Table 2.
Testosterone preparations for hypogonadism treatment available in the Italian market
| Formulation | Chemical structure | Brand name | T 1/2 | Standard dosage | Advantages | Disadvantages |
|---|---|---|---|---|---|---|
| ORAL | ||||||
| Testosterone undecanoate | 17-α-Hydroxyl-ester | Andriol© | 4 h | 120–240 mg 2–3 times daily |
- Reduction of liver involvement -Oral convenience -Modifiable dosage |
-Unpredictable absorption depending of meal fat content -Be taken with meals |
| Mesterolone | 1α-Methyl-4,5α-dihydrotestosterone | Proviron© | 12 h | 50–100 mg 2–3 times daily |
-Oral convenience -Modifiable dosage -Useful in gynecomastia |
-Not aromatizable |
| PARENTAL | ||||||
| Testosterone enanthate | 17-α-Hydroxyl-ester |
Testoenant© Testoviron depot© |
4–5 days | 250 mg every 2–3 weeks |
-Low cost -Short-acting preparation allowing drug withdrawal in case of side-effects |
-Fluctuations in circulating T levels -Multiple injections -Relative risk of polycythemia |
| Testosterone propionate | 17-α-Hydroxyl-ester | Testovis© | 20 h | 100 mg every 2 days |
-Low cost -Very short-acting preparation allowing drug withdrawal in case of side-effects |
-Fluctuations in circulating T levels -Multiple injections -Relative risk of polycythemia |
| Testosterone undecanoate in castor oil | 17-α-Hydroxyl-ester | Nebid© | 34 days |
1000 mg every 10–14 weeks *750 mg every 10 weeks |
-Steady-state testosterone level without fluctuation -Long-lasting -Less frequent administration |
-Pain at injection site -Long-acting preparation not allowing rapid drug withdrawal in case of side-effects |
| Transdermal | ||||||
| Testosterone gel 2% | Native testosterone |
Tostrex© Testavan© |
6 h | 50-100 mg/day | Steady-state testosterone level without fluctuation |
-Possible transfer during intimate contact -Daily administration |
Preparations in bold are supported by the national health service. Nebid is supported only in a limited number of Italian regions including Friuli Venezia-Giulia, Emilia Romagna, Toscana, Marche, Puglia