Testosterone Cypionate

Registered South African indications:

• Hypogonadism

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients 
• Pregnancy
• Breastfeeding
• Severe renal impairment
• Severe hepatic impairment
• Male breast cancer 
• Prostate cancer 
• Hypercalcaemia
• Cardiac decompensation
• Prepubertal males

Cautions

• Mild to moderate renal impairment
• Mild to moderate hepatic impairment
• Elderly
• Breast cancer 
• Immobilized patients 
• Cardiovascular disease  
• Congestive cardiac failure
• Benign prostatic hypertrophy

Forms avail. in SA and covered in this monograph: inj

Primary hypogonadism
Secondary hypogonadism

• IM: 200-400mg, every 3-4 weeks

More frequent administration of divided doses (e.g. 100mg, weekly or 200mg, every 2 weeks) may be required in patients experiencing significant symptoms of hypogonadism before the next injection is due; Doses should be titrated to testosterone levels as well as clinical response to therapy

Do not administer intravenously

Paed. forms avail. in SA and covered in this monograph: inj

Primary hypogonadism
Secondary hypogonadism

Prepubertal boys

• IM: Not established for use in children prior to puberty

Pubertal boys

• IM: See adult dosage

Do not administer intravenously

Pregnancy

• Contraindicated
• Testosterone is not indicated for use in women and must not be used in pregnant women

Breastfeeding

• Contraindicated
• Testosterone is not indicated for use in women and must not be used in breastfeeding women

Fertility

• In men, treatment with androgens can lead to fertility disorders by repressing sperm-formation
• In women, treatment with androgens can lead to an infrequent or repressed menstrual cycle

Renal Impairment

• Mild to moderate: Caution; no dose adjustment recommended 
  
• Severe: Contraindicated

Hepatic Impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe: Contraindicated

Elderly

• Caution; no dose adjustment recommended 
  Consider a lower testosterone target, at lower end of normal testosterone range

Porphyria Information

• Porphyrinogenic (P)

Drugs in Sport

• Prohibited - At all times

Cardiovascular Disorders

• Oedema
• Dyslipidaemia
• Venous thromboembolism

Endocrine and Metabolic Disorders

• Hypercalcaemia
• Virilization in females
• Priapism
• Excessive sexual stimulation
• Oligospermia  
• Reduced ejaculatory volume
• Gynaecomastia

Skin and Subcutaneous Tissue Disorders

• Acne
• Local irritation

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity
• Anaphylactoid reactions
• Polycythemia

• Antidiabetic agents
• Corticosteroids
• Ciclosporin
• Dehydroepiandrosterone
• Warfarin

• Full blood count 
• Lipid profile
• Hepatic function
• Renal function
• Serum testosterone

Specific cases may require

• Prostate-specific antigen 
• Bone mineral density
• Serum calcium

The effects of testosterone occur by way of two main mechanisms: by activation of the androgen receptor (directly or as 5α-dihydrotestosterone) and by conversion to estradiol and activation of certain estrogen receptors.In the eunuch and eunuchoid male, androgens act to stimulate and maintain the secondary sexual characteristics associated with the adult male. Androgens influence closure of the epiphyseal lines in males and some females.

Injection (per ml) 100mg

• Depo-testosterone (Pfizer) originator

Injection (per 2ml) 200mg

• Depotrone (Adcock)