Testosterone injections are typically intramuscular — that is, given directly into a muscle. Two relatively easy and accessible sites for intramuscular injection are the deltoid upper arm or the glut upper back portion of the thigh, ie, the butt cheek. Whichever of these sites you choose, take a sterile alcohol pad and wipe the immediate area around where you intend to inject. This will kill bacteria on the skin, preventing infection. If injecting into the glute or buttocks, choose an injection site in the top outside section of the glute.
In other words, pick a site either in the top left corner of the left glute or the top right corner of the right glute. These site have the best access to muscle tissue and allow you to avoid hitting nerves and blood vessels in other parts of the glute.
Hold your loaded syringe like a dart at a degree angle above the sterile injection site. Quickly plunge it into the flesh. Before depressing the plunger, draw back on it slightly. Inject the medication at a steady, controlled pace. Care for the injection site post-injection. Once you have fully depressed the plunger, slowly pull the needle out. Press around the injection site with a sterile cotton swab as you do so — this prevents the emerging needle from pulling on the skin and causing extra pain.
You may need a new prescription for this medication to be refilled. Ask your doctor about the refill status for this drug. Testosterone cypionate is given by injection into your muscle usually the buttocks. Your healthcare provider will teach you how to inject the drug deep into your muscle. You and your doctor should monitor certain health issues while you take this drug. This can help make sure you stay safe during your treatment. These issues include:. Not every pharmacy stocks this drug.
When filling your prescription, be sure to call ahead to make sure your pharmacy carries it. 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 to 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 other 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. Testosterone is an important hormone. It can boost libido, increase muscle mass, sharpen memory, and bump up energy.
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Testogen is an all-natural dietary supplement that claims to increase testosterone levels. You may have heard that testosterone supplements can help in the bedroom. Testosterone is a hormone found in men, less so in women.
Learn how abnormally low or high levels can impact a man's physical and mental health. There are many natural ways to boost your libido, such as eating aphrodisiacs and sleeping more.
Discover other foods and lifestyle habits you should…. Before you reach for testosterone boosting supplements, get the facts on what these products really are and whether or not they'll benefit your health. Testosterone decreases each year after age Learn about causes such as hypogonadism, and treatments such as testosterone replacement. Boron can have a slight impact on your testosterone levels, and you may very well notice some differences.
But it's less likely that you'll see any…. Certain exercises can boost testosterone levels, especially in people with penises. But testosterone levels that are too high can be harmful…. Health Conditions Discover Plan Connect.
Testosterone Cypionate, Injectable Solution. Important warnings About Side effects Interactions Other warnings Dosage Take as directed Important considerations Alternatives Highlights for testosterone cypionate Testosterone cypionate injectable solution is available as a brand-name drug and a generic drug.
Brand name: Depo-testosterone. 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.
Important warnings. What is testosterone cypionate? Elderly patients and other patients with clinical or demographic characteristics that are recognized to be associated with an increased risk of prostate cancer should be evaluated for the presence of prostate cancer prior to initiation of testosterone replacement therapy.
In patients receiving testosterone therapy, surveillance for prostate cancer should be consistent with current practices for eugonadal men. Testosterone replacement is not indicated in geriatric patients who have age-related hypogonadism only or andropause because there is insufficient safety and efficacy information to support such use.
The Beers expert panel considers use for moderate to severe hypogonadism to be acceptable. Because of reduced drug clearance and an increased risk of drug accumulation, patients with hepatic disease or hepatic dysfunction should be prescribed testosterone with caution. In addition, edema secondary to water and sodium retention may occur during treatment with androgens.
Use testosterone with caution in patients with hepatic disease; renal disease, including nephritis and nephrosis; preexisting edema; or cardiac disease, including heart failure, coronary artery disease, and myocardial infarction MI , as fluid retention may aggravate these conditions.
Further, the possible association between testosterone use and the increased risk of severe cardiovascular events, irrespective of pre-existing cardiac disease, is currently under investigation.
An observational study in the U. Veteran Affairs health system included adult male patients of an average age of 60 years. Within the larger cohort, testosterone therapy was initiated in males after a median of days following coronary angiography; males did not receive testosterone therapy.
Three years after coronary angiography, The incidence rate of MI occurring within 90 days following the initial testosterone prescription was compared to the incidence rate of MI occurring in the one year leading-up to the first prescription. Among older males, a 2-fold increase in the risk of MI was observed within the 90 day window; among younger males with a pre-existing history of cardiac disease, a 2- to 3-fold increased risk of MI was observed.
In contrast, no increased risk was observed in younger males without a history of cardiac disease. However, health care professionals are urged to carefully consider whether the benefits of treatment are likely to exceed the potential risks. The FDA will communicate their final conclusions and recommendations when the evaluation is complete.
