Hormone Replacement Therapy for Adult Hypopituitarisma
| Trophic Hormone Deficit | Hormone Replacement |
|---|---|
| ACTH | Hydrocortisone (10-20 mg A.M.; 5-10 mg P.M.) |
| Cortisone acetate (25 mg A.M.; 12.5 mg P.M.) | |
| Prednisone (5 mg A.M.) | |
| TSH | L-Thyroxine (0.075-0.15 mg daily) |
| FSH/LH | Males |
Testosterone enanthate (200 mg IM every 2 weeks) Testosterone gel (5-10 g/d applied to skin) | |
| Females | |
Conjugated estrogen (0.625-1.25 mg qd for 25 days) Estradiol skin patch (0.025-0.1 mg, every week) Progesterone (5-10 mg qd) on days 16-25 | |
| For fertility: Menopausal or biosynthetic gonadotropins, human chorionic gonadotropins | |
| GH | Adults: Somatotropin (0.1-1.25 mg SC qd) |
| Children: Somatotropin (0.02-0.05 [mg/kg per day]) | |
| Vasopressin | Intranasal desmopressin (5-20 µg twice daily) |
| Oral desmopressin (300-600 µg qd) |
aAll doses shown should be individualized for specific pts and should be reassessed during stress, surgery, or pregnancy. Male and female fertility requirements should be managed as discussed in Chaps. 174. Disorders of the Male Reproductive System and 175. Disorders of the Female Reproductive System.
Abbreviations: ACTH, adrenocorticotropin hormone; FSH, follicle-stimulating hormone; GH, growth hormone; LH, luteinizing hormone; TSH, thyroid-stimulating hormone.