Testosterone belongs to a group of hormones called androgens (male hormones). Testosterone is responsible for the growth and development of the male sex organs as well as male sex characteristics such as chest hair, facial hair, pubic hair, voice changes, and muscle growth. A deficiency of testosterone can result in underdeveloped testes or erectile dysfunction (difficulty getting or keeping an erection).

Testosterone patches are used to treat testosterone deficiency. Testosterone patches should only be used if testosterone deficiency has been confirmed by symptoms and blood tests.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult starting dose is one 24.3 mg patch or two 12.2 mg patches (supplying 5 mg testosterone every 24 hours) applied to a clean, dry area of the skin of the back, stomach, upper arms, or thighs at approximately 10 pm nightly.

The patch has a protective backing that is removed to expose an adhesive surface. Apply the patch to a surface (as described above) that is not oily, damaged, hairy, or irritated. Make sure the edges of the patch stick well to the skin. Do not place the patch on the scrotum or on bony areas such as the hips or shoulders, on mucous-producing surfaces (e.g., inside of mouth or nose), or on damaged skin. Use a different site for each daily patch or patches. Do not use the same site twice in seven days.

When applied to clean, dry skin, the patches will remain in place during normal activities, including contact with water such as showering or swimming. Strenuous exercise or excessive perspiration may loosen the patches or cause them to fall off. If a patch falls off before noon, replace it with a fresh patch directly on the same site. If it falls off later in the day, do not replace it until the nighttime application (when a new site should be chosen). If a patch becomes loose, smooth it down again by rubbing over the edges of the patch. If you are not sure what to do after the patch falls off, contact your doctor or pharmacist for advice.

After use, remove the patch and fold it so that the adhesive side is on the outside. Place the used patch in the package that the new patch has been taken from, and discard it.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor.

Store patches at room temperature and protect from heat, light, and moisture. Keep patches and discarded patches out of the reach of children.

Do not use this medication if you:

• are allergic to testosterone or to any of the ingredients of the medication
• are allergic to soy
• are female (especially if you are pregnant or breast-feeding)
• have, or are suspected to have, prostate or breast cancer

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• acne
• aggressive behaviour
• changes in sexual desire or drive
• difficulty sleeping due to breathing problems
• dizziness
• enlarged prostate
• hair loss, thinning hair, or baldness
• headache
• mood changes
• skin irritation where patch is applied
• weight gain

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• breast soreness or enlargement
• high blood pressure
• increased heart rate
• increased prostate specific antigen (PSA)
• problems with urination (change in frequency or colour, dribbling, pain or straining when urinating, weak urine stream, small urine amounts)
• prolonged (more than 4 hours) or painful erections, or erections that happen too often
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of heart failure (e.g., shortness of breath, fatigue, swelling in legs, ankles, feet)
• swelling of ankles and legs (for people with heart, liver, or kidney problems)
• symptoms of liver problems, such as:
• abdominal pain
• dark urine
• loss of appetite
• nausea or vomiting
• pale stools
• yellow eyes or skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worse when breathing in, coughing, coughing up blood, sweating, or passing out)
• signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
• signs of stroke (e.g., sudden or severe headache, sudden loss of coordination, vision changes, sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
• symptoms of a serious allergic reaction, such as:
• difficulty breathing
• hives
• rash
• swollen face or throat

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood tests: Your doctor may recommend that you have regular blood tests while using this medication to check whether the medication is working and whether you are having certain side effects. Also, the use of testosterone may interfere with a number of laboratory tests. Tell all health professionals administering these tests that you are using this medication.

Breast cancer: Long-term use of androgens, including testosterone, may increase your risk of developing breast cancer. Discuss any concerns you may have with your doctor.

Diabetes: Testosterone may affect blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart disease and stroke: This medication may worsen symptoms of heart disease and increase the risk of blood clots or stroke. If you have heart disease such as angina, congestive heart failure, or arrhythmia; or a history of heart attack, blood clots, or stroke; discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: The kidneys play an important role in breaking down and removing testosterone from the body. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Report any swelling in the feet and lower legs to a doctor immediately.

Liver function: The liver also plays an important role in breaking down and removing testosterone from the body. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Skin contact: Testosterone can be transferred to other individuals from skin or clothing that has been in direct contact with the medication. To avoid this, wash your hands well with soap and water after applying a patch or otherwise handling the medication. If you come into contact with testosterone residue on unwashed clothing, wash the area of contact with soap and water as soon as possible.

If you notice signs of development of masculine traits, such as increase in acne or changes in body hair distribution, in any person you may come into skin-to-skin contact with (including children) contact your doctor.

Skin irritation: If you continue to experience skin irritation, your doctor may recommend that you apply a corticosteroid cream to the skin under the patch. Ointments are not recommended, as they may reduce testosterone absorption by the body. Talk to your doctor to determine a treatment that is best for you.

Sleep disorders: Treatment with testosterone may cause sleep apnea (interruption of breathing during sleep). If you have sleep apnea or risk factors for sleep apnea, such as being overweight or having a chronic lung disease discuss this with your doctor.

Sperm counts: This medication may reduce sperm counts if high doses are used, or if it is used for a prolonged period.

Pregnancy and breast-feeding: This medication should not be used by women, especially pregnant or breast-feeding women. It may have unwanted effects on the developing child, including masculinization of female children. Pregnant or breast-feeding women should avoid skin contact with testosterone application sites on men who are using this medication.

Children: Testosterone use can cause growth in children to be stopped early. If this medication is being used to treat males with delayed puberty due to decreased hormone production, the child's final height may be lower than expected. Use of this medication by children should be carefully supervised by the doctor.

Seniors: Seniors may have an increased risk for prostate enlargement and should be evaluated for prostate cancer before starting testosterone replacement therapy.

There may be an interaction between testosterone patches and any of the following:

• adrenocorticotropic hormone (ACTH)
• corticosteroids (e.g., prednisone, dexamethasone)
• cyclosporine
• dehydroepiandrosterone
• diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.