How to help your patients find Cocaine in stock: A provider's guide

How to Help Your Patients Find Cocaine Hydrochloride in Stock

As a provider who performs nasal procedures, you know how valuable Cocaine Hydrochloride topical solution is for delivering both local anesthesia and vasoconstriction in a single agent. You also know how frustrating it can be when supply runs short — for you and your patients.

This guide provides practical strategies for sourcing Cocaine Hydrochloride (brand names Goprelto and Numbrino) and helping your patients understand their options when the medication isn't readily available.

Understanding the Current Supply Landscape

The Cocaine Hydrochloride supply situation in 2026 remains constrained. Key facts to keep in mind:

• Two manufacturers only: Goprelto (Genus Lifesciences / Noden Pharma, 4% solution) and Numbrino (Omnivium Pharmaceuticals, 4% and 10% solutions)
• DEA quota-limited production: Annual manufacturing quotas restrict total output
• No unapproved products: Since the 2019 FDA enforcement action, only these two products are legal
• Not a retail pharmacy product: Distributed through specialty medical channels, not standard wholesalers

For a deeper analysis, see our provider-focused shortage update.

Proactive Sourcing Strategies

1. Maintain Inventory Awareness

Don't wait until you're out of stock to start sourcing. Establish a reorder threshold and begin searching for supply well before your current inventory runs out. Consider:

• Tracking usage patterns to predict when you'll need more
• Setting up alerts with your distributor for product availability
• Designating a staff member to monitor Cocaine Hydrochloride supply status weekly

2. Check Both Products

Always check availability for both Goprelto and Numbrino. When one is unavailable, the other may be in stock. Note that Numbrino offers both 4% and 10% concentrations, giving additional flexibility.

3. Leverage Your GPO

If your facility is part of a group purchasing organization (GPO), contact your representative about preferred supplier agreements for Cocaine Hydrochloride. GPO contracts may provide priority allocation during shortages.

4. Use MedFinder for Providers

MedFinder for Providers offers tools specifically designed to help healthcare professionals track medication availability. You can:

• Search for Cocaine Hydrochloride availability across facilities in your area
• Receive alerts when supply becomes available
• Connect with other facilities that may have inventory to share

5. Contact Manufacturers

Reaching out directly to Genus Lifesciences (Goprelto) or Omnivium Pharmaceuticals (Numbrino) can sometimes yield information about upcoming shipments, allocation programs, or alternative distribution channels not available through standard ordering.

6. Network with Colleagues

Connect with other ENT surgeons, ophthalmologists, and anesthesiologists in your area. Informal networks can be surprisingly effective for sharing supply information and coordinating orders.

Developing Alternative Protocols

Every facility that uses Cocaine Hydrochloride should have documented alternative protocols ready to implement when supply is unavailable. Recommended alternatives include:

• Lidocaine (4%) + Oxymetazoline (0.05%): Most widely used and studied alternative. Apply Oxymetazoline first for vasoconstriction, followed by Lidocaine-soaked pledgets for anesthesia.
• Tetracaine + Oxymetazoline: Evidence suggests potentially superior anesthesia versus Cocaine. Consider for procedures requiring maximum mucosal numbing.
• Co-Phenylcaine (Lidocaine + Phenylephrine): Convenient combination product used widely in international ENT practice.

Key considerations when implementing alternatives:

• Document alternative protocols in your facility's procedure manual
• Ensure nursing and OR staff are trained on preparation and administration
• Adjust procedural timing — pledget soak time and onset may differ from Cocaine
• Monitor for adequate vasoconstriction and supplement if needed

For detailed comparison of alternatives, see our article: Alternatives to Cocaine for nasal procedures.

Communicating with Patients

When Cocaine Hydrochloride isn't available, patients may have questions or concerns. Here's how to address common situations:

When a Procedure Must Be Rescheduled

If you decide to delay a procedure until Cocaine Hydrochloride is available:

• Explain clearly why the delay is necessary for their specific case
• Provide an estimated timeline based on your supply intelligence
• Offer to place them on a priority list for when stock arrives
• Share the patient shortage update so they understand the broader situation

When Switching to an Alternative

If you'll use an alternative anesthetic:

• Reassure patients that the alternative is well-studied and effective
• Explain how the alternative works compared to Cocaine Hydrochloride
• Address any concerns about pain management or procedure outcomes
• Note any potential cost differences (alternatives are often less expensive)

Helpful Patient Resources

Direct patients to these articles for more information:

• Cocaine shortage update: What patients need to know in 2026
• Alternatives to Cocaine if you can't fill your prescription
• How to find Cocaine in stock near you
• Cocaine side effects: What to expect
• How to save money on Cocaine in 2026

Documentation and Compliance

During shortages, it's especially important to maintain rigorous documentation:

• Record all Cocaine Hydrochloride inventory including lot numbers, quantities received, and quantities used
• Document waste per DEA Schedule II requirements with appropriate witness signatures
• Log all administration with patient identifiers, dose, and procedure details
• Track alternative usage — document when and why alternative protocols were used in place of Cocaine Hydrochloride

Advocating for Better Supply

As healthcare providers, you can advocate for systemic improvements to the Cocaine Hydrochloride supply chain:

• Report shortages to the ASHP Drug Shortages Resource Center and the FDA Drug Shortage Database
• Contact your professional organizations (AAO-HNS, AAO, ASA) to raise awareness
• Support regulatory reforms that balance controlled substance oversight with medical supply needs

Additional Provider Resources

• MedFinder for Providers — medication availability tracking tools
• How to help patients save money on Cocaine
• Cocaine drug interactions: What to avoid
• How does Cocaine work? Mechanism of action explained