Pharmacokinetic Profile of Subcutaneous Testosterone

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Nelson Vergel

The study used 50 mg vs 100 mg testosterone enanthate per week subcutaneously with a 27 gauge 5/8" needle. They also compared both to Pk of one IM shot of 200 mg.

PK subcutaneous T 50 vs 100 mg weekly.jpg

Sex Med. 2015 Sep 17;3(4):269-79. doi: 10.1002/sm2.80. eCollection 2015 Dec.

Pharmacokinetic Profile of Subcutaneous Testosterone Enanthate Delivered via a Novel, Prefilled Single-Use Autoinjector: A Phase II Study.

Kaminetsky J, Jaffe JS, Swerdloff RS.

Hypogonadism is one of the most common male endocrine problems. Although many treatments are currently available, unmet need exists for new testosterone (T) replacement therapies that are simple to administer and use, are safe, and mimic physiologic T levels.

The study aim was to determine the pharmacokinetics (PK), safety, and tolerability of T enanthate (TE) administered via a novel single-use autoinjector system, which was designed to eject high-viscosity solutions from a prefilled syringe fitted with a five-eighths-inch 27-gauge needle.

Thirty-nine men with hypogonadism entered this dose-finding, open-label, parallel-group study. Patients were washed out of their topical T regimens and randomized to receive 50 or 100 mg of subcutaneous (SC) TE weekly. The reference group were patients with hypogonadism who were maintained on standard 200-mg intramuscular (IM) TE.

The primary outcome measure was the PK profile of SC TE, analyzed in reference to T levels used by the Food and Drug Administration to approve T products. Secondary outcome measures were safety and tolerability assessments.

Both doses of SC TE achieved normal average concentrations of serum T within a 168-h dosing interval after injection. Concentration ranges were similar at all time points following 50-mg SC TE injections and following the third injection in the 100-mg arm. Mean steady-state T concentration at week 6 was 422.4 and 895.5 ng/dL for the 50- and 100-mg SC TE arms, respectively. SC TE demonstrated PK dose proportionality. SC TE restored normal serum T with low variation relative to 200-mg IM without clinically significant adverse events.

Administration of TE via this novel injection system restored T levels to normal range in men with hypogonadism. SC TE dosed weekly demonstrated steady, dose-proportional measures of exposure and was well-tolerated. Kaminetsky J, Jaffe JS, Swerdloff RS. Pharmacokinetic profile of subcutaneous testosterone enanthate delivered via a novel, prefilled single-use autoinjector: A phase II study. Sex Med 2015;3:263-273.

Autoinjector; Clinical Trial; Hypogonadism; Male; Phase II; Subcutaneous Injection; Testosterone; Viscosity
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Nelson Vergel

Its a shame they didn't monitor E2 at the same time.
They did not measure C max (peak) but the area under the curve (AUC) and C avg of E2 and DHT. Here are the numbers comparing 50 and 100 mg subq vs 200 mg IM. Values are as expected except for the fact that the C avg (average concentration) of 100 mg subq is very close to that of 200 mg IM when it comes to E2 (aromatization in the fat layer?). So, definitely, 50 mg subq twice per week is not a bad idea. They did not report hematocrit since the IM dose was only one shot.

DHT E2 T subcutaneous vs IM.jpg
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