testosterone cypionate
Testosterone cypionate (Depo-Testosterone) is an injectable form of testosterone that’s used to treat low testosterone in adult males. It's injected into your buttock muscle and lasts for a long time, so it only needs to be used once or twice a month. But it might raise the risk of serious side effects including heart attack and stroke, especially if misused.
What is Testosterone cypionate (Depo-Testosterone)?
What is Testosterone cypionate (Depo-Testosterone) used for?
Low testosterone (hypogonadism)
How Testosterone cypionate (Depo-Testosterone) works
Testosterone cypionate (Depo-Testosterone) is a testosterone replacement that acts like the natural sex hormone. Testosterone is responsible for the development and maintenance of many male features. Testosterone cypionate (Depo-Testosterone) works by adding or replacing testosterone in the body up to normal and healthy levels.
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What are the risks and warnings for Testosterone cypionate (Depo-Testosterone)?
Testosterone cypionate (Depo-Testosterone) 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.
Potential for misuse, addiction, and dependency
Risk factors: Taking more testosterone cypionate (Depo-Testosterone) than prescribed | Taking testosterone cypionate (Depo-Testosterone) with other testosterones
Testosterone cypionate (Depo-Testosterone) is a controlled substance because it has a risk of misuse, dependency, and addiction. Misuse is when it's taken for medical reasons other than prescribed. Misusing testosterone cypionate (Depo-Testosterone) can cause serious problems involving the heart and mental health, such as heart attack, heart failure, stroke, liver problems, depression, delusions, hallucinations, and aggression.
Continued misuse of testosterone cypionate (Depo-Testosterone) can lead to addiction. Addiction can cause behaviors, such as taking a higher dose than prescribed, spending a lot of time trying to get the medication when there are problems with availability, having trouble stopping the medication even if you want to stop, prioritizing medication use over other responsibilities, and experiencing withdrawal symptoms if you stop taking the medication suddenly.
And finally, testosterone cypionate (Depo-Testosterone) can cause dependency. Dependency is when you rely on the medication to function normally and have withdrawal symptoms (e.g., depression, trouble sleeping, lowered sex drive) when you lower the dose or stop the medication suddenly. Remember to take testosterone cypionate (Depo-Testosterone) as prescribed to lower the risk of misuse, dependency, and addiction.
Heart attack and stroke risk
Risk factors: History of heart conditions
Testosterone cypionate (Depo-Testosterone) might cause heart attack, stroke, or sudden heart-related death. Let your provider know and get emergency help right away if you have chest pain, cold sweats, left arm pain, difficulty breathing, trouble walking or speaking, or weakness on one side of the body.
Blood clots
Testosterone cypionate (Depo-Testosterone) can cause blood clots in the legs and lungs, which can be life-threatening. Symptoms of a blood clot in the legs include leg pain, swelling, or redness. Symptoms of a blood clot in the lungs include difficulty breathing or chest pain. Let your provider know if you have any of these symptoms and seek medical help right away as you might have to stop the medication.
Liver problems
Risk factors: Using high doses of testosterone cypionate (Depo-Testosterone) long term
Testosterone cypionate (Depo-Testosterone) can cause liver damage. Serious liver problems that can lead to cancer or death are more likely to happen if you take high doses of testosterone cypionate (Depo-Testosterone) for a long period of time. Let your provider 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.
Use in people with an enlarged prostate
Risk factors: History of an enlarged prostate
Testosterone cypionate (Depo-Testosterone) can cause blockage of the urinary tract in people who have an enlarged prostate, or benign prostatic hyperplasia (BPH). Symptoms include pain, inability to urinate or change in the amount of urination, high blood pressure, and blood in the urine. If you notice any of these symptoms, talk to your provider right away before it becomes worse.
