Recommended Dosage of Cernos (Testosterone Undecanoate)
The recommended dosage of Cernos (Testosterone Undecanoate) is 750 mg initially, followed by 750 mg after 4 weeks, then 750 mg every 10 weeks thereafter as an intramuscular gluteal injection. 1
Administration Details
- Testosterone undecanoate is administered as an intramuscular injection into the gluteal muscle only 1
- The long-acting formulation provides stable testosterone levels with fewer injections per year compared to other testosterone preparations 1
- The 750 mg dose is standardized and does not typically require adjustment based on body weight 1
Clinical Considerations
- Testosterone undecanoate has fewer peaks and valleys in serum testosterone levels compared to shorter-acting testosterone formulations 1
- The extended interval between doses (10 weeks after the loading doses) improves treatment adherence compared to weekly or biweekly injections 1
- There is no risk of testosterone transfer to partners or children, which can occur with topical formulations 1
Monitoring Recommendations
- Baseline testosterone levels should be measured before initiating therapy 1
- Monitor testosterone levels periodically during treatment to ensure therapeutic levels are maintained 1
- Regular monitoring of hematocrit, hemoglobin, liver function, and prostate-specific antigen (PSA) is recommended during treatment 1
Potential Adverse Effects
- Injection-associated pulmonary oil microembolism is a rare but serious potential complication 1
- Common side effects may include injection site pain, mood changes, increased red blood cell count, and acne 1
- Testosterone therapy may worsen benign prostatic hyperplasia symptoms in older men 2
Special Populations
- Testosterone undecanoate is not recommended for use in women or children 1
- In elderly patients, careful monitoring for prostate issues is essential as testosterone may affect prostate health 2
Comparative Context
- Unlike shorter-acting testosterone esters (enanthate, cypionate) that require injections every 1-2 weeks, testosterone undecanoate requires only 4-5 injections per year 1
- Compared to transdermal formulations, testosterone undecanoate eliminates the risk of transfer to others and skin irritation issues 1
Common Pitfalls
- Failure to administer the second dose at 4 weeks may result in suboptimal testosterone levels 1
- Administering injections outside the gluteal muscle (such as in the deltoid or thigh) is not recommended and may alter drug absorption 1
- Restricted access in some countries may limit availability compared to other testosterone formulations 1