Medication Alternatives: What to Do During a Drug Shortage

When your regular medication runs out and no pharmacy has it in stock, it’s not just inconvenient-it’s dangerous. In 2025, over 258 active drug ingredients were in short supply across the U.S. and Australia, with many shortages lasting over two years. Insulin, antibiotics like amoxicillin, chemotherapy drugs, and even basic pain relievers like acetaminophen injections have all hit critical lows. You’re not alone if you’ve spent hours calling pharmacies, only to hear "out of stock" again. But there are real, proven ways to get through this without risking your health.

Check the FDA Drug Shortage Database First

Before you panic, go to the FDA Drug Shortage Database. It’s free, updated daily, and lists every active shortage with approved alternatives. For example, when Semglee (a biosimilar insulin) ran out in March 2025, the database flagged Lantus as a direct substitute-no new prescription needed. That’s because Semglee is FDA-approved as interchangeable with Lantus. Many people didn’t know this and wasted days searching for the exact brand. The database also tells you if a shortage is temporary or long-term, and which manufacturers are affected. Bookmark it. Check it every time you refill a prescription.

Ask Your Pharmacist-Really

Pharmacists aren’t just the people who hand you pills. They’re trained to find workarounds. In 2025, 89% of major pharmacy chains in the U.S. and Australia started offering dedicated shortage navigation services. Walk in or call and say: "I need my [drug name], but I’ve been told it’s out. What else works?" They’ll check inventory across multiple locations, including mail-order partners, and often know which nearby pharmacies have stock before it’s listed online. Some even have direct lines to manufacturers for estimated restock dates. One patient in Brisbane tracked down insulin after three pharmacies said no-her pharmacist called a regional distributor and found a shipment arriving the next day.

Therapeutic Substitution Isn’t Always Risky

You might hear "alternatives" and think it’s dangerous. But many drugs have approved therapeutic substitutes. For example:

• If amoxicillin is gone, azithromycin can be used for certain bacterial infections-but only if your doctor confirms it’s safe for your case.
• For high blood pressure, if lisinopril is unavailable, enalapril or losartan are often equally effective.
• For depression, if fluoxetine is out, sertraline or citalopram may be substituted based on your history.

The key is therapeutic equivalence. These aren’t random swaps. They’re drugs with similar mechanisms, proven outcomes, and safety profiles. Your doctor or pharmacist will check this before switching. Don’t refuse a substitute just because it’s not your usual brand. Many patients who resisted substitution during the 2023-2025 insulin shortage ended up going without-leading to hospitalizations. Those who switched safely stayed stable.

Don’t Stop Taking Your Medication

A 2025 survey by the Sterling Institute found that 32% of patients stopped their meds during shortages. That’s the biggest mistake you can make. Stopping insulin, blood thinners, or seizure meds can cause life-threatening reactions. If you can’t find your drug, call your doctor immediately. They might adjust your dose, switch you to a different formulation (like a pill instead of an injection), or prescribe a temporary alternative. One diabetic father in Texas spent three days calling seven pharmacies for Semglee. He didn’t stop his insulin-he switched to Lantus with his doctor’s approval and stayed safe. Don’t wait until you’re in crisis.

Use Mail-Order and Specialty Pharmacies

Big retail chains often run out. But mail-order pharmacies and specialty providers have larger stockpiles and better supply chains. If your insurance covers it, switch to a mail-order service for chronic meds like insulin, thyroid pills, or antidepressants. Many offer 90-day supplies, reducing how often you need to refill. During the GLP-1 weight loss drug shortage (2022-2025), patients who used mail-order services got consistent access while others waited months. Some insurers even waived copays for these alternatives during shortages. Ask your pharmacy or insurer: "Do you have a mail-order option for my medication?"

Know Your State’s Shortage Rules

Laws vary. In Hawaii, Medicaid started allowing foreign-approved drugs during shortages in 2025-meaning a drug approved in Canada or the EU could be legally dispensed if the U.S. version wasn’t available. New Jersey proposed letting pharmacists hand out emergency insulin without a prescription. California and New York stockpile critical drugs like abortion medications and chemotherapy agents. Even if you’re not in one of these states, ask your pharmacist: "Are there any state-level programs that help with drug shortages?" You might be eligible for help you didn’t know existed.

Track the Supply Chain-And Contact Manufacturers

Sometimes, the shortage isn’t about demand-it’s about a single factory shutting down. Eighty-five percent of generic drugs come from just five manufacturers. If one has a quality issue, the whole supply chain breaks. Companies like Pfizer and Eli Lilly often post shortage updates on their websites. During the amoxicillin shortage, Pfizer published a timeline: "Production resumes in June 2025." That let patients plan. Call the manufacturer’s patient help line. Ask: "When will [drug name] be available again?" They may give you a date, a replacement suggestion, or even free samples.

What About Biosimilars?

Biosimilars are near-identical versions of complex biologic drugs-like insulin or autoimmune treatments. They’re cheaper and often approved as interchangeable, meaning they can be swapped without a new prescription. Semglee and Lantus are a perfect example. But not all biosimilars are interchangeable. Check the FDA’s list. If your drug has an interchangeable biosimilar, ask your doctor if you can switch. It’s safe, legal, and saves money. Many patients assume biosimilars are "inferior," but they’re rigorously tested. During the 2025 sarilumab shortage, patients who switched to biosimilars saw no drop in effectiveness.

When All Else Fails: Talk to Your Doctor About Delaying or Adjusting

Some drugs can be safely paused or dosed differently. For example, if you’re on a low-dose statin and it’s unavailable, your doctor might increase the dose of a different statin temporarily. Or if you’re on a monthly injectable, they might switch you to a daily pill for a few weeks. This isn’t ideal-but it’s safer than stopping. One cancer patient in Melbourne had her chemotherapy drug delayed by six weeks. Her oncologist adjusted her treatment schedule to use a different agent in the meantime. She stayed in remission. Don’t assume there’s no option. Your doctor has more tools than you think.

Prepare for Next Time

Don’t wait for the next shortage to act. Build a plan:

• Keep a list of all your meds, doses, and generic names.
• Ask your doctor now: "If [drug] runs out, what’s the next best option?" Get it in writing.
• Sign up for email alerts from the FDA Drug Shortage page.
• Consider keeping a 30-day backup supply if your insurance allows it.
• Know your pharmacy’s policy on emergency refills.

The system isn’t perfect. But you don’t have to be helpless. By knowing where to look, who to ask, and what alternatives exist, you can protect your health-even when the supply chain fails.