What is Virilon IM?
Virilon IM is a naturally occurring sex hormone produced in a man's testicles. Small amounts of Virilon IM are also produced in a woman's ovaries and adrenal system.
Virilon IM is used in men and boys to treat conditions caused by a lack of this hormone, such as delayed puberty, impotence, or other hormonal imbalances. This medicine is not for use in treating low Virilon IM without certain medical conditions or due to getting older.
Virilon IM enanthate is used in women to treat breast cancer that has spread to other parts of the body (metastatic) and cannot be treated with surgery.
Virilon IM will not enhance athletic performance and should not be used for that purpose.
Virilon IM may also be used for purposes not listed in this medication guide.
Virilon IM indications
Virilon IM Gel 1% is indicated for replacement therapy in adult males for conditions associated with a deficiency or absence of endogenous Virilon IM:
- Primary hypogonadism (congenital or acquired): testicular failure due to conditions such as cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome, orchiectomy, Klinefelter's syndrome, chemotherapy, or toxic damage from alcohol or heavy metals. These men usually have low serum Virilon IM concentrations and gonadotropins (follicle-stimulating hormone [FSH], luteinizing hormone [LH]) above the normal range.
- Hypogonadotropic hypogonadism (congenital or acquired): gonadotropin or luteinizing hormone-releasing hormone (LHRH) deficiency or pituitary-hypothalamic injury from tumors, trauma, or radiation. These men have low Virilon IM serum concentrations, but have gonadotropins in the normal or low range.
Limitations of use:
- Safety and efficacy of Virilon IM Gel 1% in men with “age-related hypogonadism” (also referred to as “late-onset hypogonadism”) have not been established.
- Safety and efficacy of Virilon IM Gel 1% in males less than 18 years old have not been established.
Topical Virilon IM products may have different doses, strengths or application instructions that may result in different systemic exposure (1, 12.3).
How should I use Virilon IM?
Use Virilon IM solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Virilon IM solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Virilon IM solution refilled.
- Prime this product before the first use. To prime it, depress the pump 3 times and wash any product that is dispensed down the sink.
- Depress the pump once to fill the applicator cup. Holding the applicator upright, wipe Virilon IM solution steadily up and down onto clean, dry skin in the armpit. If Virilon IM solution drips or runs, it can be wiped back up with the applicator cup. Do NOT apply Virilon IM solution to other parts of your body (eg, scrotum, penis, stomach, shoulders, upper arms). Do NOT apply it over open sores, wounds, or irritated skin.
- Do NOT use your fingers or hand to rub the medicine into the skin.
- You may need to alternate between armpits when applying Virilon IM solution. Be sure you understand how to apply Virilon IM solution. Contact your doctor or pharmacist if you have questions or concerns about how to apply Virilon IM solution.
- Wash your hands with soap and water immediately after using Virilon IM solution.
- Allow Virilon IM solution to dry completely before dressing.
- After Virilon IM solution has dried, cover the application site (eg, with a shirt) to prevent others from coming into contact with Virilon IM solution. If direct skin-to-skin contact with another person is expected, wash the application site well with soap and water to remove the medicine.
- After using Virilon IM solution, rinse the applicator with room temperature water and pat it dry with a tissue. Replace the applicator and cap on the bottle for storage.
- Do NOT get Virilon IM solution in your eyes. If you do, rinse thoroughly with water. If eye irritation persists, contact your doctor.
- Apply Virilon IM solution at the same time every morning after showering or bathing, unless your doctor tells you otherwise.
- If you are also using an antiperspirant or deodorant (stick or roll-on), apply it at least 2 minutes before you apply Virilon IM solution.
- For best results, wait 2 hours after applying Virilon IM solution before you wash the application site or swim.
- If you miss a dose of Virilon IM solution, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Virilon IM solution.
Uses of Virilon IM in details
Virilon IM is a male hormone primarily used to treat deficiency or absence of naturally produced hormone Virilon IM in men (hypogonadal disorders). The conditions include,
- Testicular diseases (primary hypogonadism) - diseases or conditions of testes, the organ that produces Virilon IM affecting secretion of Virilon IM.
