Testosterone esters injection
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Injection of testosterone esters.
Supportive therapy for female-to-male transsexuals
Testosterone replacement therapy associated with hypogonadism in males
Adjust dose according to individual response.
Testosterone replacement therapy in primary and secondary hypogonadal disorders
250mg testosterone esters injected once every 3 weeks is often considered adequate.
Dosage recommendations vary from one 250mg injection given every two weeks, to one 250mg injection every four weeks.
For deep intramuscular injection.
Children under 3 years
Suspected prostate cancer
History of hepatic neoplasm
Precautions and Warnings
Children aged 3 to 18 years
Family history of breast cancer
Predisposition to hypercalcaemia
Predisposition to venous thromboembolism
History of endometrial cancer
Ischaemic heart disease
Renal cell carcinoma
Contains arachis (peanut) oil
Contains benzyl alcohol
Monitor testosterone levels at baseline and periodically during treatment
Monitor blood glucose closely in patients with diabetes mellitus
Monitor calcium levels in patients at risk of hypercalcaemia
Monitor female to male transsexuals for hormone dependent neoplasms
Monitor hepatic function, haematocrit and haemoglobin in long term therapy
Monitor serum lipids profile regularly in long term therapy
Patients at risk of osteoporosis should have bone density assessed
Regular examination of prostate advised to exclude prostatic cancer
Abuse may cause serious adverse events, dependence and withdrawal symptoms
Increased risk of premature sexual development+epiphyseal closure in boys
Reinitiate therapy at lower dose once androgen dependent effects resolve
May interfere with thyroid function tests
Discontinue if oedema progresses or signs of cardiac failure occur
Cases of venous thromboembolism have been reported even under anticoagulant treatment, testosterone treatment requires careful evaluation after the first thrombotic event.
Female-to-male transsexual supportive therapy
Hysterectomy and bilateral oophorectomy should be considered 18 to 24 months after treatment of testosterone, to reduce risk of endometrial and ovarian cancer. Continued monitoring is required for patients on long term treatment who did not proceed with such interventions.
Pregnancy and Lactation
Testosterone esters are contraindicated during pregnancy.
The manufacturer advises treatment with testosterone esters should be discontinued during pregnancy. Human data have shown teratogenic effects. Testosterone rapidly crosses the placenta and causes masculinisation of the female foetus.
Testosterone esters are contraindicated during breastfeeding.
The manufacturer advises testosterone esters should not be used during breastfeeding. There is no clear data on whether testosterone, given by oily injection, appears in breast milk after maternal exposure during breast feeding.
Abnormal clotting factor
Altered glucose tolerance
Altered serum lipid profile
Changes in libido
Decreased ejaculate volume
Frequent or persistent erections
Increase in haematocrit
Increase in haemoglobin
Increase in prostate specific antigen (PSA)
Increased bone growth
Injection site reactions
Male pattern baldness
Phallic enlargement in prepubertal males
Precocious sexual development (pre-pubertal males)
Premature closure of epiphyses (in pre-pubertal males)
Virilism in females
Effects on Laboratory Tests
Athletes should be advised that testosterone replacement therapy contains an active substance which may produce a positive reaction in an anti-doping test.
May decrease thyroxine-binding globulin levels. Free thyroid levels and thyroid function remain unchanged.
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: December 2019
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Summary of Product Characteristics: Sustanon 250, 250mg/ml solution for injection. Aspen. Revised June 2020.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 12 November 2019
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Testosterone Last revised: 3 December 2018
Last accessed: 14 November 2019
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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