Transdermal patches testosterone

Testosterone products Transdermal patch (Testoderm TTS, Androderm, Testim) Testoderm (R) with or without adhesive) 5 mg patch applied to arm, back, or thigh every evening (patches 2.5, 4, 5, 6 mgf 6 mg applied to scrotal skin every evening... 

Transdermal testosterone system0 150-300 mcg/day Every 3-4 days Transdermal patch... 

Testosterone is available as oral testosterone undecano-ate, buccal testosterone, intramuscular testosterone esters, testosterone implants, and testosterone transdermal patches and gel. Proponents of transdermal testosterone products, such as gels and scrotal or non-scrotal dermal patches, claim that they have a good safety profile (101). Transdermal testosterone replacement certainly improves bone mass and lean body mass, reduces fat mass, and improves mood and sexual function. There are said to be no harmful effects on the prostate and lipids. Acne, polycythemia, and gynecomastia are stated to be less common with this form of therapy than with the intramuscular esters. To date these claims must be regarded with some reservations it is not at all clear that in equieffective doses the local or topical forms of administration dissociate wanted and unwanted effects. 

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). 

Androderm is an FDA-approved membrane-moderated transdermal patch that delivers testosterone. Androderm is manufactured in two sizes and both are 24-h patches. The round Androderm patch contains 12.2 mg of testosterone and delivers a 2.5-mg dose over a 24-h period. The larger oval patch contains 24.3 mg of testosterone and delivers 5 mg over a 24-h period. The reservoir of Androderm contains testosterone gelled with alcohol and glycerin. 

Testosterone products Transdermal patch (Testoderm TTS, Androderm, Testim)... 

Transdermal patches are marketed worldwide with the drug substances glycerole trinitrate, estradiol, testosterone, clonidine, scopolamine, fentanyl and nicotine, respectively. The patch has to remain for up to one week at the appropiate body site. In this case the drug amount in the reservoir is rather high. As liquid crystalline vehicles with lamellar microstructure have... 

The use of transdermal patches for administering testosterone to hypogonadal men ( Andropatch ) seems logical and convenient, but a British study in 50 treated patients showed that patient acceptance was surprisingly poor (70). There were adverse effects in 84%, mostly skin problems 72% requested a return to depot injections, and 5% returned to oral therapy. The reservoir patches, 6 cm in diameter, were, to quote the report hteraUy, judged to be too large. 

Mazer N, Fisher D, Fischer J, et al. Transfer of transdermal apphed testosterone to clothing a comparison of a testosterone patch versus a testosterone gel. J Sex Med 2005 2(2) 227-234. 

Testosterone 150 meg/day transdermal patch twice weekly (for low libido)... 

The goal of testosterone therapy in hypogonadal men is to mimic as closely as possible the normal serum concentration therefore, serum testosterone concentration must be monitored. With transdermal patches, the serum testosterone concentration fluctuates during the 24-hour period, with a peak value 6—9 hours after application and a nadir (about 50% of the peak) just before the next patch is applied (Figure 58-6). With testosterone gels, the mean serum testosterone concentration is relatively constant from one application to the next. Occasional random fluctuations can occur, so measurements should be repeated for any dose. When the enanthate or cypionate esters of testosterone are administered once every 2 weeks (typically in a dose of200 mg), the serum testosterone concentration measured midway between doses should be normal if not, the dose should be adjusted accordingly. 

Athletes have taken testosterone by injection, by oral routes or by absorption through the skin e.g. transdermal patches). By building up muscles which repair faster, the athletes improve the level of their performance and also their... 

Transdermal patches of testosterone also have problems A fraction of the testosterone is metabolized in the skin and converts to dihydrotestosterone. This metabolic side product can cause swelling of the prostate gland. Testosterone patches are placed on the body where the rate of absorption is highest, but this unfortunately can cause the metabolic product, dihydrotestosterone, to create side effects. Improved patches can be placed in areas where metabolized dihydrotestosterone is minimized. Reduction of transdermal absorption by the changed application area can be overcome by the addition of an absorptive aid. 

Testosterone can be replaced orally, parenterally, or transdermally (see Table 83-2). Injectable regimens are preferred because they are effective, are inexpensive, and do not have the bioavailability problems or adverse hepatotoxic effects of oral regimens. Testosterone patches and gel are more expensive than other forms and should be reserved for patients who refuse injections. 

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

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. 

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