Oral testosterone undecanoate therapy
The present disclosure provides methods and compositions for testosterone replacement therapy. The methods and compositions employ a fixed dose dosing regimen that does not require titration or dose adjustments and that can provide a therapeutically effective amount of a testosterone ester while avoiding unacceptably high testosterone levels.
1. A method of restoring serum testosterone levels to a normal eugonadal range in a male having a condition associated with a deficiency or absence of endogenous testosterone, comprising orally administering a pharmaceutical composition comprising a therapeutically effective amount of testosterone undecanoate (TU) and an additive as a hard or soft capsule in a unit dosage form providing 112.5 mg or 225 mg of TU in a fixed dose administration regimen of twice daily administration with food to provide a total daily dose of TU of from 420-500 mg, said method further comprising discontinuing said orally administering when said male consistently has serum testosterone concentrations above about 1040-1100 ng/dl measured about 8-9 hours after a single dose administration of said pharmaceutical composition, wherein said serum testosterone concentrations are measured on at least two or more separate occasions with a gap of at least 24 hours.
2. A method of restoring daily average serum testosterone (C avg ) to a normal eugonadal range in at least 75% of males in a population having a condition associated with a deficiency or absence of endogenous testosterone, comprising oral administration of an oral dosage form comprising a therapeutically effective amount of testosterone undecanoate (TU) and an additive as a hard or soft capsule in a unit dosage form providing 112.5 mg or 225 mg of TU in a fixed dose administration regimen of twice daily with food to provide a total daily dose of TU of from 420-500 mg, said method further comprising discontinuing said oral administration when said male consistently has serum testosterone concentrations above about 1040-1100 ng/dl measured about 8-9 hours after a single dose administration of said pharmaceutical composition, wherein said serum testosterone concentrations are measured on at least two or more separate occasions with a gap of at least 24 hours.
3. A method of treating a condition associated with a deficiency or absence of endogenous testosterone in a male patient, comprising: orally administering a composition comprising testosterone undecanoate (TU) and an additive as a hard or soft capsule in a unit dosage form providing 112.5 or 225 mg of TU in a in a fixed dose dosing regimen of twice daily with food to provide a total daily dose of TU of from 420-500 mg TU, said method further comprising discontinuing said orally administering when said male consistently has serum testosterone concentrations above about 1040-1100 ng/dl measured about 8-9 hours after a single dose administration of said pharmaceutical composition, wherein said serum testosterone concentrations are measured on at least two or more separate occasions with a gap of at least 24 hours.
4. The method of claim 3 , further comprising determining a serum testosterone level of said male patient after initiation of administration of TU.
5. The method of claim 3 , further comprising determining a serum testosterone level of said male after initiation of TU administration, wherein unacceptably low serum testosterone levels after reaching a steady state indicates an advised discontinuation of therapy.
6. The method of claim 3 , wherein the fixed dose provides about 450 mg testosterone undecanoate per day.
7. The method of claim 3 , wherein the fixed dose provides safe and efficacious testosterone replacement therapy.
8. The method of claim 3 , wherein the fixed dose provides about 225 mg testosterone undecanoate per dose.
9. The method of claim 3 , further comprising determining a total serum testosterone concentration, wherein a total serum testosterone concentration that is consistently below 300 ng/dL indicates an advised discontinuation of therapy.
10. The method of claim 3 , further comprising assessing discontinuation criteria at steady state.
11. The method of claim 3 , further comprising assessing discontinuation criteria at steady state by measuring serum testosterone concentrations.
12. The method of claim 3 , further comprising determining a hematocrit or PSA level for the patient, wherein an unacceptably high hematocrit level or an unacceptably high PSA level indicates an advised discontinuation of therapy.
13. The method of claim 3 , wherein administration of the fixed dose of TU in the fixed dose dosing regimen provides ≥75% of patients in a population with an average serum T (C avg ) within a normal range, wherein the population comprises a group of at least 20 individuals.
14. The method of claim 3 , wherein administration of the fixed dose of TU in the fixed dose dosing regimen provides ≥65% of patients in a population with an average serum T (C avg ) within a normal range, wherein the population comprises a group of at least 20 individuals.
15. The method of claim 3 , wherein administration of the fixed dose of TU in the fixed dose dosing regimen provides ≥75% of patients in a population with a C max <1500 ng/dL, wherein the population comprises a group of at least 20 individuals.
16. The method of claim 3 , wherein administration of the fixed dose of TU in the fixed dose dosing regimen provides ≥90% of patients in a population with a C max <1800 ng/dL, wherein the population comprises a group of at least 20 individuals.
17. The method of claim 3 , wherein administration of the fixed dose of TU in the fixed dose dosing regimen provides ≥95% of patients in a population with a C max <2500 ng/dL, wherein the population comprises a group of at least 20 individuals.