Testosterone aqueous suspension
Testosterone aqueous suspension
Testosterone
(tess- TOSS-ter-ohn)
Pregnancy Category: X Histerone 100 Malogen Aqueous Tesamone 100 Testandro (Rx) (C-III)
Testosterone cypionate (in oil)
Testosterone cypionate
Testosterone
(tess- TOSS-ter-ohn)
Pregnancy Category: X depAndro 100 and 200 Depotest 100 and 200 Depo-Testosterone Depo-Testosterone Cypionate Duratest-100 and -200 Scheinpharm Testone-Cyp (Rx) (C-III)
Testosterone enanthate (in oil)
Testosterone enanthate
Testosterone
(tess- TOSS-ter-ohn)
Pregnancy Category: X Andro L.A. 200 Andropository-200 Delatestryl Durathate-200 Everone 200 Malogex LA PMS-Testosterone Enanthate (Rx) (C-III)
Testosterone propionate (in oil)
Testosterone propionate
Testosterone
(tess- TOSS-ter-ohn)
Pregnancy Category: X Malogen in Oil (Rx) (C-III)
Testosterone transdermal system
Testosterone transdermal system
Testosterone
(tess- TOSS-ter-ohn)
Pregnancy Category: X Androderm Testoderm Testoderm TTS Testoderm with Adhesive (Rx) (C-III)

Classification: Androgen, natural hormone and salts of natural hormone

Action/Kinetics: Treatment with testosterone and its congeners is complicated by the fact that the exogenous supply of the hormone may depress secretion of the natural hormone through inhibitory effects on the pituitary. Too large a dose may cause permanent damage. Treatment is usually associated with a feeling of well-being. Following PO use, 44% of testosterone is cleared by the liver in the first pass. Thus, the parenteral forms are used. t 1/2, testosterone cypionate after IM: 8 days. Ninety percent is excreted through the urine as metabolites and 6% is excreted through the feces. Testosterone and testosterone propionate are considered short-acting; testosterone enanthate and testosterone cypionate are long-acting.
Following use of Testoderm on the scrotal skin: Maximum serum levels: 2-4 hr with return to baseline in about 2 hr after system is removed. Serum levels reach a plateau in 3-4 weeks. Will not produce sufficient serum levels if applied to nongenital skin. Following use of Androderm to nonscrotal skin, there is continual absorption over 24 hr. Application of two systems at 10:00 p.m. results in serum testosterone levels similar to normal circadian variation with maximum levels occurring in the early morning hours and minimum levels in the evening.

Uses: Parenteral products: Replacement therapy in males for congenital or acquired primary hypogonadism or for congenital or acquired hypogonadotropic hypogonadism. Delayed puberty. In postmenopausal women to treat inoperable metastatic breast carcinoma or in premenopausal women following oophorectomy. Postpartum breast engorgement (evidence for effectiveness is lacking). Investigational: Male contraceptive (testosterone enanthate).
Transdermal products: Replacement therapy for acquired or congenital primary hypogonadism or for acquired or congenital secondary hypogonadotropic hypogonadism.

Contraindications: Serious renal, hepatic, or cardiac disease due to edema formation. Prostatic or breast (males) carcinoma. Use in pregnancy (masculinization of female fetus) and lactation. Discontinue if hypercalcemia occurs.

Special Concerns: Use with caution in young males who have not completed their growth (because of premature epiphyseal closure). Androgens may also cause virilization in females or precocious sexual development in males. Geriatric clients may manifest an increased risk of prostatic hypertrophy or prostatic carcinoma. Androgen therapy occasionally seems to accelerate metastatic breast carcinoma in women.

