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Jatenzo

testosterone undecanoate
Used for Testosterone Replacement

Jatenzo (testosterone undecanoate) is an oral capsule used for testosterone replacement therapy (TRT) in adult males with hypogonadism, a condition that causes low testosterone production. You take a dose by mouth twice a day, once in the morning and once in the evening. Common side effects include headaches, high blood pressure, and nausea. This medication is only available as a brand-name medication, meaning there are no generic versions.

Reviewed by:Last reviewed on February 18, 2025
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What is Jatenzo (testosterone undecanoate)?

What is Jatenzo (testosterone undecanoate) used for?

How Jatenzo (testosterone undecanoate) works

Jatenzo (testosterone undecanoate) is a testosterone replacement that works like the natural testosterone in the body. Testosterone helps develop and maintain male features. It plays a key role in building muscle and bone strength, controlling sex drive, and producing sperm. Jatenzo (testosterone undecanoate) raises testosterone levels to normal and healthy ranges in men with low testosterone.

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

Drug facts

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

Jatenzo (testosterone undecanoate) 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.

High blood pressure with risk of heart attack or stroke

  • Risk factors: High blood pressure | Heart problems

Warning IconJatenzo (testosterone undecanoate) can raise your blood pressure, which increases the risk of serious heart problems, including heart attack and stroke. This is more likely to occur in people who already have heart problems or have risk factors for heart problems. Even a small blood pressure increase can raise this risk, even if you don’t notice any symptoms. Let your prescriber know and get emergency help right away if you experience symptoms of heart problems, such as:

  • Heart attack: dizziness, tiredness, tightness or pain in the chest, heartburn, trouble breathing, sweating, anxiety
  • Stroke: sudden numbness or weakness on one side of your body, sudden confusion, trouble speaking, difficulty maintaining balance

Warning Icon Before starting Jatenzo (testosterone undecanoate), your prescriber will check your heart health and blood pressure. Your blood pressure should be checked about 3 weeks after starting or increasing your dose and regularly after that. If your blood pressure becomes too high, your prescriber might adjust your medications or consider stopping Jatenzo (testosterone undecanoate).

High red blood cell count

Jatenzo (testosterone undecanoate) can increase your red blood cell count, which might lead to blood clots, heart attacks, and strokes. Your prescriber will check your red blood cell levels with blood tests every 3 months to make sure they stay in a healthy range. If your levels get too high, your prescriber might lower your dose or pause treatment until they return to normal. If your red blood cell levels rise again after restarting Jatenzo (testosterone undecanoate), you might need to stop the medication altogether to avoid serious blood clot risks.

Blood clots

Jatenzo (testosterone undecanoate) can cause life-threatening blood clots in your legs or lungs. Watch for symptoms of a blood clot in the legs, such as leg pain, swelling, or redness. Signs of a blood clot in the lungs include trouble breathing or chest pain. If you have any of these symptoms, tell your prescriber right away and get medical help right away, as you might need to stop the medication.

Potential for misuse, dependency, and addiction

  • Risk factors: Higher doses of Jatenzo (testosterone undecanoate) than prescribed | Taking Jatenzo (testosterone undecanoate) with other testosterones

Jatenzo (testosterone undecanoate) is a controlled substance because it has a risk of misuse, dependency, and addiction, especially if taken at higher doses than prescribed or with other testosterones.

Misusing Jatenzo (testosterone undecanoate) over time can lead to addiction. The FDA has only approved this medication for treating low testosterone in males with certain conditions. Taking it for other reasons can cause serious side effects, including heart attack, heart failure, stroke, depression, and psychosis.

Worsening enlarged prostate and risk of prostate cancer

  • Risk factors: History of enlarged prostate

Taking Jatenzo (testosterone undecanoate) can worsen symptoms in people with an enlarged prostate, also known as benign prostatic hyperplasia (BPH). Let your prescriber know if you notice changes in urination, such as frequent nighttime urination, trouble urinating, a weak stream, urgency, or accidental leakage.

Jatenzo (testosterone undecanoate) can also raise your risk of prostate cancer. Your prescriber might check for prostate cancer before you start treatment and continue to monitor your prostate health while you're taking this medication.

Liver problems

Using certain forms of testosterone, such as methyltestosterone and testosterone enanthate intramuscular injection, for a long time can cause serious liver problems. This isn't a known risk of Jatenzo (testosterone undecanoate), but it's still important to watch for signs of liver damage. Tell your prescriber if you have stomach pain, light-colored stools, dark urine, or if your skin or the whites of your eyes turn yellow, as you might need to stop the medication.

