Prescription only
Testosterone Cypionate
Sold as Depo-Testosterone.
What the label states
For replacement in the hypogonadal male, 50 to 400 mg every two to four weeks.
Quoted from the approved product label. Clinics commonly prescribe differently — more frequent, smaller injections of the same weekly total are routine — and where this site describes that, it is named as practice rather than as labelling.
- Route
- Intramuscular, deep in the gluteal muscle
- Vehicle
- Cottonseed oil (736 mg/mL) with benzyl benzoate and benzyl alcohol
- Usual barrel
- 1 mL luer-lock
- Strengths covered
- 100 mg/mL, 200 mg/mL
Dosing arithmetic by vial strength
The milligrams are the same drug at either concentration; only the volume changes. One unit mark is worth a different dose on each, which is why reading the barrel without reading the label is how a dose comes out doubled.
Which syringe, and why
Testosterone cypionate is suspended in cottonseed oil — 736 mg of it per millilitre, per the label — with benzyl benzoate and benzyl alcohol. That oil is viscous, and the label specifies deep intramuscular injection into the gluteal muscle. Both facts point at a luer-lock barrel with a detachable needle: you draw through a wide gauge (18–21G), swap to a finer one to inject (22–25G), and you need 1 to 1.5 inches of needle to reach muscle. A fixed 29–31G insulin needle is both too fine to draw cold oil through at any speed and, at half an inch, too short for a gluteal intramuscular injection in most adults.
Administration
- 1
Confirm the diagnosis first
The label requires serum testosterone measured on at least two separate mornings, both below the normal range, before therapy is initiated.
- 2
Inspect the vial
Testosterone cypionate is a clear, pale-yellow oil solution. Check the expiry date and that the solution is free of particles. Crystals can form if the vial has been cold; warming to room temperature in the hand redissolves them.
- 3
Clean the stopper
Wipe the rubber stopper with an alcohol swab and let it dry.
- 4
Draw the prescribed volume
Use the table on this page to convert your prescribed dose in milligrams to syringe units. Oil solutions draw slowly — a wider-gauge needle for drawing and a finer one for injecting is common practice.
- 5
Expel air
Hold the syringe needle-up, tap to raise bubbles, and push the plunger until a drop appears at the tip.
- 6
Inject as directed
The label specifies deep intramuscular injection into the gluteal muscle, and states the product must not be given intravenously. Your prescriber will confirm site and technique.
- 7
Rotate sites and record the dose
Alternate injection sites between doses and log the date and amount. A written record is what makes a trough lab result interpretable.
Storage
- —Store at 20–25 °C (68–77 °F), the USP controlled room temperature range on the label.
- —Keep the vial in its carton, away from light.
- —Do not refrigerate — cold causes the oil to thicken and crystals to form.
- —A multi-dose vial should be discarded per your pharmacy’s beyond-use date once entered.
Monitoring
| Marker | When | Why |
|---|---|---|
| Total testosterone | Baseline, then as directed — commonly at a trough, immediately before the next dose | Confirms the dose is achieving the intended range. The label requires two low morning values before therapy begins. |
| Haematocrit | Baseline and periodically | Erythrocytosis is the most common clinically significant adverse effect of testosterone therapy and may require dose reduction or phlebotomy. |
| PSA | Baseline and periodically in men over 40 | The Endocrine Society guideline recommends prostate monitoring in men starting testosterone who are at higher baseline risk. |
| Estradiol | If symptoms suggest | Testosterone aromatises to estradiol. Testing is symptom-driven rather than routine in most practices. |
Frequently asked questions
- What dose does the FDA label actually state?
- The Depo-Testosterone label states that for replacement in the hypogonadal male, 50 to 400 mg should be administered every two to four weeks, and that dosage is adjusted according to the patient’s response and the appearance of adverse reactions. It specifies intramuscular use only.
- Why do some prescribers split the dose weekly instead of every two weeks?
- Testosterone esters in oil are absorbed slowly from the lipid phase, which is why the label permits two-to-four-week intervals. Some prescribers use shorter intervals to narrow the peak-to-trough swing. That is a clinical judgement your prescriber makes; it is not specified on the label.
- Can testosterone cypionate be injected subcutaneously?
- The Depo-Testosterone label specifies intramuscular use only. Subcutaneous administration of testosterone cypionate is used in some practices and is documented in the literature, but it is not the labelled route — ask your prescriber rather than changing route on your own.
- Does this page tell me what dose to take?
- No. It converts a dose your prescriber has already set into the volume and syringe units you draw, and it quotes the labelled range. Selecting a dose requires confirmed hypogonadism, your lab values, and clinical supervision.
Sources
- [1]FDA label — DEPO-Testosterone (testosterone cypionate) injection, Pharmacia & Upjohn (DailyMed SPL)
- [2]Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744
- [3]FDA — Testosterone postmarket drug safety information for patients and providers
Related
Educational reference, not medical advice. Dose, route and whether this compound is appropriate at all are decisions for your clinician.