testosterone enantate: clinical use

Prescribing considerations

• Confirm testosterone deficiency using compatible clinical features and biochemical testing.
• Exclude prostate carcinoma before treatment; experience in people over 65 is limited.
• Assess cardiovascular, hepatic and renal disease, oedema risk, hypertension, sleep apnoea, thrombophilia or previous venous thromboembolism.
• Use caution with epilepsy, migraine, diabetes and skeletal metastases.
• Discuss possible reversible suppression of spermatogenesis when fertility is relevant.
• Administer strictly intramuscularly and extremely slowly, with observation during and immediately afterwards.

Contraindications and cautions

• Hypersensitivity to testosterone enantate or an excipient
• Androgen-dependent prostate or male breast carcinoma
• Hypercalcaemia
• Past or present liver tumour
• Nephrosis

Monitoring

• Serum testosterone at baseline and periodically
• Haemoglobin, haematocrit and red blood cell count
• Prostate assessment and clinically appropriate prostate-specific antigen monitoring
• Liver function and lipid profile during long-term treatment
• Blood pressure and signs of fluid retention
• Clotting status with coumarin anticoagulants; glucose control with antidiabetic treatment

Clinical pharmacology

Testosterone enantate is an ester of endogenous testosterone. Slow conversion after intramuscular depot injection prolongs testosterone exposure and produces natural androgen effects.

Formulation and product differences

• The selected product is a clear, yellowish oily intramuscular solution containing benzyl benzoate and refined castor oil.
• It must not be mixed with other medicines, should be protected from light and should only be used when clear and particle-free.
• Excipients and release profiles differ between testosterone formulations, so products should not be treated as automatically interchangeable.