Contraindications
The use of Androgel is contraindicated in cases of hypersensitivity to the components of the drug, breast carcinoma, prostate cancer or if it is suspected. The drug is not prescribed to children and women, since there is no experience with the use of the drug in these groups of patients.
Androgel is prescribed with caution for malignant tumors, severe liver, heart or kidney failure, arterial hypertension, migraine, coronary heart disease and epilepsy.
Drug interactions
With the simultaneous use of Androgel and indirect anticoagulants, it is possible to enhance the effect of the latter by modifying the synthesis of hepatic coagulation factor and competitive inhibition of binding to plasma proteins. For patients receiving oral anticoagulants while using Androgel, it is recommended to monitor prothrombin time, especially often at the beginning and/or end of the course of androgen treatment.
Concomitant use of Androgel with ACTH or corticosteroids may increase the risk of edema. Caution is advised when using these drugs together, especially in patients with heart, kidney, or liver disease.
Androgens can decrease thyroxine-binding globulin levels, resulting in decreased serum T4 concentrations and increased sensitivity to T3 and T4. Levels of free thyroid hormones, however, remain unchanged, and there are no clinical manifestations of hypothyroidism.
Directions for use and dosage
The drug is used once a day, 5 g, at the same time (preferably in the morning). The doctor, depending on the concentration of testosterone in the patient’s serum, reduces or increases the daily dose of Androgel, the maximum it can be 10 g of gel per day. Achieving a constant concentration of testosterone in the blood plasma occurs approximately on the second day of therapy.
The product, immediately after opening the bag, is applied in a thin layer to dry, clean and intact skin of the abdomen, forearms or shoulders. After this, you need to wash your hands thoroughly with soap, let the gel dry for 3-5 minutes, after which you can get dressed.
Pharmacokinetics
Suction
The rate of absorption of testosterone through the skin varies from approximately 9% to 14% of the applied dose.
Distribution
Once absorbed, testosterone enters the systemic circulation in relatively constant concentrations over a 24-hour cycle. Serum testosterone concentrations increase from the first hour after administration of the drug, reaching a constant value from the second day of treatment. Daily fluctuations in testosterone concentrations have the same amplitude as changes in endogenous testosterone levels observed in circadian rhythms.
With the external route of administration of the drug, it is thus possible to avoid distribution peaks in the blood that occur with the injection route of administration. In contrast to oral androgen therapy, external use of the drug does not cause an increase in steroid concentrations in the liver above physiological norms. The use of 5 g of Androgel causes an average increase in plasma testosterone concentrations of approximately 2.5 ng/ml (8.7 nmol/l).
Metabolism
The main active metabolites of testosterone are dihydrotestosterone and estradiol.
Removal
After treatment is stopped, testosterone concentrations begin to decrease approximately 24 hours after the last application. Concentrations return to baseline approximately 72-96 hours after the last dose. The drug is excreted mainly in urine and feces in the form of conjugated testosterone metabolites.
Side effects of Androgel
In accordance with the instructions, Androgel may cause side effects from certain body systems, namely:
- Acne, erythema, alopecia and dryness of the epidermis (skin and its appendages);
- Mastodynia, changes in the prostate gland and gynecomastia (genitourinary system);
- Paresthesia, hyperesthesia, dizziness, amnesia and mood changes (peripheral and central nervous system);
- Increased blood pressure (cardiovascular system);
- Diarrhea (gastrointestinal tract).
In cases where high doses of the drug are prescribed, nervousness and irritability, frequent and prolonged erections, and an increase in body weight may appear.
Does Androgel gel have analogues?
Experts consider all medicines containing natural testosterone esters to be analogues of the drug Androgel. Unlike the dosage form discussed in the article, they must be taken orally or by injection. For example, the medicine “Andriol” in tablet form containing a therapeutic dose of testosterone undecanoate. This compound has the property of soluble in fats, in particular in oleic acid, which is also included in each tablet. The main feature of this Androgel analogue is the absorption pattern: hormones enter the systemic bloodstream through the lymphatic system of the small intestine, bypassing the liver. Thus, the hormone is more completely absorbed and its normal concentrations in the blood are quickly achieved.
