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Xyosted

testosterone enanthate
Used for Testosterone Replacement

Xyosted (testosterone enanthate) is a testosterone replacement therapy used to treat adult males with low testosterone. It comes as a prefilled autoinjector that you inject under the skin in the stomach once a week. Side effects include high blood pressure, headache, and bruising at the injection site.

Reviewed by:Last reviewed on June 10, 2026
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What is Xyosted (testosterone enanthate)?

What is Xyosted (testosterone enanthate) used for?

How Xyosted (testosterone enanthate) works

Xyosted (testosterone enanthate) 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.

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

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

Drug facts

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

Xyosted (testosterone enanthate) 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

Xyosted (testosterone enanthate) 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

Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate) 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.

Xyosted (testosterone enanthate) 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

Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate) than prescribed | Taking Xyosted (testosterone enanthate) with other testosterones

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

Lower sperm count

  • Risk factors: Taking more Xyosted (testosterone enanthate) than prescribed

Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate), 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

Xyosted (testosterone enanthate) 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

Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate) 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

Xyosted (testosterone enanthate) 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.

Mood changes and thoughts suicide

  • Risk factors: History of depression | History of mental health conditions

Xyosted (testosterone enanthate) can affect your mood. Some people have reported depression, anxiety, or thoughts of self-harm while taking this medication.

Tell your care team right away if you notice new or worsening depression, anxiety, mood changes, or thoughts of hurting yourself. Family members and caregivers should also watch for these changes and seek medical help if they occur.

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Side effects of Xyosted (testosterone enanthate)

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

  • High red blood cell count (14%)
  • High blood pressure (13%)
  • Rise in prostate-specific antigen (PSA, (12%)
  • Injection site bruising (7%)
  • Headache (5%)

Less Common Side Effects

  • Back pain
  • Injection site bleeding
  • Acne
  • Cough
  • Swelling in the arms and legs
  • Injection site redness
  • Urinary tract infection
  • Stomach pain
  • Joint pain
  • Tiredness
  • Blood in the urine
  • Sleep apnea problems

Xyosted (testosterone enanthate) serious side effects

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

  • High blood pressure: headache, dizziness, blurred vision, shortness of breath, chest pain, nosebleeds, pounding heartbeat
  • 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
  • Suicidal thoughts and behaviors
When do Xyosted (testosterone enanthate) possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
High red blood cell count
Rise in PSA
Injection site reactions
High blood pressure
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following Xyosted (testosterone enanthate) 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.

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pros-and-cons-icon

Pros and cons of Xyosted (testosterone enanthate)

Pros

  • Only needs to be injected once a week
  • Available as a ready-to-use autoinjector
  • Can be injected at home

Cons

  • Can cause high blood pressure
  • Requires regular blood tests to monitor testosterone
  • Not approved for children
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Pharmacist tips for Xyosted (testosterone enanthate)

pharmacist
  • Check your blood pressure regularly while taking Xyosted (testosterone enanthate). This medication can raise your blood pressure, which might increase your risk of heart attack or stroke.
  • Xyosted (testosterone enanthate) can cause breast swelling, tenderness, or pain. Tell your prescriber if these symptoms become bothersome.
  • Xyosted (testosterone enanthate) can lower your blood sugar. If you have diabetes, you might need to check your blood sugar more often. Know how to treat low blood sugar.
  • If you take warfarin, you might need more frequent INR blood tests when starting, stopping it, or changing your dose of Xyosted (testosterone enanthate). Testosterones can increase your risk of bleeding.
  • Xyosted (testosterone enanthate) can lower your sperm count and may affect your ability to have children. Talk to your care team before starting treatment if you plan to have a baby in the future.
  • Storage: Keep Xyosted (testosterone enanthate) at room temperature. Don't refrigerate or freeze it, and keep it in the original box until you’re ready to use it.

How to use Xyosted (testosterone enanthate)

  • Read the instructions for use before your first injection. Ask your prescriber or pharmacist if you have questions about how to inject it.
  • When you're ready to inject, use your fingers to gently pinch an area of your stomach, and keep pinching until you finish injecting. With your other hand, press the injector firmly against the skin until you hear a click, then hold it in place for 10 seconds.
  • Rotate injection sites each week to help reduce bruising and skin irritation.
  • After injecting, throw away the injector in a sharps container to avoid injury. Follow local instructions for safe disposal.
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Xyosted (testosterone enanthate) dosage

The average cost for 1 carton of 4 autoinjectors of 75mg of Xyosted (testosterone enanthate) is $437.21 with a free GoodRx coupon. This is 45.05% off the average retail price of $795.67.
autoinjectorAutoinjector
DosageQuantityPrice as low asPrice per unit
50mg1 autoinjector$165.23$165.23
75mg1 autoinjector$165.23$165.23
100mg1 autoinjector$165.23$165.23
cartonCarton
DosageQuantityPrice as low asPrice per unit
4 autoinjectors of 50mg1 carton$444.77$444.77
4 autoinjectors of 75mg1 carton$437.21$437.21
4 autoinjectors of 100mg1 carton$437.21$437.21
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Interactions between Xyosted (testosterone enanthate) and other drugs

Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate). 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.

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How much does Xyosted (testosterone enanthate) cost?

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Xyosted (testosterone enanthate) 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 Xyosted (testosterone enanthate) will not be safe for you to take.

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

There are a number of medications that your doctor can prescribe in place of Xyosted (testosterone enanthate). Compare a few possible alternatives below.
Xyosted (testosterone enanthate)
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News about Xyosted (testosterone enanthate)

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Xyosted (testosterone enanthate) images

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