Testosterone (Topical)

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[edit] BRAND NAMES

[edit] STRUCTURE

Testosterone.jpg

[edit] MECHANISM OF ACTION

Topical testosterone is a replacement therapy in males for conditions associated with a deficiency or absence of endogenous testosterone.

Endogenous androgens, including testosterone and dihydrotestosterone (DHT), are responsible for the normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. These effects include the growth and maturation of prostate, seminal vesicles, penis and scrotum; the development of male hair distribution, such as facial, pubic, chest and axillary hair; laryngeal enlargement, vocal cord thickening, alterations in body musculature and fat distribution.

Male hypogonadism results from insufficient secretion of testosterone and is characterized by low serum testosterone concentrations. Signs/symptoms associated with male hypogonadism include erectile dysfunction and decreased sexual desire, fatigue and loss of energy, mood depression, regression of secondary sexual characteristics and osteoporosis.

Male hypogonadism has two main etiologies. Primary hypogonadism is caused by defects of the gonads, such as Klinefelter’s Syndrome or Leydig cell aplasia, whereas secondary hypogonadism is the failure of the hypothalamus (or pituitary) to produce sufficient gonadotropins (FSH, LH).

[edit] INDICATIONS

Replacement therapy in males for conditions associated with a deficiency or absence of endogenous testosterone (e.g. Primary hypogonadism, Hypogonadotropic hypogonadism)

[edit] DOSAGE

Refer to the prescribing information

[edit] CONTRAINDICATIONS

  • Men with carcinoma of the breast or known or suspected carcinoma of the prostate
  • Pregnant or breastfeeding women.

[edit] WARNINGS AND PRECAUTIONS

  • Monitor patients with benign prostatic hyperplasia (BPH) for worsening of signs and symptoms
  • Virilization has been reported in children who were secondarily exposed to topical testosterone products. Children should avoid contact with unwashed or unclothed application sites in men
  • Exogenous administration of testosterone may lead to azoospermia
  • Edema with or without congestive heart failure, may be a complication in patients with preexisting cardiac, renal, or hepatic disease.
  • Sleep apnea may occur in those with risk factors especially in those with risk factors such as obesity and chronic lung disease.
  • Monitor serum testosterone, prostate specific antigen (PSA), liver function, lipid concentrations, hematocrit and hemoglobin periodically

[edit] INTERACTIONS

  • Androgens may decrease blood glucose and insulin requirement in diabetic patients.
  • Changes in anticoagulant activity may be seen with androgens. More frequent monitoring of International Normalized Ratio (INR) and prothrombin time is recommended.
  • Use of testosterone with Adrenocorticotropic Hormone (ACTH) or corticosteroids may result in increased fluid retention. Use with caution, particularly in patients with cardiac, renal, or hepatic disease

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category X (US), Testosterone may cause fetal harm and is contraindicated during pregnancy or in women who may become pregnant

[edit] SIDE EFFECTS

Most common adverse reactions are skin application site reactions, increased red blood cell count, headache, diarrhea, vomiting, and increased serum PSA

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[edit] BIBLIOGRAPHY

[edit] REFERENCES