Testosterone Cypionate

Medically Reviewed by Dr. J.R.G. Peries, M.D – Cardiology

Last Reviewed: Apr 28, 2023

Warnings


Testosterone-cypionate Risks, Warnings, and Complications


Testosterone-cypionate can cause severe health problems, especially in certain high-risk patients. Some of the risks of testosterone-cypionate use include:

  • ABUSE, MISUSE, ADDICTION, AND DEPENDENCY FOR TESTOSTERONE: Testosterone-cypionate (Depo-Testosterone) is a controlled substance. Misuse of testosterone-cypionate means when it is used for medical conditions for which it was not intended, such as sexual dysfunction. Abuse of testosterone-cypionate means when it is intentionally used for non-medical purposes, such as to gain muscle mass and enhance athletic performance. Abuse or misuse can lead to major heart and mental health issues, including heart attack, heart failure, stroke, liver issues, depression, delusions, hallucinations, and aggressiveness. Dependency on this medication occurs when you depend on it to function optimally and have withdrawal symptoms when you reduce the dose or discontinue the medicine abruptly. Withdrawal symptoms include depression, sleeplessness, and a decrease in sexual desire. Depo-Testosterone abuse that goes on for a long time might become an addiction. Addiction can lead to behaviors like exceeding the recommended dosage, spending a lot of time searching for the medication when it's hard to find, struggling to stop using the medication even when you want to, giving the most importance to its use, and going through withdrawal symptoms if you stop taking the medication abruptly. To reduce the danger of misuse, abuse, dependency, and addiction, you should always take testosterone cypionate (Depo-Testosterone) as directed.

  • MAJOR ADVERSE CARDIOVASCULAR EVENTS: Testosterone-cypionate (Depo-Testosterone) might increase your blood cholesterol levels, which can cause a heart attack. Additionally, testosterone cypionate by itself has the potential to result in sudden cardiac death, a stroke, or a heart attack. People with a history of heart disease are more at risk. If you experience chest pain, cold sweats, pain in your left arm, breathing difficulty, difficulty speaking or walking, or weakness on one side of your body, let your doctor know and get emergency help right away.

  • BLOOD CLOTS: Testosterone-cypionate (Depo-Testosterone) can result in blood clots in the lungs and legs, which can be fatal. Pain, swelling, or redness in the legs are signs of a blood clot in the legs. Breathlessness or chest pain are signs of a blood clot in the lungs. If you have any of these signs, inform your doctor immediately since you might need to stop your medicine.

  • LIVER DISEASES: Testosterone-cypionate (Depo-Testosterone) has the potential to harm the liver. If you take large doses of testosterone cypionate (Depo-Testosterone) for an extended period of time, you have a higher risk of developing serious liver disease that might result in liver cancer or death. If you experience stomach pain, light-colored stools, dark urine, or yellow eyes, you should tell your doctor immediately because you may need to stop taking the drug.

  • USAGE IN INDIVIDUALS WITH ENLARGED PROSTATE: Testosterone-cypionate (Depo-Testosterone) can lead to urinary tract blockage in people with an enlarged prostate or benign prostatic hyperplasia (BPH). The symptoms increase and include pain, failure to urinate, or a variation in the amount of urination, elevated blood pressure, and blood in the urine. Before they get worse, discuss them with your doctor as soon as possible. The medication also has the potential to increase the risk of prostate cancer as well.

  • EDEMA: Testosterone-cypionate (Depo-Testosterone) can make your body retain more salt and water, which can result in swelling in your arms or legs, leading to a rapid increase in weight. If you also take other drugs like corticosteroids that make you swell, then this is more likely to occur. People with heart, liver, or kidney disorders may experience more severe symptoms. If you have any of these signs, consult your doctor since you might need to discontinue taking the drug.

  • HIGH LEVELS OF CALCIUM IN THE BLOOD: Testosterone-cypionate (Depo-Testosterone) can raise blood calcium levels, particularly in people with limited mobility. Excessive calcium can cause kidney problems, such as increased urination, thirst, stomach pain, and blood in the urine, as well as muscle weakness. Stop using this medication if this happens, and inform your doctor. Your doctor may request that you get your routine blood tests done while you are using testosterone-cypionate to ensure that your calcium levels are within the normal range.

