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Azmiro

testosterone cypionate
Used for Testosterone Replacement

Azmiro (testosterone cypionate) is a prescription injection used to treat males with low testosterone. It's a type of testosterone replacement therapy that raises your testosterone levels to healthy levels and improves symptoms like low energy, reduced sex drive, mood changes, and muscle loss. The injection goes deep into the buttock muscle and is given by a healthcare professional, usually every 2 to 4 weeks. Some side effects include injection site reactions, headache, and higher red blood cell counts.

Reviewed by:Last reviewed on December 4, 2025
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What is Azmiro (testosterone cypionate)?

What is Azmiro (testosterone cypionate) used for?

How Azmiro (testosterone cypionate) works

Azmiro (testosterone cypionate) is a testosterone replacement therapy that acts like the natural hormone testosterone. Testosterone helps support many male traits and functions, such as muscle and bone strength, sex drive, and sperm production.

Azmiro (testosterone cypionate) works by raising testosterone levels back to a normal and healthy range in males with low testosterone.

When does Azmiro (testosterone cypionate) start working?Time passed since treatment started:
HOURS
DAYS
WEEKS
Initial effect
MONTHS
Full effect

Drug facts

Common BrandsAzmiro
Drug ClassTestosterone replacement
Controlled Substance ClassificationSchedule III
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Risks and warnings for Azmiro (testosterone cypionate)

Azmiro (testosterone cypionate) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Higher red blood cell count

Azmiro (testosterone cypionate) can raise your red blood cell count, which can lead to blood clots. Your prescriber will check your red blood cell levels before you start treatment and during it. If your levels get too high, you might have to stop the medication until they go back to normal.

Blood clots

Azmiro (testosterone cypionate) itself can cause life-threatening blood clots in your legs or lungs. If you notice leg pain, swelling, warmth, or redness, tell your prescriber right away, as these could be signs of a blood clot in your leg. If you suddenly have trouble breathing or chest pain, it could mean a clot has moved to your lungs. If this happens, you might have to stop taking the medication.

Worsening of enlarged prostate and risk of prostate cancer

  • Risk factors: History of enlarged prostate

Taking Azmiro (testosterone cypionate) can worsen certain symptoms if you have an enlarged prostate, also called benign prostatic hyperplasia (BPH). Let your prescriber know if you notice changes in urination, such as going more often at night, feeling like you need to go right away, having trouble starting, leaking, or a weak stream.

Azmiro (testosterone cypionate) might also raise your risk of prostate cancer. Your prescriber might order blood tests or check your prostate before and during treatment to help keep you safe.

Higher blood pressure

  • Risk factors: History of high blood pressure

Azmiro (testosterone cypionate) can raise your blood pressure. Having high blood pressure over time can raise your risk for heart problems, like heart attack or stroke.

Get emergency help right away if you have chest pain, cold sweats, left arm pain, trouble breathing, trouble walking, trouble speaking, or weakness on one side of the body. You should check your blood pressure often while you’re using this medication, especially if you already have high blood pressure.

Potential for misuse, addiction, and dependency

  • Risk factors: Taking more Azmiro (testosterone cypionate) than prescribed | Taking Azmiro (testosterone cypionate) with other testosterones

Azmiro (testosterone cypionate) is a controlled substance because it can be misused or cause dependence, especially if you take higher doses than prescribed or combine it with other testosterone products.

Misusing Azmiro (testosterone cypionate) can lead to addiction. This medication is only approved by the FDA to treat low testosterone in men. Taking Azmiro (testosterone cypionate) for other reasons can cause serious heart and mental health problems. Always use it exactly as prescribed.

Lower sperm count

  • Risk factors: Taking more Azmiro (testosterone cypionate) than prescribed

Azmiro (testosterone cypionate) can lower sperm count, which might make it harder to have a baby. This is more likely with higher doses, and the effect could be permanent. Tell your prescriber if you plan to have children before starting this medication.

Liver problems

Using certain forms of testosterone, such as methyltestosterone or testosterone enanthate intramuscular injection, for a long time can cause serious liver problems. This isn't a known risk of Azmiro (testosterone cypionate), but it's still important to look out for symptoms of liver damage. Let your prescriber know if you have stomach pain, pale stools, dark urine, or yellowing of your skin or eyes.

