Medication Alternatives: What to Do During a Shortage

November 13 Elias Sutherland 9 Comments

When your prescription runs out and no pharmacy has it in stock, it’s not just inconvenient-it’s dangerous. In 2025, over 250 different active drug ingredients were in short supply across the U.S., with many shortages lasting more than two years. This isn’t a rare glitch. It’s the new normal. And if you’re taking insulin, chemotherapy drugs, antibiotics, or even something as basic as acetaminophen injection, you’ve probably felt the panic of calling five pharmacies in one day just to find one vial.

Why Do Drug Shortages Happen?

It’s not one thing. It’s a chain of failures. Most generic drugs-about 85%-are made by just five manufacturers. If one factory has a quality issue, a power outage, or a supply glitch, it can knock out half the country’s supply of a critical drug. In October 2025, a single plant producing acetaminophen injection shut down for weeks, leaving hospitals scrambling. The FDA stepped in with monthly inspections instead of quarterly, and that helped cut new manufacturing shortages by 15%-but it didn’t fix the root problem.

Then there’s profit. Generic drug makers often skip making low-margin drugs because they’re not worth the cost. If a drug sells for $2 a pill and costs $1.80 to produce, why would a company invest in it? That’s why antibiotics, chemotherapy agents, and even some thyroid meds keep disappearing. And when a drug is discontinued, it’s rarely brought back. Once a manufacturer leaves a market, they rarely return.

What Can You Do When Your Drug Is Gone?

The first thing to do is don’t stop taking it. Skipping doses or cutting them in half can make your condition worse-especially with blood pressure meds, insulin, or seizure drugs. Instead, follow these steps:

Check the FDA Drug Shortage Database-it’s the most reliable source for current shortages and approved alternatives. Type in your drug name, and it will list whether there’s a therapeutic substitute and if it’s approved for interchangeability.
Call your pharmacist. Not just one-call three. Pharmacies get stock at different times. Mail-order pharmacies often have better inventory than local ones. In March 2025, during the Semglee insulin shortage, patients who used mail-order services found supply 40% faster than those relying only on neighborhood pharmacies.
Ask your doctor about alternatives. Not every substitute is perfect, but many are safe. For example, if Semglee (a biosimilar to Lantus) is unavailable, Lantus can often be substituted without a new prescription because they’re considered interchangeable. But Toujeo or Tresiba? Those require a new prescription. Your doctor needs to know the difference.
Check your insurance formulary. Some insurers changed their rules during the 2025 insulin shortage. Blue Cross NC removed prior authorizations for Lantus on certain plans. That means you might get it covered even if it wasn’t on your list before. Call your insurer or log in to your portal-don’t assume your coverage hasn’t changed.

Therapeutic Substitutions: Safe or Risky?

Not all alternatives are created equal. Some are exact matches. Others are close-but not the same.

For antibiotics like amoxicillin, azithromycin was used as a substitute during the 2025 shortage. But it’s not just a swap. Azithromycin works differently. It’s taken for fewer days, has different side effects, and can contribute to antibiotic resistance if used incorrectly. In hospitals, doctors had to adjust protocols to avoid overprescribing it.

With insulin, the situation is clearer. Semglee and Lantus are biosimilars-meaning they’re nearly identical in structure and effect. Swapping them is safe and common. But if your doctor prescribed a specific brand for a reason (like a pump compatibility issue), switching without consultation can cause blood sugar swings.

Oncology drugs are the toughest. Of the 15 cancer medications in shortage between 2023 and 2025, 12 had no direct substitute. Doctors had to stretch doses, delay treatments, or use older, less effective drugs. One study found that in German hospitals, the clot-busting drug alteplase-used for strokes-was repurposed for pulmonary embolism during shortages. It worked, but less reliably. The risk? You might survive, but with more complications.

A pharmacist helping a patient with insulin while digital inventory maps and medical icons appear around them.

