Testosterone Cypionate, Injectable Solution

• Heart effects warning: There haven’t been any long-term studies done to know if testosterone replacement therapy in men has a negative effect on heart health. However, short-term studies have shown that this drug may increase your risk of a heart attack, stroke, or death.
• Liver problems warning: Using high doses of this drug for a long period of time can increase your risk of liver problems. These problems include liver cancer and hepatitis. These are serious conditions that can be life-threatening.
• Blood clots warning: This drug may raise your risk of developing blood clots in your lungs or the deep veins of your legs.
• Misuse warning: Testosterone can be misused. There is an increased risk if you take the drug at higher doses than your doctor prescribes, or if you use it along with other anabolic steroids. Misusing testosterone can lead to serious health problems. These problems include heart attack, heart failure, depression, and psychosis. Your doctor can tell you more about the risks of testosterone misuse.

Testosterone cypionate is a prescription drug. It comes as an injectable solution given into the muscle. Testosterone cypionate is a self-injectable drug. You can give this medication to yourself at home after your doctor shows you how to do so.

Testosterone cypionate is available as the brand-name drug Depo-Testosterone. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Testosterone cypionate is a controlled substance. This means it’s regulated by the government.

Why it’s used

Testosterone cypionate is used to treat symptoms of hypogonadism in males. In this condition, males don’t produce enough of the sex hormone testosterone.

Low testosterone levels in males can lead to mood changes, poor concentration, erectile dysfunction (trouble getting or keeping an erection), and low sex drive. It can also cause reduced growth of penis and testicles, gynecomastia (breast growth), loss of body hair and muscle mass, anemia, and osteoporosis.

There are two types of hypogonadism: primary and hypogonadotropic. This drug may be used to treat both.

• Primary hypogonadism occurs when the testicles can’t produce enough testosterone.
• Hypogonadotropic hypogonadism occurs when there is damage to parts of the brain (hypothalamus or pituitary gland) that tell the testicles to produce testosterone.

Testosterone cypionate is also prescribed off-label for testosterone therapy for transgender men and gender diverse people. Off-label means a doctor can prescribe the medication for a different use than what it was approved for.

How it works

Testosterone cypionate belongs to a class of drugs called androgens. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Testosterone cypionate works to treat hypogonadism in males by replacing the testosterone your body is unable to make.

Testosterone cypionate injectable solution doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of testosterone cypionate can include:

• acne
• pain and swelling at injection site
• hair growth
• gynecomastia (breast enlargement)
• more frequent erections
• erections that last longer than normal
• mood swings
• headache
• decrease in sperm count when the drug is used at high doses

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain
  • shortness of breath
  • discomfort in your upper body
• Stroke. Symptoms can include:
  • weakness in one part or side of your body
  • slurred speech
• Enlargement of your prostate gland. Symptoms can include:
  • frequent or urgent need to urinate
  • nocturia (need to urinate more often at night)
  • trouble starting urination
  • weak urine stream or a stream that stops and starts
  • dribbling at the end of urination
  • straining while urinating
  • not being able to completely empty your bladder
• Prostate cancer. Your doctor should check for prostate cancer or any prostate problems before and during treatment with this drug, especially if you’re 65 years or older.
• Liver problems. Symptoms can include:
  • nausea
  • vomiting
  • stomach pain and swelling
  • swelling in your legs and ankles
  • bruising more easily than normal
  • pale-colored stool
  • unusual or unexplained tiredness
  • loss of appetite
  • dark-colored urine
  • yellowing of your skin or the whites of your eyes
• Deep vein thrombosis (blood clots in the deep veins of your legs). Symptoms can include:
  • swelling of your leg
  • pain in your leg
• Pulmonary embolism (blood clots in your lungs). Symptoms can include:
  • shortness of breath
  • chest pain or discomfort that gets worse when you take a deep breath or when you cough
  • feeling lightheaded or dizzy, or fainting
  • fast pulse
  • coughing up blood
• Polycythemia (increase in your red blood cell count). Symptoms can include:
  • reddening in your face
  • headaches
  • confusion
  • stroke
  • blood clots
  • tiredness
  • decrease in mental alertness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Testosterone cypionate injectable solution can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with testosterone cypionate are listed below.