Swelling in the arms and legs (edema)

  • Risk factors: History of heart, liver, or kidney conditions | Taking other medications that cause swelling like corticosteroids

Azmiro (testosterone cypionate) can make your body keep extra salt and water, which might lead to edema, or swelling in your arms and legs. This is more likely if you take other medications that cause swelling, like corticosteroids (e.g., prednisone, methylprednisolone). Swelling can be more serious if you have heart, liver, or kidney problems. Tell your prescriber if you notice these symptoms.

Breathing problems during sleep (sleep apnea)

  • Risk factors: Obesity | History of lung problems

Azmiro (testosterone cypionate) can make sleep apnea, a condition that causes breathing problems during sleep, worse in some people. This is more likely if you have obesity or lung problems. Talk to your prescriber if you or your partner notice loud snoring, pauses in breathing during sleep, or if you feel very tired during the day.

Enlarged breasts

Some people using Azmiro (testosterone cypionate) might develop gynecomastia, which is swelling or enlargement of breast tissue in men. You might also feel soreness or pain in your chest area. Talk to your prescriber if you have questions about this side effect.

Changes in cholesterol levels

Testosterone treatments like Azmiro (testosterone cypionate) can affect your cholesterol levels. Your prescriber might need to adjust your dose or stop the medication if these changes happen. They will check your cholesterol regularly, especially when you first start using the medication.

High calcium levels

  • Risk factors: History of cancer

Azmiro (testosterone cypionate) can raise calcium levels in your blood and urine, especially in people with cancer. High calcium levels can cause symptoms such as muscle weakness, frequent urination, thirst, stomach pain, and blood in the urine. Your prescriber might check your blood regularly during treatment to make sure your calcium levels stay normal.

Effects on growing bones in children

  • Risk factors: Young children

Azmiro (testosterone cypionate) can affect bone growth in children. It can cause the bones to mature too quickly, which can make the growth plates close early. This can lead to a shorter adult height. The younger the child, the higher the risk. If your child is using this medication, their care team should check bone growth every 6 months by taking X-rays of the wrist and hand to make sure the bones are developing safely.

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Side effects of Azmiro (testosterone cypionate)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Less Common Side Effects

  • Problems with erections

Azmiro (testosterone cypionate) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Heart attack: chest pain, cold sweats, left arm pain, difficulty breathing
  • Stroke: face drooping, trouble seeing, walking, or speaking, weakness on one side of the body
  • Blood clot in the legs: pain, swelling, warm to touch, redness
  • Blood clot in the lungs: trouble breathing, chest pain, cough
  • Liver damage: stomach pain, nausea, vomiting, yellowing of the skin, yellowing of the whites of the eyes, light-colored stools, dark urine, weight loss
  • Withdrawal: depression, fatigue, craving, restlessness, irritability, lack of appetite, trouble sleeping, lowered sex drive, low testosterone

Source: DailyMed

The following Azmiro (testosterone cypionate) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Pain, redness, or swelling in the arm or leg

trouble breathing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blurred vision

headache

seizures

slurred speech

sudden and severe inability to speak

temporary blindness

weakness in the arm or leg on one side of the body, sudden and severe

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Gum or mouth irritation

Less common

Bad, unusual, or unpleasant (after) taste

bleeding gums

blemishes on the skin

breast pain

change in taste

cough

crying

depersonalization

diarrhea

discouragement

dizziness

dry mouth

dysphoria

enlarged breasts

euphoria

fear or nervousness

feeling sad or empty

gum pain or blisters

hoarseness

indigestion

irritability

itching skin

loss of appetite

loss of interest or pleasure

lower back or side pain

mouth ulcers

nausea

noisy breathing

painful or difficult urination

paranoia

passing of gas

pounding in the ears

quick to react or overreact emotionally

rapidly changing moods

redness and swelling of the gums

slow or fast heartbeat

stinging of the lips

stomach cramps, pain, fullness, or discomfort

swelling of the gums

swelling of the nose

tiredness

toothache

trouble concentrating

trouble sleeping

unusual tiredness or weakness

vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Azmiro (testosterone cypionate)

Pros

  • Injected once every 2 to 4 weeks
  • Comes as a vial or prefilled syringe
  • Helps with energy, muscle mass, mood, and sex drive