Another analogue of the drug “Androgel” is “Testosterone propionate”, which also contains active testosterone esters. This drug is introduced into the patient's body intramuscularly by injection and, unlike other drugs, ensures normal levels of testosterone in the blood for four weeks after one injection. The only disadvantage of this dosage form is the high risk of testosterone overdose.
special instructions
The use of Androgel is possible only in cases of testosterone deficiency accompanied by regression of secondary sexual characteristics, erectile dysfunction, asthenia, etc.
The drug is not intended for the treatment of male infertility and erectile dysfunction not associated with testosterone deficiency, and it is not prescribed in cases of prostate cancer, since the androgens contained in the drug can accelerate the progression of benign hyperplasia and subclinical prostate cancer.
During Androgel therapy, once a year, and for elderly patients and patients with family or clinical factors - twice a year, it is necessary to conduct regular and thorough examination of the prostate gland.
The drug should be used with caution in patients with malignant tumors due to the risk of hypercalcemia resulting from bone metastases. In patients in this group, serum calcium concentrations should be monitored.
It is recommended to maintain an interval of at least six hours between applying the product and taking water procedures; after using Androgel, you must wash your hands thoroughly with soap.
The use of Androgel in patients suffering from liver, kidney or heart failure may lead to the development of complications characterized by edema, as well as congestive heart failure (or without it). In such cases, therapy should be stopped immediately and diuretics may be required.
Due to the fact that testosterone can increase blood pressure, the drug is used with caution in patients with arterial hypertension.
In cases of long-term treatment with Androgel, it is necessary to periodically check the content of hematocrit and hemoglobin in the blood, as well as perform liver function tests.
How does Androgel work?
This drug is intended primarily for men, although in some cases it is also prescribed for women. Its main task is to increase testosterone levels in the blood. The use of Androgel by men allows you to normalize processes closely related to testosterone: improve potency, increase libido, strengthen erections, reduce the percentage of body fat.
With the help of Androgel, men over 40 years old can easily maintain testosterone levels in the body, against the background of a natural decrease in its concentration due to age-related changes in the body.
Unlike injectable testosterone preparations, Androgel can be stopped at any time, while the course of injections must be completed.
Numerous patient reviews indicate that replacement therapy based on Androgel in some cases exceeds the effectiveness of the same therapy using other drugs.
replacement therapy prescribed
Alexander 58 years old, Moscow
Androgel, if men use it under the supervision of a doctor, is completely safe. In addition, it eliminates painful injections.
Some patients, according to their reviews, use this drug for other purposes.
I am engaged in bodybuilding, in which it is impossible to achieve good results without hormonal therapy. I’m afraid to use steroids, so I chose the safest drug according to other people’s reviews - Androgel. So far I have not noticed any side effects, but the increase in muscle mass has become noticeable.
Vladimir 21 years old, Kyiv
Indications
The main indication for the use of Androgel is a lack of endogenous testosterone.
Indications for use:
- Failure of synthesis of male hormones;
- Andropause;
- Klinefelter's syndrome;
- Bilateral testicular torsion;
- Cryptorchidism;
- Idiopathic failure;
- Bruises or neoplasms in the pituitary gland, hypothalamus;
- Failure of the testicles, which occurs due to large amounts of alcohol consumption;
- Weak erection.
The medicine is prescribed only when the lack of testosterone is confirmed by laboratory tests. Androgel cannot be purchased without a prescription, since it is not used to improve potency. The drug is used in cases where a person has a lack of androgens.
New rules for dispensing medications: stop panicking
On September 22, new rules for the dispensing of medicines came into force - order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n “On approval of the rules for dispensing medicines,” which regulates the sale of medicines in pharmacies.