  • USE IN CHILDREN: If a child receives a testosterone-cypionate injection, their bones may develop more quickly than usual. This implies that the growth in children might stop earlier than expected and can have an adult height shorter than expected.

    Additionally, benzyl alcohol, a preservative, is present in testosterone-cypionate.  Gasping syndrome is a significant adverse effect of this preservative that can affect young children and newborns. Breathing problems brought on by this syndrome can be fatal. It's essential to be aware of this possibility even though recommended dosages of testosterone-cypionate contain less benzyl alcohol than what is generally associated with this condition. Higher doses of the medicine and conditions where your liver and kidneys have trouble eliminating it from your body increase the probability of this condition.

  • NOT IN WOMEN: Testosterone-cypionate injection (Depo-Testosterone) is not indicated for use in women and is contraindicated in pregnant women. This medication may harm your unborn baby.

    Talk to your doctor or pharmacist for medical advice and risk evaluation if you are at a high risk of complications or adverse effects from testosterone-cypionate use.


Precautions Before Starting Testosterone cypionate

Tell your doctor if you have ever had an allergic reaction to testosterone-cypionate, other medications, or any of the ingredients in testosterone injection products. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Testosterone-cypionate may not be right for people with certain medical conditions, such as cancer (e.g., breast cancer in men, prostate cancer), blood clots (e.g., in the leg, lungs), heart disease (e.g., heart failure, chest pain, heart attack), stroke, hepatic disease, kidney disease, lung problems, high cholesterol, high blood pressure, enlarged prostate, sleep apnea, diabetes, high blood levels of calcium, depression or other mental illness, an allergy to castor oil or sesame oil and high red blood cell (RBC) counts.

Before administration of Depo-Testosterone injection, a hypogonadism diagnosis must be confirmed by getting serum testosterone concentration tests done in the morning on at least two different days. These serum concentrations should be below the normal range for starting injections.

Give your doctor a complete list of all your medications, including prescription and nonprescription drugs, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between testosterone-cypionate and your other medications.

Precautions During Use of Testosterone-cypionate

Keep all your doctors’ appointments while on testosterone-cypionate. Your doctor may order certain tests to check your body's response to testosterone injection.

Your healthcare provider will monitor your cholesterol levels closely while you receive this medication. This drug may affect your cholesterol levels and may cause an increased risk of heart or blood vessel problems.

Your doctor should check your red blood cell count and hemoglobin while you receive a testosterone-cypionate injection, as it can increase red blood cell counts in some people. High red blood cell counts can increase the risk of strokes, blood clots, and heart attacks. You may have to discontinue testosterone-cypionate injections if your red blood cell count increases.

Diabetic patients receiving testosterone-cypionate injections should check their blood sugar levels as directed, as this medication may lower blood sugar. Tell your doctor right away if you notice low blood sugar symptoms, such as shaking, a fast heartbeat, hunger, sudden sweating, blurred vision, dizziness, or tingling hands or feet. Your healthcare professional may need to make changes in your diabetes treatment. 

Testosterone injections are not usually indicated for use in women. If a woman wants to get pregnant or believes she might already be pregnant, she should notify her doctor. This medicine can cause serious side effects to an unborn child. For more information, speak with your doctor or pharmacist. While using this medication, discuss birth control options with your doctor.

Tell all your doctors you are on testosterone-cypionate before surgery, including dental surgery.

Testosterone-cypionate Drug Interactions

Taking testosterone-cypionate with certain drugs can affect how the medications work. Possible interactions between drugs can also increase the risk of serious side effects. Your healthcare professional may choose a different medication for you, change the dose or frequency of your medications, and/or closely monitor you for side effects if there are known interactions between testosterone-cypionate and your other drugs.

There can also be possible interactions between testosterone-cypionate and the following medications:

  • Insulin (Apidra, Humalog, Humulin, others)
  • Medications for diabetes
  • Oral blood thinners (anticoagulants) like warfarin (Coumadin, Jantoven)
  • Oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos)
  • Oxyphenbutazone
  • Propranolol

The above list does not include all the possible drug interactions of testosterone-cypionate. To prevent dangerous interactions, give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. 

Also, tell your doctor if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription drugs.