When Your Pharmacy Can't Fill Your Testosterone Prescription

If you rely on Depo-Testosterone (Testosterone Cypionate) for testosterone replacement therapy or gender-affirming hormone therapy, a pharmacy stockout feels personal. This isn't a medication you can simply skip — interrupting testosterone therapy can cause fatigue, mood changes, and a return of the symptoms you started treatment to manage.

The good news: Depo-Testosterone isn't your only option. Several alternative testosterone formulations can deliver similar results. In this guide, we'll explain what Depo-Testosterone is, how it works, and walk you through the best alternatives to discuss with your doctor.

What Is Depo-Testosterone?

Depo-Testosterone is the brand name for Testosterone Cypionate, an injectable testosterone used to treat low testosterone (hypogonadism) in men and as part of gender-affirming hormone therapy. It's a Schedule III controlled substance administered as an intramuscular injection, typically every 1 to 2 weeks.

The medication comes in 100 mg/mL and 200 mg/mL concentrations, usually in 10 mL multi-dose vials. It's dissolved in cottonseed oil and injected into a large muscle like the gluteus or thigh.

For a complete overview of this medication, see our guide: What Is Depo-Testosterone? Uses, Dosage, and What You Need to Know.

How Does Depo-Testosterone Work?

Testosterone Cypionate is an esterified form of testosterone. After injection into the muscle, it forms a depot (reservoir) that slowly releases testosterone into the bloodstream over days to weeks. The ester is then cleaved off, releasing active testosterone.

Once in the bloodstream, testosterone binds to androgen receptors throughout the body, promoting:

• Development and maintenance of male secondary sexual characteristics
• Muscle mass and bone density
• Red blood cell production
• Mood regulation and energy levels
• Libido and sexual function

For a deeper explanation, read How Does Depo-Testosterone Work? Mechanism of Action Explained.

Alternatives to Depo-Testosterone

If you can't find Testosterone Cypionate, here are the most commonly prescribed alternatives. All require a prescription and are also controlled substances (Schedule III).

1. Testosterone Enanthate (Delatestryl)

Testosterone Enanthate is the closest alternative to Testosterone Cypionate. The two medications are so similar that many doctors and patients use them interchangeably.

• How it works: Like Testosterone Cypionate, it's an injectable ester of testosterone given intramuscularly. The ester (enanthate vs. cypionate) slightly affects how long the drug stays in your system, but the difference is minimal.
• Dosing: Typically 50–400 mg IM every 2–4 weeks, though many patients inject 100–200 mg weekly or biweekly — similar to Testosterone Cypionate dosing.
• Key difference: Testosterone Enanthate is dissolved in sesame oil (not cottonseed oil), which matters if you have an allergy to either oil.
• Availability: Sometimes easier to find because it's produced by different manufacturers and may not be affected by the same supply disruptions.
• Cost: Generic Testosterone Enanthate costs roughly $30–$80 per 5 mL vial without insurance.

2. Testosterone Undecanoate (Aveed)

Aveed is a long-acting injectable testosterone that only needs to be given every 10 weeks (after an initial loading phase).

• How it works: The undecanoate ester provides a much longer duration of action than cypionate or enanthate. A single injection maintains testosterone levels for about 10 weeks.
• Dosing: 750 mg IM at week 0, week 4, then every 10 weeks thereafter.
• Key difference: Must be administered in a healthcare setting (doctor's office or clinic) because of a rare but serious risk of pulmonary oil microembolism (POME) and anaphylaxis. It's part of a REMS program — patients must be observed for 30 minutes after each injection.
• Pros: Far fewer injections per year (about 5–6 vs. 26–52 for weekly Testosterone Cypionate). Very stable testosterone levels.
• Cons: Can't self-inject. Higher per-injection cost. May require prior authorization from insurance.
• Cost: $1,000–$2,500 per injection without insurance, though most insurance plans cover it with prior authorization.

3. Testosterone Gel (AndroGel, Testim, Vogelxo)

Testosterone gels are topical formulations applied to the skin daily.

• How it works: Testosterone absorbs through the skin into the bloodstream, providing steady daily levels rather than the peaks and troughs of injectable testosterone.
• Dosing: Typically 50–100 mg applied daily to the shoulders, upper arms, or abdomen (depending on the product). Available as 1% and 1.62% concentrations.
• Key difference: No needles required. However, there's a risk of secondary transfer — testosterone can transfer to women and children through skin contact, which can cause serious side effects including virilization.
• Pros: Easy to apply. Steady testosterone levels throughout the day.
• Cons: Must apply daily. Transfer risk requires careful precautions (washing hands, covering application site, avoiding skin contact). Generally more expensive than injectable testosterone.
• Cost: Generic testosterone gel costs about $30–$100 per month with a discount card. Brand-name AndroGel can cost $500+ without insurance.

4. Testosterone Pellets (Testopel)

Testopel consists of small testosterone pellets implanted under the skin every 3–6 months.

• How it works: A healthcare provider makes a small incision (usually in the hip or buttock area) and implants several pellets subcutaneously. The pellets slowly dissolve, releasing testosterone over months.
• Dosing: 150–450 mg (2–6 pellets) implanted every 3–6 months, depending on individual needs.
• Key difference: Longest duration between doses of any testosterone formulation. Requires an in-office procedure.
• Pros: Very convenient — no daily or weekly dosing to remember. Steady testosterone levels.
• Cons: Requires a minor surgical procedure. Risk of pellet extrusion (pellet pushing out through the skin). Not easily reversible if side effects occur.
• Cost: $500–$1,000 per insertion procedure, though frequency is only 2–4 times per year.

How to Choose the Right Alternative

The best alternative depends on your situation:

• If you want the closest match: Testosterone Enanthate is nearly identical to Testosterone Cypionate and is the easiest switch.
• If you hate needles: Testosterone gel or pellets eliminate the need for self-injection.
• If you want fewer doses: Aveed (every 10 weeks) or Testopel (every 3–6 months) offer the longest intervals.
• If cost is a concern: Generic Testosterone Enanthate and generic testosterone gel are the most affordable options.

Always discuss switching with your doctor. They can adjust your dose and monitoring schedule based on the formulation you switch to.

Final Thoughts

Not being able to find your testosterone prescription is stressful, but you have real options. Talk to your prescriber about these alternatives, and use Medfinder to check availability for whatever medication you and your doctor decide on.

For tips on locating Depo-Testosterone specifically, read our guide on how to find Depo-Testosterone in stock near you. And if cost is a barrier, check out how to save money on Depo-Testosterone.