The treatment of hypogonadal men with testosterone esters may potentiate sleep apnea, especially in patients that have risk factors for apnea such as obesity or chronic pulmonary disease. Patients receiving high doses of testosterone are at risk for polycythemia. Periodically, patients receiving testosterone should have their hemoglobin and hematocrit concentrations measured to detect polycythemia.
Testosterone is contraindicated during pregnancy because of probable adverse effects on the fetus FDA pregnancy risk category X. Women of childbearing potential who are receiving testosterone treatments should utilize adequate contraception. Because testosterone is not used during pregnancy, there should be no particular reason to administer the products to women during labor or obstetric delivery; safety and efficacy in these settings have not been established.
Testim testosterone gel is specifically contraindicated in females; the drug is for males only; the dosage form supplies testosterone in excess of what should be prescribed to females under certain endocrine situations. At high doses, virilization is common and is not prevented by concomitant use of estrogens. Some virilization may be judged to be acceptable during treatment for breast carcinoma; however, if mild virilism is evident, discontinuation of drug therapy is necessary to prevent long term virilization.
When clothing covered the treated site on the male, the transfer of testosterone to the female was avoided. Accidental exposure to topical testosterone gel has also occurred in pediatric patients after contact between the child and the application site in treated individuals. The adverse events reported include genitalia enlargement, development of pubic hair, advanced bone age, increased libido, and aggressive behavior.
Symptoms resolved in most patients when exposure to the product stopped. However, in a few patients, the genitalia enlargement and advanced bone age did not fully return to expected measurements. The FDA recommends taking precautions to minimize the potential for accidental exposure of topical testosterone products by washing hands with soap and warm water after each application, covering application site with clothing, and removing medication with soap and water when contact with another person is anticipated.
In the case of direct skin-to-skin contact with the site of testosterone application, the non-treated person should wash the area with soap and water as soon as possible. Testosterone topical solution, transdermal patches, and gels are contraindicated in lactating women who are breast-feeding. Significant exposure to this androgen via breast-feeding may have adverse androgenic effects on the infant and the drug may also interfere with proper establishment of lactation in the mother.
Androgen therapy, such as testosterone, can result in loss of diabetic control and should be used with caution in patients with diabetes mellitus. Close monitoring of blood glucose is recommended. Testosterone has induced osteolysis and should be used with caution in patients with hypercalcemia, which can be exacerbated in patients with metastatic breast cancer.
Administration of testosterone undecanoate has been associated with cases of serious pulmonary oil microembolism POME reactions as well anaphylactoid reactions. Reported cases of POME reactions occurred during or immediately after a mg intramuscular injection of testosterone undecanoate. Symptoms included: cough, urge to cough, dyspnea, hyperhidrosis, throat tightening, chest pain, dizziness, and syncope. When administering testosterone undecanoate, clinicians should take care to inject deeply into the gluteal muscle, avoiding intravascular injection.
In addition to POME reactions, episodes of anaphylaxis, including life-threatening reactions, have also been reported following the intramuscular injection of testosterone undecanoate. Patients with suspected hypersensitivity reactions should not be retreated with testosterone undecanoate.
After every administration, monitor patient for 30 minutes and provide appropriate medical treatment in the event of serious POME or anaphylactoid reactions. Clinicians wanting to prescribe Aveed, must be certified with the REMS Program for purposes of ordering or dispensing the product.
Healthcare settings must also be certified with the REMS Program and must have the resources to provide emergency medical treatment in cases of serious POME and anaphylaxis. Further information is available at www. Intranasal formulations of testosterone e. In addition, the safety and efficacy of intranasal testosterone has not been evaluated in individuals with mucosal inflammatory disorders such as Sjogren's syndrome.
Patients with rhinorrhea rhinitis who are receiving intranasal formulations of testosterone may experience decreased medication absorption secondary to nasal discharge. These patients may experience a blunted or impeded response to the intranasal medication. Treatment with intranasal testosterone should be delayed until symptoms resolve in patients with nasal congestion, allergic rhinitis, or upper respiratory infection. If severe rhinitis symptoms persist, an alternative testosterone replacement therapy is advised.
Testosterone may accelerate bone maturation without stimulating compensatory linear growth, sometimes resulting in compromised adult stature. If testosterone is administered to prepubertal males, radiographic examinations of the hand and wrist should be performed every 6 months to assess the rate of bone maturation and the effect of the drug on epiphyseal centers.
Once the epiphyses have closed, growth is terminated. Even after discontinuation of treatment, epiphyseal closure can be enhanced for several months. Accidental exposure to topical testosterone gel has also occurred in pediatric patients after skin to skin contact between the child and the application site in treated individuals.
