Testosterone (Transdermal)

A synthetic hormone, the Testosterone transdermal patch is used to treat hypogonadism, and allows for the slow release of the hormone through the skin.

Overview

The testosterone transdermal patch is a treatment for men who do not manufacture sufficient quantities of the male hormone testosterone. This condition is referred to as hypogonadism, which can impact a man's sexual desire, performance or ability to get or maintain an erection. As testosterone is the hormone required for development of male sex organs, a lack of sufficient testosterone will impact these sexual characteristics. Using the testosterone patch can help boost hormone levels and result in improvement of these sexual characteristics in the patient.

The testosterone transdermal patch is sold as a patch which contains an amount of the synthetic hormone. The patch is applied to the patient's arm or other location on the body, and worn for a certain amount of time. This allows the slow release of the hormone, which is absorbed through the skin into the body. How much of this medication to apply, and how frequently to apply it will be determined by the doctor.

The patch can only be purchased with a prescription, and should not be worn by anyone without a doctor's approval. Since the patch comes in different doses and sizes, the doctor will determine what is best depending on the patient's condition. Doctors who prescribe this medication will first check the patient's hormone levels through a blood test, and will schedule additional office visits to monitor the progress of the patient and to take blood samples to determine its effectiveness. There can be side effects for the patient, but also for women or children who might be exposed to the medication on the patch.

Usually, a patch will be applied in the evening before bed, and worn for a period of 24 hours. After that, a new patch is applied. How many doses and for how long they should be taken will be determined according to doctor's instructions.

Conditions Treated

  • Hormone replacement

Type of Medicine

  • Synthetic hormone

Side Effects

Similar to all medications, using the testosterone patch may have some unwanted side effects. Some side effects may be more common than others, and some rarer than others. Not all patients will experience side effects. However, if any of the following occur, the patient may need to seek the advice of their doctor or a health care professional.

Patients should immediately contact their doctor if they experience skin irritation, such as itching or redness on the skin where the patch is applied. Some of the less common side effects which are also related to skin irritation are blisters, unusual pain or swelling, or crusty, dry or flaky skin. The patient may feel a burning sensation where the patch is applied, or find that the skin at that spot may become hard or thick and very red. Other side effects in this category are black or bloody stools, constipation, difficulty urinating, or pelvic soreness. If the patient begins to vomit any bloody substance or other substances that appear similar to coffee grounds, a doctor should be consulted immediately.

Some of the rare side effects are just as serious and require medication attention. Difficulty or pain when urinating, a frequent urge to urinate, urine that contains blood or is cloudy, or an unusual pain in the side or lower back fall into this category. Patients may experience blurry vision or a dizzy feeling or headaches. Any testicular or bladder pain or problems may also be side effects of the testosterone patch, and medical attention should be sought.

There may be some side effects of using the testosterone patch which may be uncomfortable, but which may be a result of the body adjusting to the medication and not serious side effects. In some cases, the doctor may prescribe additional medications or suggest other ways the patient can relieve some of these side effects. These side effects may include a change in mood (such as becoming more irritable, feeling sad or depressed), a loss of appetite, unusual tiredness, or a rash that appears after beginning treatment. Some patients may experience even rarer side effects including skin blemishes, any kind of unusual itching or tingling or other sensation, and unusual feelings of fear, disorientation, dizziness or lightheadedness, or unusual thoughts generally. Any kind of drop in sexual performance or desire may also be a side effect of the Testosterone transdermal patch, such as being unable to maintain an erection or being disinterested in sexual intercourse.

This is not intended to be a complete list, so there may be side effects that patients experience that are not included here. A patient should discuss with their doctor any unusual change that appears after beginning this medication. Patients may also contact the FDA to notify them of side effects, at 1-800-FDA-1088.

Dosage

For use of the Testosterone transdermal patch, each patient may have a different dose depending on their individual condition and its severity. A prescribing doctor will determine the appropriate dose, and it is important to follow those instructions. The information listed below regarding dosages for this medication are only based on the average prescription, so actual dosages may vary. Patients should not change their dose without the instruction of their doctor.

