Depo-Testosterone

Depo^®-Testosterone is an injectable form of testosterone cypionate, a synthetic version of testosterone used in testosterone replacement therapy (TRT) for men with hypogonadism, a condition where the body does not naturally produce enough testosterone. This hormone is essential for maintaining muscle mass, bone density, libido, mood stability, and overall energy levels in men. 

Depo-Testosterone works by supplementing low testosterone levels, helping to restore normal bodily functions. It’s typically administered as a deep intramuscular injection in the gluteal muscle, with dosages commonly ranging from 50 to 400 milligrams (mg) every two to four weeks, depending on individual needs and medical guidance.

Common side effects include acne, increased red blood cell count, fluid retention, mood swings, and changes in libido. More serious risks involve high blood pressure, an increased risk of blood clots, sleep apnea, and prostate enlargement. Long-term use may also suppress natural testosterone production, potentially leading to testicular shrinkage and reduced sperm count.

Depo-Testosterone (testosterone cypionate) is indicated for:

• Replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone:

  • Primary hypogonadism (congenital or acquired) — testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy

  • Hypogonadotropic hypogonadism (congenital or acquired) — gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation

Androgen

The following adverse reactions in the male have occurred with some androgens:

• Endocrine and urogenital: Breast tissue growth in men and excessive frequency and duration of penile erections. Oligospermia may occur at high dosages

• Skin and appendages: Hirsutism, male pattern of baldness, seborrhea, and acne

• Cardiovascular disorders: Heart attack, stroke

• Fluid and electrolyte disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates

• Gastrointestinal: Nausea, cholestatic jaundice, alterations in liver function tests, rarely hepatocellular neoplasms and peliosis hepatis

• Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia

• Nervous system: Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia

• Allergic: Hypersensitivity, including skin manifestations and anaphylactoid reactions

• Vascular disorders: Venous thromboembolism

• Special senses: Rare cases of central serous chorioretinopathy (CSCR)

• Miscellaneous: Inflammation and pain at the site of intramuscular injection

The price of Depo-Testosterone may vary depending on where you buy it, your dosage, your insurance plan, and whether you purchase the brand-name or generic version of the medication. 

Without insurance, the average retail price of brand-name Depo-Testosterone is about $200 per injection, while the generic version (testosterone cypionate) costs about $127 per dose, although coupons and discount cards may be available to help lower the price. Many insurance plans cover the medication at a copay of $60 to $80. Depo-Testosterone’s manufacturer, Pfizer, has a patient assistance program called Pfizer RxPathways that connects eligible people with a range of assistance programs that offer insurance support, copay help, and medicines for free or at an additional savings.

Depo-Testosterone is only available by prescription from a healthcare provider. If you’re interested in taking this medication, make an appointment with your provider so they can assess your testosterone levels and discuss whether testosterone therapy is the right treatment for you based on factors like your health status, medical history, and symptoms.

• Known hypersensitivity to the drug

• 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

• Drug interactions: Androgens may increase sensitivity to oral anticoagulants, concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone, in diabetic patients the metabolic effects of androgens may decrease blood glucose and insulin requirements

• Patients with benign prostatic hypertrophy may develop acute urethral obstruction

• Priapism or excessive sexual stimulation may develop

• Oligospermia may occur after prolonged administration or excessive dosage

• Testosterone cypionate should not be used interchangeably with testosterone propionate because of differences in duration of action

• Testosterone cypionate is not for intravenous use

• Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis

• Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration

• Serum cholesterol may increase during androgen therapy

• Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4

• High blood calcium may occur in immobilized patients

• Prolonged use of high doses of androgens (principally the 17-α alkyl-androgens) has been associated with development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis

• Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking

• There have been postmarketing reports of venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients using testosterone products, such as testosterone cypionate

• Long term clinical safety trials have not been conducted to assess the cardiovascular outcomes of testosterone replacement therapy in men

• Testosterone has been subject to abuse, typically at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids

• Edema, with or without congestive heart failure, may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease

• Breast tissue growth in males may develop and occasionally persists in patients being treated for hypogonadism

• The preservative benzyl alcohol has been associated with serious adverse events, including the "gasping syndrome", and death in pediatric patients

• Androgen therapy should be used cautiously in healthy males with delayed puberty

• This drug has not been shown to be safe and effective for the enhancement of athletic performance

• Pregnancy: The use of testosterone in women who are pregnant is contraindicated

• Breastfeeding: Depo-Testosterone is not recommended for use in nursing mothers

There are other treatments for low testosterone or hypogonadism, some of which may be better suited to you than others. If you’re interested in an alternative to Depo-Testosterone, connect with a healthcare provider who can help you evaluate your options.

Other types of testosterone replacement therapy (sometimes called androgen replacement) include:

• Other injectable testosterone medications, such as Aveed^® or Xyosted^®

• Implantable testosterone pellets, such as Testopel^®

• Oral testosterone therapy medications, including Jatenzo^® and Tlando^®

• Topical testosterone, such as Androderm^® (testosterone patch) and Testim^® (testosterone gel)

Alternatives to TRT that may help manage low testosterone in men include the following interventions, all of which can signal the body to have or produce more testosterone:

• Aromatase inhibitors like Arimidex^® (anastrozole)

• Human chorionic gonadotropin (hCG) or Ovidrel^®, a lab-made version of hCG

• Selective estrogen receptor modulators like Clomid (clomiphene)

Your healthcare provider may also prescribe non-medication alternatives that can support healthy testosterone levels naturally, including:

• Exercise

• Stress management

• Dietary improvements

• Getting enough sleep

• Weight loss

*This information is from the label for brand name Depo-Testosterone^®. See the Full Prescribing Information for more complete information. Testosterone cypionate, the active ingredient in Depo-Testosterone, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient testosterone cypionate.