Adult Dosing
Primary Hypogonadism, Hypogonadism, hypogonadotropic
- Apply 5 g qd (preferably in morning) to a clean dry, intact skin of the shoulders/upper arms/abdomen
- May increase to a maximum of 10 g based on serum testosterone levels
- Do not apply to genitals
- 5 g gel = 50 mg testosterone
Fortesta
- 40 mg qam on intact skin of the thighs. Max: 70 mg/day
Notes- Adjust dose between 10-70 mg based on testosterone levels
- Refer package insert for dose adjustments required at each titration step
Axiron
- Apply 60 mg qam on clean, dry, intact skin of axilla. Max: 120 mg/day
- Adjust dose based on serum testosterone concentration from a single blood draw 2-8 hrs after application, and at least 14 days after starting treatment or following dose adjustment
Vogelxo
- Apply 50mg qd to clean dry, intact skin of the shoulders/upper arms. Max: 100mg/day
- Measure morning (predose) serum testosterone concentrations 14 days after initiation of therapy to ensure proper serum testosterone concentrations are achieved
- If the level is below normal range (300-1,000 ng/dL), increase dose to 100 mg qd
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- Prolonged use of high doses can cause serious hepatic adverse effects including peliosis hepatis, hepatic neoplasms, cholestatic hepatitis, and jaundice
- Evaluate geriatric patients for the presence of prostate cancer prior to starting therapy and also during treatment
- Periodically evaluate patients for signs and symptoms of benign prostatic hyperplasia
- Inform women of child bearing potential or lactating women about the potential for transfer of testosterone from men treated with testosterone. It may cause fetal harm or serious adverse reactions in nursing infants
- Secondary exposure to testosterone in children and women can occur with testosterone gel use in men resulting in virilization; drug should be promptly discontinued until the cause of virilization has been identified
- Gel should be applied only to the shoulders, upper arms, and/or abdomen
- Large doses of exogenous androgens suppresses spermatogenesis through feedback inhibition of pituitary FSH which leads to adverse effects on semen parameters
- Edema with or without congestive heart failure may occur in patients with preexisting cardiac, renal, or hepatic disease
- Gynecomastia may develop in patients being treated with androgens
- Androgens should be used with caution in cancer patients at risk of hypercalcemia; regular monitoring of serum calcium concentrations is recommended
- Avoid fire, flame or smoking until the gel has dried as the product is flammable
- Changes in anticoagulant activity may be seen; initiate frequent monitoring of INR and prothrombin time in patients taking anticoagulants, especially at the initiation and termination of androgen therapy
- Patients should wash their hands immediately with soap and water after application and cover the application site with clothing after the gel had dried
- Monitor Hb, HCT periodically if long term treatment; LFTs, PSA and Lipid panel
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- CV disease
- CHF
- Edema
- Diabetes mellitus
- Chronic Pulmonary disease
- Obese patients
- Hyperlipidemia
- BPH
- Geriatric population (increased risk of prostate CA)
Pregnancy Category:X
Breastfeeding: Unsafe. Testosterone is not indicated for use in women.
Pricing data from www.DrugStore.com in U.S.A.
- AndroGel Pump 20.25 MG/ACT (1.62%) GEL [Pump Btl] (UNIMED)
75 (1.62%) = $326.45
225 (1.62%) = $959.76 - Testim 1 % GEL [Box] (AUXILIUM PHARMACEUTICALS)
INC % = $150
% = $450 - AndroGel 50 MG/5GM GEL [Box] (ABBOTT)
150 5gm = $368.97
450 5gm = $1015.95 - AndroGel Pump 1 % GEL [Box] (ABBOTT)
150 % = $360.97
450 % = $986.92
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
