Testosterone cypionate
DEPO-TESTOSTERONE
Pronunciation: tes-TOS-ter-oen
What it isLong-acting androgen-receptor agonist injection; testosterone replacement for male hypogonadism.
Why this oneUnlike injectable undecanoate, it has no post-injection pulmonary-oil warning or observation requirement.
What limits itMonitor hematocrit, prostate risk and symptoms of sleep apnea. It suppresses spermatogenesis and can cause acne, edema and mood swings.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Male hypogonadism (primary or hypogonadotropic) — testosterone replacement | Males | 50–400 mg IM every 2–4 weeks | Adjust to clinical response | 400 mg per 2–4 weeks |
Renal Undefined
Hepatic Undefined
Instructions
- IM only, deep in gluteal muscle; not for IV use
- Confirm hypogonadism with morning serum testosterone below normal on at least two separate days before starting
- Warm and shake vial to redissolve any crystals
- Do not interchange with testosterone propionate (different duration)
Available strengths
- inj 100, 200 mg/mL
Contraindications
- Males with carcinoma of the breast
- Males with known or suspected carcinoma of the prostate gland
- Women who are pregnant
- Patients with serious cardiac, hepatic or renal disease
Cautions
- Venous thromboembolism (DVT/PE)
- Possible increased risk of major adverse cardiovascular events
- Can increase blood pressure/CV risk; not recommended in uncontrolled hypertension
- Abuse potential (anabolic androgenic steroids)
- Hepatic effects (peliosis hepatis, adenoma, hepatocellular carcinoma) with prolonged high doses
- Edema, with or without CHF, in cardiac/renal/hepatic disease
- Contains benzyl alcohol — gasping syndrome in neonates
- May accelerate bone maturation in children
Adverse reactions
- Gynecomastia
- Excessive/prolonged penile erections
- Oligospermia at high doses
- Fluid and electrolyte retention
- Polycythemia
- Nausea, cholestatic jaundice, abnormal LFTs
- Venous thromboembolism
- Injection site pain and inflammation
Pregnancy Contraindicated in pregnancy; testosterone is teratogenic and virilizes the female fetus
Lactation Not recommended for use in nursing mothers
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 100 mg/mL | inj | per unit | $5.07/mL | not offered |
| 200 mg/mL | inj | per unit | $11.39/mL | not offered |
NO BOXED WARNINGS
Principal riskRaises blood pressure and hematocrit
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityErythrocytosis, infertility, hepatic/lipid effects and mood or misuse concerns.
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