Testosterone Enanthate
Indications
Testosterone Enanthate is used for:
Inoperable metastatic breast cancer, Delayed puberty, Male hypogonadism
Adult Dose
Intramuscular
Male hypogonadism
Adult: 50-400 mg every 2-4 wk (or an initial dose of 250 mg every 2-3 wk followed by a maintenance dose every 3-6 wk);
Inoperable metastatic breast cancer
Adult: As enanthate: 200-400 mg every 2-4 wk.
Child Dose
Hypogonadism
<12 years
Safety and efficacy not established
>12 years
50-400 mg IM every 2-4 weeks
Renal Dose
Administration
For IM use, should be administered deep in gluteal muscle
Contra Indications
Hypercalcaemia or hypercalciuria, males with breast or prostate carcinoma. Pregnancy and lactation.
Precautions
Cardiovascular disorders, skeletal metastases, renal or hepatic impairment, epilepsy, migraine, diabetes or other conditions which may be aggravated by fluid retention, eg heart failure. Elderly, prepubertal boys. Monitor signs of virilization (females) and development of priapism or excessive sexual stimulation (males). Periodic haemoglobin, lipid determinations and rectal prostate examination.
Lactation: Drug is excreted into breast milk; avoid using
Pregnancy-Lactation
Pregnancy
Contraindicated in pregnant women
Teratogenic; may cause fetal harm when administered to a pregnant woman based on data from animal studies and its mechanism of action
Exposure of a female fetus to androgens may result in varying degrees of virilization
Animal data
In animal developmental studies, exposure to testosterone in utero resulted in hormonal and behavioral changes in offspring and structural impairments of reproductive tissues in female and male offspring
These studies did not meet current standards for nonclinical development toxicity studies
Infertility
During treatment with large doses of exogenous androgens, spermatogenesis may be suppressed through feedback inhibition of the hypothalamic-pituitary-testicular axis
Observed reduced fertility in some men taking testosterone replacement therapy; impact on fertility may be irreversible
Lactation
Not indicated for women
Interactions
Enhance activities of ciclosporine, antidiabetics, thyroxine, anticoagulants. Long term use of testosterone may cause resistance to effects of neuromuscular blockers. Enhance fluid retention from corticosteroids
Adverse Effects
Side effects of Testosterone Enanthate :
Fluid and electrolyte retention; increased vascularity of the skin; hypercalcaemia, impaired glucose tolerance; increased bone growth and skeletal weight; increase LDL cholesterol; increase haematocrit and fibrinolytic activity; headache, depression and GI bleeding.
Males: spermatogenesis suppression, priapism, gynaecomastia, prostatic hyperplasia and accelerate growth of malignant prostate neoplasms.
Females: suppression of lactation, ovarian activity and menstruation; virilization, clitoris hypertrophy, increased libido, oily skin, acne, hirsutism, male pattern baldness.
Children: Closure of the epiphyses and stop linear growth in early puberty, symptoms of virilisation. Precocious sexual development, increased frequency of erection in boys, and clitoral enlargement in girls.
IM: urticaria, inflammation at Inj site, postinjection induration, furunculosis.
Potentially Fatal: Peliosis hepatis, liver toxicity, malignant neoplasm.
Mechanism of Action
Testosterone is the principal endogenous androgen responsible for promoting the growth and development of male sexual organs and maintaining secondary sex characteristics in androgen-deficient males.