Testosterone cypionate is a generic prescription drug that’s used to increase testosterone levels in certain males. Testosterone cypionate comes as a solution for injection into muscle.

  1. Testosterone cypionate injectable solution is available as a brand-name drug and a generic drug. Brand name: Depo-Testosterone.
  2. Testosterone cypionate comes only in the form of an injectable solution given into your muscle. You can give this medication to yourself at home after your doctor shows you how.
  3. Testosterone cypionate is used to treat symptoms of hypogonadism in males. In this condition, males don’t produce enough of the sex hormone testosterone.

Note: In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

  • Heart effects warning: There haven’t been any long-term studies done to know whether testosterone replacement therapy in males has a negative effect on heart health. However, short-term studies have shown that this drug may increase your risk of heart attack or stroke, or even be fatal.
  • Liver problems warning: Using high doses of this drug for a long period can increase your risk of liver problems, including liver cancer. These are serious conditions that can be life threatening.
  • Blood clots warning: This drug may raise your risk of developing blood clots in your lungs or the deep veins of your legs.
  • Misuse warning: Testosterone can be misused (using a drug differently than how it’s prescribed). There is an increased risk if you receive higher doses of the drug than your doctor prescribes, or if you use it along with other anabolic steroids. Misusing testosterone can lead to serious health problems. These problems include heart attack, heart failure, depression, and psychosis. Your doctor can tell you more about the risks of testosterone misuse.

Testosterone cypionate is a prescription drug. It comes as an injectable solution given into muscle. Testosterone cypionate is a self-injectable drug. You can give this medication to yourself at home after your doctor shows you how to do so.

Testosterone cypionate is available as the brand-name drug Depo-Testosterone. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Testosterone cypionate is a controlled substance. This means it’s regulated by the U.S. government.

Why it’s used

Testosterone cypionate is used to treat symptoms of hypogonadism in males. With this condition, males don’t produce enough of the sex hormone testosterone.

Low testosterone levels in males can lead to mood changes, difficulty concentrating, erectile dysfunction (trouble getting or keeping an erection), and low sex drive. It can also cause reduced growth of the penis and testicles, gynecomastia (breast growth), loss of body hair and muscle mass, anemia (low level of red blood cells), and osteoporosis (weakened bones).

There are two types of hypogonadism: primary and hypogonadotropic. This drug may be used to treat both.

  • Primary hypogonadism occurs when the testicles can’t produce enough testosterone.
  • Hypogonadotropic hypogonadism occurs when there is damage to parts of the brain (hypothalamus or pituitary gland) that tell the testicles to produce testosterone.

Testosterone cypionate is also prescribed off-label for testosterone therapy for transgender males and gender diverse people. Off-label means a doctor can prescribe the medication for a different use than what it was approved for.

Note: In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

How it works

Testosterone cypionate belongs to a class of drugs called androgens. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Testosterone cypionate works to treat hypogonadism in males by replacing the testosterone the body is unable to make.

How quickly does testosterone cypionate work?

Testosterone cypionate starts to work as soon as you give yourself a dose. However, it may take 3 weeks or more before you start to feel symptoms of your condition ease. For more information about when to expect symptom reduction after you start using testosterone cypionate, talk with your doctor.

Testosterone cypionate can cause mild or serious side effects. The following list contains some of the key side effects that may occur during testosterone cypionate treatment. This list does not include all possible side effects.

For more information on the possible side effects of testosterone cypionate, or tips on how to manage a bothersome side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of testosterone cypionate can include:

  • acne
  • pain and swelling at the injection site
  • hair growth
  • gynecomastia (breast enlargement)
  • more frequent erections
  • erections that last longer than usual
  • mood changes
  • headache
  • decrease in sperm count when the drug is used at high doses

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart attack. Symptoms can include:
    • chest pain
    • shortness of breath
    • discomfort in your upper body
  • Stroke. Symptoms can include:
    • weakness in one part or side of your body
    • slurred speech
  • Enlargement of your prostate gland. Symptoms can include:
    • frequent or urgent need to urinate
    • nocturia (need to urinate more often at night)
    • trouble starting urination
    • weak urine stream or a stream that stops and starts
    • dribbling at the end of urination
    • straining while urinating
    • not being able to completely empty your bladder
  • Prostate cancer. Your doctor should check for prostate cancer or any prostate problems before and during treatment with this drug, especially if you’re age 65 years or older.
  • Liver problems. Symptoms can include:
    • nausea
    • vomiting
    • abdominal pain and swelling
    • swelling in your legs and ankles
    • bruising more easily than usual
    • pale-colored stool
    • unusual or unexplained tiredness
    • loss of appetite
    • dark-colored urine
    • yellowing of your skin or the whites of your eyes
  • Deep vein thrombosis (blood clots in the deep veins of your legs). Symptoms can include:
    • swelling of your leg
    • pain in your leg
  • Pulmonary embolism (blood clots in your lungs). Symptoms can include:
    • shortness of breath
    • chest pain or discomfort that gets worse when you take a deep breath or when you cough
    • feeling lightheaded or dizzy, or fainting
    • fast pulse
    • coughing up blood
  • Polycythemia (increase in your red blood cell count). Symptoms can include:
    • reddening or discoloration in your face
    • headaches
    • confusion
    • stroke
    • blood clots
    • tiredness
    • decrease in mental alertness

Testosterone cypionate can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with testosterone cypionate. This list does not contain all drugs that may interact with testosterone cypionate.

