Testosterone transdermal system

8% is a white to off-white, water-washable cream for intravaginal administration containing 0.8% of the antifungal agent terconazole, cis-l-[p-[[2-(2,4-dichlorophe-nyl)-2-(lH-l,2,4-triazol-l-ylmethyl)-l,3-dioxolan-4-yl]methoxy]phenyl] -4-isopropylpiperazine, compounded in a cream base consisting of butylated hydroxyanisole, cetyl alcohol, isopropyl myristate, polysorbate 60, polysorbate 80, propylene glycol, stearyl alcohol, and purified water. 

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When the testosterone transdermal system Testoderm is prescribed, the nurse places the system on clean, dry scrotal skin. Optimal skin contact of the transdermal system is achieved by dry shaving scrotal hair before placing the system. 

Testosterone transdermal system—Apply according to the directions supplied witii die product. (See Promoting an Optimal Response to Therapy .) Be sure the skin is clean and dry and die placement area is free of hair. Do not store outside die pouch or use damped systems. Discard systems in household trash in a safe manner to prevent ingestion by children or pets. 

Parenteral 200 mg/mL for IM injection Testosterone transdermal system Patch (Androderm) 2.5, 5 mg/24 h release rate Gel (AndroGel) 1%... 

Testosterone transdermal systems AndroGel Androgen deficiency Transdermal... 

Meikle, A.W. Arver, S. Dobs, AS. Sanders, S.W. Rajaram, L. Mazer, N.A. Pharmacokinetics and metabolism of a permeation enhanced testosterone transdermal system in hypogonadal men influence of application site—clinical research center study. J. Clin. Endocrinol. Metab. 1996, 81, 1832-1840. 

Testosterone transdermal system (4 mg/day) is used in primary or hypogonadotropic hypogonadism in men age 18 and older. 

Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996 155 1604-1608. 

Androderm, anotiier transdermal system, is applied nightly to clean, dry skin on the abdomen, tiiigh, back, or upper arm. This system is not applied to die scrotum. Sites are rotated, witii 7 days between application to any specific site The system is applied immediately after opening the pouch and removing die protective covering. If the patient has not exhibited a therapeutic response after 8 weeks of tiierapy, another form of testosterone replacement therapy should be considered. 

Bhasin S, Storer TW, Asbel-Sethi N, Kilbourne A, Hays R, Sinha-Hikim I, Shen R, Arver S, Beall G. Effects of testosterone replacement with a nongenital, transdermal system, Androderm, in human immunodeficiency virus-infected men with low testosterone levels. J Clin Endocrinol Metab 1998 83(9) 3155-62. 

Jordan WP Jr. Allergy and topical irritation associated with transdermal testosterone administration a comparison of scrotal and nonscrotal transdermal systems. Am J Contact Dermat 1997 8(2) 108-13. 

Topical application of testosterone, as a gel or from transdermal patches, can lead to absorption and systemic effects (SEDA-16, 158). Transdermal absorption of testosterone (usually from treatment of vulvar lichen scler-osus et atrophicus) can lead to increased libido, clitoral hypertrophy, pubic hirsutism, thinning of the scalp hair, facial acne, voice change, hirsutism, and even virilization (111). 

These testosterone systems illustrate two different approaches to solve the problem of inadequate percutaneous absorption rate. In the former case, the patch must be applied to the body s most permeable skin site, the scrotum (which has been shown to be at least five times more permeable than ary other site). In the latter, the difficulty is resolved by creating a transdermal formulation which includes excipients to reduce barrier function. Neither solution is ideal scrotal application is clearly not preferred from a patient compliance standpoint on the other hand, permeation enhancers, by their very nature, tend to be irritating (and the more effective they are, the greater the irritation they provoke). This general problem, which presently limits the application of transdermal delivery, is now discussed in more detail. 

Advances in transdermal delivery systems (TDSs) and the technology involved have been rapid because of the sophistication of polymer science, which now allows incorporation of polymeric additives in TDSs in adequate quantity. Drugs with which transdermal therapy was pioneered include scopolamine, nitroglycerine, iso-sorbide dinitrite, clonidine, estradiol, nicotine, and testosterone [74],... 

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