What States Are Doing to Help

Some states are taking action. New Jersey proposed letting pharmacists hand out emergency insulin supplies without a prescription during shortages. Hawaii went further: in 2025, their Medicaid program started allowing drugs approved in other countries-like Canada or the EU-if they’re FDA-recognized for safety. That’s huge. It means if a drug is running out in the U.S., you might get the same medicine from a trusted international source.

California, New York, and Massachusetts started stockpiling critical drugs, especially those used in abortions or emergency care, in case federal restrictions cut off supply. These aren’t just political moves-they’re public health safeguards.

New York also proposed a public online database that shows exactly which pharmacies have what in stock. Right now, you have to call every place. With this tool, you’d see real-time inventory like you’re checking movie times. It’s not live yet, but if it passes, it could cut the time to find a drug from days to minutes.

What Patients Are Saying

Reddit threads from March 2025 tell the real story. One user, ‘DiabeticDad87’, spent three days calling seven pharmacies before finding Semglee for his child. Another said her doctor switched her from a brand-name GLP-1 weight-loss drug to a generic alternative-and her insurance covered it. She lost weight, felt better, and didn’t miss a dose.

But 32% of patients in a February 2025 survey admitted they stopped taking their meds during a shortage. That’s dangerous. One woman with high blood pressure stopped her pill for a week. She ended up in the ER with a stroke.

Those who reached out to manufacturers often got answers. Pfizer shared exact timelines for amoxicillin restocks. Eli Lilly told patients when their insulin production would resume. That kind of transparency reduces panic. But most companies don’t offer that. You have to ask.

Patients outside a government building receiving emergency insulin kits as international drug sources are shown on a glowing screen.

How to Prepare for the Next Shortage

You can’t control the supply chain-but you can control your response.

Keep a list of all your medications, including dosages and why you take them. Share it with your pharmacist and a family member.
Ask your doctor now: “If this drug runs out, what’s my backup?” Don’t wait until you’re out of pills.
Use mail-order pharmacies. They often have larger stock and can ship ahead.
Sign up for alerts from the FDA Drug Shortage page. It’s free and updated daily.
Know your insurance’s formulary. Check it every 3 months-rules change fast during shortages.

When to Seek Help Immediately

If you’re on insulin, chemotherapy, seizure meds, or heart drugs, and you can’t find your medication for more than 48 hours, contact your doctor or go to an urgent care center. Don’t wait. Your body doesn’t pause for supply chain issues.

Pharmacists are now trained to help. Eighty-nine percent of major pharmacy chains have dedicated shortage support lines. Use them. They can check inventory across multiple locations, contact distributors, and even help you get samples from manufacturers.

Remember: a shortage doesn’t mean you’re out of options. It means you need to be more proactive. The system is broken-but you’re not powerless.

Elias Sutherland (Author)

Hello, my name is Elias Sutherland and I am a pharmaceutical expert with a passion for writing about medication and diseases. My years of experience in the industry have provided me with a wealth of knowledge on various drugs, their effects, and how they are used to treat a wide range of illnesses. I enjoy sharing my expertise through informative articles and blogs, aiming to educate others on the importance of pharmaceuticals in modern healthcare. My ultimate goal is to help people understand the vital role medications play in managing and preventing diseases, as well as promoting overall health and well-being.

Ryan Anderson

I can't believe we're still dealing with this in 2025. I had to call 12 pharmacies last month for my dad's insulin. One had it-$450 for a vial, no insurance coverage. 🤯 We're not talking luxury meds here-we're talking LIFE-SAVING drugs. The fact that a single factory shutdown can cripple the entire country is insane.

And don't get me started on the profit motive. If a drug makes $0.20 profit per pill, they just stop making it? What kind of broken system is this? We need public manufacturing for essential meds. Period.

Eleanora Keene

Thank you for writing this. I'm a nurse, and I see this every single day. Patients crying because they can't afford the alternative. One woman came in with her husband-she had stopped her blood pressure med for 9 days because she couldn't find it. She had a mini-stroke. It breaks my heart.

