Transbuccal (oral absorbable) forms of testosterone work by absorption through the mucous membranes of the mouth. A lozenge containing testosterone is placed under the tongue or against the surface of your gums twice daily. The transbuccal system is designed to adhere to the gum or inner check for a 12 hour period, after which time it is replaced. There is significantly less potential liver toxicity associated with testosterone lozenges than with other oral testosterone forms because it is absorbed through the gums rather than being swallowed and metabolized by the liver. The only FDA approved transbuccal testosterone replacement therapy (TRT) product in the US is Striant.
This form is less commonly used for TRT due to the twice-daily dosing requirement and the need to keep the lozenge in your mouth for up to 12 hours. The more widely used TRT alternatives to testosterone lozenges are either gels or injections.
- This transbuccal testosterone form has a significantly lower likelihood of liver toxicity than other forms of oral testosterone because it is absorbed through the mucous membranes of the mouth rather than being swallowed.
- It is relatively easy to ensure proper dosing because of the ease with which a regimen can be modified.
- Lozenges must be kept in the mouth for a long period of time (up to 12 hours) and replaced twice daily.
- Testosterone may potentially be transferred to another person through saliva.1
- Lozenges may aggravate the gums or cause gum-related adverse side effects.1
Striant by Endo Pharmaceuticals, Inc. is the only FDA approved transbuccal testosterone replacement product in the US. Endo provides further information about it along with full prescribing information HERE. One lozenge is applied twice a day, in the morning and in the evening. Each lozenge contains 30 mg of testosterone.
Striant costs approximately $350 per month. (Note: These are self-pay prices and do not take into account any discounts or prescription insurance coverage that you may have.)
For more information on the different available TRT administration methods, select any of the the links below.
EMG’s TRT Resource: Types of Testosterone
- Testosterone Injections
- Testosterone Gel
- Testosterone Nasal Gel
- Testosterone Implants
- Oral Testosterone
External Resources: NCBI: Testosterone Lozenges
Updated: April 30, 2015
1. Prescribing Information: Striant (testosterone buccal system) mucoadhesive for buccal administration. http://www.endo.com/File%20Library/Products/Prescribing%20Information/Striant_prescribing_information.html