Lower sperm production

  • Risk factors: Taking higher doses of Jatenzo (testosterone undecanoate)

Taking high doses of testosterone, including Jatenzo (testosterone undecanoate), can lower sperm production by affecting hormone levels in the body. This might lead to reduced sperm count and other changes in semen quality. If you are planning to have children, talk to your prescriber about this possible risk before starting or continuing this medication.

Swelling in the legs or arms (edema)

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

Taking Jatenzo (testosterone undecanoate) can make your body hold onto extra salt and water, which might cause swelling in your legs or arms and sudden weight gain. This is more likely if you're also taking medications that cause swelling, like corticosteroids. It can be more serious in people with heart, liver, or kidney conditions. Swelling can be more serious if you have heart, liver, or kidney problems. If you notice swelling, talk to your prescriber, as you might need to stop Jatenzo (testosterone undecanoate) or take a diuretic (water pill) to help reduce fluid buildup.

Breathing problems during sleep (sleep apnea)

  • Risk factors: History of sleep apnea | Obesity | History of lung disease

Jatenzo (testosterone undecanoate) can worsen sleep apnea, a condition that causes breathing problems during sleep. This is more likely if you have risk factors like obesity or long-term lung disease. If you experience loud snoring, choking during sleep, or excessive daytime tiredness, talk to your prescriber.

High calcium in the blood

  • Risk factors: History of cancer | Taking other medications that cause high calcium in the blood

If you have cancer and are at risk for high calcium levels (hypercalcemia), be careful when taking Jatenzo (testosterone undecanoate) or other androgens. Your prescriber might check your calcium levels regularly to make sure they stay in a safe range. If you notice symptoms like nausea, weakness, or confusion, contact your prescriber.

Depression and suicide thoughts

  • Risk factors: History of depression, anxiety, or other mental health conditions | History of suicidal thoughts and behavior

Some people taking Jatenzo (testosterone undecanoate) in clinical trials have reported depression and suicidal thoughts. Let your prescriber know if you or someone you care for notices new or worsening depression, anxiety, mood changes, or thoughts of self-harm. If these symptoms appear, get medical help right away.

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Side effects of Jatenzo (testosterone undecanoate)

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

  • Headache (5%)
  • High red blood cell count (5%)
  • High blood pressure (4%)
  • Changes in cholesterol levels (3%)
  • Nausea (2%)

Less Common Side Effects

  • Faster heart rate
  • Indigestion
  • Diarrhea
  • Depression and thoughts of suicide

Jatenzo (testosterone undecanoate) serious side effects

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

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

Source: DailyMed

The following Jatenzo (testosterone undecanoate) side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
  • Heart attackpain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
  • Increase in blood pressure
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Mood swings, irritability, or hostility
  • Prolonged or painful erection
  • Sleep apnea—loud snoring, gasping during sleep, daytime sleepiness
  • Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
  • Swelling of the ankles, hands or feet
  • Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

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Pros and cons of Jatenzo (testosterone undecanoate)

Pros

  • Works well to replace testosterone in the body
  • Comes as a capsule taken by mouth
  • Lower risk of liver problems compared to other testosterone products

Cons

  • Must take it twice a day
  • Can cause high blood pressure, which can raise your risk of serious heart problems
  • Requires regular blood tests to monitor testosterone and nutrient levels
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Pharmacist tips for Jatenzo (testosterone undecanoate)

pharmacist
  • Take Jatenzo (testosterone undecanoate) twice daily—once in the morning and once in the evening—with food. Taking it with food helps your body absorb it better, leading to better results.
  • Take Jatenzo (testosterone undecanoate) exactly as prescribed by your prescriber. This medication is only FDA-approved for the treatment of low testosterone in males with certain medical conditions. Misusing it can cause serious side effects like heart attack, heart failure, stroke, depression, and psychosis.
  • Jatenzo (testosterone undecanoate) can cause breast enlargement, tenderness, or pain. This side effect can continue during treatment, so let your prescriber know if it becomes bothersome.
  • Jatenzo (testosterone undecanoate) can raise your blood pressure, so check your blood pressure regularly while taking it. If your blood pressure gets too high, your prescriber might recommend medication to lower it or stop your treatment if it can't be controlled.
  • Jatenzo (testosterone undecanoate) can lower your blood sugar. You might need to check your blood sugar more often, especially if you use insulin. If you experience symptoms of low blood sugar like shakiness, sweating, fast heartbeat, and confusion, talk to your prescriber because it might require changes to your medications.
  • Taking Jatenzo (testosterone undecanoate) together with blood thinners like warfarin (Coumadin) can make bleeding easier and harder to stop. Your prescriber might check your blood clotting time more often when you're taking this medication. Let them know if you have unusual bleeding, bruising, blood in your urine, or dark stools, as your blood thinner dose might need adjusting.
  • Taking Jatenzo (testosterone undecanoate) might affect your cholesterol levels, which could require adjusting your cholesterol medication or stopping testosterone therapy. Your prescriber will check your cholesterol levels regularly, especially after you start treatment, to make sure they stay in a healthy range.
  • Jatenzo (testosterone undecanoate) can raise your risk of heart attack and stroke due to high blood pressure. Some medications can also raise blood pressure, so always check with your prescriber or pharmacist before starting any new medications.
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Common questions about Jatenzo (testosterone undecanoate)

