Maximum per order: 4
Pregnancy: Not suitable
Breastfeeding: Not suitable
Testosterone replacement therapies are for men who have low testosterone levels and also clinical symptoms of the deficiency. It is not for use by men who have normal levels of testosterone, as to do so could cause side-effects rather than produce any benefits.
In a condition known as hypogonadism, men do not produce sufficient levels of natural testosterone to produce sperm, or to maintain the male characteristics of body hair and a deep voice. Tostran gel helps increase levels of testosterone and helps maintain both a normal sex drive and sexual function, as well as maintain muscle strength and size.
Tostran gel comes in a 60g canister and the piston emits doses of a half a gram of gel, which contains 10mg of testosterone. Before using it for the first time, press the piston about 8 times, to get it ready for use and discard any gel which escapes during this priming of the piston.
The gel should be applied on clean and dry skin, alternating daily between sharing the dose between the inner thighs, or applying it to the abdomen and never to the genitals. Apply the gel gently and do not wash that area of skin for at least 6 hours, as doing so would reduce the amount of gel available for absorption into the skin.
The normal recommended daily dose it 6 depressions of the canister pump, which will deliver 3g of gel (60mg of testosterone). While a doctor may sometimes recommend a higher daily dose which will relate to your general health, it should never exceed 8 depressions, which would amount to 4g of gel (80mg of testosterone).
Once applied, smooth the gel very gently into your skin and wait until it is fully absorbed, before washing your hands and then dressing. This application takes only a few minutes.
Testim gel and Testogel are two other products which contain the same active ingredient.
Tostran Gel is applied to clean dry skin on the abdomen or on the inner thighs (half the dose on each inner thigh); it's recommended that both of these parts of the body are used on different days. It should not be applied to the genitals. The gel should be applied once a day, at about the same time of day; preferably in the morning. If you have a bath or shower in the morning, the gel should be applied after you have washed and dried the skin, not before you have washed: it's recommended that you do not wash the area for at least 6 hours after the gel has been applied, otherwise the amount of testosterone absorbed by the body will be reduced.
Before using Tostran Gel for the first time, the pump needs to be primed, by depressing the piston 8 times. Any gel that is dispensed should be discarded. This only needs doing once for each canister; the canister should then be kept upright while it's in use.
The normal daily starting dose is 3g of gel (60mg of testosterone; 6 depressions of the Tostran pump). Sometimes a higher or lower dose is recommended by the doctor, depending on the response and your general health. The amount used each day should not exceed 4g of gel (80mg of testosterone; 8 depressions of the pump).
The required amount of gel should be put on to one finger, and then rubbed in gently to the abdomen or the inner thighs as above. The hands should then be washed, and dressing can continue after the gel has dried on the skin which usually only takes a few minutes.
The patient information leaflet gives more detail about how the gel should be applied to the skin.
There is a chance that the gel - and therefore testosterone - can be transferred from one person to another by skin contact with the parts of the body that the gel was rubbed in to. This can cause side effects in people who have made contact in this way, even if it is a small amount of contact but over a long period of time. It is important to prevent this happening, especially where contact with pregnant women or children is likely. The product leaflet gives details about how to do this, but briefly, you should wash your hands after applying the gel, cover the application site with clothing after the gel has dried, and shower before any such contact is anticipated (such as sexual contact).
Like all medicines, Tostran (testosterone) Gel can cause side effects, although not everybody gets them. Side effects that are considered to be common include a worsening of existing high blood pressure, changes in hair distribution, swelling of the extremities, enlargement of the breast tissue (gynaecomastia), changes to some blood test results, and itching or rashes on the skin where the gel is applied. Side effects that have been linked to testosterone treatments in general include a increased risk of prostate cancer, electrolyte changes, lowered libido, anxiety, nausea, skin reactions such as increased hair growth or hair loss, muscle cramps, cholesterol level changes, and weight gain.
If you experience any changes in skin colour, unexplained nausea or vomiting, ankle swelling, changes in skin colour, any breathing disturbances including those associated with sleep, or too frequent or persistent erections of the penis, then stop using Tostran Gel and talk to your doctor.
For a full list of potential side effects and other important information, please read the patient leaflet provided in the pack before starting any course of treatment. It is very important to read the leaflet in full before starting to use Tostran (testosterone) Gel. The leaflet can be viewed online here:
There are some situations where Tostran (testosterone) Gel should be used with caution or would not be recommended, for example in women, males under the age of 18 or over 65, men with diagnosed or suspected cancer of any kind especially of the breast or prostate gland, benign prostatic hyperplasia ("BPH") or an enlarged prostate gland, symptoms of lower urinary tract infections, blood disorders including erythrocytosis, high blood pressure, heart failure or heart disease including angina, liver or kidney problems, epilepsy, migraines, sleep apnoea, and people who are allergic to any of the active or inactive ingredients.
