Testosterone gel belongs to a group of medications known as androgens (male hormones). It is used to treat people who have testosterone deficiency.

Testosterone is a sex hormone that produces "male" physical characteristics and increases sex drive. This medication works by replacing the testosterone that would normally be produced by the body. Testosterone gel 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 being given this medication, speak to your doctor. Do not stop using 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 using this medication if their doctor has not prescribed it.

The usual recommended dose is 5 g of gel (which contains 50 mg testosterone) applied once daily, preferably in the morning after showering or bathing. If using the pump, make sure you know how many pumps to use per application. Some people may need up to 10 g once daily.

Apply the gel to a clean, dry area of non-broken skin on the shoulders, upper arms, or abdomen. Use a circular motion to rub the gel into the skin. Do not apply the gel to the genitals or to any damaged skin. After applying the gel, let it dry for a few minutes, then cover it with clothing and wash your hands with soap and water to avoid getting the medication on other people's skin. Wait at least 5 to 6 hours before showering or swimming. After applying the gel, allow it to dry completely before smoking or going near an open flame.

If you expect the area of skin to which you applied this medication to come into direct skin contact with another person, wash the application site with soap and water before that encounter or keep the area covered with clothing.

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 using the medication without consulting your doctor.

It is important that you use this medication exactly as prescribed by your doctor. If you miss a dose, and it is more than 12 hours until your next dose, apply the missed dose as soon as possible and continue with your regular schedule. If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Each gram of clear, colourless gel contains 10 mg of testosterone. Nonmedicinal ingredients: alcohol, Carbopol 980, isopropyl myristate, purified water, and sodium hydroxide.

Do not use this medication if you:

• are allergic to testosterone or any ingredients of the medication
• 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
• dizziness
• hair loss, thinning hair, or baldness
• headache
• mood changes
• prostate disorders (enlarged prostate, or higher-than-normal results on the PSA [prostate-specific antigen] test)
• skin irritation, redness, or rash where applied
• sleep disturbances caused by breathing problems (sleep apnea)
• weight gain

Although most of the 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
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• decreased size of testicles
• high blood pressure
• increased or irregular heart rate
• problems with urination (change in frequency or colour, dribbling, pain or straining when urinating, weak urine stream, small urine amounts)
• 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)
• symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine)

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

• prolonged (more than 4 hours) or painful erections, or erections that happen too often
• swelling of ankles and legs (for people with heart, liver, or kidney problems)
• signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)
• 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)
• signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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 testosterone may increase the risk of developing breast cancer. Talk to your doctor if you have concerns.

Diabetes: This medication may affect blood sugar levels. If you have diabetes, your doctor may ask you to monitor your blood sugar carefully while using this medication.

Heart disease: Testosterone can cause increased blood pressure and may cause fluid to build up in the body. Both conditions can increase the risk of certain types of heart disease.

In addition, androgens have been linked to increased risk of heart disease, including congestive heart failure, increased or irregular heart rate, heart attack and stroke. If you have heart disease or risk factors for developing heart 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.

Kidney or liver disease: If you have kidney or liver disease, your doctor should monitor your condition closely while you are using this medication. Report any swelling in the feet and lower legs to a doctor immediately.

Prostate problems: Medications such as testosterone may increase the speed at which prostate cancer or benign prostatic hypertrophy (BPH, or enlarged prostate) progresses. If you have a history of prostate cancer or BPH, or you are at risk of developing prostate cancer, 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.

Sleep disorders: Treatment with testosterone may cause sleep apnea (interruption of breathing during sleep) and high blood pressure for some people, especially those with risk factors such as being overweight or having a chronic lung disease.

Soy allergy: Some testosterone products are synthesized from soy. If you are allergic to soy, check with your doctor before using this medication.

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. Women risk exposure to the medication through skin-to-skin contact with a man wearing the gel. Men using the gel should cover the treated area with clothing after the gel has dried to avoid exposing women and children to the medication.

Children: The safety and effectiveness of this medication have not been established for males under the age of 18. Secondary exposure in children can occur through skin-to-skin contact with a man wearing the gel. Men using the gel should cover the treated area with clothing after the gel has dried, and children should avoid contact with any unwashed clothes that were worn by men using this gel.

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

For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.

If you are taking other 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.

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.