Side Effects: Hepatic: Liver toxicity is the most serious side effect. Jaundice, cholestasis, alterations in BSP retention, AST, and ALT. Rarely, hepatic necrosis, hepatocellular neoplasms peliosis hepatis, acute intermittent porphyria in clients with this disease. GI: N&V;, diarrhea, anorexia, symptoms of peptic ulcer. CNS: Headache, anxiety, increased or decreased libido, insomnia, excitation, paresthesias, sleep apnea syndrome, CNS hemorrhage chills, choreiform movements, habituation, confusion (toxic doses). GU: Testicular atrophy with inhibition of testicular function (e.g., oligospermia), impotence, epididymitis, irritable bladder, prepubertal phallic enlargement, gynecomastia. Electrolyte: Retention of sodium, chloride, calcium, potassium, phosphates. Edema. Miscellaneous: Acne, flushing, suppression of clotting factors (II, V, VII, X), polycythemia, leukopenia, rashes, dermatitis, anaphylaxis (rare) muscle cramps, hypercholesterolemia, male-pattern baldness, acne, seborrhea, hirsutism. Hypercalcemia, especially in immobilized clients or those with metastatic breast carcinoma. Virilization in women.
In females, menstrual irregularities (including amenorrhea), virilization, clitoral enlargement, hirsutism, increased libido, baldness (male pattern), virilization of external genitalia of female fetus.
In males, decreased ejaculatory volume, oligospermia (high doses), gynecomastia, increased frequency and duration of penile erections.
In children, disturbances of growth, premature closure of epiphyses, precocious sexual development.
Inflammation and pain at site of IM or SC injection.
NOTE: Side effects of the cypionate and enanthate products are not readily reversible due to the long duration of action of these dosage forms.
The patch may cause itching, irritation, erythema, or discomfort of the scrotum (Testoderm) or on skin areas where applied (Androderm). Potentially, small amounts of testosterone may be transferred to a sex partner.

Laboratory Test Alterations: Altered thyroid function tests. False + or BSP, alkaline phosphatase, bilirubin, cholesterol, and acid phosphatase (in women). Alteration of glucose tolerance tests.

Drug Interactions: Anticoagulants, oral / Anticoagulant effect Antidiabetic agents / Additive hypoglycemia Barbiturates / Androgenic effect R/T breakdown by liver Corticosteroids / Chance of edema Saw palmetto / Antiandrogenic effect may testosterone activitiy

How Supplied: Testosterone aqueous suspension: Injection: 50 mg/mL, 100 mg/mL. Testosterone cypionate: Injection: 200 mg/mL. Testosterone enanthate: Injection: 100 mg/mL, 200 mg/mL. Testosterone propionate: Injection: 100 mg/mL. Testosterone transdermal system: Film, extended release: 2.5 mg/24 hr, 4 mg/24 hr, 5 mg/24 hr, 6 mg/24 hr

Dosage
Testosterone aqueous suspension and Testosterone propionate in oil

?IM Only Replacement therapy.
25-50 mg 2-3 times/week.
Breast cancer.
50-100 mg 3 times/week.
Growth stimulation in Turner's syndrome or constitutional delay of puberty.
40-50 mg/m ²/dose given monthly for 6 months.
Male hypogonadism, initiation of pubertal growth.
40-50 mg/m ²/month until growth rate falls to prepubertal levels (about 5 cm/year).
Male hypogonadism, during terminal growth phase.
100 mg/m ²/month until growth ceases.
Male hypogonadism, maintain virilization.
100 mg/m ² twice monthly or 50-400 mg/dose q 2-4 weeks.
Postpartum breast engorgement.
25-50 mg of testostrone propionate for 3-4 days.
Testosterone enanthate and cypionate ?IM Only Hypogonadism, replacement therapy.
50-400 mg q 2-4 weeks.
Delayed puberty.
50-200 mg q 2-4 weeks for no more than 4-6 months.
Palliation of inoperable breast cancer in women.
200-400 mg q 2-4 weeks.
?Transdermal System Replacement therapy (congenital or acquired primary hypogonadism, congenital or acquired hypogonadotropic hypogonadism).
Testoderm: One 6-mg patch applied daily on clean, dry scrotal skin that has been dry-shaved to remove hair. Clients with a smaller scrotum can use a 4-mg patch. The patch should be worn for 22-24 hr/day for 6-8 weeks. Testoderm TTS: One 5-mg patch applied to the arm, back, or upper buttocks each day. The patch can be removed and reapplied if the client wants to swim, bathe, or vigorously exercise.
Androderm: Initial dose, usual: Two systems applied nightly for 24 hr providing a total dose of 5 mg/day. The systems are applied to a clean, dry area of the skin on the back, abdomen, upper arms, or thighs.