Depo-Testosterone

Depo-Testosterone

 [de″po-tes-tos´ter-ōn]
trademark for a sustained-action preparation of testosterone cypionate, used in treatment of hypogonadism or delayed puberty in males and certain forms of metastatic breast cancer in females.

testosterone cypionate

(tess-toss-te-rone sip-eye-oh-nate) ,

Depo-Testosterone

(trade name)

Classification

Therapeutic: hormones
Pharmacologic: androgens
Pregnancy Category: X

Indications

Hypogonadism in androgen-deficient men.

Action

Responsible for the normal growth and development of male sex organs.
Maintenance of male secondary sex characteristics:
  • Growth and maturation of the prostate, seminal vesicles, penis, scrotum,
  • Development of male hair distribution,
  • Vocal cord thickening,
  • Alterations in body musculature and fat distribution.

Therapeutic effects

Correction of hormone deficiency in male hypogonadism.

Pharmacokinetics

Absorption: Well absorbed from IM sites; absorbed slowly.
Distribution: Crosses the placenta.
Protein Binding: 98%.
Metabolism and Excretion: Metabolized by the liver; 90% eliminated in urine as metabolites.
Half-life: 8 days.

Time/action profile (androgenic effects†)

ROUTEONSETPEAKDURATION
IMunknownunknown2–4 wk
†Response is highly variable among individuals; may take months

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Obstetric: Pregnancy and lactation; Male patients with breast or prostate cancer; Severe liver, renal, or cardiac disease; Patients with known hypersensitivity to benzyl alcohol.
Use Cautiously in: Benign prostatic hyperplasia; Hypercalcemia; Geriatric patients (↑ risk of prostatic hyperplasia/carcinoma); Males <12 yr (safety and effectiveness not established).

Adverse Reactions/Side Effects

Ear, Eye, Nose, Throat

  • deepening of voice (most frequent)

Cardiovascular

  • edema (most frequent)

Gastrointestinal

  • cholestatic jaundice
  • drug-induced hepatitis
  • liver function test elevation
  • nausea
  • vomiting

Genitourinary

  • change in libido (most frequent)
  • erectile dysfunction (most frequent)
  • priapism (most frequent)
  • prostatic enlargement

Endocrinologic

  • gynecomastia (most frequent)
  • hirsutism (most frequent)
  • oligospermia (most frequent)
  • hypercholesterolemia

Fluid and Electrolyte

  • hypercalcemia
  • hyperkalemia
  • hyperphosphatemia

Dermatologic

  • male pattern baldness

Local

  • pain at injection site

Interactions

Drug-Drug interaction

May ↑ action of warfarin, oral hypoglycemic agents, andinsulin.Concurrent use with corticosteroids may ↑ risk of edema formation.

Route/Dosage

Intramuscular (Adults) Replacement therapy–50–400 mg every 2–4 wk.

Availability (generic available)

Injection (in oil): 100 mg/mL in 10-mL vials, 200 mg/mL in 1- and 10-mL vials

Nursing implications

Nursing assessment

  • Monitor intake and output ratios, weigh patient twice weekly, and assess patient for edema. Report significant changes indicative of fluid retention.
  • Men: Monitor for precocious puberty in boys (acne, darkening of skin, development of male secondary sex characteristics—increase in penis size, frequent erections, growth of body hair). Bone age determinations should be measured every 6 mo to determine rate of bone maturation and effects on epiphyseal closure.
    • Monitor for breast enlargement, persistent erections, and increased urge to urinate in men. Monitor for difficulty urinating in elderly men, because prostate enlargement may occur.
  • Lab Test Considerations: Monitor hemoglobin and hematocrit periodically during therapy; may cause polycythemia.
    • Monitor hepatic function tests and serum cholesterol levels periodically during therapy. May ↑ serum AST, ALT, and bilirubin, ↑ cholesterol levels, and suppress clotting factors II, V, VII, and X.
    • Monitor blood glucose closely in patients with diabetes who are receiving oral hypoglycemic agents or insulin.
    • Monitor serum sodium, chloride, potassium, and phosphate concentrations (may be ↑).

Potential Nursing Diagnoses

Sexual dysfunction (Indications,  Side Effects)

Implementation

  • Range-of-motion exercises should be done with all bedridden patients to prevent mobilization of calcium from the bone.
  • Intramuscular: Administer IM deep into gluteal muscle. Crystals may form when vials are stored at low temperatures; warming and shaking the vial will redissolve crystals. Use of a wet syringe or needle may cause solution to become cloudy but will not affect its potency.

Patient/Family Teaching

  • Advise patient to report the following signs and symptoms promptly: priapism (sustained and often painful erections), difficulty urinating, gynecomastia, edema (unexpected weight gain, swelling of feet), hepatitis (yellowing of skin or eyes and abdominal pain), or unusual bleeding or bruising.
    • Explain rationale for prohibiting use of testosterone for increasing athletic performance. Testosterone is neither safe nor effective for this use and has a potential risk of serious side effects.
    • Advise diabetic patients to monitor blood closely for alterations in blood glucose concentrations.
    • Emphasize the importance of regular follow-up physical exams, lab tests, and x-ray exams to monitor progress.
    • Radiologic bone age determinations should be evaluated every 6 mo in prepubertal children to determine rate of bone maturation and effects on epiphyseal centers.

Evaluation/Desired Outcomes

  • Resolution of the signs of androgen deficiency without side effects. Therapy is usually limited to 3–6 mo followed by bone growth or maturation determinations.
Mentioned in ?
References in periodicals archive ?
Commonly used testosterone medications include Androgel, Depo-Testosterone, Axiron, Testim, Androderm, Fortesta, Delatestryl, Methiest, Testred, Android and Straint.
Prescribing Information: Depo-Testosterone (testosterone cypionate injection USP) 100 mg/mL Sterile solution.
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Acromegaly lanreotide acetate octreotide acetate Hormone Therapy Medroxyprogesterone Somatropin Infectious Disease Interferon Metabolic Exenatide Oncology Neoplastic Meningitis Cytarabine Prostate leuprolide acetate leuprolide acetate triptorelin pamoate Schizophrenia Fluphenazine Haloperidol paliperidone palmitate olanzapine risperidone Substance Abuse naltrexone Reproductive Health Estradiol valerate Depo-estradiol Depo-testosterone
Bart is currently evaluating cases that involve some of the most commonly prescribed testosterone therapies such as Androgel, Androderm, Android 10, Axiron, Depo-Testosterone, Bio-T-Gel, Delatestryl, Fortesta, Striant, Testim and Testopel.
A month of testosterone for replacement therapy costs about $50 for the Depo-Testosterone injections or $100-$150 for transdermal patches, topical gels, oral testosterone, or testosterone pellets, said Dr.
PRODUCT LAUNCHES/APPROVALS II-27 HRTI Obtains FDA Clearance for Commencing Testagen TDS Clinical Trials II-27 Eli Lily Launches Axiron in Canada II-27 FDA Approves Generic Depo-Testosterone Injection of Sun Pharmaceutical II-27 Perrigo Obtains FDA Approval for AndroGel 1% II-28 TestoMeds Launches Androfeme, Andromforte and Profeme Testosterone Replacement Creams II-28 BioSante's Bio-T-Gel(TM) Receives FDA Clearance II-28 Eli Lilly Launches Axiron Topical Solution in the US II-29 US FDA Grants Approval Low-Dose Formulations of Watson's Androderm II-29 Abbott Obtains FDA Clearance for AndroGel 1.
Androgel, Androderm, Axirom, Bio-T-Gel, Delatestryl, Depo-Testosterone, Fortesta, Striant, Testim, Testopel