Application site pruritus (itching) — 9% of patients
Application site pain — 10% of patients
Crusting of the skin — common
Serious side effects (seek medical care):
Vesiculation or pustulation (blistering) — mild in 7%, seek care if severe
Erosion or ulceration — mild in 9%, moderate in 3%; report severe cases
Eye irritation — if drug contacts eyes, flush immediately and seek care
Severe allergic reaction — stop use and seek emergency care immediately
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Fluorouracil (5-FU) cream
Generic topical chemotherapy agent (Efudex, Carac, Tolak); applied 1-2x daily for 2-4 weeks; ~49% complete clearance with 5% formulation; $30-80 generic cost; more skin irritation but highest long-term efficacy data
Imiquimod cream
Immune modulator (Aldara, Zyclara); applied 3x/week for 4 weeks; generic available for $30-80; may provide immune memory against future AK; different mechanism from Klisyri
Diclofenac 3% gel
NSAID-based topical AK treatment (Solaraze); applied 2x daily for 60-90 days; best-tolerated option with minimal inflammation; widely covered by Medicare and commercial insurance
Cryotherapy
In-office liquid nitrogen treatment; best for individual lesions rather than field treatment; no prescription needed; immediate results; often combined with topical field therapy for comprehensive management
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Topical corticosteroids (hydrocortisone, triamcinolone)
moderateDo not apply topical corticosteroids to the Klisyri treatment area during the course. Steroids may interfere with Klisyri's mechanism and reduce AK clearance effectiveness.
Concurrent topical AK treatments (5-FU, imiquimod, diclofenac)
majorDo not use other topical AK treatments on the same area simultaneously. Wait until skin is fully healed from prior topical AK treatment before starting Klisyri.
Post-procedure skin (cryotherapy, laser, dermabrasion)
majorDo not apply Klisyri to skin that has not fully healed from prior AK procedures or surgeries. Applying to unhealed skin increases risk of severe local reactions.
Occlusive dressings
moderateDo not cover the treatment area with bandages or occlusive wraps after applying Klisyri. Occlusion significantly increases local drug concentration and irritation risk.
Klisyri (tirbanibulin) represents a meaningful advance in actinic keratosis treatment. Its 5-day course — the shortest of any topical AK treatment — addresses one of the most common barriers to treatment completion: adherence over weeks-long regimens. With the 2024 FDA expansion to 100 cm² treatment areas, it is now even more versatile for dermatologists treating patients with extensive field cancerization.
The main challenges remain cost (retail ~$1,959 without assistance) and limited routine pharmacy stocking due to brand-only status. However, the Almirall Advantage savings program brings cost to as low as $25 for commercially insured patients. For those without commercial insurance, GoodRx coupons offer meaningful savings.
If you're struggling to find Klisyri at a pharmacy near you, medfinder can help. We call pharmacies on your behalf to find which ones can fill your prescription — and text you the results. No hold music. No frustration.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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