- Pituitary diseases (secondary hypogonadism) - diseases or conditions of pituitary gland or hypothalamus that produce hormones (gonadotropins) which stimulate release of Virilon IM.
Virilon IM description
Virilon IM is a steroid sex hormone found in both men and women. In men, Virilon IM is produced primarily by the Leydig (interstitial) cells of the testes when stimulated by luteinizing hormone (LH). It functions to stimulate spermatogenesis, promote physical and functional maturation of spermatozoa, maintain accessory organs of the male reproductive tract, support development of secondary sexual characteristics, stimulate growth and metabolism throughout the body and influence brain development by stimulating sexual behaviors and sexual drive. In women, Virilon IM is produced by the ovaries (25%), adrenals (25%) and via peripheral conversion from androstenedione (50%). Testerone in women functions to maintain libido and general wellbeing. Virilon IM exerts a negative feedback mechanism on pituitary release of LH and follicle-stimulating hormone (FSH). Virilon IM may be further converted to dihydrotestosterone or estradiol depending on the tissue.
Virilon IM dosage
Virilon IM (Virilon IM (transdermal)) TTS
One system is applied at about the same time each day. The adhesive side of the Virilon IM (Virilon IM (transdermal)) TTS system should be placed on a clean, dry area of skin on the arm, back or upper buttocks immediately upon removal from the protective pouch. DO NOT APPLY TO THE SCROTUM. The area selected should not be oily, damaged, or irritated. The system should be pressed firmly in place with the palm of the hand for about 10 seconds, making sure there is good contact, especially around the edges. In the event that a system should fall off, the same system may be reapplied. If the system comes off after it has been worn for more than 12 hours and it cannot be reapplied, a new system may be applied at the next routine application time. In either case, the daily treatment schedule should be continued. The Virilon IM (Virilon IM (transdermal)) TTS system should be worn approximately 24 hours and then replaced. To ensure proper dosing, serum Virilon IM concentration may be measured 2-4 hours after an application of Virilon IM (Virilon IM (transdermal)) TTS. If the serum Virilon IM concentrations are low, the dosing regimen may be increased to 2 systems. Because of variability in analytical values among diagnostic laboratories, all Virilon IM measurements should be performed at the same laboratory.
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE
Patients should start therapy with a 6 mg/d system of either Virilon IM (Virilon IM (transdermal)) or Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE applied daily; if the scrotal area cannot accommodate a 6 mg/d system, a 4 mg/d Virilon IM (Virilon IM (transdermal)) system should be used. One Virilon IM (Virilon IM (transdermal)) or Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE system should be placed on clean, dry, scrotal skin. Scrotal hair should be dry-shaved for optimal skin contact. Chemical depilatories should not be used. Virilon IM (Virilon IM (transdermal)) or Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE should be worn 22-24 hours.
After 3-4 weeks of daily system use, blood should be drawn 2-4 hours after system application for determination of serum total Virilon IM. Because of variability in analytical values among diagnostic laboratories, this laboratory work and later analyses for assessing the effect of the Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE therapy should be performed at the same laboratory.
If patients have not achieved desired results by the end of 6-8 weeks of treatment with any of the Virilon IM (Virilon IM (transdermal)) products, another form of Virilon IM replacement therapy should be considered.
How supplied
Virilon IM (Virilon IM (transdermal)) TTS, Virilon IM (Virilon IM (transdermal)), and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE Virilon IM transdermal systems contain a Schedule III controlled substance as defined by the Anabolic Steroids Control Act.
Virilon IM (Virilon IM (transdermal)) TTS
Virilon IM (Virilon IM (transdermal)) TTS systems are supplied as individually pouched systems, 30 per carton. Virilon IM (Virilon IM (transdermal)) TTS 5 mg/d (Virilon IM Transdermal System) -- each 60 cm2 system contains 328 mg Virilon IM USP for nominal dose of 5 mg/day
Carton of 30 Virilon IM (Virilon IM (transdermal)) TTS 5 mg/d systemsNDC 17314-4717-3
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE systems are supplied as individually pouched systems, 30 per carton.