The document caused a lot of noise and confusion among both patients and pharmacy employees. Today we tried to answer the most important questions about the new order that an ordinary pharmacy visitor may have.
New order makes all drugs prescription drugs?
No. The new dispensing rules only slightly change how some prescription drugs are sold. It does not place any restrictions on common over-the-counter medications.
And now you can’t just buy a prescription drug?
In fact, selling prescription drugs without a prescription has always been prohibited. For this, the pharmacy faces a considerable fine and loss of license. But, as everyone knows, the severity of the law is compensated by the optionality of its implementation.
Therefore, a number of pharmacies ignore the rules. However, the emergence of new dispensing rules means close attention to their implementation, and therefore, pharmacies have now become more sensitive to prescription dispensing.
How do you even know if you need a prescription for the drug?
Whether the drug is prescription or not is stated in the instructions for use. In addition, such information is always indicated on the packaging. Of all drugs registered in Russia, approximately 70% are prescription drugs.
In an ideal world, the doctor knows by heart which drugs require a prescription and which do not. But in harsh reality, very often such information has to be verified independently. Therefore, when a doctor advises you on any medications, you can check them online right at your appointment and immediately ask for a prescription.
Prescriptions are written only on special forms. The most common is form No. 107-1/у. It looks like this:
To check whether a drug is a prescription drug, you can go to apteka.ru and enter the name of the drug. All prescription medications on our website are marked “prescription.” By the way, not so long ago we got a special label for drugs for which the prescription remains in the pharmacy.
How do you mean “the prescription stays at the pharmacy”?
The pharmacy has a list of drugs that are subject to strict registration. As a rule, these are medications containing narcotic or psychotropic substances included in a special list. Prescriptions for such drugs always remain in the pharmacy in order to control their sale. The circulation of narcotic substances is checked not only by Roszdravnadzor, but also by the structures of the Ministry of Internal Affairs.
But now, according to the new dispensing rules, the pharmacy must also keep prescriptions for certain medications (antidepressants, tranquilizers, antipsychotics, sleeping pills and sedatives, as well as alcohol-containing medications with an alcohol content of more than 15%)*.
“Medicines containing alcohol”? So, now you need to get a prescription for Corvalol or valerian?
No. Let us repeat that the new order does not make medications prescription drugs. We are talking only about prescription drugs. Corvalol, valerian tincture and many other popular tinctures and elixirs are over-the-counter. Accordingly, no one can require a prescription for them unless this is stated in the instructions for use.
Okay, let's say I have a prescription, but it contains several drugs, and one of them is marked "remains at the pharmacy." And I want to buy only one. Will they take my prescription?
Yes. Exceptions are made only for annual prescriptions, provided that you do not purchase the entire prescribed amount of the drug at one time (for this you also need the permission of the doctor who wrote the prescription).
For example, you are prescribed a course of antidepressants for a year, but you only need to purchase one package. In this case, the pharmacy does not have the right to take away your prescription. The pharmacist only makes a note of how much of the drug you bought and returns the prescription.
Can I get medications if the prescription is not written for me?
Yes. Almost all medicines are dispensed simply to the bearer of a prescription. Both the patient himself and his friend, relative, or just an acquaintance can get the drug at the pharmacy. The main thing is to have a recipe.
An exception is made only for narcotic or psychotropic drugs. Prescriptions for such drugs are written out on a special form No. 107/u-NP. It is easy to distinguish from other recipes because it is pink in color. When receiving such drugs at a pharmacy, you must have a power of attorney to receive medications and a passport confirming that you are the one for whom the power of attorney was issued.
At the same time, the Ministry of Health especially notes that the power of attorney can even be handwritten. You can write in it that “I trust such and such to receive such and such medications according to such and such a prescription to such and such a person.” And be sure to indicate the passport details of this person. In addition, it must indicate the date of its compilation. Notarization of such a power of attorney is not required.
What else has changed with the new procedure for dispensing medications?