Swelling in the arms and legs (edema)
Risk factors: History of heart, liver, or kidney conditions | Taking other medications that cause swelling like corticosteroids
Taking testosterone cypionate (Depo-Testosterone) can cause your body to hold onto more salt and water, which leads to swelling in your arms and legs and sudden weight gain. This is more likely to happen if you're also taking other medications that cause swelling, such as corticosteroids (e.g., prednisone, methylprednisolone (Medrol)). It can be more serious in people with heart, liver, or kidney conditions. Talk to your provider if you have any of these symptoms, because you might need to stop the medication.
High calcium in the blood
Risk factors: People with restricted movement | Taking other medications that cause high calcium in the blood
Testosterone cypionate (Depo-Testosterone) can cause high calcium in the blood, especially in people who are unable to move. Too much calcium can lead to symptoms like muscle weakness, frequent urination, thirst, stomach pain, and blood in the urine. If this occurs, stop taking testosterone cypionate (Depo-Testosterone), and let your provider know. During treatment with testosterone cypionate (Depo-Testosterone), your provider might have you perform regular blood tests to make sure your calcium levels are within the normal range.
Use in young children
Risk factors: Using testosterone cypionate (Depo-Testosterone) in young children | Using higher doses of testosterone cypionate (Depo-Testosterone)
Testosterone cypionate (Depo-Testosterone) is not recommended in children under 12 years old.
Testosterone cypionate (Depo-Testosterone) contains a preservative called benzyl alcohol. This preservative can cause a serious side effect in newborn babies and children known as "gasping syndrome." "Gasping syndrome" causes trouble breathing and can lead to death. Although recommended doses of testosterone cypionate (Depo-Testosterone) contain less benzyl alcohol than what's typically linked to "gasping syndrome," it's important to be aware of this risk. This is more likely to happen with higher doses of the medication and if your liver and kidneys have problems clearing it from your body.
Testosterone also causes children's bones to mature faster and stop growing in length. Because of this, children who use testosterone therapy like testosterone cypionate (Depo-Testosterone) can become shorter in height if used long term. The risk of this happening is higher in younger children.
What are the side effects of Testosterone cypionate (Depo-Testosterone)?
Common Side Effects
- Enlargement of male breasts
- Acne
- Pain at the injection site
Other Side Effects
- More hair on the face and body
- More erections
- Erections lasting a long time
- Changes in sex drive
- Low sperm count
- Nausea
- Headache
- Anxiety
- Depression
- Feeling a tingling sensation
- Swelling in the legs and arms
- High red blood cell count
Serious Side Effects
- Heart attack: Chest pain, cold sweats, left arm pain, difficulty breathing
- Stroke: Face drooping, weakness on one side of the body, trouble seeing, walking, or speaking
- Blood clots: Legs (pain, swelling, warm to touch, redness), 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
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
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
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
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
loss of appetite, continuing
mood or mental changes
purple or red spots on body or inside the mouth or nose
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
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 of Testosterone cypionate (Depo-Testosterone)
Pros
Only needs to be used once every 2 to 4 weeks
Can be injected at home
Comes in a vial that can be used for more than one dose, meaning fewer trips to the pharmacy
Available in as a lower-cost generic
Cons
Risk of misuse, addiction, and dependency
Might raise the risk of serious side effects like heart attack and stroke if misused
Needs to be injected into the buttock muscle
Only available as an injection
Pharmacist tips for Testosterone cypionate (Depo-Testosterone)
Taking testosterone cypionate (Depo-Testosterone) at higher doses than prescribed can lead to misuse. This can cause serious side effects, such as heart attack, heart failure, stroke, depression, hallucinations, and delusions. Take the medication as prescribed by your provider to prevent the risk of misuse.
Testosterone cypionate (Depo-Testosterone) shouldn't be used for bodybuilding or improving your athletic ability because of the risks of serious side effects from abuse. The FDA has only approved this medication for the treatment of low testosterone in males. Take testosterone cypionate (Depo-Testosterone) as prescribed by your provider.
Testosterone cypionate (Depo-Testosterone) can often cause the breast area to become bigger, painful, or tender. This might continue throughout treatment with testosterone cypionate (Depo-Testosterone). Let your provider know if this becomes bothersome.
