Generic Name: testosterone nasal (tes TOS ter own NAY sul)
Brand Name: Natesto
What is testosterone nasal?
Testosterone is a naturally occurring male hormone necessary for many processes in the body.
Testosterone nasal (for use in the nose) is used to treat conditions in men that result from a lack of natural testosterone.
Testosterone will not enhance athletic performance and should not be used for that purpose.
Testosterone nasal may also be used for purposes not listed in this medication guide.
What is the most important information I should know about testosterone nasal?
You should not use this medicine if you have prostate cancer or male breast cancer.
Testosterone nasal should not be used by a woman. Testosterone can cause birth defects in an unborn baby.
Misuse of testosterone can cause dangerous or irreversible effects. Never use more than your prescribed dose. Do not share this medicine with another person.
What should I discuss with my healthcare provider before using testosterone nasal?
You should not use this medicine if you are allergic to testosterone nasal gel, or if you have:
prostate cancer; or
male breast cancer.
To make sure testosterone nasal is safe for you, tell your doctor if you have:
a history of problems with your sinuses or nasal passages;
a history of surgery on your nose or sinuses;
a broken nose (now or within the past 6 months);
a deviated septum (crooked nose);
breast cancer, prostate cancer;
enlarged prostate, urination problems;
sleep apnea (breathing stops during sleep);
heart disease, history of heart attack or stroke;
a history of blood clots; or
liver disease or kidney disease.
Older men who use testosterone nasal may have an increased risk of prostate enlargement. If you are over 65, talk with your doctor about your specific risk.
This medicine should not be used by a woman. Testosterone can cause birth defects in an unborn baby. A pregnant woman should avoid coming into contact with testosterone nasal gel. If contact does occur, wash with soap and water right away.
Testosterone nasal is not approved for use by anyone younger than 18 years old.
How should I use testosterone nasal?
Follow all directions on your prescription label. Never use testosterone nasal in larger amounts, or for longer than prescribed.
Misuse of testosterone can cause dangerous or irreversible effects, such as enlarged breasts, small testicles, infertility, high blood pressure, heart attack, stroke, liver disease, bone growth problems, addiction, and mental effects such as aggression and violence.
Do not share this medicine with another person.
Do not take by mouth or use on the skin. Testosterone nasal is for use only in the nose.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Blow your nose gently before using testosterone nasal gel.
Wash with soap and water if the gel gets on your hands or skin while using it.
While using testosterone nasal, you may need frequent blood tests.
Use testosterone nasal regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Do not share this medicine with another person.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Apply the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using testosterone nasal?
Avoid using other medications in your nose, unless your doctor tells you to.
Testosterone nasal side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using testosterone nasal and call your doctor at once if you have:
increased urination (many times per day), loss of bladder control;
painful or difficult urination;
swelling, rapid weight gain, shortness of breath during sleep;
breast pain or swelling;
chest pain or pressure, pain spreading to your jaw or shoulder;
painful or bothersome erections;
nasal problems--runny or stuffy nose, sneezing, nosebleed, nose pain or dryness, scabs inside or around your nose;
liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
signs of a blood clot in the lung--chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or
signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs.
Common side effects may include:
sore throat; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Testosterone nasal dosing information
Usual Adult Dose for Hypogonadism -- Male:
-Testosterone Undecanoate: 750 mg (3 mL) IM injection followed by 750 mg (3 mL) injected after 4 weeks, then 750 mg (3 mL) every 10 weeks thereafter
-Testosterone Enanthate and Cypionate: 50 to 400 mg IM injection every 2 to 4 weeks
-2 to 6 pellets (75 mg each) implanted subcutaneously every 3 to 6 months.
-The number of pellets to be implanted depends upon the minimal daily requirements of testosterone propionate administered parenterally. Thus, implant two 75 mg pellets for each 25 mg testosterone propionate required weekly.
-The chronological and skeletal ages must be taken into consideration, both in determining the initial dose and in adjusting the dose.
-This drug should be used only if the benefits outweigh the serious risks of pulmonary oil microembolism and anaphylaxis.
-Injections more frequently than every two weeks are not recommended.
-Adequate effect of the implants (pellets) continues for three to four months, sometimes as long as six months.
-Mucoadhesive Oral Patch: Apply a 30 mg patch to the gum region twice a day; morning and evening (about 12 hours apart).
-Transdermal Film: 2 to 6 mg applied to the back, abdomen, upper arm, or upper thigh once a day, preferably at night.
-Gel (in tubes, packets or spray): 5 g applied once a day, preferably in the morning. Consult the manufacturer product information for specific dosage and additional instructions of use.
-Transdermal Solution: Initial dose is 60 mg of testosterone (1 pump actuation of 30 mg of testosterone to each axilla), applied once a day, at the same time each morning. Consult the manufacturer product information for specific dosage and additional instructions of use.
Comments: Prior to initiating therapy with this drug, confirm the diagnosis of hypogonadism by ensuring that serum testosterone concentrations have been measured in the morning on at least two separate days, and that these serum testosterone concentrations are below the normal range.
-Primary hypogonadism (congenital or acquired): Testicular failure due to conditions such as cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome, orchiectomy, Klinefelter Syndrome, chemotherapy, or toxic damage from alcohol or heavy metals. These men usually have low serum testosterone concentrations and gonadotropins (FSH, LH) above the normal range.
-Hypogonadotropic hypogonadism (congenital or acquired): Gonadotropin or luteinizing hormone-releasing hormone (LHRH) deficiency or pituitary-hypothalamic injury from tumors, trauma, or radiation. These men have low testosterone serum concentrations but have gonadotropins in the normal or low range.
Usual Adult Dose for Breast Cancer--Palliative:
-200 to 400 mg IM injection every 2 to 4 weeks
-Androgen therapy can accelerate the disease. Close monitoring is recommended.
-Report any hoarseness, acne, changes in menstrual periods, or more facial hair.
-This drug may be used secondarily in women with advancing inoperable metastatic (skeletal) mammary cancer who are one to five years postmenopausal.
-Premenopausal women with breast cancer who have benefited from oophorectomy and are considered to have a hormone-responsive tumor.
Usual Pediatric Dose for Delayed Puberty -- Male:
-Testosterone Enanthate: 50 to 200 mg every 2 to 4 weeks for 4 to 6 months
-2 pellets (each pellet contain 75 mg of testosterone) implanted subcutaneously every 3 to 6 months
-Duration of therapy: 4 to 6 months
-The chronological and skeletal ages should be taken into consideration when determining the initial dose and when adjusting the dose.
-An X-ray of the hand and wrist to determine bone age should be obtained every six months to assess the effect of treatment on the epiphyseal centers.
-Report frequent or persistent erections.
-Androgen therapy should be used very cautiously in children and only by specialists who are aware of the adverse effects on bone maturation.
Use: To stimulate puberty in selected males with clearly delayed puberty
What other drugs will affect testosterone nasal?
Tell your doctor about all your current medicines and any you start or stop using, especially:
a blood thinner (warfarin, Coumadin, Jantoven); or
a steroid such as methylprednisolone, prednisone, and others.
This list is not complete. Other drugs may interact with testosterone nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
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Where can I get more information?
- Your pharmacist can provide more information about testosterone nasal.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02.
Date modified: April 03, 2017
Last reviewed: November 03, 2016