But here's the thing-you're not alone. Call your pharmacist. Ask for samples. Check the FDA site. And if you're scared, text a friend. You don't have to fight this alone. You're stronger than the system thinks.

Joe Goodrow

This is what happens when you let foreigners make our medicine. China and India control 80% of the active ingredients. We used to make antibiotics in Ohio. Now? We beg for scraps. This isn't a shortage-it's a betrayal. We need tariffs on foreign drug makers and nationalize the supply chain. End of story.

And stop whining about cost. If you can't afford your meds, go to a VA hospital. Taxpayers paid for your freedom-now pay for your pills.

Don Ablett

While the systemic issues are indeed profound, I would like to offer a nuanced perspective regarding international sourcing. The Canadian and EU regulatory frameworks, particularly those of Health Canada and the European Medicines Agency, maintain stringent pharmacovigilance standards that are functionally equivalent to those of the FDA. In certain cases, the therapeutic equivalence of medications approved under these jurisdictions is demonstrably higher than that of some domestically produced generics due to superior manufacturing consistency.

Furthermore, the logistical barriers to cross-border procurement are not insurmountable; indeed, pilot programs in British Columbia have demonstrated a 67% reduction in patient wait times for critical medications through pre-vetted international suppliers. The reluctance to adopt such models in the United States appears to be rooted more in regulatory inertia than in clinical necessity.

Kevin Wagner

Y'all are playing checkers while the system is playing 4D chess. The FDA’s monthly inspections? Cute. But who’s holding the manufacturers accountable when they cut corners? The answer: NO ONE. We need a public drug bank-like a food bank, but for insulin, antibiotics, chemo meds. Communities can stockpile, share, and distribute. No corporate middlemen. No profit. Just survival.

And listen-I’m not asking. I’m demanding. If you’re reading this and you’re healthy? Volunteer. Donate. Fight. This isn’t about politics. It’s about whether your kid lives or dies next month. I’ve seen it. I’ve held the hand of a 7-year-old who didn’t get her insulin because the factory in India had a power outage. Don’t you dare sit this one out.

gent wood

It is worth noting that the phenomenon of drug shortages is not unique to the United States, nor is it entirely unprecedented in historical context. During the Second World War, penicillin shortages were similarly acute, yet were addressed through coordinated public-private mobilization, rationing, and scientific innovation. The current crisis, while severe, lacks the same level of societal urgency in its response.

Moreover, the reliance on mail-order pharmacies as a solution, while pragmatic, may exacerbate disparities in rural communities where delivery infrastructure is inadequate. A truly equitable strategy would require not only inventory transparency but also localized distribution hubs, perhaps integrated with community health centers.

Dilip Patel

lol you guys are so weak. In India we dont have all this fancy stuff but we still live. We use generics from local factories, no problem. You Americans think you need brand name shit. Just take what works. Why you think your body is so special? You dont need Lantus, you need discipline. Also why you let pharma companies control you? Fight back. Buy from Mexico. Its cheaper and better. And stop crying on reddit. Grow up.

Jane Johnson

It is worth considering that the promotion of therapeutic substitution may, in fact, constitute an implicit endorsement of pharmaceutical deregulation. The FDA’s designation of interchangeability does not equate to clinical equivalence in all physiological contexts, particularly for patients with comorbidities or polypharmacy regimens. Furthermore, the suggestion that patients should rely on mail-order pharmacies as a primary solution ignores the documented delays and packaging inconsistencies that have resulted in medication errors in over 12% of cases during recent shortage events.

One must ask: if the system is so fragile, why are we incentivizing patients to become logistics coordinators rather than demanding structural reform?

Peter Aultman

Just got my insulin from a CVS 3 towns over. Took 45 mins. No one helped me. I just kept calling. One tech said 'we got 2 vials, but they're in the back.' I said 'I'll wait.' She shrugged. I sat there. Got it.

Also-sign up for FDA alerts. It's free. I didn't know they existed until last month. Now I get texts when my meds are running low. No drama. No panic. Just info.

Stay calm. Be stubborn. You got this.