Testosterone undecanoate
Clinical data | |
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Pronunciation | /tɛˈstɒstəroʊn ənˈdɛkənoʊeɪt/ teh-STOS-tə-rohn ən-DEK-ə-noh-ayt |
Trade names | Oral: Kyzatrex, Andriol, Jatenzo, others IM: Aveed, Nebido, others |
Other names | TU; Testosterone undecylate; Testosterone 17β-undecanoate; ORG-538; CLR-610 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a614041 |
License data | |
Pregnancy category |
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Routes of administration | By mouth, intramuscular injection |
Drug class | Androgen; Anabolic steroid; Androgen ester |
ATC code | |
Legal status | |
Legal status | |
undecanoic acid, metabolites of testosterone | |
Elimination half-life | IM (in tea seed oil): 20.9 days[6][7] IM (in castor oil): 33.9 days[6][7] |
Excretion | ~90% Urine, 6% feces |
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Testosterone undecanoate, sold under the brand names Andriol, Aveed and Nebido among others, is an
Testosterone undecanoate was introduced in China for use by injection and in the European Union for use by mouth in the 1970s.[17][18] It became available for use by injection in the European Union in the early to mid 2000s and in the United States in 2014.[19][20] Formulations for use by mouth are approved in the United States.[3][4][21] Along with testosterone enanthate, testosterone cypionate, and testosterone propionate, testosterone undecanoate is one of the most widely used testosterone esters.[15][6][10] However, it has advantages over other testosterone esters in that it can be taken by mouth and in that it has a far longer duration when given by injection.[22][8][6][7][10] In addition to its medical use, testosterone undecanoate is used to improve physique and performance.[10] The drug is a controlled substance in many countries and so non-medical use is generally illicit.[10]
Oral administration of testosterone undecanoate is an effective method to achieve therapeutic physiological levels of serum testosterone in patients with hypogonadism. In addition, oral therapy has been found to have a positive impact in these patients on quality of life factors such as sexual function, mood, and mental status, as documented in various studies.[23]
Medical dosage
Testosterone undecanoate is used in
Conversely, oral testosterone undecanoate must be taken two or three times a day with food.[14][28]
Side effects
Side effects of testosterone undecanoate include virilization among others.[10]
Anaphylaxis
The Reandron 1000 formulation (Aveed in the United States) contains 1,000 mg of testosterone undecanoate
Pharmacology
Pharmacodynamics
Medication | Ratioa |
---|---|
Testosterone | ~1:1 |
Androstanolone (DHT) | ~1:1 |
Methyltestosterone | ~1:1 |
Methandriol | ~1:1 |
Fluoxymesterone | 1:1–1:15 |
Metandienone | 1:1–1:8 |
Drostanolone | 1:3–1:4 |
Metenolone | 1:2–1:30 |
Oxymetholone | 1:2–1:9 |
Oxandrolone | 1:3–1:13 |
Stanozolol | 1:1–1:30 |
Nandrolone | 1:3–1:16 |
Ethylestrenol | 1:2–1:19 |
Norethandrolone | 1:1–1:20 |
Notes: In rodents. Footnotes: a = Ratio of androgenic to anabolic activity. Sources: See template. |
Testosterone undecanoate is a
Pharmacokinetics
Testosterone undecanoate has a very long
Chemistry
Testosterone undecanoate, or testosterone 17β-undecanoate, is a
History
In the late 1970s, testosterone undecanoate was introduced for oral use in Europe,[17] although intramuscular testosterone undecanoate had already been in use in China for several years.[18] Intramuscular testosterone undecanoate was not introduced in Europe and the United States until much later, in the early to mid 2000s and 2014, respectively.[19][20] Testosterone undecanoate was approved in the United States only in 2014 after three previous rejections due to safety concerns.[35]
Society and culture
Generic names
Testosterone undecanoate is the
Brand names
Testosterone undecanoate is or has been marketed under a variety of brand names, including Andriol, Androxon, Aveed, Cernos Depot, Jatenzo, Kyzatrex,[5] Nebido, Nebido-R, Panteston, Reandron 1000, Restandol, Sustanon 250, Undecanoate 250, and Undestor.[33][34][36][38][37]
Availability
Oral testosterone undecanoate is available in Europe, Mexico, Asia, and in the United States.[39][40]
Intramuscular testosterone undecanoate has approved in over 100 countries worldwide,
Legal status
Testosterone undecanoate, along with other AAS, is a schedule III controlled substance in the United States under the Controlled Substances Act and a schedule IV controlled substance in Canada under the Controlled Drugs and Substances Act.[42][43]
In March 2019, the US Food and Drug Administration approved testosterone undecanoate (Jatenzo), an oral testosterone capsule to treat men with certain forms of hypogonadism. These men have low testosterone levels due to specific medical conditions, such as genetic disorders like Klinefelter syndrome or tumors that have damaged the pituitary gland.[21] The FDA granted the approval of Jatenzo to Clarus Therapeutics.[21][44]
In March 2022, testosterone undecanoate (Tlando) was approved for medical use in the United States.[4]
In July 2022, Kyzatrex, an oral testosterone undecanoate capsule, was approved for medical use in the United States.[5] The FDA granted the approval of Kyzatrex to Marius Pharmaceuticals.[45]
Research
Non-alcoholic steatohepatitis
In 2013, a
Osteoporosis
In 2013, a study aimed to evaluate the efficacy of testosterone undecanoate therapy on bone mineral density (BMD) and biochemical markers of bone turnover in elderly males with osteoporosis and low serum testosterone levels.
They study found that administering low-dose testosterone undecanoate (TU) at a rate of 20 mg per day to elderly men with low serum testosterone and osteoporosis effectively increases bone mineral density in the lumbar spine and femoral neck, and improves bone turnover, similar to the standard-dose TU (40 mg, per day) treatment. The treatment did not exhibit any adverse side effects on the prostate gland, including prostate-specific antigen. Therefore, low-dose TU appears to be a safe and cost-effective protocol for treating elderly male osteoporosis.[48] However, further clinical trials with larger sample sizes, multiple centers, and long-term follow-ups are required to determine the efficacy and safety of low-dose testosterone undecanoate treatment in elderly male osteoporosis with low serum testosterone.
Health implications
Risks associated with treatment of late-onset hypogonadism
There is a potential concern in the medical community that the administration of testosterone therapy for the treatment of late-onset hypogonadism may escalate the risks associated with benign prostatic hyperplasia, prostate cancer and heart diseases.[49]
Body composition
In 2020, a study that evaluated the effects of testosterone therapy in men with testosterone deficiency and varying degrees of weight (normal weight, overweight, and obesity) on anthropometric and metabolic parameters found that long-term testosterone undecanoate therapy in hypogonadal men, regardless of their weight at the start of the study, led to improvements in several body composition parameters, including body weight, waist circumference, and body mass index. Additionally, testosterone undecanoate therapy was found to lower fasting blood glucose and HbA1c levels and improve lipid profiles in this population.[50]
Bone density
There have been several studies that evaluate the effect of testosterone therapy on bone density or bone mineral density (BMD). One study concluded that long-term testosterone replacement therapy (TRT) in middle-aged men with late-onset hypogonadism (LOH) and metabolic syndrome (MS) led to a significant increase in both vertebral and femoral bone mineral density (BMD) after 36 months of treatment, as measured by dual-energy x-ray absorptiometry. The TRT treatment was shown to induce a 5% per year increase in BMD without changes in body mass index (BMI). The study suggests that long-term TRT could be beneficial for improving bone health in middle-aged men with LOH and MS, even in the absence of osteoporosis.[51]
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