provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

Testopel

testosterone pellets
Used for Testosterone Replacement
Used for Testosterone Replacement

Testopel (testosterone pellets) is an implantable pellet medication used as long-acting testosterone replacement therapy. It treats certain males with low testosterone and delayed puberty. The pellets are implanted, or placed under your skin, by a healthcare professional (HCP) typically every 3 to 6 months. Side effects include pain and swelling at the implantation site, as well as sexual side effects like more frequent erections and changes in sex drive.

Reviewed by:
reviewer
Daisy Chau, PharmD
reviewer
Ashley Wong, PharmD
Last reviewed on August 25, 2024
BasicsWarningsSide effectsPros & consPharmacist tipsFAQsDosageInteractionsContraindicationsAlternativesLatest newsReferencesPricesMedicare
Testopel (testosterone pellets) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
basics-icon

What is Testopel (testosterone pellets)?

What is Testopel (testosterone pellets) used for?

How Testopel (testosterone pellets) works

Testopel (testosterone pellets) is a testosterone replacement therapy that acts like the natural sex hormone, testosterone. Testosterone is responsible for the development and maintenance of many male features and functions, such as muscle and bone strength and growth and regulating sex drive and sperm production. Testopel (testosterone pellets) works by raising testosterone to normal and healthy levels in males with low testosterone.

Are you looking for information on testosterone enanthate intramuscular injection, Xyosted (testosterone enanthate) subcutaneous injection, or Jatenzo (testosterone undecanoate) oral capsule instead?

Drug Facts

Common BrandsTestopel
Drug ClassTestosterone replacement
Controlled Substance ClassificationSchedule III
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
warings-icon

What are the risks and warnings for Testopel (testosterone pellets)?

Testopel (testosterone pellets) 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.

risk-warning

Infection and extrusion at the implantation site

Infections can occur where Testopel (testosterone pellets) is implanted. In addition, there's a chance the pellets can come out of your skin, a condition also known as extrusion. Both of these can happen together or separately at any time, but it's more likely to occur during the first month after implantation. Let your prescriber know if you have a fever, hardening of the skin at the implantation site, swelling, bleeding, bruising, pain, itching, or pellets coming out of the skin, because this might require further treatment.

risk-warning

Risk of blood clots, including heart attack or stroke

  • Risk factors: History of heart conditions

    Taking testosterone replacement therapy, like Testopel (testosterone pellets), can raise your risk of blood clots. This can lead to problems such as strokes and heart attacks. Your healthcare team will have you perform regular blood tests, called the complete blood count (CBC), to check that your blood cell counts are in the safe range. Get emergency help right away if you have chest pain, cold sweats, left arm pain, difficulty breathing, trouble walking, trouble speaking, or weakness on one side of the body, since you might have to stop taking the medication.

    risk-warning

    Potential for misuse, dependency, and addiction

    • Risk factors: Taking more Testopel (testosterone pellets) than prescribed | Taking Testopel (testosterone pellets) with other testosterones

      Testopel (testosterone pellets) is a controlled substance because it has a risk of misuse and dependency, especially if you use higher doses than prescribed or use it with other testosterones.

      Continued misuse of Testopel (testosterone pellets) can lead to addiction. The FDA has only approved this medication for the treatment of low testosterone in males. Taking Testopel (testosterone pellets) for other reasons can lead to serious side effects, such as heart attack, heart failure, stroke, depression, hallucinations, and delusions. Only take this medication as prescribed by your healthcare professional.

      risk-warning

      Prostate problems

      • Risk factors: Older adults

        Taking Testopel (testosterone pellets) can raise the risk of developing an enlarged prostate, or benign prostatic hyperplasia (BPH), especially in older adults. Let your prescriber know if you experience any changes in your urinary routine, such as more urination at night, feeling like you need to urinate more often or immediately, trouble urinating, accidentally urinating, or urinating slowly.

        Testopel (testosterone pellets) can also raise your risk of prostate cancer. Your prescriber might have you perform occasional blood tests and physical check-ups before and during treatment with this medication.

        risk-warning

        Liver problems

        • Risk factors: Using high doses of Testopel (testosterone pellets) for a long time

          Testopel (testosterone pellets) might cause serious liver problems that can lead to cancer or death. This is more likely to happen if you take high doses of Testopel (testosterone pellets) for a long period of time. Let your prescriber know if you are experiencing stomach pain, light-colored stools, dark urine, or if your skin or the whites of your eyes turn yellow, because you might need to stop the medication.

          risk-warning

          Swelling in the legs or arms (edema)

