Provider Briefing: Lupron Depot Supply Challenges Continue Into 2026

Lupron Depot (Leuprolide Acetate for depot suspension) remains one of the most supply-constrained specialty injectables in the U.S. formulary. If your practice has encountered difficulty sourcing specific strengths — or if patients are reporting delays in receiving their scheduled injections — this briefing provides the clinical and logistical context you need to manage the situation effectively.

This article is written for urologists, oncologists, gynecologists, pediatric endocrinologists, and other prescribers who rely on Lupron Depot as part of their treatment protocols.

Shortage Timeline: How We Got Here

The Lupron Depot supply disruption has been a recurring issue for over five years:

• July 2020: ASHP first listed Leuprolide Acetate long-acting suspension for IM injection as being in shortage. AbbVie cited manufacturing constraints.
• August 2020 – July 2021: Multiple ASHP updates documented ongoing supply limitations across various strengths. The FDA shortage database also tracked the issue.
• May 2022: ASHP marked the shortage as resolved. However, this reflected improved — not fully normalized — supply.
• 2023–2025: Intermittent availability gaps continued to surface, particularly for the 22.5 mg (3-month prostate cancer), 3.75 mg and 11.25 mg (endometriosis/fibroids), and pediatric formulations.
• 2026: While AbbVie has not announced new manufacturing disruptions, distribution remains uneven. Some practices report consistent access; others face recurring sourcing difficulties, especially when relying on a single distributor.

Prescribing Implications

The clinical impact of Lupron Depot supply constraints varies by patient population:

Prostate Cancer (Advanced)

For patients on androgen deprivation therapy (ADT), treatment interruption can lead to testosterone recovery and disease progression. If Lupron Depot is unavailable:

• Eligard (Leuprolide Acetate SC depot) is the most direct substitution — same molecule, subcutaneous delivery. Available in 1-, 3-, 4-, and 6-month formulations.
• Trelstar (Triptorelin Pamoate) — GnRH agonist with 1-, 3-, and 6-month IM depot options.
• Zoladex (Goserelin Acetate) — GnRH agonist SC implant, 1-month and 3-month.
• Orgovyx (Relugolix) — Oral GnRH antagonist, 120 mg daily. Phase III data (HERO trial) demonstrated non-inferior testosterone suppression with a more favorable cardiovascular safety signal. No injection site reactions; faster testosterone recovery post-discontinuation. Increasingly used as a primary option, not just a shortage alternative.

Endometriosis and Uterine Fibroids

For gynecologic indications, switching options are more limited because many GnRH agonists are only approved for prostate cancer:

• Zoladex 3.6 mg — FDA-approved for endometriosis (monthly SC implant).
• Orilissa (Elagolix) — Oral GnRH antagonist approved for endometriosis-associated pain. Available in 150 mg (once daily) and 200 mg (twice daily) doses.
• Myfembree (Relugolix 40 mg/estradiol 1 mg/norethindrone acetate 0.5 mg) — Oral combination approved for uterine fibroids with heavy menstrual bleeding and endometriosis. Includes hormonal add-back therapy to mitigate bone density loss and vasomotor symptoms.

Central Precocious Puberty (CPP)

Lupron Depot-PED shortages are particularly concerning given the narrow therapeutic window:

• Triptodur (Triptorelin, 22.5 mg 6-month IM) — FDA-approved for CPP.
• Supprelin LA (Histrelin Acetate, 50 mg SC implant) — Provides 12 months of continuous GnRH agonism. Implant requires minor surgical procedure for placement and removal.
• Fensolvi (Leuprolide Acetate, 45 mg SC 6-month) — Same molecule as Lupron, 6-month SC depot for CPP.

Current Availability Picture

Lupron Depot availability in 2026 is best described as inconsistent but not critically short. Key factors affecting your ability to source it:

• Distributor dependency: Practices relying on a single distributor (McKesson, Cardinal Health, or AmerisourceBergen) may face allocation limits. Cross-checking multiple distributors can improve fill rates.
• Strength-specific gaps: Not all strengths are equally affected. The 7.5 mg and 45 mg prostate cancer formulations tend to have better availability than the 22.5 mg and gynecologic strengths.
• Regional variation: Supply constraints are more pronounced in some regions than others, likely reflecting distributor allocation algorithms and local demand patterns.
• Advance ordering: Practices that order 2-4 weeks ahead of scheduled patient appointments report significantly fewer disruptions.

Cost and Access Considerations

Lupron Depot's cost profile creates additional access barriers:

• Cash pricing: $2,200–$5,500+ per injection depending on strength and dosing interval.
• Insurance: Most commercial and Medicare plans cover Lupron Depot under the medical benefit (buy-and-bill). Prior authorization is standard.
• AbbVie savings card: Commercially insured patients may qualify for copays as low as $10/dose (max savings $300/month for 1-month supply, $600/month for 3-month supply).
• myAbbVie Assist: Patient assistance program provides free medication for qualifying uninsured/underinsured patients. Income threshold generally under 600% FPL. Application: abbvie.com or 1-800-222-6885.

For more on helping patients navigate costs, see our provider's guide to helping patients save on Lupron.

Tools and Resources for Your Practice

Several tools can help your practice manage Lupron supply challenges:

• Medfinder for Providers — Search real-time Lupron Depot availability across pharmacies and practices. Help patients locate nearby sources when your office is out of stock.
• ASHP Drug Shortage Database — Monitor official shortage status and estimated recovery timelines.
• FDA Drug Shortage Database — Check FDA's current list and manufacturer communications.
• AbbVie Provider Resources: Sample requests at 833-999-1779; medical information at 1-800-633-9110.

Looking Ahead

Several trends may improve the Lupron access landscape in coming years:

• Oral GnRH antagonist adoption: As Orgovyx and Myfembree gain broader insurance coverage and clinical acceptance, demand pressure on injectable GnRH agonists may ease.
• Biosimilar/generic potential: While no generic Lupron Depot is currently approved, the specialty injectable generic pipeline continues to expand. Any future entrant would significantly improve supply resilience.
• Prescribing diversification: Practices that proactively incorporate alternatives into their formulary — rather than defaulting to Lupron Depot for all patients — are better positioned to manage supply disruptions.

Final Thoughts

The Lupron Depot supply situation in 2026 requires ongoing vigilance but is manageable with proactive planning. Key recommendations for your practice:

1. Diversify your GnRH agonist formulary — Don't rely solely on Lupron Depot
2. Order early — 2-4 weeks ahead of scheduled injections
3. Use multiple distributors when possible
4. Leverage Medfinder to find supply for patients when your office is out
5. Keep patients informed — Share resources like our patient-facing shortage update

The goal is continuity of care. With the right preparation, treatment interruptions due to supply issues can be minimized or eliminated entirely.