Uses

This medicated gel contains testosterone. It is used for hormone replacement in men who are not able to produce enough testosterone (for example, due to hypogonadism). This medication is absorbed through the skin, enters your bloodstream, and helps your body reach normal testosterone levels.

Testosterone helps the body to develop and maintain the male sexual characteristics (masculinity), such as a deep voice and body hair. It also helps to maintain muscle and prevent bone loss, and is necessary for natural sexual ability/desire.

This drug should not be used by women.

How To Use

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using testosterone gel and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

There are many testosterone products available for use on the skin. They may have different amounts of testosterone and may not have the same effects. Read the dosing instructions carefully for each product. Do not change products without asking your doctor or pharmacist.

If you are using the gel pump, learn how to prepare the pump for use. You may pump this medication into the palm of your hand or directly onto the desired application site. If you are not sure how to use the pump, ask your pharmacist.

Apply the medication as directed to clean, dry skin of the shoulders/upper arms once daily in the morning or as directed by your doctor. Apply only to areas that would be covered if you were to wear a short sleeve t-shirt. Certain brands of this medication may also be applied to the stomach area (abdomen). Check your product's instructions or ask your pharmacist if your brand may be applied to the abdomen. Avoid applying this medication to broken, irritated skin. Do not apply to the genitals (penis or scrotum). Do not let others apply this medication to your body.

Dosage is based on your medical condition, laboratory tests, and response to treatment.

After applying this medication, wash your hands thoroughly with soap and water to reduce the risk of accidentally spreading it from your hands to other people. Before dressing, wait a few minutes for the application site to dry completely. Be sure to always wear clothing (such as a t-shirt) to cover the application site until you wash the areas well with soap and water.

To get the best effect, wait several hours (2 to 5 hours depending on brand) before showering/swimming to allow the drug to be absorbed through the skin. Check the manufacturer's information or ask your pharmacist for details. See also Warning and Precautions sections.

Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.

Misuse or abuse of testosterone can cause serious side effects such as heart disease (including heart attack), stroke, liver disease, mental/mood problems, abnormal drug-seeking behavior, or improper bone growth (in adolescents). Do not increase your dose or use this drug more often or for longer than prescribed. When testosterone is misused or abused, you may have withdrawal symptoms (such as depression, irritability, tiredness) when you suddenly stop using the drug. These symptoms may last from weeks to months.

This medication is flammable until dry. Let the gel dry before smoking or going near an open flame.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Nausea, vomiting, headache, dizziness, hair loss, trouble sleeping, change in sexual desire, redness/swelling of the skin, change in skin color, and acne may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• breast pain/enlargement
• swelling of the feet/ankles (edema)
• weight gain
• very slow/shallow/difficult breathing (possibly while sleeping)
• weakness
• trouble urinating
• increased urination (especially at night)
• mental/mood changes (such as depression, agitation, hostility)
• change in size/shape of the testicles
• testicle pain/tenderness
• stomach/abdominal pain
• dark urine
• yellowing of eyes/skin
• fast/irregular heartbeat

Get medical help right away if you have any very serious side effects, including:

• shortness of breath/rapid breathing
• chest/jaw/left arm pain
• unusual sweating
• confusion
• sudden dizziness/fainting
• pain/swelling/warmth in the groin/calf
• sudden/severe headaches
• trouble speaking
• weakness on one side of the body
• sudden vision changes

In patients with diabetes, especially those taking insulin, testosterone may decrease your blood sugar. Be prepared to treat low blood sugar while you are using this medication. Symptoms of low blood sugar include shakiness, nervousness, rapid pulse, and sweating. If you are experiencing these symptoms, consult your doctor. Your doctor may need to adjust your diabetes medications.

For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using testosterone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as soy), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• breast cancer (males)
• prostate problems (such as cancer, enlarged prostate or BPH)
• liver problems
• heart problems (such as heart failure, heart attack)
• stroke
• kidney problems
• diabetes
• high cholesterol level
• lung disease
• obesity
• difficulty breathing during sleep (apnea)
• high blood pressure
• bone cancer
• blood clots (such as in the leg, lungs)

Direct contact with the application site can expose others to this medication. Women and children should avoid contact with the unwashed or unclothed area where the medication has been applied. If you expect to have skin-to-skin contact with another person, first wash the application area well with soap and water. If a woman or child makes contact with the application area, that area on the woman or child should be washed well with soap and water right away.

If this medication accidentally gets into your eyes, rinse the eyes right away with clean, warm water. Get medical help right away if necessary.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Some men, especially older adults, are at a higher risk for developing enlarged prostates or prostate cancer while using this medication. Your risk of prostate problems should be checked by your doctor before you start testosterone.

Children may be more sensitive to the side effects of this drug. In children, it may affect bone growth. Monitor your child's height periodically.

This medication can affect fertility in males. Ask your doctor for more details.

This medication should not be used by women. Women accidentally exposed to this medication may have side effects due to testosterone gel. If you notice symptoms in a woman such as changes in body hair or a large increase in acne, talk to her doctor and your doctor right away. Women who are pregnant or breast-feeding must avoid contact with this medication. This medication may harm an unborn or breast-feeding baby. Consult your doctor for more details.

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

• "blood thinners" (such as warfarin)

This medication may interfere with certain laboratory tests (including thyroid function tests, creatinine level), possibly causing false test results. Make sure laboratory personnel and your doctors know you use this drug.

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 9-1-1. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of an overdose may include: weakness on one side of the body, trouble speaking, vision problems, or confusion.

Notes

Do not share this medication with others. Sharing it is against the law.

Lab and/or medical tests (such as PSA, cholesterol, hemoglobin, hematocrit, testosterone blood levels, prostate exams) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

This medication has been prescribed for your current condition only. Do not use it later for another problem unless told to do so by your doctor. A different medication may be necessary in those cases.

Inform all your doctors that you are using or have used this medication.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is less than 12 hours until your next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom or near an open flame. Keep all medications away from children and pets, and throw out used medication packages in a secure trash can.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.