Certain medical conditions may warrant avoiding Kyzatrex testosterone therapy or require careful monitoring and consultation with a healthcare provider. Kyzatrex, like other testosterone replacement therapies (TRT), has been shown to increase blood pressure, particularly in men already on antihypertensive therapy. Patients with pre-existing hypertension or cardiovascular conditions should be closely monitored, as TRT can be associated with higher cardiovascular risks, including an increased risk of ischemic heart disease and other cardiovascular events. While some studies suggest that TRT does not increase the risk of prostate cancer recurrence or death after treatment for localized disease, it is generally contraindicated in men with advanced prostate cancer. Regular monitoring of prostate-specific antigen (PSA) levels is recommended for men undergoing TRT, and TRT can exacerbate symptoms of benign prostatic hyperplasia (BPH), leading to urinary retention and other complications.
Additionally, TRT can increase red blood cell count, leading to polycythemia, which can increase the risk of thromboembolic events, necessitating regular monitoring of hematocrit levels. Oral testosterone formulations, including Kyzatrex, can have hepatotoxic effects, so patients with pre-existing liver conditions should use TRT with caution and under strict medical supervision. TRT can also worsen sleep apnea, suppress spermatogenesis, leading to reduced fertility, and, although rare, increase the risk of male breast cancer. It is crucial for patients to undergo a thorough medical evaluation and engage in shared decision-making with their healthcare provider to weigh the benefits and risks of TRT. Regular monitoring and follow-up are essential to ensure safety and efficacy.
Further Reading:
- Sarkar, R. R., Patel, S. H., J. Kellogg Parsons, Deka, R., Kumar, A., Einck, J. P., Mundt, A. J., A. Karim Kader, Kane, C. J., Riviere, P., McKay, R., Murphy, J. D., & Rose, B. S. (2020). Testosterone therapy does not increase the risks of prostate cancer recurrence or death after definitive treatment for localized disease. Prostate Cancer and Prostatic Diseases, 23(4), 689–695. https://doi.org/10.1038/s41391-020-0241-3
- White, W. B., Bernstein, J. S., Rittmaster, R., & Dhingra, O. (2021). Effects of the oral testosterone undecanoate KyzatrexTM on ambulatory blood pressure in hypogonadal men. The Journal of Clinical Hypertension, 23(7), 1420–1430. https://doi.org/10.1111/jch.14297
- Desai, A., Yassin, M., Cayetano, A., Tharakan, T., Jayasena, C. N., & Minhas, S. (2022). Understanding and managing the suppression of spermatogenesis caused by testosterone replacement therapy (TRT) and anabolic–androgenic steroids (AAS). Therapeutic Advances in Urology, 14, 175628722211050. https://doi.org/10.1177/17562872221105017
- Bhasin, S., Travison, T. G., Pencina, K. M., O’Leary, M., Cunningham, G. R., Lincoff, A. M., Nissen, S. E., Lucia, M. S., Preston, M. A., Khera, M., Khan, N., Snabes, M. C., Li, X., Tangen, C. M., Buhr, K. A., & Thompson, I. M., Jr. (2023). Prostate Safety Events During Testosterone Replacement Therapy in Men with Hypogonadism: A Randomized Clinical Trial. JAMA Network Open, 6(12), e2348692. https://doi.org/10.1001/jamanetworkopen.2023.48692
- Maatje, M. G. F., Dinkelman-Smit, M., Boellaard, W. P. A., & Dohle, G. R. (2018). [Testosterone therapy: indications and risks]. Nederlands Tijdschrift Voor Geneeskunde, 162, D1947. https://pubmed.ncbi.nlm.nih.gov/29303101/
- Luther, P. M., Spillers, N. J., Talbot, N. C., Sinnathamby, E. S., Ellison, D., Kelkar, R. A., Ahmadzadeh, S., Shekoohi, S., & Kaye, A. D. (2024). Testosterone replacement therapy: clinical considerations. Expert Opinion on Pharmacotherapy, 25(1), 25–35. https://doi.org/10.1080/14656566.2024.2306832
- Elsherbiny, A., Tricomi, M., Bhatt, D.V., & Dandapantula, H.K. (2017). ISCHEMIC HEART DISEASE (D MUKHERJEE , SECTION EDITOR ) State-of-the-Art : a Review of Cardiovascular Effects of Testosterone Replacement Therapy in Adult Males.