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

            Testopel (testosterone pellets) can cause swelling in your legs or arms and sudden weight gain. It can be more serious in people with heart, liver, or kidney conditions. Talk to your prescriber if you have any of these symptoms, because you might need to stop the medication.

            risk-warning

            High calcium in the blood

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

              Testopel (testosterone pellets) can cause high calcium in the blood (hypercalcemia), especially in people with cancer. For people with cancer, high calcium levels might be a sign that the cancer has spread to the bones. During treatment with Testopel (testosterone pellets), your prescriber might have you perform regular blood tests to make sure your calcium levels are within a safe range.

              risk-warning

              Sexual side effects

              Testopel (testosterone pellets) can cause changes in sex drive, either increasing it or decreasing it. The medication might also cause more frequent or prolonged erections. Prolonged erections lasting more than 4 hours, known as priapism, can become serious. If this happens, seek medical help immediately.

              risk-warning

              Fast bone maturation in children

              • Risk factors: Children | Using Testopel (testosterone pellets) long term

                Testopel (testosterone pellets) should only be used short term for delayed puberty in children. The medication causes the bones to mature faster than normal, before they're able to grow to their full length. This can result in children being shorter in height, especially if Testopel (testosterone pellets) is taken at a young age. Taking Testopel (testosterone pellets) for long periods of time might also stop bone growth altogether. The risk of this happening is higher in younger children. Your child's pediatrician might take regular X-rays of your child's hand and wrist during treatment to make sure the bones are developing normally.

                basics-icon

                What are the side effects of Testopel (testosterone pellets)?

                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

                • Enlargement of male breasts
                • Pain or swelling at the implantation site

                Other Side Effects

                • Frequent erections
                • Prolonged erections
                • Changes in sex drive
                • Male pattern baldness
                • Acne
                • Nausea
                • Vomiting
                • Bleeding
                • Headache
                • Anxiety
                • Depression

                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, 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 (insomnia), lower sex drive, low testosterone

                Source: DailyMed

                More on Testopel (testosterone pellets) side effects

                Health: Testopel: man backpain at desk 1275745869

                7 Testopel Side Effects You Should Know About

                Written by Brian Leonard, PharmD, BCACP, BCGP

                The following side effects have also been reported

                Discuss these possible effects with your doctor:

                Tumors of the liver, liver cancer, or peliosis hepatis (a form of liver disease) have occurred during long-term, high-dose therapy with androgens. Although these effects are rare, they can be very serious and may cause death.

                Androgens can stimulate existing prostate cancer in men who already have it but have not yet been diagnosed. Also, the prostate (a male gland) may become enlarged. Enlargement of the prostate does not mean that cancer will develop. If enlargement occurs and you have difficulty in urinating, it is a good idea to be checked by your doctor.

                When androgens are used in women, especially in high doses, male-like changes may occur, such as hoarseness or deepening of the voice, unnatural hair growth, or unusual hair loss. Most of these changes will go away if the medicine is stopped as soon as the changes are noticed. However, some changes, such as voice changes or enlarged clitoris, may not go away.

                When androgens are used in high doses in males, they interfere with the production of sperm. This effect is usually temporary and only happens during the time you are taking the medicine. However, discuss this possible effect with your doctor if you are planning on having children.

                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:

                More common

                For females only

                Acne or oily skin

                decreased breast size

                irregular menstrual cycles

                hoarseness or deepening of voice

                increase in size of female genitals

                increase in unnatural hair growth or male pattern baldness

                These symptoms may occur in females whose male sexual partner uses a scrotal patch.

                For males only

                Blistering of skin under patch (especially when the nonscrotal patch is applied to bony areas of the skin)

                breast soreness or enlargement

                frequent or continuing erection of penis lasting up to 4 hours or painful penile erections lasting longer than 4 hours

                frequent urge to urinate

                itching or redness of skin under patch (less likely with nonscrotal patch) or at site of implants, mild to severe

                For prepubertal boys only

                Acne

                early growth of pubic hair

                enlargement of penis

                frequent or continuing erections

                Less common

                For males or females

                Dizziness

                frequent or continuing headache

                lack or loss of strength

                nausea

                overall body flushing, redness, or itching of skin

                rapidly changing moods, such as depersonalization, dysphoria, euphoria, depression, paranoia, and quick to react or overreact emotionally

                swelling of feet or lower legs

                unusual bleeding

                unusual tiredness

                yellow skin or eyes (occurring with fluoxymesterone or methyltestosterone more often than with testosterone)

                For females with breast cancer or bedridden males or females—in addition to the side effects listed above

