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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices. Subscribe to receive email notifications whenever new articles are published. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
To view content sources and attributions, please refer to our editorial policy. We comply with the HONcode standard for trustworthy health information - verify here. Androgens This monograph includes information on the following: AN Testosterone cypionate Primary: AN Testosterone undecanoate Primary: Controlled substance classification— Note: Controlled substance classification U. Andriol 3 ; Andro L. A 3 ; Virilon 2 ; Virilon IM 3. For a listing of dosage forms and brand names by country availability, see Dosage Forms section s.
Bracketed information in the Indications section refers to uses that are not included in U. Accepted Androgen deficiency, due to primary or secondary hypogonadism treatment —Androgens are primarily indicated in males as replacement therapy when congenital or acquired endogenous androgen absence or deficiency is associated with primary or secondary hypogonadism.
Primary hypogonadism includes conditions such as: Hypogonadotropic hypogonadism secondary hypogonadism conditions include gonadotropin-releasing hormone GnRH deficiency or pituitary-hypothalamic injury as a result of surgery, tumors, trauma, or radiation and are the most common forms of hypogonadism seen in older adults. Androgens are not recommended for accelerating the healing of fractures or shortening the duration of postsurgical convalescence. In most patients, postpartum breast engorgement is a benign, self-limiting condition that may respond to breast support and mild analgesics, such as acetaminophen and ibuprofen.
Evidence supporting the efficacy of androgens for this indication is lacking. The matrix-type transdermal system is thinner than the reservoir-type. Semi-synthetic androgens are testosterone cypionate, testosterone enanthate, and testosterone propionate. Synthetic androgens include fluoxymesterone and methyltestosterone.
Physiologic concentrations of androgens stimulate spermatogenesis and male sexual maturity at puberty, and develop and maintain male secondary sexual characteristics. In children, exogenous androgens increase linear bone growth rates and help fuse the epiphyseal growth centers. An increase in bone growth rate can also correspond to a disproportionate advancement of bone maturation.
Androgens stimulate the production of red blood cells by enhancing production of erythropoietic stimulating factors. A matrix transdermal system will not produce adequate serum testosterone concentrations if applied to nonscrotal skin. Patients should avoid applying the reservoir-type patch to scrotal skin.
The reservoir transdermal systems have similar sites of application, but manufacturers, depending on their clinical studies, recommend different sites and times for patch application. Approximately one third of the testosterone dose is absorbed in the first month, one fourth in the second month, and one sixth in the third month.
Absorption continues until the implant completely dissolves, which may take up to 6 months. In a study with the gram dose to deliver mg testosterone , all patients showed an increase in serum testosterone within 30 minutes, and 8 of 9 patients had a serum testosterone concentration within the normal range by 4 hours after the initial application.
Absorption of testosterone into the blood continues for the entire hour dosing interval. Testosterone—Free testosterone is further converted into two of the major active metabolites, DHT and estradiol. The reservoir-type patch applied to nonscrotal skin produced normal DHT and estradiol serum concentrations. DHT concentrations increased in parallel with testosterone concentrations during testosterone gel treatment. Time to peak concentration: Approximately 6 to 10 hours after application.
For testosterone transdermal systems: Three to 4 months, but may continue for 6 months. On removal of the systems, testosterone serum concentration declines to baseline within 2 hours. Problems in humans have not been documented. Potential adverse effects in infants include precocious sexual development in males and virilization of external genitalia in females.
Combinations containing any of the following medications, depending on the amount present, may also interact with this medication. Except under special circumstances, these medications should not be used when the following medical problems exist: Effects may be greater for oral formulations or when pharmacologic doses of androgens are used.
Doses of insulin or antidiabetic sulfonylurea medications may need to be adjusted, especially if hypoglycemia occurs. The side effects of testosterone enanthate and testosterone cypionate cannot be quickly reversed by discontinuing medication due to the long durations of action of these medications. Blistering of skin occurred as a single incident on one skin site in many patients; in most cases, it occurred when the reservoir-type of testosterone transdermal system was applied to skin over a bony prominence.
This effect is less likely if such areas are avoided. It should be treated like a burn. If tumescence is not reversed, interruption of blood flow may result in penile tissue ischemia and permanent tissue damage.
Clinical effects of overdose The following effects have been selected on the basis of their potential clinical significance possible signs and symptoms in parentheses where appropriate —not necessarily inclusive: One report has described acute overdosage with testosterone enanthate. Applying Testoderm TTS to back, arms, or upper buttocks.
Not applying the patches to the scrotum, chest, shin, bony prominences, or areas subject to prolonged pressure when sleeping or sitting. Some physicians prescribe a lower dose initially, gradually increase the dose as puberty progresses, and follow with a maintenance dose, which may be decreased. For treatment of breast cancer To determine whether there will be an objective response to antineoplastic therapy, treatment should be continued for at least 3 months, during which time a response to therapy is usually apparent.
Therapy should be discontinued if the disease becomes progressive again. Alternatively, the drug should be discontinued or the dosage reduced. For testosterone injection dosage form The suspension dosage form is absorbed relatively slowly; therefore, frequent injections may cause overdosage. The intramuscular injections should be administered deeply into the gluteal muscle or the deltoid muscle in larger men. For testosterone implant dosage form Insertion of testosterone implants requires a minute procedure using local anesthesia.
The number of implants inserted can vary according to patient need, diagnosis, and tolerance of testosterone. A good way to establish a proper testosterone dose for the implant is to assess patient response to a short-acting injectable form of testosterone. The preferred application site is the lower abdomen, 5 cm away from the umbilicus; other sites used include the deltoid and gluteal muscles, and upper thigh. Afterwards, the patient should feel only minor discomfort and can apply pressure to stop minor bleeding at the incision site.
Use of steri-strips covered by a water-resistant dressing for one week adequately closes and protects the incision without sutures. The crystallized testosterone implants dissolve subcutaneously and rarely require removal. The matrix-type transdermal system should be applied to clean, dry, and dry-shaved scrotal skin for optimal skin contact.
The reservoir-type transdermal system should not be applied to scrotal skin. Instead, the abdomen, back, thighs, and upper arms are the optimal areas for application for Androderm and the arm, back, or upper buttocks for Testoderm TTS.
Application areas for Androderm should be rotated, and a site should not be reused for 7 days. For treatment of adverse effects For all androgens: Treatment of adverse effects should be initiated by a physician trained in treating drug-induced tumescence. Depending on the severity, treatment may include: While monitoring blood pressure, an injection of 0.
For testosterone transdermal system reservoir-type: For chemical-induced blistering—Symptomatic relief can be provided by administering a corticosteroid cream not an ointment because ointments significantly reduce testosterone absorption to relieve mild skin irritation underneath the patch. If burn-like blisters appear under the patch, use of patch should be discontinued and treatment of skin area should follow standard guidelines for treatment of burns.
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