Cons

  • Must be injected by a healthcare professional
  • Risk of heart and prostate problems
  • Need regular lab tests
pharmacist-tips-icon

Pharmacist tips for Azmiro (testosterone cypionate)

pharmacist
  • Azmiro (testosterone cypionate) is injected by a healthcare professional deep into your buttock muscle once every 2 to 4 weeks.
  • Get all your lab tests done while you use Azmiro (testosterone cypionate). Your prescriber will check things like your testosterone level and red blood cell count to be sure the medication is safe and working well.
  • Watch for signs of a blood clot while using Azmiro (testosterone cypionate), such as pain, swelling, or redness in your legs. Get medical help right away if you have chest pain or trouble breathing, as these could be signs of a clot in your lungs.
  • Azmiro (testosterone cypionate) can raise your blood pressure, which might increase your risk for heart problems over time. You might want to check your blood pressure regularly. Let your care team know if it goes up because your blood pressure treatment might need to be adjusted.
  • Azmiro (testosterone cypionate) can sometimes cause gynecomastia, or enlarged breasts in males. Tell your prescriber if you notice changes in your chest area.
  • Azmiro (testosterone cypionate) can lower your blood sugar. If you have diabetes, you might need to check your blood sugar more often. Know how to manage low blood sugar if this happens.
  • Azmiro (testosterone cypionate) can cause changes in your urination, especially if you already have an enlarged prostate. Tell your care team if you start urinating more at night, have trouble starting to urinate, or have a weak stream.
Common questions about Azmiro

Common questions about Azmiro

Azmiro and Depo-Testosterone are both testosterone injections, but they aren’t exactly the same. Azmiro is a newer brand of testosterone cypionate, while Depo-Testosterone is an older brand of the same medication. They contain the same active ingredient and work the same way to raise your testosterone levels. One difference is how they're packaged. Depo-Testosterone only comes in vials, while Azmiro comes in vials and also in prefilled syringes. Talk to your prescriber if you have questions comparing the two medications.

Although your testosterone levels might start rising soon after you start Azmiro, it usually takes a little longer to feel the effects. You might notice improvements in mood or sex drive after about 3 to 4 weeks. Bigger changes, like stronger muscles or healthier bones, often take 2 or 3 months or longer.

Azmiro is a long-acting testosterone injection, so one dose usually lasts about 2 to 4 weeks. But how long it lasts for you can vary based on your dose, your metabolism, and how your body responds. Your prescriber will check your hormone levels and symptoms to decide the best timing for your injections.

It can. For some people Azmiro might worsen sleep apnea, especially for those who have obesity or long-term lung conditions. If you notice louder snoring, waking up gasping, or feeling very tired during the day, talk to your prescriber.

No. Azmiro isn't available over the counter (OTC). You can only get it with a prescription from a healthcare professional.

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Azmiro (testosterone cypionate) dosage

The average cost for 2 syringes of 1ml of 200mg/ml of Azmiro (testosterone cypionate) is $486.25 with a free GoodRx coupon. This is 18.52% off the average retail price of $596.74.
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DosageQuantityPrice as low asPrice per unit
1ml of 200mg/ml2 syringes$486.25$243.13

Typical dosage for Azmiro (testosterone cypionate)

Azmiro (testosterone cypionate) is injected by a healthcare professional. Your prescriber will work with you to find the right dose for you. They will adjust your dose based on how your body responds and how well you tolerate the medication.

In general, the typical dose is 50 mg to 400 mg injected deep into your buttock muscle every 2 to 4 weeks.

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Interactions between Azmiro (testosterone cypionate) and other drugs

Azmiro (testosterone cypionate) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Azmiro (testosterone cypionate). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Licorice
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Azmiro (testosterone cypionate) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Azmiro (testosterone cypionate) will not be safe for you to take.

  • Men with breast or prostate cancer
  • Women who are pregnant
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What are alternatives to Azmiro (testosterone cypionate)?

There are a number of medications that your doctor can prescribe in place of Azmiro (testosterone cypionate). Compare a few possible alternatives below.
Azmiro (testosterone cypionate)
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Azmiro (testosterone cypionate) images

yellow - AZMIRO 200mg/mL Prefilled Syringe in Oil for Injection
This medicine is Yellow Syringe.yellow - AZMIRO 200mg/mL Prefilled Syringe in Oil for Injection

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