Current Drug Shortages: Which Medications Are Scarce Today in 2025

Right now, hundreds of essential medications are hard to find in U.S. hospitals and pharmacies. It’s not a glitch. It’s a systemic breakdown. If you or someone you know relies on insulin, chemotherapy, IV fluids, or even basic antibiotics, you’re likely feeling the pinch. As of April 2025, there were 270 active drug shortages - a number that’s barely budged from last year’s crisis levels. These aren’t rare, obscure drugs. They’re the ones you count on when your life depends on them.

What’s Actually in Shortage?

The most critical shortages hit the most vulnerable patients. Sterile injectables - drugs given directly into the bloodstream - are taking the hardest hit. Why? Because making them is expensive, complex, and low-profit. A single contaminated batch can shut down a whole factory for months. Here’s what’s running out:

• 5% Dextrose Injection (small bags) - Used to deliver fluids and medications, this has been scarce since February 2022. Expected to improve by August 2025, but many hospitals are still rationing.
• 50% Dextrose Injection - Critical for treating low blood sugar in diabetics and emergency cases. Shortage began in December 2021. No clear end date yet.
• Cisplatin - A frontline chemotherapy drug for testicular, ovarian, and lung cancers. One Indian manufacturer, which supplied half of the U.S. supply, failed FDA inspections in 2022. Production hasn’t fully resumed.
• Vancomycin - A last-resort antibiotic for resistant infections. Shortages have stretched into 2025, forcing doctors to use older, more toxic alternatives.
• Levothyroxine - The go-to treatment for hypothyroidism. Demand surged 20% since 2022, and supply couldn’t keep up. Patients report switching brands or missing doses.
• GLP-1 agonists (e.g., semaglutide, tirzepatide) - Originally for diabetes, now widely used for weight loss. Demand has grown 35% yearly since 2020. Manufacturers can’t produce fast enough.
• Normal Saline (0.9% sodium chloride) - The most common IV fluid. Used in nearly every hospital procedure. Shortages have become routine, especially in rural areas.

These aren’t random. They’re clustered. Over half of all current shortages are in three categories: central nervous system drugs (like ADHD meds), antimicrobials, and fluids and electrolytes. If you’re getting cancer treatment, managing diabetes, or fighting an infection - you’re in the crosshairs.

Why Is This Happening?

It’s not just bad luck. It’s a broken system.

Most of the raw ingredients for U.S. drugs - called active pharmaceutical ingredients (APIs) - come from just two countries: India (45%) and China (25%). That’s not a coincidence. These countries produce APIs cheaply. But cheap comes with risk. Quality control failures are common. In 2022, an FDA inspection of a major Indian plant found unsanitary conditions and falsified test results. That plant made cisplatin. Production stopped. Patients waited.

Then there’s the profit problem. Generic drugs make up 90% of prescriptions but only 20% of drug revenue. Manufacturers make 5-8% profit on generics. On brand-name drugs? 30-40%. So when a generic drug’s price drops a few cents, companies stop making it. Why invest in a low-margin product when you can make more money elsewhere?

And when demand spikes - like with weight-loss drugs - supply chains can’t adjust fast enough. Factories aren’t built to ramp up overnight. It takes 18-24 months to build a new sterile injectable line. By then, the shortage is already hurting people.

The FDA tries to help. They’ve prevented about 200 potential shortages this year by warning manufacturers early. But they can’t force anyone to produce more. They can’t demand transparency. They can’t punish companies that quietly stop making a drug without telling anyone.

How Are Doctors and Pharmacies Coping?

It’s chaos on the ground.

Pharmacists spend over 10 hours a week just tracking down drugs. One hospital in Ohio had to ration cisplatin - giving it only to patients with testicular cancer, where it’s most effective. Others got alternatives that were less effective and more toxic.

Doctors are forced to substitute. A 2024 AMA survey found 43% of physicians had to switch patients to a different drug because the original wasn’t available. Sometimes it works. Sometimes it doesn’t. One patient on levothyroxine switched brands and developed heart palpitations. Another got a different antibiotic and had a severe allergic reaction.

Medication errors are rising. A 2025 ASHP study found 67% of hospital pharmacists reported errors directly tied to substitutions. A nurse gives Drug A because Drug B is out. But Drug A looks similar. The wrong dose gets given. A patient gets sick. No one’s to blame - just a system that’s stretched too thin.

Patients aren’t spared either. A 2024 survey by Patients for Affordable Drugs found 31% of cancer patients had treatment delayed because of shortages. The average delay? Nearly two weeks. That’s not just inconvenient. It’s life-threatening.

What’s Being Done?

Some fixes are starting to show up.

In January 2025, the FDA launched a new portal where doctors and pharmacists can report shortages that aren’t on the official list. In three months, they got over 1,200 reports - and acted on 87% of them. That’s progress.

Forty-seven states now let pharmacists swap in a similar drug without calling the doctor first. Only 19 states allow that without any approval. That’s a big help when every hour counts.

New York is working on a public online database that shows exactly which pharmacies have which drugs in stock. Hawaii’s Medicaid program now allows drugs approved in Canada or the EU during shortages. That’s bold. And it works.

The U.S. Pharmacopeia is pushing for three big changes: financial incentives to make APIs in the U.S., mandatory stockpiles of critical drugs, and a national early warning system that connects manufacturers, distributors, and hospitals. No one’s implemented it yet - but the need is clear.

What Can You Do?

If you’re on a medication that’s in short supply:

• Don’t wait until your last pill to call your pharmacy. Check availability early. Ask if they’ve received a new shipment.
• Ask your doctor about alternatives. Not all substitutions are equal, but some are safe and effective. Don’t assume there’s no option.
• Keep a list of your meds. Include the generic name, brand name, and dosage. This helps pharmacists find substitutes faster.
• Don’t skip doses. If you’re out, call your doctor immediately. Skipping insulin, thyroid meds, or chemo can have serious consequences.
• Join patient advocacy groups. Organizations like Patients for Affordable Drugs track shortages and push for policy change. Your voice matters.

There’s no magic fix. The problem is structural. But awareness helps. If enough people speak up - to their doctors, their lawmakers, their pharmacies - change becomes possible.

What’s Next?

The Congressional Budget Office predicts drug shortages will stay above 250 through 2027. If new tariffs on Chinese and Indian pharmaceuticals go through, that number could jump to 350. That’s not speculation. That’s projection.

Until manufacturers are financially rewarded for making generic drugs reliably, until the U.S. stops outsourcing half its medicine to countries with weak oversight, until hospitals can stockpile without going bankrupt - this won’t get better.

But it doesn’t have to stay this way. Solutions exist. They just need political will. And public pressure.