Your Patients Can't Find Their Testosterone — Here's How You Can Help

If you prescribe Depo-Testosterone (Testosterone Cypionate), you've almost certainly fielded calls from frustrated patients who can't get their prescription filled. The ongoing Testosterone Cypionate shortage has turned what should be a routine refill into a multi-pharmacy scavenger hunt for many patients — and they're looking to your office for help.

This guide provides a practical, step-by-step framework for helping your patients navigate the shortage, along with workflow tips to reduce the burden on your clinical staff.

Current Availability

As of 2026, Testosterone Cypionate supply remains intermittent nationwide. Key patterns to be aware of:

• The 200 mg/mL concentration is more consistently available than 100 mg/mL
• Multi-dose 10 mL vials are more available than single-dose 1 mL vials
• Independent and specialty pharmacies tend to have better stock than large chains
• Compounding pharmacies can prepare Testosterone Cypionate when commercial products are unavailable
• Supply varies significantly by geographic region

For a detailed overview of the shortage history and causes, see our provider shortage briefing.

Why Patients Can't Find It

Understanding the barriers your patients face helps you provide better guidance:

Pharmacy-Level Factors

• Chain pharmacies use automated ordering that may not restock controlled substances quickly
• Some pharmacies limit controlled substance inventory to reduce diversion risk
• DEA allocation limits can restrict how much a pharmacy orders per month

System-Level Factors

• DEA production quotas cap annual manufacturing volumes for Schedule III substances
• Demand growth (TRT, gender-affirming care) has outpaced supply adjustments
• Manufacturing disruptions from multiple producers have compounded the issue

Patient-Level Factors

• Many patients don't know they can use pharmacies beyond their usual chain
• Patients may not realize they can ask about different concentrations or vial sizes
• Anxiety about running out can lead to last-minute refill attempts when options are limited

What Providers Can Do: 5 Steps

Step 1: Prescribe the Most Available Formulation

When writing or adjusting prescriptions, optimize for availability:

• Prescribe the 200 mg/mL concentration when clinically appropriate — it's more widely stocked
• Specify multi-dose vial when possible
• Write for generic Testosterone Cypionate rather than brand Depo-Testosterone to give pharmacies maximum flexibility in sourcing
• If appropriate, include "may substitute Testosterone Enanthate" in your notes to the pharmacy (requires separate prescription in most states)

Step 2: Check Stock Before Sending the Prescription

A 30-second check can save your patient hours of frustration. Medfinder for Providers allows you to search real-time pharmacy availability by zip code. Have your staff check availability before sending the e-prescription, and send it directly to a pharmacy that has stock.

Step 3: Build Pharmacy Relationships

Identify 2–3 pharmacies in your area that reliably stock Testosterone Cypionate and develop relationships with their pharmacists:

• Independent pharmacies that serve your patient population
• Compounding pharmacies that can prepare testosterone when commercial supply is disrupted
• Specialty pharmacies that focus on hormone therapy or men's health

These pharmacies can become your go-to referrals when patients report stockouts.

Step 4: Have a Standing Alternative Protocol

Develop an internal protocol for when Testosterone Cypionate is unavailable. Having a pre-approved alternative pathway saves time:

• First alternative: Testosterone Enanthate (Delatestryl) at equivalent dose — most interchangeable option
• Second alternative: Testosterone gel (generic or AndroGel) — eliminates injection barriers, good for patients open to daily application
• Third alternative: Testosterone Undecanoate (Aveed) for patients who prefer long-acting injections — requires REMS enrollment and in-office administration
• Fourth alternative: Testosterone pellets (Testopel) for patients willing to do an in-office procedure every 3–6 months

For detailed information on each alternative, see our alternatives guide.

Step 5: Educate Patients Proactively

Equip your patients with tools and knowledge to manage supply issues independently:

• Share Medfinder as a resource for finding pharmacy stock
• Advise patients to refill 7–10 days early to build in buffer time
• Explain that independent pharmacies may have better access
• Provide written instructions for what to do if they can't find their medication (who to call, what alternatives exist)

Consider sharing our patient guide: How to Find Depo-Testosterone in Stock Near You.

Alternatives at a Glance

Quick reference for your clinical staff:

• Testosterone Enanthate: IM injection, same dosing as cypionate, sesame oil carrier. Most direct substitute.
• AndroGel / generic testosterone gel: Topical, 50–100 mg/day. Counsel on secondary transfer risk.
• Aveed (Testosterone Undecanoate): IM every 10 weeks. REMS required, 30-minute post-injection observation.
• Testopel (testosterone pellets): Subcutaneous implant every 3–6 months. In-office procedure.

Workflow Tips

Minimize the operational impact on your practice:

For Front Desk / Intake Staff

• When patients call about fill problems, have a script: "We can check availability at other pharmacies for you. Can you confirm your zip code?"
• Use Medfinder to look up stock while the patient is on the phone

For Clinical Staff / MAs

• Flag upcoming testosterone refills in your EHR so you can proactively check stock
• Keep a running list of pharmacies with reliable testosterone supply in your area
• When a patient reports a stockout, check if they're due for lab work — it's a good time to confirm levels and adjust therapy if needed

For Prescribers

• Use e-prescribing to send directly to pharmacies with confirmed stock
• Include your office callback number on prescriptions so pharmacies can reach you with questions
• Consider writing two prescriptions — one for Testosterone Cypionate and a backup for Testosterone Enanthate — so patients have options (check your state's regulations on this approach)

Final Thoughts

The Testosterone Cypionate shortage puts an extra burden on providers, but a systematic approach can minimize disruption for your patients and your practice. By prescribing strategically, using real-time stock tools like Medfinder, building pharmacy relationships, and having ready alternatives, you can keep your patients on therapy even when supply is tight.

Related resources:

• Depo-Testosterone Shortage: What Providers Need to Know in 2026
• How to Help Patients Save Money on Depo-Testosterone
• Patient Shortage Update (shareable with patients)