Axiron vs. Androgel

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Axiron vs. Androgel comparison

The active ingredient in both Axiron and Androgel is synthetic testosterone, and both medications consist of topical gel that allows the testosterone to absorb through the skin. Doctors prescribe these drugs to adult males who for some reason, whether a physical condition or a result of aging, are lacking normal testosterone levels.

The only difference between these two gel medications is where on your body you're supposed to put it. Axiron gel is applied in the armpits, while Androgel is applied to the upper arm, shoulders, or abdomen.

The main side effect of both these medications are itching, blisters, and redness at the application site.

What are Axiron and Androgel?

Both Axiron and Androgel are skin ointments that deliver laboratory-manufactured testosterone through the skin. Pharmaceutical researchers developed this therapy in part because testosterone production in men tends to decline as they age, causing muscle loss, bone weakness, loss of libido, erectile dysfunction, and fat accumulation. Scientists sometimes refer to this slowdown in testosterone production as "andropause," but physiologically, it's only superficially similar to menopause in women, which is a much more drastic hormonal change.

Testosterone (also referred to as an "androgen") production in men starts ramping up during puberty, and testosterone production by the testes is the end hormonal result of a production chain involving the brain and endocrine system. The hypothalamus of the brain, a structure behind the base of the forebrain, secretes gonadotropin-releasing hormone, which stimulates the nearby pituitary gland to release luteinizing hormone, which then stimulates the testicles to produce testosterone.

Testosterone, a lipid-soluble (fat-soluble) hormone, can pass through the membranes of cells because cell membranes are made of fats. Inside the cell, floating around in the cytoplasm, are protein molecules called androgen receptors (AR), which are shaped in such a way they fit like a puzzle piece with testosterone molecules. When a testosterone molecule locks into the androgen receptor, the whole assembly migrates into the cell nucleus where the DNA is stored. The testosterone-AR assembly interacts directly with the DNA to help the cell "read" the code, allowing it to produce the necessary proteins to maintain muscle mass, hair growth, genital function and other male sex characteristics.

Axiron and Androgel help replace the missing testosterone to help maintain mood, sexual function, muscle mass, and bone strength.

Quick GuideLow Testosterone (Low T) Treatments

Low Testosterone (Low T) Treatments

What are the uses for Axiron and Androgel?

Axiron and Androgel are both testosterone replacement products used for men 18 years old or older for treatment of low testosterone (low T) or absence of testosterone due to primary hypogonadism or hypogonadotropic hypogonadism. It is most often used for treatment of a slowdown in testosterone production in aging men.

What are the side effects of Axiron and Androgel?

The most common side effects for topical testosterone supplements are application site reactions such as itching, blisters, and redness.

Other side effects include:

Other important side effects include:

How should Axiron and Androgel be taken (dosage)?

Axiron

The recommended dose is 30 to 120 mg daily once every morning at approximately the same time. The starting dose is 30 mg (1 pump actuation) applied to each armpit (60 mg total). The total daily dose may be decreased to 30 mg or increased to 90 mg (3 pump actuations) or from 90 to 120 mg (4 pump actuations) based on blood testosterone levels. Hands should be washed thoroughly with soap and water after applying Axiron.

Androgel

The recommended starting dose is 50 mg applied once daily to the skin of shoulders, upper arm, or abdomen. The dose may be increased based on blood testosterone levels. The hands should be washed thoroughly with soap and water after applying Androgel.

Which drugs interact with Axiron and Androgel?

Testosterone may decrease blood glucose levels. Therefore, less insulin may be required in diabetic patients. Testosterone may increase the the action of the blood thinner warfarin (Coumadin), increasing the risk of bleeding. Combining steroids with testosterone may increase fluid retention.

Are Axiron and Androgel safe to take during pregnancy or while breastfeeding?

Women in general should not only avoid ever using Axiron and Androgel, but they should also avoid even accidental contact with the medication and parts of men's bodies where they have applied the ointment. Testosterone is harmful to a developing fetus and can cause adverse side effects to a nursing baby.

REFERENCES:

FDA Prescribing Information

"Androgen Physiology: Receptor and Metabolic Disorders"
Iain J McEwan, PhD and Albert O Brinkmann, PhD
EndoText.org
June, 2016

"Testosterone Compound Summary"
PubChem

"Transdermal testosterone replacement therapy in men"
M Iftekhar Ullah, Daniel M Riche, and Christian A Koch
Drug Design, Development and Therapy
January, 2014

"The benefits and risks of testosterone replacement therapy: a review"
Nazem Bassil, Saad Alkaade, and John E Morley
Therapeutics and Clinical Risk Management
June, 2009

"Chemistry and Structural Biology of Androgen Receptor"
Wenqing Gao, Casey E. Bohl, and James T. Dalton
Chemical Reviews
September, 2005

"The Gonad"
Nussey S. Whitehead
Endocrinology: An Integrated Approach
Oxford BIOS Scientific Publishers, 2001

"Decreased Testosterone in the Aging Male"
Jacob Rajfer, MD, Supplement Editor
Reviews in Urology
2003

Last Editorial Review: 4/19/2017

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Reviewed on 4/19/2017
References
REFERENCES:

FDA Prescribing Information

"Androgen Physiology: Receptor and Metabolic Disorders"
Iain J McEwan, PhD and Albert O Brinkmann, PhD
EndoText.org
June, 2016

"Testosterone Compound Summary"
PubChem

"Transdermal testosterone replacement therapy in men"
M Iftekhar Ullah, Daniel M Riche, and Christian A Koch
Drug Design, Development and Therapy
January, 2014

"The benefits and risks of testosterone replacement therapy: a review"
Nazem Bassil, Saad Alkaade, and John E Morley
Therapeutics and Clinical Risk Management
June, 2009

"Chemistry and Structural Biology of Androgen Receptor"
Wenqing Gao, Casey E. Bohl, and James T. Dalton
Chemical Reviews
September, 2005

"The Gonad"
Nussey S. Whitehead
Endocrinology: An Integrated Approach
Oxford BIOS Scientific Publishers, 2001

"Decreased Testosterone in the Aging Male"
Jacob Rajfer, MD, Supplement Editor
Reviews in Urology
2003

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