The correct testosterone injection site is the area approved for the exact product and injection route. Do not inject testosterone into a vein, artery, joint, spine, nerve, or damaged skin. A 2022 FDA label for testosterone cypionate specifies deep intramuscular injection into the gluteal muscle, while Xyosted is approved for abdominal injection at least 2 inches from the navel.
The site also depends on whether your prescription is for intramuscular testosterone, such as testosterone cypionate, or subcutaneous testosterone, such as Xyosted.
Testosterone Injection Sites to Avoid at a Glance
| Product or route | Do not inject into |
|---|---|
| Testosterone cypionate | Any site other than the prescribed deep gluteal muscle, unless your prescriber gives different instructions |
| Xyosted testosterone enanthate | The thigh, buttock, arm, chest, or any area outside the abdomen |
| Aveed testosterone undecanoate | A vein, the wrong part of the buttock, or any site outside the healthcare professional's instructions |
| Any injectable testosterone | A vein, artery, nerve, joint, spine, infected skin, bruised skin, scar tissue, or the same exact spot repeatedly |
Do Not Inject Testosterone Directly Into a Vein or Artery
Testosterone products intended for intramuscular or subcutaneous use should not be injected into a vein. An intravascular injection can cause serious complications, so the injection site must be selected to avoid blood vessels and nerves.
This warning is particularly important for Aveed testosterone undecanoate. Its prescribing information warns that accidental intravascular injection can cause pulmonary oil microembolism. Symptoms may include coughing, shortness of breath, throat tightening, chest pain, dizziness, or fainting.
A certified healthcare professional must administer Aveed. The patient must then be observed for at least 30 minutes.
Do Not Inject Into the Wrong Part of the Buttock
Testosterone cypionate is labeled for a deep intramuscular injection into the gluteal muscle. A shallow injection into fatty tissue may not deliver the medicine as intended.
For Aveed, the labeled site is the gluteus medius in the upper outer quadrant of the buttock. The injection must avoid the sciatic nerve and superior gluteal arteries. The left and right buttocks should be alternated between injections.
Do not inject into the center or lower-inner buttock. An incorrectly placed injection can injure the sciatic nerve or a blood vessel. If you have not been trained to identify the gluteal landmarks, have a healthcare professional administer the injection.
Do Not Use the Abdomen for Testosterone Cypionate Unless Your Prescriber Says To
Standard testosterone cypionate injection is labeled for deep intramuscular administration in the gluteal muscle, not routine abdominal injection. Do not assume that a testosterone cypionate vial can be used like a subcutaneous testosterone product.
Injectable testosterone products can have different routes, strengths, doses, and administration instructions.
The exception is a product labeled for subcutaneous use, such as Xyosted testosterone enanthate.
Do Not Inject Xyosted Anywhere Except the Abdomen
Xyosted is designed for subcutaneous injection in the abdominal region only. Do not inject it into the thigh, buttock, upper arm, chest, or another body area. Avoid the area within 2 inches of the navel.
Do not inject Xyosted into skin that is:
- Tender or painful
- Bruised
- Red or inflamed
- Scaly or hard
- Scarred
- Tattooed
- Affected by stretch marks
The official instructions also state that Xyosted should not be injected into a muscle or vein.
Do Not Inject Into Damaged or Abnormal Skin
Choose healthy skin and muscle. Avoid areas with:
- Redness, warmth, swelling, or infection
- Bruising or bleeding
- A lump or hardened tissue
- Scars or stretch marks
- A previous injection reaction that has not settled
Injecting into damaged tissue can increase pain, bleeding, irritation, poor absorption, and the risk of infection. General injection guidance recommends avoiding skin or tissue with redness, swelling, scarring, bruising, or other damage.
Do Not Repeatedly Use the Same Injection Spot
Rotate between approved sites rather than puncturing the same location each time. Repeated injections in one spot can worsen soreness, bruising, lumps, and tissue irritation. MedlinePlus advises using another approved site or the opposite side of the body when more than one injection is needed.
Rotation still has to stay within the sites approved for your product. For example, switching from the abdomen to the thigh is not appropriate for Xyosted just because the thigh is convenient.
What to Do If You Injected Testosterone Into the Wrong Place
Do not automatically inject another dose. Contact your prescriber, pharmacist, or the medical service that trained you. Explain:
- The product and strength
- The amount injected
- The body location
- Whether the needle may have entered a blood vessel
- Any bleeding, pain, numbness, swelling, or other symptoms
Seek emergency medical care for trouble breathing, chest pain, throat tightness, fainting, severe dizziness, facial swelling, a widespread rash, new weakness or numbness, or rapidly worsening pain and swelling. These symptoms can indicate a serious allergic, vascular, nerve, or injection-related complication.
If you are unsure which injection route or site applies to your prescription, check the product instructions before preparing the next dose and contact your prescriber or pharmacist.