Now all prescriptions are stamped with the statement that “the drug has been dispensed.” Thus, they cannot be reused. Therefore, if you suddenly need another standard of the drug, you will need to get a new prescription.
Also, the pharmacist is now obliged to inform the buyer about the rules for storing the medicine, its interaction with other drugs, as well as its method and dosage.
In addition, a pharmacy employee cannot hide information about the availability of drugs with the same active ingredient, but cheaper.
Such a norm existed previously in the law “On the Fundamentals of Protecting the Health of Citizens” and the Rules of Good Pharmacy Practice, but is now duplicated in the dispensing procedure.
* Below is a list of INNs, prescriptions for which, according to the new order, will now remain in the pharmacy. Please note that the active substances (INN) listed here are not specific brand names.
INN
agomelatine asenapine aminophenylbutyric acid amisulpride amitriptyline aripiprazole belladonna alkaloids+Phenobarbital+Ergotamine bromodihydrochlorophenylbenzodiazepine buspirone venlafaxine vortioxetine haloperidol hydrazinocarbonylmethylbromophenyldihydrobenzdiazepine hydroxyzine dexmedetomidine duloxetine zaleplon ziprasidone zuclopenthixol imipramine quetiapine clomipramine lithium carbonate lurasidone maprotiline melatonin mianserin milnacipran mirtazapine olanzapine paliperidone paroxetine periciazine perphenazine pipofezin pirlindole podophyllotoxin promazine common fruit extract risperidone sertindole sertraline sulpiride tetramethyltetraazabicyclooctanedione tiapride thioridazine tofisopam trazodone trifluoperazine morpholinoethylthioethoxybenzimidazole fluvoxamine fluoxetine flupenthixol fluphenazine chlorpromazine chlorprothixene citalopram escitalopram
etifoxine
Main photo istockphoto.com
Source: https://apteka.ru/info/articles/novosti-kompanii/novye-pravila-otpuska-lekarstvennykh-sredstv/
Reviews
Alexey, 52 years old
I began to notice that I was losing sexual desire. This phenomenon was accompanied by poor mood and performance. I donated blood and the urologist prescribed Androgel based on the results. I use the drug as indicated in the instructions for about 10 days. During this time I noticed gradual improvements. I did not observe any side effects, which are often mentioned in reviews.
Matvey, 48 years old
I started using Androgel on the advice of an endocrinologist, since I discovered obesity in the chest, abdomen and hips. Blood tests revealed testosterone deficiency. I applied the gel in the morning, as indicated in the instructions, for a week. So far, the result is noticeable in laboratory indicators, but this already indicates effectiveness.
Oleg, 56 years old
About a year ago I was diagnosed with erectile dysfunction. The urologist concluded that this was due to a deficiency of the sex hormone and prescribed Androgel. The medicine deserves a positive review because it does not cause discomfort and is effective. The only negative side for me was the price.
Society and culture
Brand names
Brand names of androstanolone include Anaboleen, Anabolex, Anaprotin (UK), Andractim (formerly AndroGel-DHT) (FR, BE, LU), Androlone, Apeton, Gelovit (ES), Neodrol, Ophtovital (DE), Pesomax (IT), Stanaprol, and Stanolone, among others.
Availability
The availability of pharmaceutical androstanolone is limited; it is not available in the United States or Canada, but it is or has been available in certain European countries, including the United Kingdom, Germany, France, Spain, Italy, Belgium, and Luxembourg.
The available formulations of androstanolone include buccal or sublingual tablets (Anabolex, Stanolone), topical gels (Andractim, Gelovit, Ophtovital), and, as esters in oil, injectables like androstanolone propionate (Pesomax) and androstanolone valerate (Apeton).Androstanolone benzoate ( Ermalone-Amp, Hermalone, Sarcosan) and androstanolone enanthate (Anaboleen Depot) are additional androstanolone esters that are available for medical use in some countries. Androstanolone esters act as prodrugs of androstanolone in the body and have a long-lasting depot effect when given via intramuscular injection.