                Confusion or mental depression

                constipation

                increased thirst

                increased urge to urinate or increased amount of urine

                For males only

                Black, tarry stools

                burning sensation or hardening or thickening of skin under patch

                chills

                continuing pain at site of implants

                difficulty in urinating

                itching, skin redness, or rash under patch, severe (less likely with nonscrotal patch)

                pain in scrotum or groin

                vomiting of blood or material that looks like coffee grounds

                Rare

                For males or females—more likely with oral androgens or long-term or high doses of androgens

                Abdominal or stomach pain, continuing

                bad breath odor, continuing

                black, tarry or light-colored stools or dark urine

                fever

                hives

                loss of appetite, continuing

                mood or mental changes

                purple or red spots on body or inside the mouth or nose

                sore throat

                swelling, pain, or tenderness of abdomen

                vomiting of blood

                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:

                Less common

                For males and females

                Acne, mild

                decrease or increase in sexual desire or drive

                diarrhea

                hair loss or thinning of hair

                increase in pubic hair growth

                infection, pain, redness, or other irritation at site of injection

                nervousness

                stomach pain

                trouble in sleeping

                For males only

                Decrease in testicle size

                infection, pain, redness, swelling, sores, or other skin irritation underneath patch

                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.

                pros-and-cons

                Pros and cons of Testopel (testosterone pellets)

                thumbs-up

                Pros

                A long-acting testosterone replacement medication

                Implanted every 3 to 6 months

                Can be used in children and adults

                Unlike testosterone gel, there’s no risk of accidentally exposing others to testosterone

                thumbs-down

                Cons

                Can cause pain and swelling at the implantation site

                Risk of infections or extrusions at the implantation site

                Is a surgical procedure that must be done at the prescriber's office

                Dose adjustments are difficult since they require surgical removal or addition of pellets

                pharmacist-tips

                Pharmacist tips for Testopel (testosterone pellets)

                pharmacist

                • The procedure to implant Testopel (testosterone pellets) can be quick, lasting about 15 minutes.

                  • Testopel (testosterone pellets) can cause some pain and swelling at the site of implantation, especially after the first few days. Ice the area for 20 to 30 minutes every hour as needed. If it doesn't get better, let your prescriber know - you might need to take something for the pain.

                    • Testopel (testosterone pellets) can often cause the breast area in males to become bigger, painful, or tender. This might continue throughout treatment with this medication. Let your prescriber know if this becomes bothersome.

                      • Testopel (testosterone pellets) can lower sperm count. This might affect your ability to have a baby and raise the risk for infertility. Let your healthcare team know if you're thinking of having a baby before you start this medication so they can talk with you about family planning options.

                        • Taking Testopel (testosterone pellets) together with blood thinners like warfarin (Coumadin) might cause you to bleed more easily, so you might need to get your blood clotting time (INR) checked more often. Let your prescriber know if you experience bleeding that takes longer to stop, bruising, blood in your urine, or dark stools, as your dose might need to be adjusted.

                          faqs

                          Frequently asked questions about Testopel (testosterone pellets)

                          Will the painful lump after Testopel (testosterone pellets) insertion go away?
                          You might have some pain or tenderness at the implantation site after receiving Testopel (testosterone pellets). To help with the pain, you can apply ice to the site for 20 to 30 minutes every hour as needed after implantation. If your pain continues, talk to your prescriber to see if you should use pain relief medication.
                          Is Testopel (testosterone pellets) bioidentical?
                          Yes. Testopel (testosterone pellets) is considered a bioidentical hormone, meaning it's a lab-made hormone similar to natural hormones in your body, like testosterone.
                          How do I know if my Testopel (testosterone pellets) came out?
                          It's possible for Testopel (testosterone pellets) to come out from or around the implantation site, a condition known as extrusion. While extrusion can happen at any time, the risk is higher within the first month after the pellets are implanted. It can also occur along with an infection at the site. Let your prescriber know if you experience thickening of the skin, scarring, swelling, bleeding, bruising, pain, or itching at the site.
                          How long does Testopel (testosterone pellets) last?
                          Testopel (testosterone pellets) slowly releases testosterone into your body over 3 to 4 months, and sometimes up to 6 months. Your body slowly absorbs the pellets, causing them to dissolve over time, which helps raise your testosterone levels. Because Testopel (testosterone pellets) is long-acting, you only need to have the pellets implanted every 3 to 6 months, or 2 to 4 times a year.
                          How long does it take for Testopel (testosterone pellets) to work?
                          After Testopel (testosterone pellets) implantation, your testosterone levels might rise shortly after, but it could take about one month to feel the full benefits. But finding the right dose can be a challenging because it requires a surgical procedure to remove or add pellets. Discuss with your prescriber if you have questions about how well Testopel (testosterone pellets) can work for you.
                          How is Testopel (testosterone pellets) inserted?
                          A health care professional will implant Testopel (testosterone pellets) under the skin in your hip or buttocks area. First, they'll clean and numb the area. Then, they'll make a small cut in your skin and place the pellets into the fatty tissue. Finally, they'll bandage the cut to protect your skin. All of this can be done in about 15 minutes.
                          Can Testopel (testosterone pellets) cause stomach problems?
                          Stomach problems like nausea and vomiting have been reported with people who have received Testopel (testosterone pellets). Let your prescriber know if you develop any of these symptoms.
                          GoodRxEducationalIcon

