Nursing Alert

This system is designed for application to scrotal skin only (the system is five times more permeable to scrotal skin). Testoderm or Testoderm Adhesive will not produce adequate serum testosterone levels if applied to other skin sites.

The system is worn for 22 to 24 hours, removed, and a new system applied. If the system comes off before it has been on 12 hours, it can be reapplied; however, if the system has been on more than 12 hours, the patient may wait until the next scheduled application time to apply a new patch. Before application of a new system, the skin of the scrotum is washed and dried. The nurse periodically checks the scrotum for scrotal hair and dry shaves the area if needed.

Another transdermal system is Testoderm TTS. This system is applied at about the same time each day and worn for 24 hours. The adhesive side is placed on a clean, dry area of skin on the arm, back, or upper buttocks immediately upon removal from the protective pouch. This system is not applied to the scrotum. The system is pressed firmly in place with the palm of the hand for about 10 seconds or until good contact is made with the skin. If the system falls off, the same system may be reapplied unless the system has been worn for 12 hours or more and it cannot be reapplied. Should this occur, the nurse applies the new system at the next scheduled application time.

Androderm, another transdermal system, is applied nightly to clean, dry skin on the abdomen, thigh, back, or upper arm. This system is not applied to the scrotum. Sites are rotated, with 7 days between application to any specific site. The system is applied immediately after opening the pouch and removing the protective covering. If the patient has not exhibited a therapeutic response after 8 weeks of therapy, another form of testosterone replacement therapy should be considered.

Testosterone gel (Androgel) is applied once daily (preferably in the morning) to clean, dry, intact skin of the shoulders and upper arms or abdomen. After the packet is opened, the contents are squeezed into the palm of the hand and immediately applied to the application sites. The application sites are allowed to dry before the patient gets dressed. The gel is not applied to the genitals.

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