AndroGel

Indications

Testosterone is the main male sex hormone. As a medicine it is used as hormone replacement in men whose bodies do not make enough testosterone (male hypogonadism), confirmed by symptoms and blood tests. Low testosterone can cause low sex drive, erection problems, tiredness, low mood, loss of muscle and bone strength and reduced body hair. In specialist care it is also used for delayed puberty in boys and in certain other conditions. It comes as gels, injections, capsules and patches.

How It Works

Testosterone replaces the hormone the body is lacking. It attaches to androgen receptors in many tissues, supporting the development of male characteristics, sex drive and sexual function, muscle and bone strength, red blood cell production and mood and energy.

Dosage and Administration

Testosterone is a hormone treatment and is used only as prescribed by a doctor, who sets the form, dose and timing from your blood tests. Gels are applied once a day to clean, dry skin on the shoulders, upper arms or abdomen (as directed on the label), then the hands are washed and the area covered with clothing once dry. Injections are given into a muscle by a doctor or nurse at set intervals. Blood levels are checked to adjust the dose. Do not use it for bodybuilding or without a prescription.

Interactions

• Blood thinners such as Warfarin: their effect may increase, so clotting tests may be needed.
• Insulin and diabetes medicines: blood sugar may fall and doses may need adjusting.
• Corticosteroids: may increase fluid retention and swelling.
• Ciclosporin and some other medicines: levels may change.

Contraindications

Do not use Testosterone if you have, or are suspected to have, prostate cancer or male breast cancer, have liver tumours, have very high calcium due to cancer, or are allergic to any ingredient (some injections contain peanut or soya oil). It must not be used by women who are pregnant or breastfeeding.

Side Effects

Common effects include acne, oily skin, skin irritation where gel or patches are applied, raised red blood cell count, increased prostate size, breast tenderness or enlargement, mood changes, headache and changes in cholesterol. Long-term use can reduce sperm production and shrink the testes. Fluid retention and worsening sleep apnoea can occur.

Get urgent medical help if you have chest pain, sudden breathlessness, pain or swelling in one leg (possible blood clot), signs of a stroke such as face drooping or arm weakness, an erection lasting more than 4 hours, difficulty passing urine, yellowing of the skin or eyes, or a severe allergic reaction.

Pregnancy and Lactation

Testosterone can harm an unborn baby, especially a female baby. Women and children must avoid contact with skin where gel has been applied: wash the area or cover it with clothing before close contact. Women who are pregnant or breastfeeding must not use it.

Precautions and Warnings

Regular checks are needed for testosterone levels, blood count, prostate (PSA), liver function and cholesterol. Use with care in heart, liver or kidney disease, high blood pressure, sleep apnoea and epilepsy. Older men need careful monitoring of the prostate. Misuse at high doses can cause serious heart, liver and mental health problems, and dependence.

Overdose

Using too much may cause marked mood changes, fluid retention and very high red blood cell counts. Contact your doctor; for a large accidental overdose, seek medical help.

Therapeutic Class

Androgen (male sex hormone).

Storage

Store below 30°C, away from light and heat, and out of the reach of children. Gels are flammable until dry: keep away from flames. Do not refrigerate injections.