Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA.
Clin Interv Aging. 2009;4:397-412. doi: 10.2147/cia.s4466. Epub 2009 Nov 18.
Transdermal testosterone gels were first introduced in the US in 2000. Since then, they have emerged as a favorable mode of testosterone substitution. Serum testosterone levels reach a steady-state in the first 24 hours of application and remain in the normal range for the duration of the application. This pharmacokinetic profile is comparable to that of testosterone patch but superior to injectable testosterone esters that are associated with peaks and troughs with each dose. Testosterone gels are as efficacious as patches and injectable forms in their effects on sexual function and mood. Anticipated increases in prostate-specific antigen with testosterone therapy are not significantly different with testosterone gels, and the risk of polycythemia is lower than injectable modalities. Application site reactions, a major drawback of testosterone patches, occur less frequently with testosterone gels. However, inter-personal transfer is a concern if appropriate precautions are not taken. Superior tolerability and dose flexibility make testosterone gel highly desirable over other modalities of testosterone replacement. Androgel and Testim, the two currently available testosterone gel products in the US, have certain brand-specific properties that clinicians may consider prior to prescribing.
透皮睾酮凝胶于 2000 年首次在美国推出。从那时起，它们已成为睾酮替代治疗的一种有利方式。在应用的最初 24 小时内，血清睾酮水平达到稳定状态，并在整个应用过程中保持在正常范围内。这种药代动力学特征与睾酮贴剂相似，但优于每剂都会出现峰值和谷值的注射用睾酮酯。睾酮凝胶在性功能和情绪方面的效果与贴剂和注射剂一样有效。与睾酮贴剂相比，预期的前列腺特异性抗原升高与睾酮凝胶并无显著差异，而且其发生红细胞增多症的风险也低于注射剂型。应用部位反应是睾酮贴剂的一个主要缺点，在睾酮凝胶中发生频率较低。然而，如果不采取适当的预防措施，人与人之间的转移是一个问题。由于具有更好的耐受性和剂量灵活性，与其他睾酮替代治疗方式相比，睾酮凝胶更受青睐。目前在美国上市的两种睾酮凝胶产品——Androgel 和 Testim，具有某些特定品牌的特性，临床医生在开具处方前可能会考虑这些特性。
