Short answer: Aveed is testosterone undecanoate: 750 mg into the buttock muscle at the start, at 4 weeks and then every 10 weeks, given only in a certified clinic with 30 minutes of observation for an oil-embolism or allergic reaction.1 Testosterone cypionate (Depo-Testosterone) is 50 to 400 mg every 2 to 4 weeks, can be self-injected and has no boxed warning.2
| Aveed (testosterone undecanoate) | Testosterone cypionate (Depo-Testosterone) | |
|---|---|---|
| Label dose | 750 mg (3 mL) at start, at 4 weeks, then every 10 weeks; no titration1 | 50 to 400 mg every 2 to 4 weeks for male hypogonadism2 |
| Where it is given | Deep into the gluteal muscle, injected slowly over 60 to 90 seconds, in a healthcare setting1 | Deep into the gluteal muscle2 |
| Strength | 750 mg/3 mL single-use vial (250 mg/mL)1 | 100 mg/mL and 200 mg/mL vials, in cottonseed oil2 |
| Peak and half-life | Peak a median 7 days after a shot (range 4 to 42); steady state by the third shot at 14 weeks1 | Half-life about 8 days (label: approximately eight days)2 |
| Boxed warning | Pulmonary oil microembolism (POME) and anaphylaxis; observe 30 minutes after every shot1 | None |
| Restricted program | Only through the Aveed REMS program1 | No REMS |
| Levels in the label trial | 94% of 117 men had average testosterone in the 300 to 1,000 ng/dL range after the third shot1 | No comparable trial in the label |
| Blood pressure | +3.1/2.0 mm Hg after 16 weeks on 24-hour monitoring1 | Can raise blood pressure; not recommended with uncontrolled hypertension2 |
| Controlled substance | Schedule III | Schedule III2 |
Pulmonary oil microembolism is a reaction to tiny droplets of the oily injection reaching the lungs. The Aveed boxed warning lists an urge to cough, shortness of breath, throat tightening, chest pain, dizziness and fainting, and says it can happen after any injection, including the first.1 Across 18 trials with 3,556 men, 9 POME events in 8 men and 2 anaphylaxis events were judged to have occurred.1
Because of this, Aveed is given only by certified clinics under a REMS program, and each patient is watched for 30 minutes after every shot.1
Aveed's long ester gives a slow peak (median 7 days) and steady average levels in the normal range across a 10-week gap once three shots are in.1 Cypionate has a half-life of about eight days, so it is given every 2 to 4 weeks and levels rise and fall more within each interval.2 For splitting cypionate into smaller, more frequent shots, see Weekly vs twice-weekly TRT injections: does splitting the dose help?.
More detail: Aveed side effects, Depo-Testosterone side effects, and the Aveed and Depo-Testosterone dosing schedules.
That is for you and your prescriber. The trade-off on the labels is fewer visits with a clinic-only shot and a boxed warning (Aveed) vs more frequent injections you can give yourself (cypionate).