Virilon IM (Virilon IM (transdermal)) 4 mg/d (Virilon IM Transdermal System) -- each 40 cm2 system contains 10 mg Virilon IM USP for nominal delivery of 4 mg for one day.
Carton of 30 Virilon IM (Virilon IM (transdermal)) 4 mg/d systems. NDC 17314-4608-3
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE
6 mg/d (Virilon IM Transdermal System) -- each 60 cm2 system contains 15 mg Virilon IM USP for nominal delivery of 6 mg for one day.
Carton of 30 Virilon IM (Virilon IM (transdermal)) 6 mg/d systems. NDC 17314-4609-3
Carton of 30 Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE 6 mg/d systemsNDC 17314-2836-3
Storage
Virilon IM (Virilon IM (transdermal)) TTS
Store at controlled room temperature below 25oC (77oF).
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE
Store at room temperature 15-30oC (59-86oF).
Disposal
Virilon IM (Virilon IM (transdermal)) products should be discarded in household trash in a manner that prevents accidental application or ingestion by children or pets.
Caution: Federal law prohibits dispensing without prescription.
REFERENCE
1. Matsumoto AM, Sandblom RE, Schoene RB et al. Virilon IM replacement in hypogonadal men: Effects on obstructive sleep apnoea, respiratory drives, and sleep. Clin Endocrinol (1985) 22: 713-721.
2. Schneider BK, Pickett CK, Zwillich CW et al. Influence of Virilon IM on breathing during sleep. J Appl Physiol (1986) 61: 618-623.
3. Matsumoto AM. Hormonal therapy of male hypogonadism. Endocrinol Metab Clin North Am. (1994) 23: 857-875.
4. Bardin CW, Swerdloff RS, Santen RJ. Androgens: Risks and benefits. J Clin Endocinol Metab (1991) 73: 4-7.
5. Nieschlag E, Wang CCL. Guidelines for the use of androgens in men. Geneva: World Health Organization (1992); 1-16.
6. Walle T, Walle UK, Mathur RS et al. Propranolol metabolism in normal subjects: Association with sex steroid hormones. Curr Pharmacol Ther (1994) 56:127-132.
7. Physicians Generic Rx: The Complete Drug Reference. (1996); II-1972
Virilon IM interactions
See also:
What other drugs will affect Virilon IM?
Drug Interactions
Anticoagulants: C-17 substituted derivatives of Virilon IM, such as methandrostenolone, have been reported to decrease the anticoagulant requirements of patients receiving oral anticoagulants. Patients receiving oral anticoagulant therapy require close monitoring, especially when androgens are started or stopped.
Oxyphenbutazone: Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.
Insulin: In diabetic patients, the metabolic effects of androgens may decrease blood glucose and therefore, insulin requirements.
Propranolol: In a published pharmacokinetic study of an injectable Virilon IM product, administration of Virilon IM cypionate led to an increased clearance of propranolol in the majority of men tested.6
Corticosteroids: The concurrent administration of Virilon IM with ACTH or corticosteroids may enhance edema formation; thus these drugs should be administered cautiously, particularly in patients with cardiac or hepatic disease.7
Drug/Laboratory Test Interactions
Androgens may decrease levels of thyroxin-binding globulin, resulting in decreased total T. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.
The Virilon IM (Virilon IM (transdermal)) products contain a Schedule III controlled substance as defined by the Anabolic Steroids Control Act.
Virilon IM (Virilon IM (transdermal)) TTS is designed for application to arm, back or upper buttocks skin.
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE are designed for application to scrotal skin only. Because scrotal skin is at least five times more permeable to Virilon IM than other skin sites, Virilon IM (Virilon IM (transdermal)) or Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE will not produce adequate serum Virilon IM concentrations if applied to non-scrotal skin.
