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Testosterone (Testosterone Cypionate) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Insulin

Changes in insulin sensitivity or glycemic control may occur in patients treated with androgens. In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, may decrease insulin requirements.

Oral Anticoagulants

Changes in anticoagulant activity may be seen with androgens, therefore more frequent monitoring of International Normalized Ratio (INR) and prothrombin time are recommended in patients taking anticoagulants, especially at the initiation and termination of androgen therapy.

Corticosteroids

The concurrent use of testosterone with adrenocorticotropic hormone (ACTH) or corticosteroids may result in increased fluid retention and requires careful monitoring particularly in patients with cardiac, renal or hepatic disease.

OVERDOSAGE

There is one report of acute overdosage with use of an approved injectable testosterone product: This subject had serum testosterone concentrations of up to 11,400 ng/dL with a cerebrovascular accident.

Treatment of overdosage would consist of discontinuation of testosterone gel, washing the application site with soap and water, and appropriate symptomatic and supportive care.

CONTRAINDICATIONS

  • •Testosterone gel is contraindicated in men with carcinoma of the breast or known or suspected carcinoma of the prostate [see Warnings and Precautions Adverse Reactions (6.1), and Nonclinical Toxicology].
  • •Testosterone gel is contraindicated in women who are or may become pregnant, or who are breastfeeding. Testosterone gel may cause fetal harm when administered to a pregnant woman. Testosterone gel may cause serious adverse reactions in nursing infants. Exposure of a female fetus or nursing infant to androgens may result in varying degrees of virilization. Pregnant women or those who may become pregnant need to be aware of the potential for transfer of testosterone from men treated with testosterone gel. If a pregnant woman is exposed to testosterone gel, she should be apprised of the potential hazard to the fetus [see Warnings and Precautions and Use in Specific Populations (8.1, 8.3)].

DRUG ABUSE AND DEPENDENCE

Controlled Substance

Testosterone gel contains testosterone, a Schedule III controlled substance in the Controlled Substances Act.

Abuse

Anabolic steroids, such as testosterone, are abused. Abuse is often associated with adverse physical and psychological effects.

Dependence

Although drug dependence is not documented in individuals using therapeutic doses of anabolic steroids for approved indications, dependence is observed in some individuals abusing high doses of anabolic steroids. In general, anabolic steroid dependence is characterized by any three of the following:

  • •Taking more drug than intended
  • •Continued drug use despite medical and social problems
  • •Significant time spent in obtaining adequate amounts of drug
  • •Desire for anabolic steroids when supplies of the drugs are interrupted
  • •Difficulty in discontinuing use of the drug despite desires and attempts to do so
  • •Experience of a withdrawal syndrome upon discontinuation of anabolic steroid use.

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