Before starting testosterone cypionate, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Interactions that increase your risk of side effects

Using testosterone cypionate with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

  • Insulin and oral diabetes drugs: Taking these drugs with testosterone cypionate may cause a significant decrease in your blood sugar levels. Examples include metformin (Fortamet), glipizide (Glucatrol XL), and liraglutide (Victoza). Your doctor may decrease the dosage of your diabetes drugs. You may need to monitor your blood sugar levels closely while taking these drugs together.
  • Oral blood thinners: Taking these drugs with testosterone cypionate may increase your risk of bleeding. An example is warfarin (Jantoven). Your doctor will monitor you closely if you take these drugs together.
  • Corticosteroids and adrenocorticotropic hormone: Taking these drugs with testosterone cypionate puts you at a higher risk of edema (fluid buildup). Your doctor should monitor you closely for fluid buildup if you take these drugs together, especially if you have heart or liver problems.

This drug comes with several warnings.

Allergy warning

Testosterone cypionate can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Do not use this drug again if you’ve ever had an allergic reaction to it. Using it again could be fatal.

Warnings for people with certain health conditions

For people with liver problems: This medication can cause liver damage, which may lead to serious liver disease. If you have liver disease, testosterone cypionate may also cause salt and water retention. This may make your liver disease worse.

For people with heart problems: If you have heart disease, this drug may cause salt and water retention. Both the medication and the salt and water retention can make your conditions worse. If you have a history of heart attack or heart disease, ask your doctor whether this drug is safe for you.

For people with kidney problems: If you have kidney problems or a history of kidney disease, this drug may cause salt and water retention. Both the medication and salt and water retention can make your conditions worse.

For people with breast cancer: You should not receive this drug if you have breast cancer. This medication may make your disease worse.

For people with prostate cancer: You should not receive this drug if you have prostate cancer. Testosterone cypionate may make your disease worse.

For people with sleep apnea (problems breathing while sleeping): If you have sleep apnea, ask your doctor whether this drug is safe for you. This medication may make this condition worse. You may wake up more often at night, which may cause you to be more tired during the day.

For people with polycythemia (elevated red blood cell count): This drug may significantly increase your red blood cell count and make your condition worse. You should not use this drug if your red blood cell count is above a certain level. If you have polycythemia, your doctor will order blood tests to determine whether this drug is safe for you to use.

For people with high cholesterol levels: This drug may increase your cholesterol levels. High cholesterol levels may increase your risk of heart or blood vessel problems. Your doctor will check your cholesterol levels during testosterone cypionate treatment.

For people with diabetes: This drug may cause a significant decrease in your blood sugar levels. Your doctor may lower the dosage of your diabetes drugs. You may also need to monitor your blood sugar levels closely.

For people with blood clots: This drug may increase your risk of developing blood clots in your lungs or in the deep veins of your legs, especially if you have a history of blood clots.

Warnings for other groups

For pregnant people: Testosterone cypionate should never be used during pregnancy. This medication can cause harm to the fetus.

For breastfeeding people: Testosterone cypionate should not be used during breastfeeding.

For older adults: This drug should not be used to treat age-related decreases in testosterone. There isn’t enough information to support the use of this drug for a long period of time in people ages 65 years and older.

If you’re an older adult, you may be at a higher risk of heart disease, prostate cancer, and enlarged prostate while using this drug.

For children: It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Testosterone cypionate may affect bone growth in children. The drug can cause bones to mature more quickly than usual without causing an increase in height. This can result in a shorter adult height. If your child uses this drug, their doctor will check their growth regularly.

Whether you have health insurance or not, cost may be a factor when you’re considering testosterone cypionate. What you’ll pay for testosterone cypionate may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for testosterone cypionate when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Savings programs and other assistance: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. If you need financial support to pay for testosterone cypionate, or if you need help understanding your insurance coverage, try one of these sites:
    • Medicine Assistance Tool
    • NeedyMeds

You can also check out this article to learn more.

The testosterone cypionate dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using testosterone cypionate to treat
  • your age
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Generic: testosterone cypionate

  • Form: injectable solution
  • Strengths: 100 milligrams per milliliter (mg/mL), 200 mg/mL

Brand: Depo-Testosterone

  • Form: injectable solution
  • Strengths: 100 mg/mL, 200 mg/mL

Dosage for primary hypogonadism

Adult dosage (ages 18 years and older)

  • Typical starting dosage: Your dosage depends on your age and diagnosis. Your doctor will determine your dosage based on your needs. In general, the dosage is 50 to 400 mg injected into muscle every 2 to 4 weeks.
  • Dosage increases: Your doctor may adjust your dosage based on your testosterone blood levels, response to treatment, and side effects.
  • Maximum dosage: 400 mg injected into a muscle every 2 weeks.

