testosterone pellets

Contraindicated in:

Hypersensitivity;
Male patients with breast or prostate cancer;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Renal impairment;
Hepatic impairment;
Cardiac disease;
Benign prostatic hypertrophy;
Hypercalcemia;
Pedi: Males <12 yr (safety and effectiveness not established);
Geri: Appears on Beers list. ↑ risk of prostatic hyperplasia/carcinoma in older adults. Avoid use in older adults, except for confirmed hypogonadism with clinical symptoms.

Adv. Reactions/Side Effects ⬆ ⬇

CV: edema, DEEP VEIN THROMBOSIS, MI

Derm: male pattern baldness

EENT: deepening of voice

Endo: gynecomastia, hirsutism, oligospermia

F and E: hypercalcemia, hyperkalemia, hyperphosphatemia

GI: cholestatic jaundice, drug-induced hepatitis, ↑liver enzymes, nausea, vomiting

GU: change in libido, erectile dysfunction, priapism, prostatic enlargement

Local: pain at implantation site

Metab: hypercholesterolemia

Neuro: STROKE

Interactions ⬆ ⬇

Drug-drug:

May ↑ effects of warfarin, oral hypoglycemic agents, andinsulin.
Concurrent use with corticosteroids may ↑ risk of edema formation.

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

Male Hypogonadism (Replacement Therapy)

SC (for SUBQ implantation)(Adults ): 150–450 mg every 3–6 mo.

Delayed Male Puberty

SC (for SUBQ implantation)(Children ): 150–450 mg every 3–6 mo for up to 6 mo.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Responsible for the normal growth and development of male sex organs.
Maintenance of male secondary sex characteristics:
- Growth and maturation of the prostate, seminal vesicles, penis, scrotum,
- Development of male hair distribution,
- Vocal cord thickening,
- Alterations in body musculature and fat distribution.

Therapeutic effects:

Correction of hormone deficiency in male hypogonadism:
- Initiation of male puberty.

Classifications ⬆ ⬇

Therapeutic Classification: hormones

Pharmacologic Classification: androgens

Pharmacokinetics ⬆ ⬇

Absorption: Pellets slowly release testosterone.

Distribution: Unknown.

Protein Binding: 98%.

Metabolism/Excretion: Metabolized by the liver; 90% eliminated in urine as metabolites.

Half-Life: 10–100 min.

Contr. Subst. Schedule ⬆ ⬇

Schedule III (C-III)

Time/Action Profile ⬆ ⬇

(androgenic effects‡)

ROUTE	ONSET	PEAK	DURATION
SUBQ	unknown	unknown	3–6 mo

‡Response is highly variable among individuals; may take mo.

Patient/Family Teaching ⬆ ⬇

Advise patient to report the following signs and symptoms promptly: priapism (sustained and often painful erections), difficulty urinating, gynecomastia, edema (unexpected weight gain, swelling of feet), hepatitis (yellowing of skin or eyes and abdominal pain), or unusual bleeding or bruising.
- Instruct patient to use testosterone as directed. Do not use higher than prescribed doses. Explain rationale for prohibiting use of testosterone for increasing athletic performance. Testosterone is neither safe nor effective for this use and has a potential risk of serious side effects.
- Advise patients with diabetes to monitor blood closely for alterations in blood glucose concentrations.
- Emphasize the importance of regular follow-up physical exams, lab tests, and x-ray exams to monitor progress.
- Radiologic bone age determinations should be evaluated every 6 mo in prepubertal children to determine rate of bone maturation and effects on epiphyseal centers.

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Indications ⬇

Contraind./Precautions ⬆ ⬇