The manufacturers of certain testosterone products (., AndroGel and Striant) state that their products are contraindicated in patients with soybean, soy, or soya lecithin hypersensitivity because they are derived partially from soy plants. There is a risk of serious hypersensitivity reactions or anaphylaxis with the use of testosterone undecanoate (Aveed) oil for injection. These allergic reactions can occur after any injection of testosterone undecanoate during the course of therapy, including after the first dose. Observe patients in the healthcare setting for 30 minutes after an Aveed injection in order to provide appropriate medical treatment in the event of serious hypersensitivity reactions or anaphylaxis. The Aveed injection contains benzyl benzoate, the ester of benzyl alcohol and benzoic acid, and refined castor oil. Therefore, testosterone undecanoate use is contraindicated in patients with polyoxyethylated castor oil hypersensitivity, benzoic acid hypersensitivity, or benzyl alcohol hypersensitivity. Patients with suspected hypersensitivity reactions should not be re-treated with testosterone undecanoate injection.
The effects on proliferation in vitro vary according to the androgen administered and the breast cancer cell line studied ( 52 , 53 ). At concentrations of 1 nmol/liter for 10 d, which is close to the normal female physiological range, Birrell et al . ( 52 ) reported varying stimulatory and inhibitory effects of DHT on differing breast cancer cell lines that simply could not be explained by varying hormone receptor status. The two cell lines that had no hormone receptors did not respond to treatment. DHT stimulated both the ER-positive MCF-7 cells and the ER-negative MDA-MB-453 cells. Treatment with 100-fold excess of hydroxyflutamide reversed the effects of DHT in each of the cell lines. In the same study (data not shown) the synthetic nonmetabolizable androgen mibolerone had effects similar to those of DHT, with the exception that hydroxyflutamide only partially reversed the growth-stimulatory effects of this treatment on MCF-7 and MDA-MB-453 cells. Hydroxyflutamide only partially reversed the inhibitory effects of DHT on ZR-75–1 cultures, whereas AR antisense oligonucleotides reversed the growth-inhibitory action of miberolone in this cell line.