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Use Cautiously in: Benign prostatic hyperplasia; Hypercalcemia; Geriatric patients (qrisk of prostatic hyperplasia/carcinoma); Males ⬍12 yr (safety and effectiveness not established).
testosterone cypionate
(tess-toss-te-rone sip-eye-oh-nate)
Adverse Reactions/Side Effects
EENT: deepening of voice. CV: edema. GI: cholestatic jaundice, drug-induced hepatitis, liver function test elevation, nausea, vomiting. GU: change in libido, erectile
dysfunction, priapism, prostatic enlargement. Endo: gynecomastia, hirsutism, oligospermia, hypercholesterolemia. F and E: hypercalcemia, hyperkalemia, hyperphosphatemia. Derm: male pattern baldness. Local: pain at injection site.
Depo-Testosterone
Classification
Therapeutic: hormones
Pharmacologic: androgens
Schedule III
Pregnancy Category X
Interactions
Drug-Drug: Mayqaction of warfarin, oral hypoglycemic agents, andinsulin.
Indications
Concurrent use with corticosteroids mayqrisk of edema formation.
Hypogonadism in androgen-deficient men.
Route/Dosage
Action
IM (Adults): Replacement therapy— 50– 400 mg every 2– 4 wk.
Responsible for the normal growth and development of male sex organs. Maintenance of male secondary sex characteristics: Growth and maturation of the prostate,
seminal vesicles, penis, scrotum, Development of male hair distribution, Vocal cord
thickening, Alterations in body musculature and fat distribution. Therapeutic Effects: Correction of hormone deficiency in male hypogonadism.
NURSING IMPLICATIONS
Assessment
Pharmacokinetics
Absorption: Well absorbed from IM sites; absorbed slowly.
Distribution: Crosses the placenta.
Protein Binding: 98%.
Metabolism and Excretion: Metabolized by the liver; 90% eliminated in urine
as metabolites.
Half-life: 8 days.
TIME/ACTION PROFILE (androgenic effects†)
ROUTE
ONSET
PEAK
IM
unknown
unknown
†Response is highly variable among individuals; may take months
with breast or prostate cancer; Severe liver, renal, or cardiac disease; Patients with
known hypersensitivity to benzyl alcohol.
⫽ Genetic Implication.
for edema. Report significant changes indicative of fluid retention.
● Men: Monitor for precocious puberty in boys (acne, darkening of skin, develop-
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DURATION
2–4 wk
Contraindications/Precautions
Contraindicated in: Hypersensitivity; OB: Pregnancy and lactation; Male patients
⫽ Canadian drug name.
● Monitor intake and output ratios, weigh patient twice weekly, and assess patient
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ment of male secondary sex characteristics— increase in penis size, frequent
erections, growth of body hair). Bone age determinations should be measured
every 6 mo to determine rate of bone maturation and effects on epiphyseal closure.
Monitor for breast enlargement, persistent erections, and increased urge to urinate in men. Monitor for difficulty urinating in elderly men, because prostate enlargement may occur.
Lab Test Considerations: Monitor hemoglobin and hematocrit periodically
during therapy; may cause polycythemia.
Monitor hepatic function tests and serum cholesterol levels periodically during
therapy. Mayqserum AST, ALT, and bilirubin,qcholesterol levels, and suppress
clotting factors II, V, VII, and X.
Monitor blood glucose closely in patients with diabetes who are receiving oral hypoglycemic agents or insulin.
Monitor serum sodium, chloride, potassium, and phosphate concentrations (may
beq).
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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Potential Nursing Diagnoses
Sexual dysfunction (Indications) (Side Effects)
Implementation
● Range-of-motion exercises should be done with all bedridden patients to prevent
mobilization of calcium from the bone.
● IM: Administer IM deep into gluteal muscle. Crystals may form when vials are
stored at low temperatures; warming and shaking the vial will redissolve crystals.
Use of a wet syringe or needle may cause solution to become cloudy but will not
affect its potency.
Patient/Family Teaching
● Advise patient to report the following signs and symptoms promptly: priapism
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(sustained and often painful erections), difficulty urinating, gynecomastia, edema
(unexpected weight gain, swelling of feet), hepatitis (yellowing of skin or eyes and
abdominal pain), or unusual bleeding or bruising.
Explain rationale for prohibiting use of testosterone for increasing athletic performance. Testosterone is neither safe nor effective for this use and has a potential
risk of serious side effects.
Advise diabetic patients to monitor blood closely for alterations in blood glucose
concentrations.
Emphasize the importance of regular follow-up physical exams, lab tests, and
x-ray exams to monitor progress.
Radiologic bone age determinations should be evaluated every 6 mo in prepubertal children to determine rate of bone maturation and effects on epiphyseal centers.
Evaluation/Desired Outcomes
● Resolution of the signs of androgen deficiency without side effects. Therapy is usu-
ally limited to 3– 6 mo followed by bone growth or maturation determinations.
Why was this drug prescribed for your patient?
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