Ingestion of Virilon IM, or the contents of any of the Virilon IM (Virilon IM (transdermal)) products will not result in clinically significant serum Virilon IM concentrations due to extensive first-pass metabolism. In addition, an intramuscular injection of Virilon IM from any of the Virilon IM (Virilon IM (transdermal)) products will not produce adequate serum Virilon IM levels due to its short half-life (about 10 minutes).
Virilon IM side effects
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What are the possible side effects of Virilon IM?
Adverse events are reported in this section by product. Adverse events reported during use of a given product may occur in patients who are treated with any Virilon IM (Virilon IM (transdermal)) product.
Adverse Events with Virilon IM (Virilon IM (transdermal)) TTS
In clinical studies of 457 participants (116 hypogonadal males and 341 healthy adult males) treated for up to 6 weeks with Virilon IM (Virilon IM (transdermal)) TTS, the most commonly reported adverse events were application site reactions of transient itching (12%) and moderate or severe erythema (3%).
Adverse events reported by less than 1% of Virilon IM (Virilon IM (transdermal)) TTS users in clinical trials that were of probable or unknown relationship to drug were:
Topical Reactions
Of 457 study participants, 3 men (1%) discontinued prematurely because of application site reactions.
There were no clinically significant differences in skin tolerability in younger (<65 years old) and older (³ 65 years old) subjects.
A contact sensitization rate of 0.5% for Virilon IM (Virilon IM (transdermal)) TTS was observed in a 6-week study of 233 normal male volunteers.
In one study with 14 days of daily use, 42% of patients reported 3 or more detachments of their Virilon IM (Virilon IM (transdermal)) TTS; of these detachments, 33% occurred during exercise.
Adverse Events with Virilon IM (Virilon IM (transdermal))
In clinical studies of 104 patients treated with Virilon IM (Virilon IM (transdermal)), the most common adverse effects reported were local effects. In US clinical trials, most of the 72 patients filling out a daily questionnaire reported scrotal itching, discomfort, or irritation at some time during therapy. Of all the daily questionnaire responses, 7% reported itching, 4% discomfort, and 2% irritation. All topical reactions decreased with duration of use.
The following adverse effects (greater than 1%) were reported in association with Virilon IM (Virilon IM (transdermal)) therapy in 104 patients using the product for up to three years. These effects are listed in decreasing frequency of occurrence with the percentages of patients reporting the effect in parentheses: Gynecomastia (5%), acne (4%), prostatitis/urinary tract infection (4%), breast tenderness (3%), stroke (2%). For this same patient population, the following adverse effects were reported by 1% of users: memory loss, pupillary dilation, abnormal liver enzymes, scrotal cellulitis, deep vein phlebitis, benign prostatic hyperplasia, rectal mucosal lesion over prostate, hematuria/bladder cancer, papilloma on scrotum, and congestive heart failure.
Adverse Events with Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE
In a pharmacokinetic study in 50 normal men, skin assessment scores following a single 24-hour application of Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE to scrotal skin were similar to those for Virilon IM (Virilon IM (transdermal)). Other adverse events reported during the study were headache (6%), dizziness (6%), back pain, pain, nausea, and pustular rash (1% each).
General Adverse Events with Androgen Replacement Therapy
Skin and Appendages: Hirsutism, male pattern baldness, seborrhea, and acne.
Endocrine and Urogenital: Gynecomastia and excessive frequency and duration of penile erections. Oligospermia may occur at high doses.
Fluid and Electrolyte Disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.
Gastrointestinal: Nausea, cholestatic jaundice, alterations in liver function tests. Rare instances of hepatocellular neoplasms and peliosis hepatis have occurred.
Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia.
Nervous System: Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia.
Metabolic: Increased serum cholesterol.
Miscellaneous: Rarely, anaphylactoid reactions.
DRUG ABUSE AND DEPENDENCE
The Virilon IM (Virilon IM (transdermal)) products contain a Schedule III controlled substance as defined by the Anabolic Steroids Control Act.
