Testosterone Cypionate/Testosterone Propionate is a compounded injectable formulation of two testosterone forms, designed to support patients with low or absent levels of natural testosterone. With its long and short-acting properties, it is a valuable option for addressing hormone deficiencies. This guide provides an overview of what Testosterone Cypionate/Testosterone Propionate is, how it works, approved uses, administration details, potential side effects, and important considerations for care.
What is Testosterone Cypionate/Testosterone Propionate?
Testosterone Cypionate/Testosterone Propionate is a combination of two testosterone esters, or forms, that offers both shorter (Propionate) and longer (Cypionate) durations of action, designed to provide a quicker initial increase and extended and maintained testosterone levels in between injections. It is a viable option in testosterone replacement therapy and has distinct differences from other formulations, such as Testosterone Cypionate alone or Testosterone Enanthate.
Difference Between Testosterone Enanthate, Cypionate, and the Combination
Testosterone enanthate is approved to be injected intramuscularly or subcutaneously, whereas Testosterone Cypionate is only approved for intramuscular injection. Testosterone enanthate is compounded with either sesame or grapeseed oil, while Testosterone Cypionate is made with cottonseed oil. Testosterone Cypionate/Testosterone Propionate combination is compounded with grapeseed oil and intended to be injected both intramuscularly or subcutaneously.
How Does Testosterone Cypionate/Testosterone Propionate Work In The Body?
Testosterone is a naturally occurring hormone synthesized by cells in the testes, ovaries, and the adrenal cortex. It is responsible for the normal growth and development of the male sex organs and the maintenance of secondary sex characteristics.
Testosterone Cypionate/Testosterone Propionate combination contains two esterified variants of testosterone that allow for both an initial increase in testosterone levels (due to Testosterone Propionate’s shorter acting properties and quicker onset of action) as well as stable and maintained levels in between doses (due to Testosterone Cypionate’s slow-release rate and an extended duration of action). It can be used as testosterone replacement therapy for patients with a deficiency or absence of endogenous testosterone; however, it has no FDA-approved indications due to it being a custom-compounded formulation, which is generally reserved for patients with medical needs not met by FDA-approved therapies.
Administration and Usage Guidelines
Testosterone Cypionate/Testosterone Propionate combination can be injected either intramuscularly or subcutaneously, depending on the indication determined by a healthcare provider.
Approval and Clinical Indication
Testosterone Cypionate/Testosterone Propionate combination is a custom-compounded formulation, not commercially available, and does not have any FDA-approved indications.
Dosing Frequency and Injection Schedule
Because there are no approved indications and dosing frequencies available, Testosterone Cypionate/Testosterone Propionate injections are individualized to a patient’s specific needs, and dosing is at the discretion of a healthcare provider. Common regimens for testosterone are as follows:
Intramuscular route of administration:
- 50-200 mg IM every 2-4 weeks
Subcutaneous route of administration:
- Initially, 75 mg SQ in the abdominal region once weekly
- Re-evaluate following 6 weeks of dosing
- Decrease dose by 25 mg if total testosterone trough concentration is 650 ng/dL or greater
- Increase dose by 25 mg if the total testosterone trough concentration is less than 350 ng/dL
Formulation and Mode of Administration
- Strength and form: Testosterone Cypionate/Testosterone Propionate 160mg-40mg injection solution in grapeseed oil
- Vial size: 10ml
- Route of administration: IM or SQ
Storage and Beyond Use Date
Testosterone Cypionate/Testosterone Propionate should be stored at room temperature (between 68°F to 77°F). It will have a beyond-use date of approximately 6 weeks after the patient receives it and should be used within 28 days after the first vial puncture.
Potential Side Effects of Testosterone Cypionate/Testosterone Propionate
You may experience pain, bruising, redness, or skin irritation at the injection site. Other common side effects include acne, increased facial or body hair growth, breast enlargement, mood changes, increased blood pressure, increased/decreased libido, and high red blood cell counts. Many of these adverse effects are dose-related, so if you encounter side effects, please discuss them with your provider, as dose adjustments may be necessary.
Insurance Coverage and Cost of Testosterone Cypionate/Testosterone Propionate
Compounded Testosterone Cypionate/Testosterone Propionate is customized for each patient and is not FDA-reviewed, which often means it isn’t eligible for insurance coverage. Many individuals pay out-of-pocket, but HSAs, FSAs, and conversations with insurers can offer additional cost-saving opportunities.
Medivera’s Approach to Patient Care and Pharmacy Support
Medivera Compounding Pharmacy has a staff of trained pharmacists eager to discuss Testosterone Cypionate/Testosterone Propionate or any other medications with you or your staff. They can go over any questions regarding dosing, storage, shipping, or anything else you may need.
Our pharmacy prides itself on excellent customer service. When we receive a prescription, our pharmacy team will reach out to the patient to set up pick-up or delivery and have pharmacists available to answer patient questions. You can count on Medivera to take care of your patient’s needs accurately and quickly.
Our team is ready to help with any questions you may have on starting your patients on Testosterone Cypionate/Testosterone Propionate or any other medication. We can also help in transitioning patients over from other pharmacies. Call us today to answer your questions and get your patients started on their journey to better health.
References:
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- https://www.clinicalkey.com/pharmacology/monograph/595?sec=monindi&aprid=96249
- https://www.drugs.com/mtm/testosterone-enanthate.html
- https://www.drugs.com/pro/testosterone.html
- https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a3d204c-be26-49e0-8599-0ac12a272e81
- https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58ff6e0d-cc0a-4455-8254-d883d26a3b6d
- https://pubchem.ncbi.nlm.nih.gov/compound/5995
- https://pubchem.ncbi.nlm.nih.gov/compound/Testosterone-Enanthate
- Llewellyn, W. (2011). Anabolics. Molecular Nutrition LLC
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7480784
