Medication Alternatives: What to Do During a Shortage

When your prescription runs out and the pharmacy says they don’t have it-again-you’re not alone. In 2025, more than 250 different medications were in short supply across the U.S. and Australia, from common antibiotics to life-saving insulin and cancer drugs. These aren’t temporary hiccups. Many shortages have lasted over two years. You might feel stuck, scared, or even angry. But there are real, actionable steps you can take right now to keep your treatment on track without risking your health.

Know What’s Actually Short

Not every drug shortage is the same. Some affect only one brand, while others hit every version of the same active ingredient. For example, Semglee (a biosimilar insulin) ran out in early 2025, but Lantus-the original insulin glargine-was still available. That’s because Semglee and Lantus are considered interchangeable by the FDA. You don’t need a new prescription to switch between them. But if your doctor prescribed Toujeo or Tresiba instead, those are different drugs with different dosing. Switching those requires a new script.

Check the FDA Drug Shortage Database first. It’s free, updated daily, and lists exactly which drugs are short, why, and if there are approved alternatives. Don’t rely on pharmacy staff alone-they may not know the latest updates. Type in your medication name. If it’s listed, the database will tell you what other drugs can work in its place.

Don’t Guess-Talk to Your Doctor

Some patients stop taking their meds entirely during a shortage. That’s dangerous. Others try to stretch doses or switch to over-the-counter options. Neither is safe. The right alternative isn’t always obvious. For instance, during amoxicillin shortages, some doctors switched patients to azithromycin. But azithromycin works differently. It doesn’t treat the same infections as well, and overusing it increases antibiotic resistance.

Bring up the shortage at your next appointment-even if it’s not your main reason for visiting. Ask: “Is there a therapeutic equivalent?” or “Can we adjust the dose or form?” For blood pressure meds, switching from a tablet to a liquid might work. For diabetes, changing from once-daily to twice-daily insulin can help stretch supply. Your doctor has access to clinical guidelines and knows what alternatives have been tested and approved.

Use Your Pharmacist as a Resource

Pharmacists are your hidden allies in a shortage. In 2025, 89% of major pharmacy chains in the U.S. and Australia started offering free shortage navigation services. They can:

• Check inventory across multiple locations-including mail-order pharmacies
• Verify if a generic or biosimilar is covered by your insurance
• Help you request an emergency supply if your state allows it

In New Jersey, pharmacists can now dispense a 30-day emergency insulin supply without a new prescription. Hawaii allows foreign-approved versions of drugs (like those from Canada or the EU) if they’re on an FDA-approved list. Ask your pharmacist: “What options do we have under state law?” They might know about local programs you didn’t even know existed.

Insurance Can Be a Hurdle-But It Doesn’t Have to Be

Blue Cross NC made changes in March 2025 to help patients during the Semglee shortage. They removed prior authorizations for Lantus on certain plans. That meant patients could get the substitute without waiting days for approval. But not all insurers did this. Many still require paperwork, even for safe, approved swaps.

Call your insurer. Ask: “Is there a formulary exception for [drug name] due to shortage?” If they say no, ask for the name of the medical director and request a formal exception. Many times, they’ll approve it if you show proof of shortage from the FDA site. Keep records of every call-date, time, name, what was said. You might need it later.

Stockpiling Isn’t Just for Hospitals

Some states are preparing. California, New York, and Washington are stockpiling medical abortion drugs. Other states are hoarding insulin and chemotherapy agents. You can’t do that on your own-unless your doctor prescribes extra.

If you’re on a chronic medication with a known shortage risk (like insulin, epinephrine, or certain heart drugs), ask your doctor if you can get a 90-day supply instead of 30. Many insurers allow this for maintenance meds. It’s not hoarding-it’s planning. And if you have a stable condition, some doctors will write a prescription for a backup drug to keep on hand. For example, if you take metformin and it goes short, having a prescription for sitagliptin ready can save you weeks of disruption.

When No Alternatives Exist-What Then?

Some drugs have no good substitutes. This is especially true in oncology. Between 2023 and 2025, 15 cancer drugs were in shortage, and 12 of them had no direct alternatives. For pediatric chemo, the situation is even worse-7 of those 15 were used only for children.

In these cases, your medical team may need to adjust your treatment plan. Maybe you get a different drug with similar results, or your schedule changes from weekly to every other week. Sometimes, clinical trials offer access to the drug you need. Talk to your oncologist about trial options. You can also contact the drug manufacturer directly. Pfizer and Eli Lilly have hotlines for patients during shortages. They’ll tell you when production is expected to resume-and sometimes they’ll ship a small supply directly if you’re in crisis.

What Not to Do

There are dangerous myths out there. Don’t:

• Buy drugs from unverified online sellers
• Split pills unless your doctor says it’s safe
• Use expired medication without consulting a pharmacist
• Stop taking your drug because you can’t refill it

A Reddit user named DiabeticDad87 spent three days calling seven pharmacies trying to find Semglee for his child. He didn’t give up. He didn’t try to order from a shady website. He called his doctor, his pharmacist, and his insurer. He found a solution. You can too.

Plan Ahead for the Next Shortage

Shortages aren’t going away. The FDA now inspects critical drug factories monthly instead of quarterly-and that’s helped reduce new shortages by 15%. But the system is still fragile. Eighty-five percent of generic drugs come from just five manufacturers. One factory shutdown can ripple across the country.

Start building a personal drug shortage plan:

1. Keep a list of all your meds, including generic names
2. Know your insurer’s formulary rules
3. Save your pharmacist’s direct line
4. Set calendar reminders to check the FDA shortage list every 60 days
5. Ask your doctor now: “What’s my backup plan if this drug goes short?”

The goal isn’t to panic. It’s to be prepared. When you know your options, you take back control. You don’t have to wait for someone else to fix the system. You can act today-before your next refill is due.