Testosterone subq injection sites: what the labels say, and what they leave out

"Testosterone subq injection sites" has no single answer, because the route depends on the product. Xyosted's label limits subcutaneous injection to the abdominal region only. Depo-Testosterone's label says intramuscular use only. Read the route on your own label before you trust any site chart.

The route comes first

A chart labeled "subq" assumes your product goes under the skin. Two labels show why that assumption can fail.

Some testosterone products are labeled for subcutaneous injection, into the fat layer under the skin. Others are labeled for intramuscular injection, into muscle. The two routes use different sites, and a chart written for one does not carry over to the other.

We read three sources for this post: the Xyosted label on DailyMed, the Depo-Testosterone label on DailyMed and the MedlinePlus page on testosterone injection. That is two products out of many, and your product may be neither. The method still holds: your own label names your route.

Take an illustrative case. A reader sees a forum chart that lists the thigh, the abdomen and the back of the arm as "subq sites" for testosterone. They hold a product whose label says intramuscular use only. The chart answers a question their product does not ask, and the only fix is to read the label and call the prescriber. A reader holding Xyosted meets the opposite problem: the chart offers sites the label rules out.

What the Xyosted label says

In section 2.3, Important Administration Instructions, the Xyosted label says: "XYOSTED is for subcutaneous injection in the abdominal region only." The product is supplied as a syringe in an autoinjector, and the label lists its route as subcutaneous, per the DailyMed label.

The Instructions for Use repeat the limit in blunter words: "Do not inject XYOSTED in any other areas of the body." In the Instructions for Use, the instructions for choosing a spot say to use the left or right side of the abdomen and to stay out of the area within 2 inches of the navel.

So for this one product, the answer to "which subq sites?" is one region, in the label's own words. A chart that adds the thigh or the back of the arm to Xyosted is adding something the label does not say.

What the Depo-Testosterone label says

The Dosage and Administration section of the Depo-Testosterone label says: "DEPO-Testosterone Injection is for intramuscular use only." It adds that intramuscular injections should be given deep in the gluteal muscle.

That sentence ends the subcutaneous question for this product. A subq chart does not describe it, and this label gives no instructions for injecting it under the skin. We will not describe a workaround, because the label offers none. If a thread tells you an intramuscular product is fine under the skin, ask the person who prescribes it, not the thread.

Skin to avoid, and where the sources stop

The Xyosted Instructions for Use name skin to stay away from. They list tender, bruised, red, scaly or hard skin, and areas with scars, tattoos or stretch marks. MedlinePlus gives a plain-language summary of nearly the same cautions and the same abdominal area, and it says the injection under the skin may be given by you or a caregiver, while the muscle injection is given by a doctor or nurse.

The Xyosted Instructions for Use give an instruction about changing sites: "Record the abdomen injection site you used to help you remember to use a different site each time." Here is what these sources do not say. MedlinePlus does not state a rotation rule. Neither source ranks sites, names a thigh option or says how to alternate sides. The limit is specific to what we read: your prescriber or your product's full label may say more.

Keeping track of side and area

The Xyosted label names an area, not an order. If you inject on a schedule, a record of side and area answers the question memory can get wrong: which side was the last one?

An illustrative log, with no amounts, looks like this:

• Oct 5, Xyosted, abdominal region, left side
• Oct 12, Xyosted, abdominal region, right side
• Oct 19, Xyosted, abdominal region, left side

That example is invented for this post. It uses the label's own area and the words left and right. A log like this records what you did. The Xyosted Instructions for Use ask for this kind of record, to help you remember to use a different site each time. Whether to alternate sides in a set pattern is a question for your prescriber.

Our view: a log should copy the label's vocabulary. If your label says abdominal region, write that, not a private nickname you will decode in a month.

A paper note, a spreadsheet or an app all work for this. The tool matters less than the habit of writing the product name next to the site, because a person on two injectables, or one whose product changes, otherwise cannot tell which entry belongs to which route. FreshSpot is one logbook among several; if a sheet in your notes app already does the job, keep it.

Questions for your prescriber or pharmacist

Route and site are theirs to set. Bring these:

1. Which route is my product labeled for, and where is that written?
2. Which areas does my label or my Instructions for Use allow?
3. Do you want me to alternate sides, and if so, in what pattern?
4. Which skin conditions near a site mean I should call you first?
5. What do I do if my product, my route or my site ever changes?

It is fine to stop and talk to your prescriber at any point you are unsure. The site and the dose are yours to choose, with your prescriber.

Questions people ask

A log for each product and side

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