Injectable testosterone cypionate has been in intermittent shortage in the United States since 2023, and in 2026 it still has not fully normalised. This page sets out what is actually short, which sources say so, and what that means if you get TRT through an online clinic. The options section is built from the 34 clinics we track.
Independently researched · Educational information, not medical advice · Affiliate disclosure
Updated 7 October 2026. Earlier versions of this article said testosterone appeared "repeatedly" on the FDA drug shortage database and that MangoRx was the only mainstream clinic offering FDA-approved oral testosterone. Neither was right; both are corrected below.
What is actually short
Two shortage lists matter, and they don't agree:
- ASHP (American Society of Health-System Pharmacists) has listed testosterone cypionate injection since 2023. Its 2026 entry names Pfizer's Depo-Testosterone (brand cypionate) as short because of manufacturing delays, along with some generic presentations. Hikma and Padagis reported generic cypionate available.
- FDA's drug shortage database has no testosterone entry. We queried FDA's shortage data (openFDA) on 7 October 2026 and it returned no match for testosterone.
That gap is normal: ASHP lists a drug when pharmacists report trouble getting it, while FDA lists a shortage only when national supply can't meet national demand. In practice, it means specific vials and strengths go missing at specific pharmacies, while the drug as a whole is still being made and shipped.
| Product | Status in 2026 | What it means for you |
|---|---|---|
| Depo-Testosterone (Pfizer, brand cypionate) | On ASHP's list: manufacturing delay | Brand-name scripts may need to switch to generic |
| Generic testosterone cypionate | Mixed: some makers short, Hikma and Padagis available | Usually fillable, sometimes at a different pharmacy or vial size |
| Testosterone enanthate, gels, creams | Not on either list | Normal availability |
| Kyzatrex (oral testosterone undecanoate) | Not on either list | Separate, non-sterile manufacturing |
Why cypionate is the one that runs short
- Few sterile-injectable plants. A small number of facilities make most U.S. testosterone cypionate. A quality hold at one of them is felt everywhere.
- Demand grew faster than capacity. Telehealth made TRT much easier to start after 2020, and almost all of it starts on injections. Of the 34 clinics we track, 33 offer injectable testosterone and 14 offer nothing else.
- Schedule III controls. Testosterone is a controlled substance. Manufacturing and distribution need DEA registration and quota compliance, which slows any ramp-up.
Does it affect online TRT clinics?
Less than it affects a single local pharmacy. Most online clinics ship from one or more partner pharmacies, often compounding pharmacies with their own sourcing, so a gap at your corner pharmacy doesn't mean a gap in your clinic's supply. Where it can bite:
- Brand-name prescriptions. If your protocol specifies Depo-Testosterone, a switch to a generic cypionate is the usual fix; ask the prescriber rather than the pharmacy.
- Specific vial sizes or strengths (for example 200 mg/mL in 10 mL) can be short while others are fine.
- Compounded testosterone depends on the compounder's own supply of raw material. It isn't automatically insulated.
The shortage is about physical supply. Prescribing is a separate question: the DEA's temporary telehealth flexibilities for Schedule III drugs, including testosterone, run through 31 December 2026, and the permanent special-registration rule has been under White House (OIRA) review since 25 August 2026. Our DEA special registration update tracks that.
Your options if injections are hard to get
The shortage doesn't touch the other delivery routes. Here is what the clinics we track publish for them:
| Route | Shortage exposure | Clinics we track that offer it | What it costs (published rates) |
|---|---|---|---|
| Generic injectable (cypionate or enanthate) | Some | 33 of 34 | See cheapest TRT |
| Testosterone cream or gel | None listed | 14 of 34 | See testosterone cream |
| FDA-approved oral (Kyzatrex) | None listed | 4 name it: Henry Meds, Ageless, MangoRx, Viking Alternative | Henry Meds $179/mo all-inclusive; Ageless sells it as a separate product, priced by prescribed dose; MangoRx and Viking don't publish a Kyzatrex rate we could verify |
Notes on the oral row, from our own reads of each clinic's pages:
- Henry Meds publishes $179/mo for Kyzatrex, with provider visits, labs, medication and shipping included and no contract; not available in California (read 7 October 2026). Its billing record is the weak point: the BBB rates it F, with complaints about auto-renewal and cancellation.
- Ageless sells Kyzatrex on its own product page, separately from its TRT plans; the page says the exact price depends on the prescribed dose and is shown after clinical review, and its plans page no longer names Kyzatrex on any plan (read 26 October 2026). Correction, 26 October 2026: we said Kyzatrex was part of its $209/mo Optimize tier. Our partnership with Ageless is paused, so we don't link to its signup.
- MangoRx sells Kyzatrex as its "Prime Protocol", described on its site but absent from its product pages, without a rate we could verify. Its published injectable plan is $149/mo.
- Viking Alternative offers oral Kyzatrex among four delivery routes, but stopped publishing prices in September; you get a cost after a consultation.
Oral testosterone undecanoate is FDA-approved for men with hypogonadism, taken as capsules twice a day with a meal, and needs labs like any other form. It is not a like-for-like swap: dosing and lab timing differ, so a switch goes through your prescriber. Our oral vs injectable guide and oral testosterone page cover the clinical differences.
What to do if your pharmacy is out
- Ask your prescriber, not just the pharmacist, about switching brand to generic, or to a different vial size or strength of the same drug.
- Ask whether enanthate is an option. It's a different ester with a similar weekly schedule and isn't on either shortage list.
- If you're with an online clinic, ask which pharmacy fills for them and whether it has your product. Many use several.
- Don't stretch or skip doses on your own. Levels can fall back to symptomatic lows within weeks; any bridging plan is the prescriber's call.
- If you haven't started TRT yet, the shortage is a reason to ask about delivery route up front, not a reason to avoid treatment. See how to choose an online TRT clinic.
Frequently asked questions
Is testosterone on the FDA drug shortage list in 2026? No. FDA's shortage database had no testosterone entry when we checked on 7 October 2026. ASHP's separate list does include testosterone cypionate injection, mainly Pfizer's Depo-Testosterone.
Why is there a testosterone shortage? It is mostly a manufacturing problem with injectable cypionate: few sterile-injectable plants, a Pfizer manufacturing delay, and demand that grew fast with telehealth TRT. Other forms are not affected.
Can I still get injectable TRT? Usually, yes. Generic cypionate from several makers has stayed available; what fails is often one brand, strength or pharmacy.
Is oral testosterone a substitute for injections? Kyzatrex is FDA-approved and brings testosterone into the normal range, but the dosing schedule and lab monitoring differ. Treat it as a different prescription, decided with your clinician.
Will the shortage end? ASHP's entry has been open since 2023 with gradual improvement. We'll update this page when its status changes.
Related reading
- Oral testosterone vs injections
- Injectable TRT: what online clinics charge
- Testosterone cream
- DEA special registration update
- FDA drops the testosterone heart warning
Sources: ASHP Drug Shortages, testosterone cypionate injection entry (2026); FDA drug shortage data via openFDA, queried 7 October 2026; clinic prices from each clinic's own pages on the dates given above. Medical disclaimer: this article is for informational purposes only and is not medical advice. Testosterone therapy is a prescription treatment; talk to a licensed clinician before changing your protocol. Affiliate disclosure: TRT Picks may earn a commission if you sign up through some links on this site, at no extra cost to you. Commissions never influence our scores. See our affiliate disclosure.