Virilon IM (Virilon IM (transdermal)) TTS is designed for application to arm, back or upper buttocks skin.
Virilon IM (Virilon IM (transdermal)) and Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE are designed for application to scrotal skin only. Because scrotal skin is at least five times more permeable to Virilon IM than other skin sites, Virilon IM (Virilon IM (transdermal)) or Virilon IM (Virilon IM (transdermal)) WITH ADHESIVE will not produce adequate serum Virilon IM concentrations if applied to non-scrotal skin.
Ingestion of Virilon IM, or the contents of any of the Virilon IM (Virilon IM (transdermal)) products will not result in clinically significant serum Virilon IM concentrations due to extensive first-pass metabolism. In addition, an intramuscular injection of Virilon IM from any of the Virilon IM (Virilon IM (transdermal)) products will not produce adequate serum Virilon IM levels due to its short half-life (about 10 minutes).
Virilon IM contraindications
See also:
What is the most important information I should know about Virilon IM?
-
Virilon IM Gel 1% is contraindicated in men with carcinoma of the breast or known or suspected carcinoma of the prostate.
-
Virilon IM Gel 1% is contraindicated in women who are or may become pregnant, or who are breastfeeding. Virilon IM Gel 1% may cause fetal harm when administered to a pregnant woman. Virilon IM Gel 1% may cause serious adverse reactions in nursing infants. Exposure of a female fetus or nursing infant to androgens may result in varying degrees of virilization. Pregnant women or those who may become pregnant need to be aware of the potential for transfer of Virilon IM from men treated with Virilon IM Gel 1%. If a pregnant woman is exposed to Virilon IM Gel 1%, she should be apprised of the potential hazard to the fetus.
Active ingredient matches for Virilon IM:
List of Virilon IM substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Testoviron Schering | |
| Testoviron T | |
| Testoviron-Depot (Argentina, Ethiopia, Germany, Hong Kong, India, Oman, Peru, Switzerland, Thailand) | |
| Testoviron-Depot Paranova (Denmark) | |
| Testoviron-Depot-250 (Germany) | |
| Testovis (Italy) | |
| Testovital (Chile) | |
| Gel; Topical; Testosterone Micronized 1% | |
| Testovital 1% (Peru) | |
| Testoxyl | |
| Testozzard | |
| Testred Cypionate 200 | |
| Testred Injections | |
| Injectable; Injection; Testosterone Cypionate | |
| Testrex | |
| Testrin-P.A | |
| Testrin-P.A. | |
| Testro | |
| Testro AQ | |
| Testro-LA | |
| Testron Depot (Japan) | |
| Testrone | |
| Testryl | |
| Tostran (Czech Republic, Denmark, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Switzerland, United Kingdom) | |
| Tostran 2% (Poland) | |
| Tostran 2% Gel (United Kingdom) | |
| Tostrelle | |
| Tostrex (Italy, South Korea) | |
| Tostrex 2 % x 60 g x 1's (Kalbe Farma) | |
| Tostrin | |
| Triolandren | |
| Undestor (Argentina, Bulgaria, Czech Republic, Poland, Romania, Slovakia, Sweden) | |
| Undestor Testocaps (Sweden) | |
| Uni-Test | |
| Injectable; Injection; Testosterone 100 mg / ml | |
| Uniteston | |
| Veto-Test | |
| Injectable; Injection; Testosterone 100 mg / ml | |
| Virigen (Denmark, Turkey) | |
| Virilisterona | |
| Virilon Injections | |
| Injectable; Injection; Testosterone Cypionate | |
| Virormone (Bahrain, Cyprus, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, United Kingdom, Yemen) | |
| Virosterone | |
| Vulvan | |
| Xyosted | |
See 613 substitutes for Virilon IM | |
References
- DailyMed. "TESTOSTERONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "testosterone". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "testosterone". http://www.drugbank.ca/drugs/DB00624 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Virilon IM are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Virilon IM. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
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Information checked by Dr. Sachin Kumar, MD Pharmacology
