Androgens

Androgens

ANDROGENS
Generic	Brand	Strength	Dose
Capsules
methyl– testosterone	—	10mg	Adults and Children: Usually 10−50mg daily. Delayed puberty: use low dose and limit duration to 4−6mos.
	Testred	10mg
INTRAMUSCULAR INJECTION
testosterone cypionate	Depo-Testos– terone	100mg/mL, 200mg/mL	Adults: Give by deep IM inj into gluteal muscle once every 2−4wks. 50−400mg; max 400mg/month. Children: Not recommended.
testosterone enanthate	—	200mg/mL	Adults: Give by deep IM inj into gluteal muscle once every 2−4wks. Male hypogonadism: 50−400mg. Delayed puberty: 50−200mg. Max 400mg/month. Children: See full labeling.
testosterone undecanoate	Aveed	250mg/mL	≥18yrs: Give by deep IM inj into gluteal muscle. 3mL (750mg) once at initiation, followed by 3mL (750mg) at 4wks, then 3mL (750mg) every 10wks thereafter. <18yrs: Not established.
NASAL GEL
testosterone	Natesto	5.5mg/  0.122g per pump actuation	≥18yrs: Administer intranasally once in the morning, afternoon, and evening (6−8hrs apart) at same time each day. 11mg (1 pump per nostril) three times daily (total dose: 33mg daily); check serum testosterone levels periodically as soon as one month after initiation. <18yrs: Not established.
SUBCUTANEOUS INJECTION
testosterone enanthate	Xyosted	50mg/0.5mL, 75mg/0.5mL, 100mg/0.5mL	≥18yrs: Give by SC inj into abdomen. Male hypogonadism: 75mg once weekly. Decrease by 25mg if total testosterone trough level ≥650ng/dL; or, increase by 25mg if <350ng/dL. <18yrs: Not established.
Tablets
fluoxy– mesterone	—	10mg	Adults: Male hypogonadism: 5−20mg/day. Children: Delayed puberty: Use low dose, with appropriate skeletal monitoring. Duration of therapy: 4−6mos.
methyl– testosterone	—	10mg	Adults and Children: Usually 10−50mg daily. Delayed puberty: use low dose and limit duration to 4−6mos
oxandrolone	—	2.5mg, 10mg	Adults: 2.5−20mg daily in 2−4 divided doses for 2−4wks; may repeat intermittently as needed. Elderly: 5mg twice daily. Children: ≤0.1mg/kg/day; may repeat intermittently as needed.
TRANSDERMAL GEL
testosterone	Androgel 1%*	12.5mg/  1.25g per pump actuation	≥18yrs: Apply to clean, intact, dry skin of the shoulders, upper arms, and/or abdomen; do not apply to genitals, chest, axillae, knees, or back. 5g (50mg of testosterone) once daily in AM; check serum testosterone level at intervals until normal range; may increase to 7.5g/day (75mg of testosterone), then to 10g/day (100mg of testosterone) if needed. <18yrs: Not established.
		25mg/2.5g, 50mg/5g pkt
	Androgel 1.62%*	20.25mg/  1.25g per pump actuation	≥18yrs: Apply to clean, intact, dry skin of the shoulders and upper arms; do not apply to abdomen, genitals, chest, axillae, or knees. 2.5g (40.5mg of testosterone [2 pump actuations]) once daily in AM. May adjust dose between min of 20.25mg (1 pump actuation) and a max of 81mg (4 pump actuations) based on the pre‑dose morning serum testosterone concentration at approx. 14 days and 28 days after starting treatment or following dose adjustment. <18yrs: Not established.
		20.25mg/  1.25g, 40.5mg/  2.5g pkt
	Fortesta*	10mg/0.5g per pump actuation	≥18yrs: Apply to clean, dry, intact skin on front and inner thighs only. Initially 40mg (4 pump actuations) once daily in the AM. Adjust based on serum testosterone levels (see full labeling); min: 10mg/day, max: 70mg/day. <18yrs: Not established.
	Testim*	50mg/5g	≥18yrs: Apply to clean, dry intact skin of the shoulders and/or upper arms; do not apply to genitals or abdomen. Initially apply 5g (1 tube) once daily in the AM; measure serum testosterone level to ensure response; may increase to 10g after 2wks. <18yrs: Not recommended.
	Vogelxo*	50mg/5g per tube or pkt	≥18yrs: Apply to clean, dry intact skin of the shoulders and/or upper arms at the same time each day; do not apply to the genitals or abdomen. Initially 50mg (1 tube or pkt, or 4 pump actuations) once daily; check morning, pre‑dose serum testosterone levels approx. 14 days after initiation. May increase to 100mg (2 tubes or pkts, or 8 pump actuations) once daily based on serum testosterone concentration; max 100mg once daily. <18yrs: Not established.
		12.5mg/  1.25g per pump actuation
TRANSDERMAL PATCH
testosterone	Androderm	2mg/day, 4mg/day	≥18yrs: Initially apply one 4mg/day system nightly for 24hrs to intact clean, dry skin of the back, abdomen, thighs, or upper arms. Do not apply to scrotum; avoid bony prominences and areas subject to pressure during sleep or sitting. Rotate appl. sites at intervals of 7 days. Increase to 6mg (one 4mg/day + one 2mg/day system) or decrease to 2mg (one 2mg/day system) based on confirmed AM serum testosterone concentrations. <18yrs: Not established.
NOTES
Prior to the above treatments, confirm diagnosis by ensuring serum testosterone is below normal range as measured in the AM on at least 2 separate days. *Wash hands after application. Do not wash site for at least 2hrs after application. Allow gel or solution to dry before covering with clothing. Advise patients to strictly adhere to recommended instructions. Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 11/2019)