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Long-acting testosterone ester

Testosterone undecanoate

Brand names: Nebido, Restandol Testocaps

Adult dose

Dose: IM (Nebido): 1g every 10–14 weeks. PO (Restandol): 120–160mg/day in 2 divided doses
Route: IM/PO
Frequency: q10-14w (IM)

Clinical pearls

  • Male hypogonadism
  • Inject slowly over 2 minutes; observe 30 min for POME

Contraindications

  • Prostate / breast cancer
  • Pregnancy
  • Hypercalcaemia
  • Severe hepatic/cardiac impairment

Side effects

  • Polycythaemia
  • Pulmonary oil microembolism (POME — IM)
  • Mood changes
  • Prostate effects
  • Sleep apnoea

Interactions

  • Anticoagulants
  • Insulin
  • Corticosteroids

Monitoring

  • Testosterone
  • PSA
  • Hct
  • LFTs

Reference: BNF; UK Endocrine Society; MHRA; https://bnf.nice.org.uk/drugs/testosterone-undecanoate/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.