Testosterone Replacement Therapy with Nebido

Standard Dosing Protocol

The American College of Physicians recommends an initial dose of 1000 mg testosterone undecanoate, followed by a second injection after 6 weeks, and subsequent injections every 12 weeks thereafter 1

Target serum testosterone levels should be in the mid- to upper-normal physiological range for optimal clinical response, as suggested by the Endocrine Society 2, 1

Initial follow-up should be 1-2 months after starting treatment to assess efficacy and consider dose adjustments, according to the American Academy of Family Physicians 2
Subsequent monitoring should be every 3-6 months for the first year, then yearly thereafter, as recommended by the American College of Physicians 2
Testosterone levels should be measured midway between injections, targeting mid-normal values, as suggested by the European Association of Urology 3, 1

Monitor for potential adverse effects, including hematocrit/hemoglobin increases, PSA elevation, fluid retention, and local injection site reactions, as recommended by the American Urological Association 2, 1
If hematocrit rises above the reference range, consider temporarily withholding treatment, reducing the dose, or performing phlebotomy, according to the National Institute of Diabetes and Digestive and Kidney Diseases 2
Prostate monitoring is mandatory with regular PSA measurements and digital rectal examinations, as recommended by the American Cancer Society 2, 4

Not monitoring testosterone levels at appropriate intervals between injections, as recommended by the Endocrine Society 2, 3
Overlooking the need for regular prostate monitoring and hematocrit assessment, according to the American Urological Association 2, 4