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Drug: Testosterone
For hypogonadism due to testosterone deficiency in adult men
(For information relating to the prescribing of testosterone for trans men (this applies to a
person assigned female, cis-female, at birth undertaking gender transition to become a
male) a prescribing information sheet is available via: www.lancsmmg.nhs.uk)
Introduction
Indication (licensed):
Testosterone replacement therapy for male hypogonadism when testosterone
deficiency has been confirmed by clinical features and biochemical tests.
Clinical Background:
Endogenous androgens, principally testosterone, secreted by the testes and its major
metabolite DHT, are responsible for the development of the external and internal
genital organs and for maintaining the secondary sexual characteristics (stimulating
hair growth, deepening of the voice, development of the libido); for a general effect on
protein anabolism; for development of skeletal muscle and body fat distribution; for a
reduction in urinary nitrogen, sodium, potassium, chloride, phosphate and water
excretion.
Background to shared care arrangements:
The best interest, agreement and preferences of the patient should be at the centre of
any shared care agreement and their wishes followed wherever possible. Patients
should be able to decline shared care if, after due consideration of the options, they
decide it is not in their best interests.
Please note:
The provision of shared care prescribing guidelines does not necessarily mean
that the GP must agree to and accept clinical and legal responsibility for
prescribing; they should only do so if they feel clinically confident in managing
that condition.
Referral to the GP should only take place once the GP has agreed to this in
each individual case, and the hospital or specialist will continue to provide
prescriptions until a successful transfer of responsibilities has occurred. The
GP should confirm the agreement and acceptance of the shared care
prescribing arrangement and that supply arrangements have been finalised.
The secondary/tertiary provider must supply an adequate amount of the
medication to cover the transition period. The patient should then be informed
to obtain further prescriptions from the GP.
This shared care guideline excludes:
1. Unlicensed indications;
The information contained herein may be superseded in due course. All rights reserved.
Produced for use by the NHS, no reproduction by or for commercial organisations, or for commercial purposes, is allowed
without express written permission.
Produced for use by the NHS. No reproduction by or for commercial organisations, or for commercial purposes, is
allowed without express written permission.
Date: September 2019 The information contained in this document will be superseded in due course.
Review date: September 2022 Page 6 of 8
Appendix 1
PLEASE NOTE: The use of this form is not compulsory, but the same
information must be communicated between the specialist service and
primary care in advance of entering into a shared-care agreement.
for the above patient in accordance with the LMMG shared care guideline(s) (Available
on the LMMG website).
Last Prescription Issued: Click or tap to enter a date.
Next Supply Due: Click or tap to enter a date.
Date of last blood test (if Click or tap to enter a date.
applicable):
Date of next blood test (if Click or tap to enter a date.
applicable:
Frequency of blood test (if Click or tap here to enter text.
applicable:
I confirm that the patient has been stabilised and reviewed on the above regime in
accordance with the Shared Care guideline.
Date: September 2019
Review date: September 2022 Page 7 of 8
If this is a Shared Care Agreement for a drug indication which is unlicensed or off label, I
confirm that informed consent has been received from the patient.
I will accept referral for reassessment at your request. The medical staff of the
department are available if required to give you advice.
Details of Specialist Clinicians
Name: Click or tap here to enter text.
Date: Click or tap to enter a date.
Position: Choose an item.
Signature: Click or tap here to enter text.
(An email from the specialist clinician will be taken as the authorised signature)
In all cases, please also provide the name and contact details of the Consultant.
When the request for shared care is made by a Specialist Nurse, it is the supervising
consultant who takes medicolegal responsibility for the agreement.
Contact Details
Telephone Number Click or tap here to enter text.
Extension Click or tap here to enter text.
Email Address Click or tap here to enter text.
Please sign and return a copy within 14 calendar days to the address
above OR
If you do not agree to prescribe, please sign below and provide any
supporting information as appropriate:
I DO NOT agree to enter in to a shared care agreement on this occasion.