How much medication a patient applies using the patch will be based upon the dosage strength, the number of times the mediation is taken each day, how long to wait between doses, and how many days to take this medication. For an adult using the patch for hormone replacement, the average prescription will instruct the patient to wear one testosterone patch at night, which should be kept in place for 24 hours. After 24 hours, the patch can be thrown away. Additional applications and dosages will be determined by the patient's doctor.

This medication is not recommended for use in children without the instruction of a doctor.

If a patient misses a night, and forgets to put on the patch in the evening, he can apply the patch as soon as he remembers to do so. If it's close to the next evening and time to apply the next dose, however, the patient should skip the missed patch, and continue with the application of the next patch as normally scheduled. In no event should a patient wear two patches at the same time, or otherwise try to correct the missed dose by doubling up on the medication. This can result in unwanted side effects.

To apply the patch to the skin, a patient should first wash both their hands and the spot where the patch will be applied using soap and water, drying well. The area should also be washed after the patch is removed. Patients should not have any kind of oils or ointments at the location before applying the patch, to allow the patch to stick properly.

The patient should open the packet with the patch inside, and immediately place the patch on a flat area of the skin. After opening the pouch that contains the patch, apply the patch immediately. Usually the patch can be applied to any spot on the upper arm, thigh, abdomen, stomach or back. Patients should avoid putting the patch on any areas near the genitals or scrotum, as well as spots on the body where the patient puts pressure during the day or night. For example, the patch shouldn't be worn on the back of the thigh, where sitting might cause constant pressure for a period of time. It is also recommended that the patient put the patch on areas of their body where there is less hair than other spots, as hair causes the patch to not be close to the skin and may prevent it from sticking to the skin.

Typically, patients can wear this patch while exercising, bathing or during sexual intercourse without any problems. For the first three hours after application, however, avoid showering, bathing or swimming to avoid washing the medication away from the site.

Once the patch is applied to the skin, it will remain in place for 24 hours. When it's time to put on a new patch, the patient should find a different area of the body on which to apply the patch, and avoid putting the patch in the same place for seven days.

Sometimes the patch may come off, such as during or after heavy exercise. If this happens, the patient can apply a new patch to the same spot, and keep the patch on for the remainder of the 24 hour period for that dose. Afterwards, this patch should be discarded at the regular time, and the patient should continue their treatment on the normal schedule. If, however, the patch has been worn for more than 12 hours when it falls off, the patient does not have to put on a replacement patch but can pick up with the next patch at the regularly scheduled time for the next dose. It is very important that two patches not be applied, as there is a risk of side effects.

Major Drug Interactions

For patients using the testosterone patch, there are some other medications which may interact with the hormone therapy. The doctor will determine if any of these medications can be used in conjunction with the patch, or if there needs to be a change in dose. Patients should inform their doctor of all medications they are taking, including over the counter medications, before using the patch.

Below are some other medications which are known to interact with the testosterone patch. This may not be a complete list, so patients should consult with their doctor for further instructions:

  • Anisindione
  • Bupropion
  • Dasabuvir
  • Dicumarol
  • Paclitaxel
  • Paclitaxel Protein-Bound
  • Phenprocoumon
  • Warfarin

In addition to other medications, it's possible that an interaction can occur with some types of foods. One such food is licorice. Drinking alcohol or using tobacco products can also cause some interactions. Patients should discuss their use of these products with their doctor.

Warnings

Use of the testosterone patch should be under the continued supervision of a doctor, with regular checkups. During these visits, the doctor will check to ensure that the patch is working as prescribed, and that there is no incidence of detrimental side effects. The doctor may need to conduct blood tests during these visits to make sure that there are no side effects.

Testosterone can cause birth defects in a fetus if the mother is exposed to the patch or the testosterone. As a result, women who are pregnant, intend to become pregnant or who may become pregnant should not use the testosterone patch. Patients should also inform their doctor if their partner is pregnant. In cases where a pregnancy happens while being treated with testosterone, the patient should inform their physician immediately.

Because testosterone is a male hormone, coming into contact with the patch can have unwanted effects on women. Where a woman's skin has contact with the medicine, she should immediately wash all of the medicine from the area using soap and water. Similarly, if a patch touches a woman's skin, she should remove it immediately and again wash the area thoroughly.

If a patient's female partner begins to experience any masculine-type physical changes, including acne or hair growth, medical advice should be sought.

