Testogel contains the active ingredient testosterone, which is the same as the naturally occurring male hormone testosterone.

What is it used for?

  • Testosterone replacement therapy in men with low or no production of natural testosterone (hypogonadism).

How does it work?

  • Testogel contains the active ingredient testosterone, which is the same as the naturally occurring male hormone testosterone.
  • Testosterone is known as an androgen. It is produced by the testicles and is the main hormone essential for normal growth and development of the male sex organs and male sexual characteristics.
  • The natural production of testosterone is controlled by another set of hormones called gonadotrophins, which are released from the pituitary gland in the brain.
  • During adult life, testosterone is essential for the production of sperm, the maintenance of sex drive, erectile potency, and the functioning of the prostate gland and other reproductive structures.
It also has functions in the skin, muscles, skeleton, kidney, liver, bone marrow and central nervous system.
  • Low levels of testosterone can cause decreased sex drive, impotence, infertility due to decreased sperm production, decreased mental and physical activity, fatigue and weakening of bones (osteoporosis). Testosterone is given as replacement therapy when natural testosterone levels fall too low, causing problems such as those above.
  • Natural testosterone levels fall slowly with age and fall rapidly following surgical removal of the testicles (for example in the treatment of testicular cancer). They may also fall due to decreased functioning of the testicles (hypogonadism or eunuchoidism) caused by testicular disease, or by decreased gonadotrophin production by the pituitary gland, as a result of pituitary disease.
  • Testosterone replacement allows natural testosterone levels to return to normal, thus relieving the symptoms of the deficiency.
  • Testogel is applied in a thin layer to the skin. The testosterone is absorbed through the skin into the bloodstream.
  • How do I use it?

    • Testogel should only be applied by the man being treated. No-one else should apply it for you.
    • The gel should be applied once a day at about the same time each day, preferably in the morning. If you shower or bathe in the morning, apply the gel after doing this and once your skin has dried and cooled down.
    • Apply the gel as a thin layer onto clean, dry, healthy, unbroken skin over the shoulders, upper arms or abdomen.
    • Do not apply the gel to the genitals as this may cause irritation.
    • Wash your hands with soap and water after applying the gel.
    • Allow the gel to dry for a few minutes before dressing.
    • If you forget to apply the gel at your usual time and it is 12 hours or more until your next application is due then you should apply the gel as soon as you remember. If it is less than 12 hours until your next application is due just leave out the missed application and apply the gel as usual when it is next due. Don't apply twice the amount of gel to make up for a missed application.

    Use with caution in

    • Elderly people.
    • People with a history of kidney or liver disease.
    • People with a history of heart disease, eg heart attack or heart failure.
    • People with a history of high blood pressure (hypertension).
    • Epilepsy.
    • Diabetes.
    • People with a history of migraines.
    • People with sleep apnoea (when breathing temporarily stops during sleep).
    • People with cancer that has spread from its original site to the bones (skeletal metastases).
    • Not to be used in
    • Women.
    • Children and adolescents under 18 years of age.
    • Prostate cancer.
    • Men with breast cancer.
    • People with a history of primary liver cancer.
    • People with a kidney disorder called nephrosis or nephrotic syndrome.
    • People with a high level of calcium in their blood (hypercalcaemia).

    This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    • Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
    • This medicine is for men only. It must not be used by women or applied by women to men. Pregnant women should take particular care to avoid contact with any of the application sites on the man's skin, as the testosterone can be absorbed through the woman's skin and have adverse effects on the developing baby. If a pregnant woman does come into contact with the application site or the gel, she should wash the area with soap and water as soon as possible.

    Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

    • Skin reactions at application site, such as redness, rash, itching or dryness. If you get a severe reaction to the gel you should consult your doctor for advice.
    • Acne.
    • Itching.
    • Flushing.
    • Prostate problems, such as growth of the prostate gland, increased PSA levels and prostate cancer.
    • Headache.
    • Feeling sick and vomiting.
    • Mood changes.
    • Depression.
    • Nervousness, anxiety or irritability.
    • Change in sex drive.
    • Breast pain, enlargement of the breasts.
    • Persistent painful erection of the penis (priapism). Tell your doctor straight away if you experience this.
    • Decreased sperm count.
    • Swelling caused by fluid retention (oedema).
    • Increased blood pressure (hypertension).
    • Increased levels of red blood cells and haemoglobin in the blood (polycythaemia).
    • Weight gain.
    • Pain in the muscle or joints.
    • Male-pattern hair loss.
    • Raised cholesterol levels.
    • Jaundice.
    • Liver tumours.
    • Excessive hair growth and voice changes if used in women.
    • Premature sexual development if used in boys who haven't reached puberty.
    • Premature closure of the ends of bones, causing stunted growth if used in boys who haven't reached puberty.

    The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    • It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before starting treatment this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.
    • Testosterone may increase the anti-blood-clotting effects of coumarin anticoagulants such as warfarin, nicoumalone and phenindione. If you are taking any of these your blood clotting time (INR) may need to be monitored more frequently; in particular it should be measured after you start or stop testosterone treatment.
    • If testosterone is used in combination with corticosteroids such as dexamethasone, there may be a greater risk of fluid retention and swelling (oedema) since both medicines can cause fluid retention. This combination of medicines should be used with caution in people with heart, liver or kidney disease.
    • If you have diabetes, your dose of insulin or antidiabetic tablets may need to be reduced after you start treatment with this medicine.

    References:

    http://www.myvmc.com/uploads/VMC/DrugCMI/3238_Testogel_CMI_july07.pdf

    https://www.medicines.org.uk/emc/product/6808/pil

    https://www.hpra.ie/img/uploaded/swedocuments/2167887.PPA0465_306_001.b8858730-4297-4b24-8e1a-550a84c5f8dc.000001Testogel%20PIL.151020.pdf

    https://www.myvmc.com/drugs/testogel/

    https://www.netdoctor.co.uk/medicines/a8539/testogel-testosterone/