                          How to save using GoodRx

                          Compare Prices
                          1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.
                          Select your free coupon
                          2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.
                          Show coupon to your pharmacist
                          3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.
                          Get free couponLearn more
                          dosage

                          Testopel (testosterone pellets) dosage forms

                          Typical dosing for Testopel (testosterone pellets)

                          The dose of Testopel (testosterone pellets) depends on your age and condition being treated. Your prescriber might change the dose based on your response to the medication and how well you tolerate it.

                          • Low testosterone: The typical dose is 150 mg to 450 mg implanted under the skin every 3 to 6 months.

                          • Delayed puberty: The typical dose varies. Generally, the dose is lower than the dosing range for low testosterone and should be given for a shorter duration, about 4 to 6 months.

                          interactions

                          Interactions between Testopel (testosterone pellets) and other drugs

                          Testopel (testosterone pellets) 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 Testopel (testosterone pellets). 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 any of these medicines, 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 medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

                          Using medicines in this class 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.

                          contraindications-icon

                          Testopel (testosterone pellets) 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 Testopel (testosterone pellets) will not be safe for you to take.

                          • Males with breast cancer or prostate cancer

                          • Currently pregnant

                          alternatives

                          What are alternatives to Testopel (testosterone pellets)?

                          There are a number of medications that your doctor can prescribe in place of Testopel (testosterone pellets). Compare a few possible alternatives below.
                          Testopel (testosterone pellets)
                          Used for:
                          View Prices
                          Testosterone gel
                          Used for:

                          • Low testosterone (hypogonadism)

                          $47.35 Lowest GoodRx priceView Prices
                          Testosterone enanthate
                          Used for:
                          $32.44 Lowest GoodRx priceView Prices

                          Get savings updates for Testopel (testosterone pellets)

                          Receive price alerts, news, and other messages from GoodRx about Testopel (testosterone pellets) and other healthcare topics and relevant savings offers.

                          By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

                          References

                          Best studies we found

                          Endo International plc. (2016). Testopel® post-insertion tips and considerations.

                          Endo International plc. (2023). Testopel®: An in-office procedure completed in approximately 15 minutes.

                          ENDO USA, Inc. (2024). TESTOPEL- testosterone pellet [package insert]. DailyMed

                          View All References (4)

                          HealthyChildren.org. (2015). Delayed puberty in boys: Information for parents. American Academy of Pediatrics.

                          McCullough A. (2014). A review of testosterone pellets in the treatment of hypogonadism. Current Sexual Health Reports.

                          Yamaguchi, A. V., et al. (2019). Testosterone replacement therapy and the risk of hypoglycemia. Case Reports in Endocrinology.

                          You and Your Hormones. (2020). Testosterone.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
                          Was this page helpful?

                          Compare other Testosterone Replacement drugs

                          Fluoxymesterone vs TestopelFortesta vs TestopelMethyltestosterone vs TestopelStriant vs TestopelTestim vs TestopelTestopel vs AveedTestopel vs DelatestrylTestopel vs Depo TestosteroneFluoxymesterone vs AveedFluoxymesterone vs DelatestrylFluoxymesterone vs Depo TestosteroneFluoxymesterone vs MethyltestosteroneFluoxymesterone vs StriantFortesta vs AveedFortesta vs DelatestrylFortesta vs Depo TestosteroneFortesta vs StriantMethyltestosterone vs AndrodermMethyltestosterone vs AndrogelMethyltestosterone vs AveedMethyltestosterone vs DelatestrylMethyltestosterone vs Depo TestosteroneMethyltestosterone vs StriantStriant vs AveedStriant vs DelatestrylStriant vs Depo TestosteroneTestim vs AveedTestim vs DelatestrylTestim vs Depo TestosteroneTestim vs Striant
                          View More

                          Browse medications

                          View All

                          Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.