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6.4.2 Male sex hormones and antagonists

6.4.2 Male sex hormones and antagonists
Used for replacement therapy in pituitary or testicular disease. 
NOT licensed or indicated for use in increasing libido   
AMBER     Testosterone Link to Shared Care Guideline  
SHARED                  esters injection (Sustanon 100®, Sustanon 250®) 
CARE                       depot injection 250mg/mL (Nebido®)
                                 transdermal gel 16.2mg/gram pump (Testogel®pump)*
                                 (*One pump actuation delivers 1.25g of gel containing 20.25mg of testosterone)
                                 transdermal gel 20mg/1gram pump dispenser (Tostran®)**    
                                 (**One press of the canister piston delivers 0.5 g of gel  containing 10 mg testosterone). 
                                 transdermal gel 20mg/1gram pump dispenser (Testavan®)
                                 The dose should be applied either to  the abdomen, or spread over both inner thighs.

Finasteride is used for benign prostatic hyperplasia, cyproterone is used for severe hypersexuality and sexual deviation in males, 
and to treat hyperandrogenism in women with polycystic ovary syndrome (unlicensed).
GREEN      Cyproterone tablets 50mg (Androcur®) 
GREEN      Finasteride tablets 5mg  
Consultant Urologist initiation only then primary care prescribing. Only to be used for 1 years treatment, when patients should be 
reviewed by the consultant urologist to either stop dutasteride, switch to finasteride, or progress to other management strategies
and this communicated to the GP. Dutasteride is restricted for a high risk patient group, used in combination with tamsulosin in
patients with moderate to severe symptoms (IPSS>12) with larger prostates (>30cc) and elevated PSA (>1.5ng/mL). 
AMBER     Dutasteride capsules 500mcg  (Avodart®)

All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the  
public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service. 
  Email: info.elmmb@nhs.net
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