Transdermal testosterone replacement therapy
For transdermal testosterone replacement therapy, use:
1 testosterone 5% cream 2 mL (100 mg) transdermally, in the morning applied to the trunk or proximally on the limbs. Adjust in 1 mL (50 mg) increments according to clinical response and serum testosterone concentration. Maximum dose 4 mL (200 mg) daily male androgen deficiency, topical therapy testosterone
OR
1 testosterone 1% gel 5 g (50 mg) transdermally, in the morning applied to the trunk or proximally on the limbs. Adjust in 2.5 g (25 mg) increments according to clinical response and serum testosterone concentration. Maximum dose 10 g (100 mg) daily1 testosterone
OR
1 testosterone 2% gel 1 pump (23 mg/1.15 g) transdermally, in the morning applied to trunk or proximally on the limbs. Adjust in 1 pump (23 mg) increments according to clinical response and serum testosterone concentration. Maximum dose 3 pumps (69 mg/3.45 g) daily testosterone
OR
2 testosterone patch 5 mg per 24 hours transdermally, at night applied to the trunk or proximally on the limbs for 24 hours. Adjust in 2.5 mg per 24 hours increments according to clinical response and serum testosterone concentration. Maximum dose 7.5 mg per 24 hours. testosterone
See Monitoring testosterone replacement therapy for guidance on adjusting testosterone therapy.
The main limitation of transdermal testosterone patches is skin irritation, which is occurs in about 50% of patients and can be severe. Pretreating the application site with topical hydrocortisone may reduce irritation.
To avoid transferring active drug to another person through skin-to-skin contact, advise thorough hand washing after applying testosterone gel or liquid, covering the application area with clothing, and showering before direct skin contact with others. Repeated inadvertent transfer to another person could increase their serum testosterone concentration and cause adverse effects (eg growth of facial or body hair, deepening of the voice, menstrual irregularities in females, premature puberty and genital enlargement in children).