The FDA recommends taking precautions to minimize the potential for accidental exposure by washing hands with soap and warm water after each application, covering application site with clothing, and removing medication with soap and water when contact with another person is anticipated. Possible interactions include: certain medicines for diabetes; certain medicines that treat or prevent blood clots like warfarin; oxyphenbutazone; propranolol; steroid medicines like prednisone or cortisone.
This list may not describe all possible interactions. Testosterone can increase the anticoagulant action of warfarin. Although the mechanism is unclear, testosterone may reduce procoagulant factors.
Reduction of warfarin dosage may be necessary if testosterone therapy is coadministered. More frequent monitoring of INR and prothrombin time in patients taking such oral anticoagulants is recommneded, especially at the initiation and termination of androgen therapy.
Based on case reports with methyltestosterone and danazol, androgens may increase plasma concentrations of cyclosporine, leading to a greater risk of nephrotoxicity. Coadministration of corticosteroids and testoterone may increase the risk of edema, especially in patients with underlying cardiac or hepatic disease.
Corticosteroids with greater mineralocorticoid activity, such as fludrocortisone, may be more likely to cause edema. Administer these drugs in combination with caution. Goserelin 26 and leuprolide 27 inhibit steroidogenesis. Concomitant use of androgens with goserelin or leuprolide is relatively contraindicated and would defeat the purpose of goserelin or leuprolide therapy.
Androgens can increase the risk of hepatotoxicity and therefore should be used with caution when administered concomitantly with other hepatotoxic medications. Patients should be monitored closely for signs of liver damage, especially those with a history of liver disease.
Androgens may be necessary to assist in the growth response to human growth hormone, but excessive doses of androgens in prepubescent males can accelerate epiphyseal maturation. Androgens are known to stimulate erythropoiesis. Concurrent administration of androgens can increase the patient's response to epoetin alfa, reducing the amount required to treat anemia. Because adverse reactions have been associated with an abrupt increase in blood viscosity, this drug combination should be avoided, if possible.
Further evaluation of this combination needs to be made. The antiandrogenic effects of the 5-alpha reductase inhibitors i. Drug interactions with Saw palmetto, Serenoa repens have not been specifically studied or reported. Saw palmetto extracts appear to have antiandrogenic effects.
Limited data suggest that testosterone concentrations increase during fluconazole administration. Although data are not available, a similar reaction may occur with voriconazole. Both fluconazole and voriconazole are inhibitors of CYP3A4, the hepatic microsomal isoenzyme responsible for metabolism of testosterone.
Exogenously administered androgens testosterone derivatives or anabolic steroids have variable effects on blood glucose control in patients with diabetes mellitus. In general, low testosterone concentrations are associated with insulin resistance.
Further, when hypogonadal men with or without diabetes are administered exogenous androgens, glycemic control typically improves as indicated by significant reductions in fasting plasma glucose concentrations and HbA1c.
Significant reductions in HbA1c and fasting plasma glucose concentrations did not occur in patients taking placebo. Hypoglycemia or hyperglycemia can occur; dosage adjustments of the antidiabetic agent may be necessary. In vitro, both genistein and daidzein inhibit 5 alpha-reductase isoenzyme II, resulting in decreased conversion of testosterone to the potent androgen 5-alpha-dihydrotestosterone DHT and a subsequent reduction in testosterone-dependent tissue proliferation. Theoretically, because the soy isoflavones appear to inhibit type II 5-alpha-reductase, the soy isoflavones may counteract the activity of the androgens.
Testosterone is a substrate for CYP3A4 isoenzymes. Testosterone is an inhibitor of P-glycoprotein transport. Ambrisentan is a substrate for P-glycoprotein transport, an energy-dependent drug efflux pump. If ambrisentan is coadministered with a P-glycoprotein inhibitor, patients should be monitored closely for adverse effects. Coadministration of oxyphenbutazone and testosterone may lead to elevated concentrations of oxyphenbutazone. Monitor patients for adverse effects when coadministering these drugs together.
Testosterone cypionate has been shown to increase the clearance of propranolol in one study. Monitor patients taking testosterone and propranolol together for decreased therapeutic efficacy of propranolol. Coadministration of dabigatran and testosterone may result in increased dabigatran serum concentrations, and, therefore, an increased risk of adverse effects. Dabigatran is a substrate of P-gp; testosterone is a P-gp inhibitor.
Concomitant use of testosterone, a P-glycoprotein P-gp inhibitor, 19 and afatinib, a P-gp substrate, may increase the exposure of afatinib. If the use of both agents is necessary, consider reducing the afatinib dose if the original dose is not tolerated. Concomitant use of intranasal testosterone e. A mean decrease in AUC and Cmax 2. Concomitant use of oxymetazoline does not impact the absorption of testosterone.
This list may not include all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use.
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