Testosterone can be a habit forming medication. Patients should not take more than the amount prescribed. If the patient feels that the medication is not working, only a doctor should recommend any change in dose.

Patients taking this medication may be at higher risk for prostate cancer, particularly older men. Patients should inform their doctor if they or any family member has prostate cancer.

This medication may also cause blood clots. Symptoms of a blood clot include swelling in a leg or arm, any redness or pain, sharp chest pains, or difficulty breathing or shortness of breath. If a patient has any of these symptoms, they should contact their doctor immediately.

The testosterone patch can lead to a higher risk of having a heart attack or stroke. Patients should immediately notify their doctor or go to the nearest emergency room if they have any symptoms such as a pain in the chest that spreads to the arm, feeling faint, having a headache, vomiting or feeling nauseous, or having any trouble breathing. In addition, having vision or speech problems, or difficulty breathing may also indicate heart attack or stroke.

Patients should inform their doctor if they experience either difficulty maintaining an erection, or having erections too frequently, as well as seeing an unusual yellow color to the skin or eyes, or the swelling of the ankles. This medication may also cause swelling or pain in the breasts for some patients, which should also be discussed with a doctor.

Testosterone may result in a decrease in sperm for some men, thereby causing some difficulty in having children. A patient who is planning to have children should discuss this with their doctor prior to taking this medication.

For some patients, testosterone may alter cholesterol levels or fat levels in the blood. Doctors may discover this condition through blood tests taken during treatment, and provide an additional medication to address this.

The patch that is used to deliver this testosterone medication contains aluminum. Any patient who is planning to have a magnetic resonance imaging (MRI) scan must remove the patch before having the MRI to avoid having burns on the skin at the location where the patch is worn.

If either during or after wearing a patch a patient experiences any slight redness, blistering, itching or puffiness or swelling at the location where the patch is applied, a doctor should be consulted immediately.

Patients who are using the testosterone patch should avoid taking other medications, including any over the counter or non-prescription medications or vitamin or herbal supplements.

Certain other illnesses or diseases may have an impact on a patient's use of testosterone. Patients should discuss any of the following with their doctor:

  • Problems with or a history of blood clots (including pulmonary embolism or deep vein thrombosis)
  • Diabetes
  • A history of drug abuse
  • Enlarged prostate
  • A history of heart attacks
  • Excess calcium in the bloodstream (hypercalcemia)
  • High cholesterol (Hyperlipidemia)
  • Difficulty urinating
  • Apnea or other breathing problems
  • History of stroke (can worsen this condition)
  • Any type of blood disorder (potential risk for thromboembolic disease)
  • Male breast cancer
  • Known or possible prostate cancer (Testosterone should not be used in this case)
  • History of heart disease or congestive heart failure)
  • History of kidney disease
  • History of liver disease (may worsen this condition)
  • History of lung disease or
  • Obesity (potential risk for sleep apnea)

Storage

The Testosterone transdermal patch should be kept at room temperature. Keep it in a container that can be kept closed, and do not expose to moisture, heat or direct light.

Because of the possibility of side effects, be sure to store this medication in a secure location. This and all medications should be kept away from children. It's important that this medication not be taken by anyone other than the patient it has been prescribed for.

For medications that have expired or are no longer being used, be sure to dispose of them properly. Consult a healthcare professional or local law enforcement for ways to dispose of drugs.

Summary

The testosterone transdermal patch is very helpful in patients who have lower than normal male hormone levels. This condition can cause issues with the growth of sex organs in men, or impact sexual characteristics in men. To deliver the medication, the patch is applied to the body as prescribed, allowing the synthetic hormone to be absorbed into the bloodstream and normalize testosterone levels in the patient.

Use of this medication is by prescription only, and requires both a preliminary blood test as well as regular visits to the doctor to assess the patient's progress in taking this medication. There are certain side effects to using this medication, including redness or swelling of the skin at or near the location where the patch is applied, changes in mood, changes in ability to urinate or discoloration in the urine, among others. To avoid unwanted side effects, this medication is to be used only as prescribed, and should not be given to anyone else, including women or children.

When used as prescribed, the testosterone transdermal patch is very effective at restoring normal hormone levels in patients.

Resources
Last Reviewed:
December 24, 2017
Last Updated:
April 03, 2018
Content Source: