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Testosterone dosing regimens for male hypogonadism

Testosterone dosing regimens for male hypogonadism
Administration route Preparation Initial dose Usual dose range
IM Solution (testosterone enanthate [eg, Delatestryl*], testosterone cypionate [eg, Depo-Testosterone]) 75 to 100 mg once weekly, or 150 to 200 mg every 2 weeks 50 to 100 mg once weekly, or 100 to 200 mg every 2 weeks
Solution (testosterone undecanoate [Aveed]) 750 mg; repeat 750 mg dose after 4 weeks, and then every 10 weeks thereafter
Intranasal Gel (Natesto) 11 mg (2 pump actuations; 1 actuation per nostril) 3 times daily (6 to 8 hours apart)
Oral Capsule (Jatenzo) 237 mg twice daily 158 to 396 mg twice daily
Capsule (Kyzatrex) 200 mg twice daily 100 mg once daily to 400 mg twice daily (maximum: 800 mg/day)
Capsule (Tlando) 225 mg twice daily Dose is not adjusted; may continue use at fixed dose if serum testosterone concentrations remain within normal range
Capsule (testosterone undecanoate)* 120 to 160 mg/day in 2 divided doses for 2 to 3 weeks 40 to 120 mg/day
SUBQ (injection) Solution (Xyosted) 75 mg once weekly 50 to 100 mg once weekly
SUBQ (implantation) Pellet (Testopel) 150 to 450 mg every 3 to 6 months
Topical 1% Gel (eg, AndroGel 1%,* Testim, Vogelxo) 50 mg applied once daily in the morning to the shoulders and/or upper armsΔ◊ 50 to 100 mg/day (maximum: 100 mg/day)◊§
1.62% Gel (eg, AndroGel 1.62%) 40.5 mg applied once daily in the morning to the shoulders and upper arms¥ 20.25 to 81 mg/day (maximum: 81 mg/day)¥
2% Gel (eg, Fortesta) 40 mg (4 pump actuations) applied once daily in the morning to the thighs 10 to 70 mg/day (1 to 7 pump actuations; maximum: 70 mg/day)
Transdermal solution 60 mg (2 pump actuations) applied once daily in the morning to the axillae 30 to 120 mg/day (1 to 4 pump actuations)

IM: intramuscular; SUBQ; subcutaneous.

* Canadian product.

¶ Dosing for this formulation is from the following sources: AUA (Mulhall 2018)[1], ES (Bhasin 2018)[2].

Δ AndroGel 1% and generic equivalents may also be applied to the abdomen.

◊ For the testosterone 1% gel and Vogelxo pump formulations, 1 pump actuation = 12.5 mg.

§ Maximum dose according to manufacturers of Testim and Vogelxo.

¥ For the testosterone 1.62% gel and AndroGel 1.62% pump formulations, 1 pump actuation = 20.25 mg.
References:
  1. Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol 2018; 200:423.
  2. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018; 103:1715.

Reproduced with permission from: UpToDate Lexidrug. Copyright © 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

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