Xyosted (Testosterone) - Subcutaneous

Warning:

Xyosted (testosterone) contains a boxed warning for the risk of blood pressure increases. Before starting Xyosted, your healthcare provider may check your baseline cardiovascular risk and blood pressure levels. They will also monitor for and treat blood pressure increases during treatment.

What Is Xyosted?

Xyosted (testosterone) is a prescription medication used to treat low testosterone levels in males (sex assigned at birth) 18 years and older. It belongs to a drug class called androgens.

Your body naturally makes certain hormones like testosterone and dihydrotestosterone (DHT). These hormones help develop male sex organs and maintain secondary sex characteristics. Xyosted works like these hormones in males to increase testosterone levels.

Xyosted is a controlled substance (Schedule III) because it has the potential for abuse and dependency. It is a weekly injection only given under the skin (subcutaneously). It is preservative-free and contains sesame oil. Other forms of testosterone injection are available for intramuscular (shot into the muscle) use, but Xyosted should only be administered subcutaneously.

Drug Facts

Generic Name: Testosterone

Brand Name(s): Xyosted, Aveed, Depo-Testosterone, Testopel

Administration Route: Subcutaneous, Intramuscular

Drug Availability: Prescription

Therapeutic Classification: Endocrine-metabolic agent

Available Generically: Yes

Controlled Substance: Schedule III

Active ingredient: Testosterone enanthate

Dosage Form(s): Solution, oil

What Is Xyosted Used For?

The Food and Drug Administration (FDA) approved Xyosted for use alone or with other medicines to treat the symptoms of conditions associated with a deficiency or absence of endogenous testosterone.

Generically available testosterone can also be used in children with delayed puberty and in certain women with an inoperable type of breast cancer.

Xyosted contains a boxed warning, the FDA's strictest safety warning, for the risk of blood pressure increases. Before starting Xyosted, your healthcare provider may check your baseline cardiovascular risk and blood pressure levels. During treatment, routine monitoring of blood pressure and cardiovascular risk factors or heart disease may be necessary.

Xyosted (Testosterone) Drug Information: Inner parts of a male reproductive system

Verywell / Zoe Hansen

How to Use Xyosted

Inject Xyosted under the skin in the abdominal (stomach) area only. Avoid injecting into your muscle or veins. Use once weekly or as told by your healthcare provider.

To use Xyosted:

  • Wash your hand before and after use.
  • Using an alcohol pad, clean the injection site.
  • Inspect the solution. Xyosted solution is colorless to pale yellow. Do not use if cloudy, discolored, or has particles. Do not use if the drug seal is broken.
  • Inject medicine under your skin (stomach area only)

Do not inject Xyosted into the muscle or swap it out with other forms of testosterone enanthate shot into the muscle.

The improper use of this drug may affect bone growth in children.

Once you're finished with your injection, immediately dispose of the auto-injector and cap in an FDA-cleared sharps disposal container.

If you do not have an FDA-cleared sharps disposal container, you can use any container that is:

  • Made of heavy-duty plastic
  • Can be closed with a tight-fitting, puncture-resistant lid
  • Upright and stable
  • Leak-resistant
  • Properly labeled to warn of hazardous waste

Do not dispose of the auto-injector in your household trash.

Storage

For storing, leave Xyosted in its original box until use. Store it at room temperature away from light, children, and pets. While traveling, you may store this drug between cool and mildly hot temperatures (59 to 86 degrees F). However, do not refrigerate or freeze it.

Discard any expired or unused drugs. Do not toss them down the drain, sink, or toilet. Ask your pharmacist about the best ways to throw out your medication. Look into drug take back programs that may be available near you.

Off-Label Uses

Healthcare providers may prescribe Xyosted for off-label uses, meaning for conditions not specifically indicated by the FDA. Xyosted can be used off-label as hormone therapy for people transitioning from female to male.

How Long Does Xyosted Take to Work?

Xyosted takes about 12 hours to peak in the body. It is then used weekly for 12 weeks.

What Are the Side Effects of Xyosted?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some people may have little or no side effects with Xyosted. Contact your healthcare provider if you experience side effects that do not go away or become troublesome. Some common side effects of Xyosted are:

  • Heartburn
  • Emotional imbalance
  • Acne
  • Application site irritation
  • Change in taste or bad taste
  • Burping
  • Trouble sleeping
  • Loss of strength and energy
  • Sore throat
  • Back pain
  • Diarrhea

Severe Side Effects

Call your healthcare provider promptly if you have serious side effects. Call 911 if you have a medical emergency or if your symptoms feel life-threatening. Serious side effects may include symptoms of infections, liver problems, or the following:

  • Vomiting
  • Bone pain
  • Blood clot
  • Dark urine
  • Light-colored stools
  • Weakness on one side of the body
  • Trouble speaking or thinking
  • Change in balance
  • Drooping on one side of the face
  • Blurred vision
  • Chest pain
  • Sweating a lot
  • Severe headache
  • Dizziness
  • Erection that lasts more than four hours
  • Depression
  • Mood and behavior changes
  • Thoughts of suicide
  • Enlarged breasts
  • Breast pain
  • Big weight gain
  • Trouble breathing during sleep
  • Skin discoloration
  • Testicle irregularities
  • Nosebleed
  • Nasal dryness
  • Gum changes

Virilization (the development of male physical features) may happen. This can cause facial hair, deep voice, or menstrual changes.

