Testosterone Transdermal Patch

Testosterone transdermal patches are used to treat the symptoms of low testosterone in adult men who have hypogonadism (a condition in which the body does not produce enough natural testosterone). Testosterone is used only for men with low testosterone levels caused by certain medical conditions, including disorders of the testicles, pituitary gland, (a small gland in the brain), or hypothalamus (a part of the brain) that cause hypogonadism. Your doctor will order certain lab tests to check your testosterone levels to see if they are low before you begin to use testosterone transdermal patches. Testosterone should not be used treat the symptoms of low testosterone in men who have low testosterone due to aging ('age-related hypogonadism'). Testosterone is in a class of medications called androgenic hormones. Testosterone is a hormone produced by the body that contributes to the growth, development, and functioning of the male sexual organs and typical male characteristics. Testosterone transdermal patches work by replacing the testosterone that is normally produced by the body.

Transdermal testosterone comes as a patch to apply to the skin. It is usually applied each night between 8:00 p.m. and midnight and left in place for 24 hours. Apply testosterone patches at around the same time every evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use testosterone patch(es) exactly as directed. Do not apply more or fewer patches or apply the patches more often than prescribed by your doctor.

Choose a spot on your back, stomach, thighs, or upper arms to apply your patch(es). Be sure that the spot you have chosen is not oily, hairy, likely to perspire heavily, over a bone such as a shoulder or hip, or likely to be under pressure from sitting or sleeping. Do not apply the patch(es) to the scrotum or to a skin area with open sores, wounds, or irritation. Also be sure that the patch will stay flat against the skin and will not be pulled, folded, or stretched during normal activity. Choose a different spot each night and wait at least 7 days before applying another patch to a spot you have already used.

Use testosterone patches immediately after opening. Do not use if the pouch seal is broken or if the patch appears to be damaged. Do not cut the patches.

After you apply the patch(es), do not shower, bathe, swim, or wash the place where you applied the medication for at least 3 hours. Wear your testosterone patch(es) at all times until you are ready to apply the new patch(es). Do not remove your patch(es) before swimming, bathing, showering, or sexual activity.

Exercise or excessive sweating may loosen a patch or cause it to fall off. If a patch becomes loose, smooth it down with your fingers. If a patch falls off before noon, apply a new patch. If a patch falls off after noon, do not apply a new patch until your next scheduled application time that evening. Do not tape the testosterone patch to the skin.

Your doctor may adjust your dose of testosterone depending on the amount of testosterone in your blood during your treatment.

Testosterone patches may control your condition but will not cure it. Continue to use testosterone patches even if you feel well. Do not stop using testosterone patches without talking to your doctor. If you stop using testosterone, your symptoms may return.

To use testosterone patches, follow these steps:

1. Clean and dry the spot where you will apply the patch.
2. Tear the foil pouch along the edge and remove the patch. Do not open the pouch until you are ready to apply the patch.
3. Peel the protective liner and silver disc off the patch and dispose of them.
4. Place the patch on your skin with the sticky side down and press down firmly with your palm for 10 seconds. Be sure the patch is completely stuck to your skin, especially around the edges.
5. When you are ready to remove the patch, pull it off the skin, fold the used patch in half with the sticky sides stuck together, and dispose of it safely, so that it is out of the reach of and pets. Children and pets can be harmed if they chew on or play with used patches.
6. Apply a new patch immediately by following steps 1-4.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using testosterone patches,

• tell your doctor and pharmacist if you are allergic to testosterone, any other medications, or any of the ingredients in testosterone patches. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using testosterone patches. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have breast cancer or have or may have prostate cancer. Your doctor will probably tell you that you should not use testosterone transdermal patch.
• tell your doctor if you have or ever had urinary problems due to benign prostate hyperplasia (BPH; an enlarged prostate), high blood levels of calcium, sleep apnea (a sleep disorder that causes breathing to stop for short periods during sleep), diabetes, or lung, heart, kidney, or liver disease.
• you should know that transdermal testosterone is only for use in adult men. Children, teenagers, and women should not use this medication. Testosterone may stop bone growth and cause precocious puberty (early puberty) in children and teenagers. If testosterone is used by a woman who is pregnant, may become pregnant, or is breast-feeding, it may harm the baby.
• talk to your doctor about the risks and benefits of using testosterone transdermal patch if you are 65 years of age or older. Older men should not usually use testosterone, unless they have hypogonadism.
• tell your doctor if you will be having a magnetic resonance imaging exam (MRI; a medical test that uses powerful magnets to take pictures of the inside of the body). Your doctor will probably tell you to remove your testosterone patch(es) before you have the exam.
• you should know that testosterone patches may be worn during sexual activity. It is very unlikely that your partner will be exposed to more than slight amounts of testosterone. Call a doctor immediately if your female partner develops new or increasing acne, or grows hair in new places on her body.
• you should know that your skin may become irritated in the place where you apply the patch(es). If this happens, you may apply a small amount of hydrocortisone cream to the area after removing your patch(es). If your skin remains irritated after this treatment, call your doctor. Your doctor may prescribe a different cream to apply to the irritated area.
• you should know that there have been reports of serious side effects in people who use testosterone at higher doses, along with other male sex hormone products, or ways other than directed by a doctor. These side effects may include a heart attack, heart failure, or other heart problems; stroke and mini-stroke; liver disease; seizures; or mental health changes such as depression, mania (frenzied, abnormally excited mood), aggressive or unfriendly behavior, hallucinations (seeing things or hearing voices that do not exist), or delusions (having strange thoughts or beliefs that have no basis in reality). People who use higher doses of testosterone than recommended by a doctor may also experience withdrawal symptoms such as depression, extreme tiredness, craving, irritability, restlessness, loss of appetite, inability to fall asleep or stay asleep, or a decreased sex drive, if they suddenly stop using testosterone. Be sure to use testosterone transdermal patch exactly as directed by your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Apply the missed patch(es) as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra patches to make up for a missed dose.

Transdermal testosterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• burn-like blisters, pain, redness, hardness, burning, or itching in the place you applied the patches
• enlarged or tender breasts
• acne
• depression
• headache

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• lower leg pain, swelling, warmth, or redness
• shortness of breath
• slow or difficult speech
• dizziness or faintness
• weakness or numbness of an arm or leg
• chest pain
• erections that happen more than usual or that do not go away
• swelling of the hands, feet, and ankles
• difficulty urinating, weak urine flow, frequent urination, sudden need to urinate right away
• nausea
• vomiting
• yellowing of the skin or eyes
• rash
• hives
• itching
• difficulty breathing, especially at night

Testosterone patches may cause a decrease in the number of sperm (male reproductive cells) produced, especially if it is used at high doses. Talk to your doctor about the risks of using this medication if you are a man and would like to have children.

Testosterone may increase the risk of developing prostate cancer. Talk to your doctor about the risks of using this medication.

Testosterone may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Testosterone patches may burst if exposed to extreme heat or pressure.

Store testosterone transdermal patches in a safe place so that no one else can use it accidentally or on purpose. Keep track of how many patches are left so you will know if any are missing.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

If you wear too many patches, or wear patches for too long, too much testosterone may be absorbed into your bloodstream. In that case, you may experience symptoms of an overdose.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to testosterone.

Testosterone can interfere with the results of certain laboratory tests. Before having any tests, tell your doctor and the laboratory personnel that you are using testosterone patches.

Do not let anyone else use your medication. Testosterone transdermal patches are a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Androderm^®
• Testoderm^®¶