The successful treatment of low testosterone levels can improve type 2 diabetes in some men, so if you have this condition you should monitor it closely and tell your doctor or diabetic nurse in case adjustments to your diabetes medicines are necessary.
Tell the doctor if you are taking any other medicines, either from your doctor or purchased from a pharmacy. Tostran (testosterone) Gel may not be suitable or may need to be used with caution if you are taking some medicines including warfarin and other anticoagulants, or steroids.
It's very important to give a full picture of your general health in the consultation, to make sure the doctor has all the information required to assess the safety and suitability of treatment for you.
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Delivery is free for all NHS prescriptions.
Please note: Royal Mail do not deliver on Sundays or Bank Holidays - this should be taken into account when ordering.
If you are not home to accept your delivery, a card should be left by the Royal Mail representative. This card will provide details of where you can collect the order or how to arrange re-delivery.
Should you be unable to collect your missed delivery or arrange for your medication to be redelivered by Royal Mail, the pharmacy can resend your medication to the same, or a different address provided it has been returned to us and this happens within a
Once a package has been shipped with Royal Mail we advise that you are bound to the terms and conditions of their use together with the terms and conditions contained herein.
You have the right to cancel your order up to the point when your treatment is dispatched. The pharmacist must destroy any medication within 30 days of it being returned, even un-opened boxes, so we are not able to offer refunds once your treatment has been dispatched.
We are currently unable to ship orders outside of the UK.
We are unable to ship orders to
Hypogonadism can also indicate other health issues which affect testosterone levels and so the treatment has three main aims:
Low testosterone is also found in 60% of obese men.
Skin contact can cause the gel to be transferred to someone else and they could experience side-effects, even if contact was in an isolated area of skin but over a long period of time. Take care in the cases of children or pregnant women, by washing your hands fairly rigorously and covering the skin where the gel has been applied. In the case of sexual activity, always shower first. All of this information will be given in the product leaflet which comes with the medication.
After the doctor has checked that the medication is right for you, you will receive the test kit in the post. The pack contains everything you need to take a blood sample, which you will post to the laboratory in the pre-paid envelope provided.
They are processed on the day of receipt and results are sent to you electronically.
While one test is for testosterone levels, a test may be needed of your prostate (PSA), if this has not been examined in the past. The test kit received may be to check both testosterone and prostate and these can both be done from one blood sample.
PSA (prostate specific antigen) is a protein which is produced by both normal and cancer cells in the prostate and the PSA test measures the quantity of this protein in your blood. The amount of this protein increases with age and this can cause the prostate to increase in size, so the test is simply to check the health of the prostate and is not necessarily looking for cancer. This test can be done at any surgery and the result can be discussed with the practice nurse.
The PSA test is a guide and the result, together with information you provide via a consultation, helps decide whether testosterone treatment is the right way ahead for you.
If there is a raised PSA level, this could indicate:
These are not the only health conditions which can be identified from a PSA test and so there are times when you may be referred to a hospital specialist for further information. This information is important in deciding whether testosterone therapy can be given as, if the person does have prostate cancer, it is important to keep testosterone levels as low as possible and not to increase the levels via this therapy.
A raised PSA level does not mean that you have prostate cancer, as prostate cancer can also be found in men who have low PSA counts. The likelihood of having prostate cancer rises if:
Deciding if you should see a specialist is not based solely on your PSA level but on the above points and also if you have been for a prostate biopsy in the past. A digital rectal examination (DRE) can also be done, to assess if your prostate feels normal.
Whilst it is normal to have a small amount of prostate specific antigen (PSA) in your blood, this level does increase with age, with prostate problems (prostatitis or an enlarged prostate) and also with:
Taking a PSA test comes with both advantages and disadvantages:
Then we would recommend you see your own doctor for further tests. Our doctors will advise on the next steps when your results come back.
Only by knowing your testosterone level can we decide if this treatment is right for you. You then have to wait three weeks for the medication to be fully absorbed into your system, so that a future test can tell if your levels have indeed increased.
Different treatments are applied to different areas of the body:
While there should be an improvement with your PSA level within 3 weeks, the level reached depends on your starting level, which would have been identified with the PSA test.
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