Treatment
10
Table 5. Clinical Pharmacology of T Formulations Approved
in the United States and Europe
Formulation Typical Starting Doses Pharmacokinetic Profile
T enanthate or
cypionate
150–200 mg IM every 2 wk or
75–100 mg/wk
Aer a single IM injection,
serum T concentrations rise into
the supraphysiological range,
then decline gradually into the
hypogonadal range by the end of
the dosing interval
T transdermal
gels: 1%, 1.62%,
or 2%
50–100 mg of 1% transdermal
gel; 20.25–81 mg of 1.62%
gel or 40–70 mg of 2%
transdermal gel applied to
skin; check package insert
for application site and
instructions
With appropriate dose,
restores serum T and estradiol
(E2) concentrations to the
physiological male range; less
fluctuation of T concentrations
than T enanthate or cypionate
T Axillary
Solution
60 mg of T solution applied in
the axillae
Restores serum T and
E2 concentrations to the
physiological male range
Transdermal T
patch
One or two patches, designed
to nominally deliver 2–4 mg
of T during 24 h applied every
day on nonpressure areas
Restores serum T, DHT, and
E2 concentrations to the
physiological male range
Buccal,
bioadhesive T
tablets
30-mg controlled release,
bioadhesive tablets twice daily
Restores serum T, DHT, and
E2 concentrations to the
physiological male range;
absorbed from the buccal
mucosa
T pellets Pellets containing 600–1200 mg
T implanted SC; the number
of pellets and the regimen may
vary with formulation
Serum T peaks at 1 month and
then is sustained in normal
range for 3–6 mo, depending on
formulation
Injectable
long-acting T
undecanoate
in oil
United States regimen:
750 mg IM, followed
by 750 mg at 4 wk, and
750 mg every 10 wk
When administered at
a dose of 750 mg IM, serum T
concentrations are maintained
in the normal range in most
treated men
Nasal T gel 11 mg two or three times daily Serum T concentrations are
maintained in the normal range
in most treated men
Adapted with permission from Bhasin et al. J Clin Endocrinol Metab. 2010;95(6):2536–2559.
