What are the different types of Testosterone Treatments?

How Is Hypogonadism Treated?

If a man has been diagnosed with androgen deficiency, he may be a candidate for testosterone therapy (TT).  It should be a therapeutic goal to raise his T levels to the low to mid range of the reference range (240-950 ng/dl)[i]. Pharmaceutical companies have developed and commercialized several types of TT for low T.  Following is a list of some of the most prevalent types of TT products in the U.S.:

Intramuscular Injection:   Until recently, injection therapy was one of the most frequently used treatment methods.  Injections, usually self-administered, are taken at periodic intervals of typically two weeks or more.  Available products include:

  • DEPO-Testosterone, which is manufactured by Pfizer; and
  • Delatestryl, which is manufactured by Endo Pharmaceuticals.

Transdermal/Topical:  Transdermal testosterone delivery includes daily gel applications and patches.  These products are far and away the most prescribed products.  They include:

  • Forestra, which is manufactured by Endo Pharmaceuticals.  Forestra is a gel that is applied once daily to the thighs in the morning.
  • AndroGel, is currently promoted by AbbVie, formerly part of Abbott Labs, and Actavis AndroGel is applied once daily in the mornings to the shoulders and upper arms.
  • Androderm, is manufactured by Actavis, formerly Watson Pharm.  Androderm is applied a patch product that is applied daily to the back, abdomen, upper arms, or thighs.
  • Axiron, is manufactured by Lilly.  It is a topical solution that is applied once daily, generally in the morning, to the underarms.
  • Testrim, is manufactured by Auxilium Pharmaceuticals.  It is a gel that is applied once daily to the shoulders and upper arms.

Buccal:  Buccal formulations of testosterone involve placing a product with a bioadhesive onto the gums where it delivers an extended dose of testosterone through the gums and cheeks.   Available products include:

  • Striant.  Striant is currently marketed by Auxilium in the U.S.  It is applied to the upper gum twice daily, approximately 12 hours apart.

Subdermal Implant:  Subdermal testosterone implants are surgically implanted underneath the skin.  They deliver prolonged, steady-doses of testosterone.  Products include:

  • Testopel.  Testopel is manufactured by Auxilium.  Is placed underneath the skin where it delivers 3-6 months of testosterone.

[i] J Clin Endocrinol Metab. 2007;92:3844–3853, “Androgen receptor gene CAG repeat length and body mass index modulate the safety of long-term intramuscular testosterone undecanoate therapy in hypogonadal men.”

 

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