Short answer: Xyosted is testosterone enanthate injected under the skin of the belly once a week from an autoinjector, starting at 75 mg.1 AndroGel 1.62% is a gel applied each morning to the shoulders and upper arms, starting at 40.5 mg.2 AndroGel carries a boxed warning about testosterone passing to children through skin contact; the current Xyosted label has none. Neither label compares the two.
| Xyosted | AndroGel 1.62% | |
|---|---|---|
| How used | Autoinjector under the skin of the belly, once a week1 | Gel from a pump or packet on the shoulders and upper arms, once each morning2 |
| Dose | 75 mg to start; 50, 75 or 100 mg1 | 40.5 mg to start; 20.25 mg to 81 mg2 |
| Level checks | Trough 7 days after a dose, after 6 weeks; aim 350 to under 650 ng/dL, 25 mg steps1 | Before the morning dose at about 14 and 28 days; aim 350 to 750 ng/dL, 20.25 mg steps2 |
| Hematocrit checks | Before starting, then about every 3 months1 | Before starting, at 3 to 6 months, then yearly2 |
| Most common side effects | Hematocrit increased 14.0%, hypertension 12.7%, PSA increased 12.0% in a 1-year study1 | PSA increased 11.1% vs 0% on placebo2 |
| Average blood pressure rise | 3.9/1.5 mm Hg at 12 weeks1 | 1.9/1.3 mm Hg at 16 weeks2 |
| Boxed warning | None1 | WARNING: SECONDARY EXPOSURE TO TESTOSTERONE2 |
AndroGel's boxed warning covers children who developed male-type changes after contact with a man's unwashed or uncovered application site, and the gel is flammable until dry.2 Xyosted's label adds a warning on depression and suicidal thoughts: 4 of 283 men (1.4%) in its trials had depression that led to stopping or a suicide attempt.1 Both share the testosterone set: high red blood cells, clots, prostate checks, blood pressure, abuse and lower sperm counts. These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Which, if either, fits is for your prescriber. More detail: Xyosted side effects, AndroGel side effects, the Xyosted and AndroGel dosing schedules, the Xyosted and AndroGel missed-dose pages, the testosterone enanthate and testosterone gel guides, and Xyosted vs Depo-Testosterone: how do they differ?.