Testosterone replacement therapies such as Tostran Gel are intended for use by men who have been diagnosed with low testosterone levels and who have clinical symptoms of the deficiency. These therapies should not be used by men who have testosterone levels within the normal range because it may cause more side effects without any therapeutic benefits.
Testosterone replacement therapies can be used at the same time as medicines for erectile dysfunction if necessary (such as Viagra, Cialis, or Levitra).
Tostran Gel is presented in a canister containing 60g of gel. Each press of the canister piston delivers half a gram of gel, containing 10mg of testosterone.
How to use Tostran Gel?
Tostran Gel is applied to clean dry skin on the abdomen or on the inner thighs (half the dose on each inner thigh); it's recommended that both of these parts of the body are used on different days. It should not be applied to the genitals. The gel should be applied once a day, at about the same time of day; preferably in the morning. If you have a bath or shower in the morning, the gel should be applied after you have washed and dried the skin, not before you have washed: it's recommended that you do not wash the area for at least 6 hours after the gel has been applied, otherwise the amount of testosterone absorbed by the body will be reduced.
Before using Tostran Gel for the first time, the pump needs to be primed, by depressing the piston 8 times. Any gel that is dispensed should be discarded. This only needs doing once for each canister; the canister should then be kept upright while it's in use.
The normal daily starting dose is 3g of gel (60mg of testosterone; 6 depressions of the Tostran pump). Sometimes a higher or lower dose is recommended by the doctor, depending on the response and your general health. The amount used each day should not exceed 4g of gel (80mg of testosterone; 8 depressions of the pump).
The required amount of gel should be put on to one finger, and then rubbed in gently to the abdomen or the inner thighs as above. The hands should then be washed, and dressing can continue after the gel has dried on the skin which usually only takes a few minutes.
The patient information leaflet gives more detail about how the gel should be applied to the skin.
Preventing the gel transferring on to other people
There is a chance that the gel - and therefore testosterone - can be transferred from one person to another by skin contact with the parts of the body that the gel was rubbed in to. This can cause side effects in people who have made contact in this way, even if it is a small amount of contact but over a long period of time. It is important to prevent this happening, especially where contact with pregnant women or children is likely. The product leaflet gives details about how to do this, but briefly, you should wash your hands after applying the gel, cover the application site with clothing after the gel has dried, and shower before any such contact is anticipated (such as sexual contact).
Is Tostran Gel suitable for me?
There are some situations where Tostran Gel should be used with caution or would not be recommended, for example in women, males under the age of 18 or over 65, men with diagnosed or suspected cancer of any kind especially of the breast or prostate gland, benign prostatic hyperplasia ("BPH") or an enlarged prostate gland, symptoms of lower urinary tract infections, blood disorders including erythrocytosis, high blood pressure, heart failure or heart disease including angina, liver or kidney problems, epilepsy, migraines, sleep apnoea, and people who are allergic to any of the active or inactive ingredients.
The successful treatment of low testosterone levels can improve type 2 diabetes in some men, so if you have this condition you should monitor it closely and tell your doctor or diabetic nurse in case adjustments to your diabetes medicines are necessary.
Tell the doctor if you are taking any other medicines, either from your doctor or purchased from a pharmacy. Tostran Gel may not be suitable or may need to be used with caution if you are taking some medicines including warfarin and other anticoagulants, or steroids.
It's very important to give a full picture of your general health in the consultation, to make sure the doctor has all the information required to assess the safety and suitability of treatment for you.
Tostran Gel Side Effects
Like all medicines, Tostran Gel can cause side effects, although not everybody will experience them. Side effects that are considered to be common include a worsening of existing high blood pressure, changes in hair distribution, swelling of the extremities, enlargement of the breast tissue (gynaecomastia), changes to some blood test results, and itching or rashes on the skin where the gel is applied. Side effects that have been linked to testosterone treatments in general include a increased risk of prostate cancer, electrolyte changes, lowered libido, anxiety, nausea, skin reactions such as increased hair growth or hair loss, muscle cramps, cholesterol level changes, and weight gain.
If you experience any changes in skin colour, unexplained nausea or vomiting, ankle swelling, any breathing disturbances including those associated with sleep, or too frequent or persistent erections of the penis, then stop using Tostran Gel and talk to your doctor.
For a full list of potential side effects and other important information, please read the patient leaflet provided in the pack before starting any course of treatment. It is very important to read the leaflet in full before starting to use Tostran Gel. The leaflet can be viewed online here.