Child dosage (ages 12 to 17 years)

  • Typical starting dosage: Your child’s dosage depends on their age, body size, and diagnosis. Their doctor will decide a dosage based on your child’s needs.
  • Dosage increases: Your child’s doctor may adjust your child’s dosage based on their testosterone blood levels, response to treatment, and side effects.
  • Maximum dosage: 400 mg injected into a muscle every 2 weeks.

Child dosage (ages 0 to 11 years)

It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Dosage for hypogonadotropic hypogonadism

Adult dosage (ages 18 years and older)

  • Typical starting dosage: Your dosage depends on your age and diagnosis. Your doctor will decide a dosage based on your needs. In general, the dosage is 50 to 400 mg injected into a muscle every 2 to 4 weeks.
  • Dosage increases: Your doctor may adjust your dosage based on your testosterone blood levels, response to treatment, and side effects.
  • Maximum dosage: 400 mg injected into a muscle every 2 weeks.

Child dosage (ages 12 to 17 years)

  • Typical starting dosage: Your child’s dosage depends on their age, body size, and diagnosis. Their doctor will decide a dosage based on your child’s needs.
  • Dosage increases: Your child’s doctor may adjust your child’s dosage based on their testosterone blood levels, response to treatment, and side effects.
  • Maximum dosage: 400 mg injected into a muscle every 2 weeks.

Child dosage (ages 0 to 11 years)

It hasn’t been confirmed that testosterone cypionate is safe and effective for use in children younger than 12 years.

Testosterone cypionate injectable solution is used for long-term treatment. It comes with serious risks if you do not use it as prescribed.

If you stop using the drug suddenly or don’t use it at all: Your medication may not work as well as usual. For this drug to work well, a certain amount needs to be in your body at all times. If you don’t use this drug, you may still have symptoms of low testosterone.

If you miss doses or don’t give yourself the drug on schedule: Your medication may not work as well as usual or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you give yourself too much: You could have dangerous levels of the drug in your body. Symptoms can include:

  • acne
  • pain and swelling at the injection site
  • hair growth
  • gynecomastia (breast enlargement)
  • more frequent erections
  • erections that last longer than usual
  • decrease in sperm count
  • mood changes
  • headache

If you think you’ve used too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Call your doctor and tell them how long it’s been since you last injected testosterone cypionate. They will help you set up a new dosing schedule. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms of low testosterone should improve and may go away.

Keep these considerations in mind if your doctor prescribes testosterone cypionate for you.

General

  • Give yourself injections of this drug at the time(s) recommended by your doctor.

Storage

  • Store testosterone cypionate at a room temperature of 68°F to 77°F (20°C to 25°C).
  • Keep this drug away from light.

Refills

A prescription for this medication may not be refillable. You may need a new prescription for this medication to be refilled. Ask your doctor about the refill status for this drug.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
  • Remember to bring syringes and needles so you can inject your medication while you’re away from home.

Self-management

Testosterone cypionate is given by injection into a muscle (usually the buttocks). Your doctor will teach you how to inject the drug deep into your muscle.

You’ll need to purchase the following to give yourself an injection:

  • sterile alcohol wipes
  • syringes
  • needles
  • a sharps container (a bin for safe disposal of used syringes)

Clinical monitoring

You and your doctor should monitor certain health issues while you receive this drug. This can help make sure you stay safe during your treatment. These issues include:

  • Cholesterol levels: This drug may increase your cholesterol levels. High cholesterol levels may raise your risk of heart or blood vessel problems. Your doctor will check your cholesterol levels while you receive this medication.
  • Polycythemia: In rare cases, this drug may increase your red blood cell count to very high levels. This is called polycythemia. Your doctor will order blood tests to monitor polycythemia while you receive this medication.
  • Testosterone levels: Your doctor will check your total testosterone level every 6 to 12 months after you start treatment with this drug. After that, they’ll check your testosterone levels once per year to make sure this drug is working for you. Your doctor may adjust your dosage based on your testosterone levels.
  • Bone age: If your child is receiving this drug for delayed puberty, their doctor should do an X-ray of your child’s wrist and hand every 6 months to check how fast their bones are maturing.
  • Prostate health: Older adults treated with this drug may have an increased risk of developing an enlarged prostate and prostate cancer. Your doctor may check your prostate and measure your prostate-specific antigen levels (PSA) to make sure your prostate is healthy.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Hidden costs

You may need to purchase the following:

  • sterile alcohol wipes
  • syringes and needles to inject testosterone cypionate
  • a sharps container (a bin for safe disposal of used syringes)

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.