Short answer: Testim (1% gel in 50 mg tubes) and AndroGel 1.62% (pump or packets) are both once-daily testosterone gels for men with low testosterone from a testicle, pituitary or hypothalamus cause.12 Testim starts at 50 mg with one step up to 100 mg; AndroGel starts at 40.5 mg and moves in 20.25 mg steps from 20.25 to 81 mg. Both carry a boxed warning about gel passing to children.
| Testim (1%) | AndroGel 1.62% | |
|---|---|---|
| Form | 1% gel, 50 mg testosterone per tube1 | 1.62% gel by pump (20.25 mg per press) or 20.25 mg and 40.5 mg packets2 |
| Start | 50 mg (one tube) once a day, preferably in the morning1 | 40.5 mg once a day in the morning2 |
| Dose changes | One step up to 100 mg (two tubes), the maximum, if a day-14 morning level is below 300 ng/dL1 | 20.25 mg steps between 20.25 and 81 mg, from morning levels at about 14 and 28 days2 |
| Where | Shoulders and upper arms1 | Shoulders and upper arms2 |
| Swap with other gels | Site and dose not substitutable1 | Site and dose not substitutable2 |
| Main trial | 90 days, 205 men vs 99 on placebo1 | 182 days, 234 men vs 40 on placebo2 |
| Notable side effects | Application site reactions 2% to 4% vs 3%; hematocrit or hemoglobin up 1% to 2% vs 0%1 | PSA increased 11.1% vs 0%; mood swings 2.6%; contact dermatitis 2.1%2 |
| Boxed warning | Secondary exposure of children1 | Secondary exposure of children2 |
Testim has two doses. Men start with one 50 mg tube a day, and a morning level is checked about 14 days later. If it is below the 300 to 1,000 ng/dL normal range, the dose goes to two tubes (100 mg), the maximum.1 AndroGel 1.62% starts at 40.5 mg (two pump presses or one 40.5 mg packet) and is adjusted by 20.25 mg, from 20.25 mg up to 81 mg, using morning levels at about 14 and 28 days after starting or after any change.2
Both labels say the dose and site are not interchangeable with other testosterone gels, so moving between them is a new prescription with its own dose checks.12
Testim's 90-day trial reported few side effects above placebo, each about 1% to 4%.1 AndroGel 1.62%'s 182-day trial reported increased PSA in 11.1% vs 0% on placebo, and 10.7% stopped because of side effects, 17 of them for PSA.2 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison. The AndroGel trial counted PSA rises from lab values as well as reported events.2
Both labels share the same class warnings: red blood cell rise, blood clots, prostate effects, blood pressure rises, sleep apnea and more. They report the same TRAVERSE heart-safety study of a topical testosterone gel, in which major heart events were 7.0% vs 7.3% on placebo.12
Both labels carry a boxed warning: children exposed through skin contact have developed male-type changes. Children should not touch unwashed or uncovered skin where gel was applied.12 In a Testim study, a long-sleeved T-shirt over the site prevented transfer to a partner.1
More detail: Testim side effects, AndroGel side effects, the Testim and AndroGel dosing schedules, and the Testosterone Gel guide.