Interactions that increase your risk of side effects

Taking testosterone cypionate with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

• Insulin and oral diabetes drugs, such as nateglinide, pioglitazone, repaglinide, rosiglitazone, metformin, glimepiride, glipizide, sitagliptin, saxagliptin, linagliptin, exenatide and liraglutide. Taking these drugs together may cause a significant decrease in your blood sugar levels. Your doctor may decrease the dosage of your diabetes drugs. You may need to monitor your blood sugar levels closely while taking these drugs together.
• Oral blood thinners, such as warfarin. Taking these drugs together may increase your risk of bleeding. Your doctor will monitor you closely if you take these drugs together.
• Corticosteroids and adrenocorticotropic hormone. Taking these drugs with testosterone cypionate puts you at a higher risk of edema (fluid build-up). Your doctor should monitor you closely for fluid build-up if you take these drugs together, especially if you have heart or liver problems.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Testosterone cypionate can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with liver problems: This medication can cause liver damage. This may lead to serious liver disease. If you have liver disease, this drug may also cause salt and water retention. This may make your liver disease worse.

For people with heart problems: If you have heart disease, this drug may cause salt and water retention. Both the medication and the salt and water retention can make your conditions worse. If you have a history of heart attack or heart disease, ask your doctor whether this drug is safe for you.

For people with kidney problems: If you have kidney problems or a history of kidney disease, this drug may cause salt and water retention. Both the medication and salt and water retention can make your conditions worse.

For people with breast cancer: You shouldn’t take this drug if you have breast cancer. This medication may make your disease worse.

For people with prostate cancer: You shouldn’t take this drug if you have prostate cancer. Testosterone cypionate may make your disease worse.

For people with sleep apnea (problems breathing while sleeping): If you have sleep apnea, ask your doctor whether this drug is safe for you. This medication may make this condition worse. You may wake up more often at night, which may cause you to be more tired during the day.

For people with polycythemia (elevated red blood cell count): This drug may significantly increase your red blood cell count and make your condition worse. You shouldn’t use this drug if your hematocrit is above 54%.

For people with high cholesterol levels: This drug may increase your cholesterol levels. High cholesterol levels may increase your risk of heart or blood vessel problems. Your doctor will check your cholesterol levels while you take this medication.

For people with diabetes: This drug may cause a significant decrease in your blood sugar levels. Your doctor may lower the dosage of your diabetes drugs. You may also need to monitor your blood sugar levels closely.

For people with blood clots: This drug may increase your risk of developing blood clots in your lungs or in the deep veins of your legs, especially if you have a history of blood clots.

Warnings for other groups

For pregnant people: Testosterone cypionate should never be used during pregnancy. This medication can cause harm to the fetus.

People who can become pregnant are advised to use birth control while taking testosterone cypionate.

Testosterone cypionate should not be used by people who are breastfeeding or chestfeeding.

For seniors: This drug shouldn’t be used to treat age-related decreases in testosterone. There isn’t enough information from clinical trials in seniors ages 65 years and older to support the use of this drug for a long period of time.

If you’re older than 65 years, you may be at a higher risk of heart disease, prostate cancer, and enlarged prostate while taking this drug.

For children: It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Testosterone cypionate may affect bone growth in children. This drug can cause bones to mature more quickly than normal without causing an increase in height. This can result in a shorter adult height. Your doctor will check your child’s growth regularly if your child takes this drug.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Generic: Testosterone cypionate

• Form: injectable solution
• Strengths: 100 mg/mL, 200 mg/mL

Brand: Depo-testosterone

• Form: injectable solution
• Strengths: 100 mg/mL, 200 mg/mL

Dosage for primary hypogonadism

Adult dosage (ages 18 years and older)

• Typical starting dosage: Your dosage depends on your age and diagnosis. Your doctor will decide a dosage based on your needs. In general, the dosage is 50–400 mg injected into your muscle every 2–4 weeks.
• Dosage increases: Your doctor may adjust your dosage based on your testosterone blood levels, response to treatment, and side effects.
• Maximum dosage: 400 mg injected into your muscle every 2 weeks.

