BNF for Children (BNFC) 2018-2019

Spironolactone is sometimes used in combination with
testolactone because it has some androgen receptor blocking
properties.
High blood concentration of sex hormones may activate
release of gonadotrophin releasing hormone, leading to
development of secondary, central gonadotrophin-
dependent precocious puberty. This may require the
addition of gonadorelin analogues to prevent progression of
pubertal development and skeletal maturation.
Anabolic steroids have some androgenic activity but they
cause less virilisation than androgens in girls. They are used
in the treatment of someaplastic anaemias.
Oxandrolone is used to stimulate late pre-pubertal growth
prior to induction of sexual maturation in boys with short
stature and in girls with Turner’s syndrome; specialist
management is required.

ANABOLIC STEROIDS›ANDROSTAN

DERIVATIVES

Oxandrolone

lINDICATIONS AND DOSE

Stimulation of late pre-pubertal growth in boys (of

appropriate age) with short stature

▶BY MOUTH

▶Child 10–17 years (male): 1. 25 – 2. 5 mg daily for

3 – 6 months.

Stimulation of late pre-pubertal growth in girls with

Turner’s syndrome

▶BY MOUTH

▶Child (female): 0. 625 – 2. 5 mg daily, to be taken in

combination with growth hormone.

lCONTRA-INDICATIONSHistory of primary liver tumours.
hypercalcaemia.nephrosis

lCAUTIONSCardiac impairment.diabetes mellitus.
epilepsy.hypertension.migraine.skeletal metastases
(risk of hypercalcaemia)

lSIDE-EFFECTS
▶Common or very commonAndrogenetic alopecia.
androgenic effects.anxiety.asthenia.bone formation
increased.depression.electrolyte imbalance.epiphyses
premature fusion (in pre-pubertal males).gastrointestinal
haemorrhage.gynaecomastia.headache.hirsutism.
hypertension.jaundice cholestatic.nausea.oedema.
paraesthesia.polycythaemia.precocious puberty (in pre-
pubertal males).seborrhoea.sexual dysfunction.skin
reactions.spermatogenesis reduced.virilism.weight
increased
▶Rare or very rareHepatic neoplasm
▶Frequency not knownSleep apnoea

lPREGNANCYAvoid—causes masculinisation of female
fetus.

lBREAST FEEDINGAvoid; may cause masculinisation in the
female infant or precocious development in the male
infant. High doses suppress lactation.

lHEPATIC IMPAIRMENTAvoid if possible—fluid retention
and dose-related toxicity.

lRENAL IMPAIRMENTUse with caution—potential forfluid
retention.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet
Tablet
▶Oxandrin (Imported (Australia))
Oxandrolone 2.5 mgOxandrin 2. 5 mg tablets|
100 tabletPse

ANDROGENS

Androgens f

lCONTRA-INDICATIONSBreast cancer in males.history of

liver tumours.hypercalcaemia.prostate cancer

lCAUTIONSCardiac impairment.diabetes mellitus.

epilepsy.hypertension.migraine.pre-pubertal boys

(fusion of epiphyses is hastened and may result in short

stature)—statural growth and sexual development should

be monitored.skeletal metastases—risk of hypercalcaemia

or hypercalciuria (if this occurs, treat appropriately and

restart treatment once normal serum calcium

concentration restored).sleep apnoea.stop treatment or

reduce dose if severe polycythaemia occurs.tumours—risk

of hypercalcaemia or hypercalciuria (if this occurs, treat

appropriately and restart treatment once normal serum

calcium concentration restored)

lSIDE-EFFECTS

▶Common or very commonHeadache.skin reactions

▶UncommonAlopecia.gynaecomastia.nausea

▶Frequency not knownFluid retention.jaundice.

polycythaemia.sexual dysfunction

SIDE-EFFECTS, FURTHER INFORMATIONStop treatment or

reduce dose if severe polycythaemia occurs.

lPREGNANCYAvoid—causes masculinisation of female

fetus.

lBREAST FEEDINGAvoid.

lHEPATIC IMPAIRMENTAvoid if possible—fluid retention

and dose-related toxicity.

lRENAL IMPAIRMENTCaution—potential forfluid

retention.

lMONITORING REQUIREMENTSMonitor haematocrit and

haemoglobulin before treatment, every three months for

thefirst year, and yearly thereafter.

eiiiiFabove

Testosterone enantate

lINDICATIONS AND DOSE

Induction and maintenance of sexual maturation in males

(specialist use only)

▶BY DEEP INTRAMUSCULAR INJECTION

▶Child 12–17 years: 25 – 50 mg/m^2 every month, increase

dose every 6 – 12 months according to response

lUNLICENSED USENot licensed for use in children.

lCAUTIONSThrombophilia—increased risk of thrombosis

lSIDE-EFFECTSAndrogenetic alopecia.anxiety.asthenia.

bone disorders.circulatory system disorder.depression.

gastrointestinal disorder.gastrointestinal haemorrhage.

hepatomegaly.hypercalcaemia.libido increased.

neoplasms.oedema.paraesthesia.precocious puberty.

prostatic disorder.spermatogenesis abnormal.urticaria

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Solution for injection

▶Testosterone enantate (Non-proprietary)

Testosterone enantate 250 mg per 1 mlTestosterone enantate

250 mg/ 1 ml solution for injection ampoules| 3 ampouleP

£ 83. 74 – £ 87. 73 DT = £ 85. 74 e

BNFC 2018 – 2019 Male sex hormone responsive conditions 481

Endocrine system

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