Long-Term Side Effects

Long-term use of Xyosted may lead to:

Report Side Effects

Xyosted may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much of Xyosted Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injectable dosage form (solution):
    • For low testosterone levels:
      • Adults—At first, 75 milligrams (mg) injected under the skin once a week. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

Inject the missed dose once you think of it. Skip the missed dose if it is too close to your next dose. Go back to your regular dosing frequency. Do not inject extra or double the amount.

Overdose: What Happens If I Use Too Much Xyosted?

Overdose symptoms of Xyosted may include: 

  • Chest pain
  • Vomiting
  • Trouble speaking
  • Blurred vision
  • Confusion

What Happens If I Overdose on Xyosted?

If you think you or someone else may have used too much Xyosted, call a healthcare provider or the Poison Control Center (800-222-1222).

If you or someone else starts to experience any overdose symptoms, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine should not be used by women who are pregnant or might become pregnant. Testosterone may cause birth defects if a pregnant woman comes in contact with the medicine. Make sure your doctor knows if your sexual partner is pregnant. If a pregnancy occurs while you are using this medicine, tell your doctor right away.

Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

This medicine may cause a serious lung problem called pulmonary oil microembolism (POME). Tell your doctor right away if you have a cough or urge to cough, dizziness, fainting, trouble breathing, sweating, tightening of your throat, or chest pain.

This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive the medicine.

This medicine may increase the risk of prostate cancer, especially in older men. Make sure your doctor knows if you have prostate cancer, or if anyone in your family has prostate cancer.

This medicine may cause blood clotting problems. Tell your doctor right away if you have pain, redness, or swelling in the arm or leg, sharp pains in the chest, or trouble breathing.

This medicine may increase your risk of having heart or blood vessel problems, including a heart attack or stroke. Tell your doctor right away if you have chest pain that may spread to your arms, jaw, back, or neck, faintness, headache, nausea, vomiting, trouble breathing, trouble seeing or speaking, or unusual sweating.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

In some cases, this medicine may decrease the amount of sperm men make and affect their ability to have children. Talk with your doctor before you use this medicine if you plan to have children.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Depo®-Testosterone contains benzyl alcohol which may cause serious reactions to newborn, premature, or low-birthweight infants. Check with your doctor if you are concerned.

This medicine may cause changes in the level of cholesterol and fats in your blood. If this condition occurs, your doctor may give you a medicine to adjust the cholesterol and fats. Talk to your doctor if you have concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. .

What Are Reasons I Shouldn't Take Xyosted?

Avoid the use of Xyosted if you are:

  • Pregnant (it can cause serious harm to the fetus)
  • A male (sex assigned at birth) with known or suspected breast or prostate cancer
  • A male who is allergic to testosterone or sesame oil
  • A male with low testosterone due to age
  • A male with low testosterone without specific medical conditions

Xyosted should also be avoided in adult males with age-related hypogonadism due to the risk of increased blood pressure and adverse cardiovascular events.

What Other Medications Interact With Xyosted?

Avoid another hormone called dehydroepiandrosterone (DHEA) while you are taking Xyosted. It may increase the side effects of testosterone if taken together.

What Medications Are Similar?

Other preparations of testosterone products like Xyosted include:

  • Natesto (intranasal testosterone gel)
  • Jatenzo (oral testosterone softgel capsule)
  • Testopel (testosterone pellet implant under the skin)
  • AndroGel (topical testosterone gel)
  • Fortesta (topical testosterone gel)
  • Androderm (topical testosterone patch)

This list is a list of drugs also prescribed to treat low testosterone levels in males. It is NOT a list of medicines recommended to take with Xyosted. In fact, you should not take these drugs together unless your healthcare provider tells you to. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Xyosted used to treat?

    Xyosted (testosterone) is commonly used to treat low testosterone levels in males (sex assigned at birth).

  • What should I do if I miss a dose of Xyosted?

    Inject the missed dose once you think of it. Skip the missed dose if it is too close to the next dose. Return to your regular dosing schedule. Do not inject extra doses or double the amount.

  • Can I store Xyosted at room temperature?

    Yes. Store Xyosted at room temperature. Do not refrigerate or freeze.

  • What are the common side effects of Xyosted?

    Some common side effects of Xyosted include:

    • Application site irritation
    • Back pain
    • Diarrhea
    • Change in taste or bad taste
    • Heartburn
    • Trouble sleeping
    • Sore throat
    • Emotional imbalance
    • Acne

How Can I Stay Healthy While Taking Xyosted?

In addition to administering your shot weekly, you should also pay attention to your body while using Xyosted. This medication can increase the risk of having a heart attack or stroke. Therefore, you should monitor your blood pressure daily regardless of when you began treatment.

Check your blood pressure at your neighborhood pharmacy if you do not have a blood pressure monitor at home. You can also call your health insurance provider to see if you can get one at no cost. Remember to notify your healthcare provider any time you notice that your blood pressure is high.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Xyosted label.

  2. MedlinePlus. Testosterone injection.

  3. Food and Drug Administration. Safely using sharps (needles and syringes) at home, at work and on travel.

  4. Petering R, Brooks NA. Testosterone therapy: review of clinical applications. Am Fam Physician. 2017;96(7):441-449.

  5. Li Y, Ren J, Li N, et al. A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials. Experimental Gerontology. 2020;141:111110. doi:10.1016/j.exger.2020.111110

By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.