Provider Briefing: The Prometrium Shortage in 2026

The ongoing shortage of Progesterone capsules — both brand-name Prometrium and generic formulations — continues to affect prescribers across specialties in 2026. Whether you practice in OB/GYN, reproductive endocrinology, primary care, or endocrinology, there's a good chance your patients have encountered difficulty filling their Progesterone prescriptions.

This article provides a concise overview of the shortage timeline, its clinical implications, alternative prescribing strategies, and tools you can share with patients to improve access.

Shortage Timeline

Progesterone capsule supply issues first appeared on the ASHP Drug Shortage list in late 2023. Key milestones include:

• Late 2023: Amneal Pharmaceuticals, a major generic Progesterone manufacturer, reported supply constraints for both 100 mg and 200 mg capsules. Patients began reporting difficulty filling prescriptions at chain pharmacies.
• 2024: The shortage expanded to affect brand-name Prometrium from Virtus Pharmaceuticals as well. Intermittent availability became the norm, with significant regional variation.
• October 2025: ASHP updated its shortage listing. Both Prometrium (Virtus, 200 mg) and generic Progesterone (Amneal, 100 mg and 200 mg) remained listed with no confirmed resolution date.
• Early 2026: Supply has partially stabilized in some markets, but shortages persist in others. The situation remains fluid.

Prescribing Implications

The Progesterone capsule shortage presents several clinical challenges:

Continuity of Therapy

Patients on established Progesterone regimens — particularly those using it for endometrial protection during HRT — may experience gaps in therapy if they cannot locate their medication. Interruptions in progestin coverage during estrogen therapy increase the risk of endometrial hyperplasia.

Fertility Treatment Protocols

Reproductive endocrinologists frequently prescribe Progesterone capsules for luteal phase support. Supply disruptions can be particularly critical in IVF cycles where timing is essential. Consider having backup protocols in place that specify alternative formulations.

Patient Anxiety and Non-Adherence

Patients frustrated by repeated stockouts may discontinue therapy altogether or turn to unregulated sources. Proactive communication about the shortage and available alternatives can mitigate this risk.

Current Availability Picture

Availability varies significantly by region, pharmacy type, and formulation:

• Brand-name Prometrium (Virtus): Intermittently available. Some pharmacies maintain stock while others cannot source it.
• Generic Progesterone (Amneal and others): Availability is inconsistent. Pharmacies may have one strength but not the other.
• Independent pharmacies: Often have better access to alternative distribution channels and may be able to source stock when chains cannot.
• Compounding pharmacies: Can prepare micronized Progesterone capsules, suppositories, or other formulations. These are not FDA-approved products but represent a viable stopgap during shortages.

Cost and Access Considerations

Cost dynamics during the shortage are important to understand when advising patients:

• Brand-name Prometrium: Cash price approximately $1,800 to $1,900 per 90 capsules. Brand may require prior authorization from many insurers.
• Generic Progesterone: With discount cards (GoodRx, SingleCare), generic capsules can cost as low as $12 to $50 for a 30-day supply. Most commercial and Medicare Part D plans cover generic Progesterone on Tier 1 or Tier 2.
• Compounded Progesterone: Typically $30 to $90 per month, often not covered by insurance.

Directing patients to savings resources can improve adherence when cost is a barrier.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder offers a real-time pharmacy stock search tool that providers can recommend to patients. Rather than having office staff call multiple pharmacies, patients can search for Prometrium or Progesterone availability near their location independently.

ASHP Drug Shortage Database

Monitor the official ASHP drug shortage database for updates on Progesterone capsule availability, including manufacturer-specific information and estimated resolution dates.

Alternative Prescribing Reference

When Progesterone capsules are unavailable, consider the following alternatives based on indication:

• Endometrial protection (HRT): Medroxyprogesterone Acetate (Provera) 5-10 mg daily for 12-14 days per cycle. Well-established efficacy for this indication, widely available.
• Secondary amenorrhea: Medroxyprogesterone Acetate 10 mg daily for 10 days. Alternative: Norethindrone Acetate 5 mg daily for 10 days.
• Luteal phase support (ART/IVF): Endometrin 100 mg vaginal insert 2-3 times daily. Alternative: Progesterone in oil (intramuscular injection). Compounded vaginal Progesterone suppositories.
• Patient preference for bioidentical: Compounded micronized Progesterone from an accredited compounding pharmacy.

For a detailed comparison of alternatives, see: Alternatives to Prometrium.

Looking Ahead

Several developments may improve the supply situation:

• Additional generic manufacturers may enter the market, increasing competition and supply
• Ongoing FDA efforts to expedite review of ANDA applications for drugs in shortage
• Growing compounding pharmacy infrastructure provides an alternative supply source

However, there is no confirmed resolution date for the current shortage. Providers should continue to have contingency plans in place and communicate proactively with patients about the situation.

Final Thoughts

The Progesterone capsule shortage requires a proactive, multi-strategy approach. Keeping patients informed, having alternative prescribing plans ready, and directing patients to tools like Medfinder can meaningfully reduce the clinical impact of this ongoing supply disruption.

For patient-facing information you can share, see: Prometrium shortage update: What patients need to know in 2026. For a step-by-step provider guide on helping patients locate stock, read: How to help your patients find Prometrium in stock.