Testosterone cypionate (Depo-Testosterone) can lower your blood sugar. If you have diabetes, you might need to monitor your blood sugar more often while taking this medication. Make sure you know how to recognize and treat low blood sugar. Talk to your provider if you have diabetes and are experiencing any symptoms of low blood sugar, including shakiness, sweating, fast heartbeat, and confusion, because you might require changes to your medications.
Store testosterone cypionate (Depo-Testosterone) at room temperature. Make sure to inspect the vial before injection for any particles or changes in color. If you see crystals in the vial, warm up and shake the vial to redissolve those crystals. Keep the medication in the box when you aren't using it to protect it from light.
Frequently asked questions about Testosterone cypionate (Depo-Testosterone)
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Testosterone cypionate (Depo-Testosterone) dosage forms
Typical dosing for Testosterone cypionate (Depo-Testosterone)
Your provider will work with you to find the right dose of testosterone cypionate (Depo-Testosterone) for you since it depends on your age, sex, and condition that's being treated. They might change the dose based on your response to the medication and how well you tolerate it.
In general, the typical dose is 50 mg to 400 mg injected slowly and deeply into your buttock muscle every 2 to 4 weeks.
Testosterone cypionate (Depo-Testosterone) Reviews
GoodRx has partnered with PatientsLikeMe to provide reviews on the different aspects of Testosterone cypionate (Depo-Testosterone).
Effectiveness
Learn more about the effectiveness of Testosterone cypionate (Depo-Testosterone) based on real life experiences.
Overall Rating
Based on 55 people taking this medication
4.1
Effectiveness by condition:
hypogonadism23 reviews
4.1
gender dysphoria19 reviews
4.8
multiple sclerosis6 reviews
4.0
Klinefelter syndrome4 reviews
2.8
transsexualism3 reviews
5.0
Severity of side effects
Based on 93 people taking this medication
0%
50%
100%
Top side effects
Elevated hematocrit
5%
Irritability
4%
Acne
3%
Hair loss
3%
Hair growth
3%
Reasons people stopped taking Testosterone cypionate (Depo-Testosterone)
Based on 47 people who have taken this medication
Doctor's advice
24%
Side effects too severe
18%
Did not seem to work
15%
Course of treatment ended
13%
Other
13%
Personal research
9%
Change in health plan coverage
7%
Expense
5%
How long people take Testosterone cypionate (Depo-Testosterone)
Based on 202 people taking this medication
0%
50%
100%
Interactions between Testosterone cypionate (Depo-Testosterone) and other drugs
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.
- Acenocoumarol
- Anisindione
- Atorvastatin
- Bupropion
- Dicumarol
- Fluvastatin
- Lovastatin
- Paclitaxel
- Paclitaxel Protein-Bound
- Pexidartinib
- Phenindione
- Phenprocoumon
- Warfarin
How much does Testosterone cypionate (Depo-Testosterone) cost?
Testosterone cypionate (Depo-Testosterone) contraindications
Males with breast cancer or prostate cancer
Women who are pregnant or might become pregnant
People with serious heart, liver, or kidney conditions
What are alternatives to Testosterone cypionate (Depo-Testosterone)?
Low testosterone (hypogonadism)
Low testosterone (hypogonadism) in males
Delayed puberty in males
Metastatic breast cancer that have spread to the bones in females who've started menopause in the past 1 to 5 years
What is the latest news about Testosterone cypionate (Depo-Testosterone)?
Testosterone cypionate (Depo-Testosterone) images
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References
Best studies we foundAlvogen Inc. (2022). TESTOSTERONE CYPIONATE injection, solution [package insert]. DailyMed.
Bhasin, S., et al. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism.
Hembree, W. C., et al. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism.
MedGen. (n.d.). Gasping syndrome.
Saad, F., et al. (2011). Onset of effects of testosterone treatment and time span until maximum effects are achieved. European Journal of Endocrinology.
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