Child dosage (ages 12–17 years)

• Typical starting dosage: Your child’s dosage depends on their age, body size, and diagnosis. Your doctor will decide a dosage based on your child’s needs. In general, the starting dosage is 40-50 mg per meters squared (mg/m2) injected into your child’s muscle once a month. Meters squared is a measure of your child’s body size.
• Dosage increases: Your doctor may adjust your child’s dosage based on their testosterone blood levels, response to treatment, and side effects. For the terminal growth phase, the typical dosage is 100 mg/m2 injected into your child’s muscle once per month. For the maintenance phase, the typical dosage is 100 mg/m2 injected into your child’s muscle twice per month.
• Maximum dosage: 400 mg injected into your child’s muscle every 2 weeks.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Dosage for hypogonadotropic hypogonadism

Adult dosage (ages 18 years and older)

• Typical starting dosage: Your dosage depends on your age and diagnosis. Your doctor will decide a dosage based on your needs. In general, the dosage is 50–400 mg injected into your muscle every 2–4 weeks.
• Dosage increases: Your doctor may adjust your dosage based on your testosterone blood levels, response to treatment, and side effects.
• Maximum dosage: 400 mg injected into your muscle every 2 weeks.

Child dosage (ages 12–17 years)

• Typical starting dosage: Your child’s dosage depends on their age, body size, and diagnosis. Your doctor will decide a dosage based on your child’s needs. In general, the starting dosage is 40-50 mg per meters squared (mg/m2) injected into your child’s muscle once a month. Meters squared is a measure of your child’s body size.
• Dosage increases: Your doctor may adjust your child’s dosage based on their testosterone blood levels, response to treatment, and side effects. For the terminal growth phase, the typical dosage is 100 mg/m2 injected into your child’s muscle once per month. For the maintenance phase, the typical dosage is 100 mg/m2 injected into your child’s muscle twice per month.
• Maximum dosage: 400 mg injected into your child’s muscle every 2 weeks.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Testosterone cypionate injectable solution is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your medication may not work as well. For this drug to work well, a certain amount needs to be in your body at all times. If you don’t take this drug, you may still have symptoms of low testosterone.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms can include:

• acne
• pain and swelling at injection site
• hair growth
• gynecomastia (breast enlargement)
• more frequent erections
• erections that last longer than normal
• decrease in sperm count
• mood swings
• headache

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Call your doctor and tell them how long it’s been since you last injected testosterone cypionate. They will help you set up a new dosing schedule. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms of low testosterone should improve and may go away.

Keep these considerations in mind if your doctor prescribes testosterone cypionate for you.

General

• Take this drug at the time(s) recommended by your doctor.

Storage

• Store testosterone cypionate at room temperature between 68°F and 77°F (20°C and 25°C).
• Keep this drug away from light.

Refills

A prescription for this medication may not be refillable. You may need a new prescription for this medication to be refilled. Ask your doctor about the refill status for this drug.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
• Remember to bring syringes and needles so you can inject your medication while you’re away from home.

Self-management

Testosterone cypionate is given by injection into your muscle (usually the buttocks). Your healthcare provider will teach you how to inject the drug deep into your muscle.

You’ll need to purchase the following to give yourself an injection:

• sterile alcohol wipes
• syringes
• needles
• a sharps container (a bin for safe disposal of used syringes)

Clinical monitoring

You and your doctor should monitor certain health issues while you take this drug. This can help make sure you stay safe during your treatment. These issues include:

• Cholesterol levels. This drug may increase your cholesterol levels. High cholesterol levels may raise your risk of heart or blood vessel problems. Your doctor will check your cholesterol levels while you take this medication.
• Hemoglobin and hematocrit. In rare cases, this drug may increase your red blood cell count to very high levels. This is called polycythemia. Your doctor will check your hemoglobin and hematocrit levels to make sure they’re not significantly increased while you take this medication.
• Testosterone levels. Your doctor will check your total testosterone level 3–6 months after you start taking this drug. After that, they’ll check your testosterone levels once per year to make sure this drug is working for you. Your doctor may adjust your dosage based on your testosterone levels.
• Bone age. If your child is receiving this drug for delayed puberty, your doctor should do an X-ray of your child’s wrist and hand every 6 months to check how fast their bones are maturing.
• Prostate health. Seniors treated with this drug may have an increased risk of developing an enlarged prostate and prostate cancer. Your doctor may check your prostate and measure your prostate specific antigen levels (PSA) to make sure your prostate is healthy.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Hidden costs

You may need to purchase the following:

• sterile alcohol wipes
• syringes and needles to inject testosterone cypionate
• a sharps container (a bin for safe disposal of used syringes)

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.