Jatenzo (testosterone undecanoate) is safe for most people when taken as prescribed, but it comes with serious risks. It can raise blood pressure, which can increase the risk of a heart attack or stroke, and it might also cause mood changes, swelling, or blood clots. Since Jatenzo (testosterone undecanoate) affects hormone levels and blood pressure, your prescriber will monitor you regularly to make sure it’s safe for you. If you have concerns, talk to your prescriber before starting treatment.

Yes, Jatenzo (testosterone undecanoate) is a controlled substance because it contains testosterone, which can be misused. It's categorized as a Schedule III medication, meaning it has a moderate to low risk of dependence or addiction if not used properly. Because of this, your prescriber will monitor your treatment closely. Always take Jatenzo (testosterone undecanoate) exactly as prescribed to avoid serious side effects. If you have concerns about safety or addiction, talk to your prescriber.

The best time to take Jatenzo (testosterone undecanoate) is twice a day with food, once in the morning and once in the evening. Try to take it at the same times each day to keep your testosterone levels steady. If you're unsure about your schedule, talk to your prescriber for guidance.

Jatenzo (testosterone undecanoate) starts raising testosterone levels soon after your first dose, but it might take several weeks to find the right dose for you. Your prescriber will check your testosterone levels with lab tests at least one week after starting treatment. Based on your results, they might adjust your dose and recheck your levels after another week to make sure it’s working properly.

You'll start taking Jatenzo (testosterone undecanoate) at 237 mg twice a day with food, once in the morning and once at night. Your prescriber will check your testosterone levels and might adjust your dose based on how your body responds. Most people end up taking between 158 mg and 396 mg twice a day. It's important to take Jatenzo (testosterone undecanoate) exactly as prescribed to get the best results and avoid serious side effects.

Jatenzo (testosterone undecanoate) comes in 158 mg, 198 mg, and 237 mg capsules. The typical starting dose is 237 mg twice a day, but your prescriber might adjust your dose based on your testosterone levels.

Not necessarily. Some older testosterone medications, like methyltestosterone (Methitest), are known to cause liver problems. But Jatenzo (testosterone undecanoate) is designed to bypass the liver so it's less likely to have harmful effects on the liver. However, you should still watch for signs of liver problems, such as stomach pain, light-colored stools, dark urine, or yellowing of your skin or eyes, and tell your prescriber right away if you experience any of these symptoms.

Pretty well. In clinical studies, Jatenzo (testosterone undecanoate) raised testosterone levels to a healthy range in 87% of males within 3 to 4 months. But since everyone responds differently, talk to your prescriber if you have questions about how well Jatenzo (testosterone undecanoate) might work for you.

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Jatenzo (testosterone undecanoate) dosage

The average cost for 60 capsules of 237mg of Jatenzo (testosterone undecanoate) is $1,046.29 with a free GoodRx coupon. This is 17.52% off the average retail price of $1,268.50.
capsuleCapsule
DosageQuantityPrice as low asPrice per unit
158mg60 capsules$492.34$8.21
198mg60 capsules$525.78$8.76
237mg60 capsules$1,046.29$17.44

Typical dosage for Jatenzo (testosterone undecanoate)

The typical starting dose is 237 mg by mouth twice a day, once in the morning and once in the evening. Your prescriber will adjust your dose based on your testosterone blood levels.

The typical maintenance dose ranges from 158 mg to 396 mg twice daily.

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Jatenzo (testosterone undecanoate) 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 Jatenzo (testosterone undecanoate) will not be safe for you to take.

  • Males with breast cancer or prostate cancer
  • Females who are pregnant
  • Males with low testosterone without certain medical conditions, such as having low testosterone due to age
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What are alternatives to Jatenzo (testosterone undecanoate)?

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