Estradiol benzoate/testosterone isobutyrate

Estradiol benzoate/testosterone isobutyrate (EB/TiB), sold under the brand names Femandren M and Folivirin, is an injectable combination medication of estradiol benzoate (EB), an estrogen, and testosterone isobutyrate (TiB), an androgen/anabolic steroid, which is used in menopausal hormone therapy for women.[1][2][3][4][5][6][7] It is provided in the form of 1 mL ampoules containing 2.5 mg estradiol benzoate and 25 mg testosterone isobutyrate in a microcrystalline aqueous suspension and is administered by intramuscular injection once every 4 to 6 weeks.[6][8] EB/TiB reportedly has a duration of about 14 to 21 days.[9]

Estradiol benzoate /
testosterone isobutyrate
Combination of
Estradiol benzoateEstrogen
Testosterone isobutyrateAndrogen; Anabolic steroid
Clinical data
Trade namesFemandren M, Folivirin
Other namesEB/TiB; EB/TiB
Routes of
administration		Intramuscular injection

The medication is available only in the Czech Republic and Slovakia.[10][11][12][13] EB/TiB was originally developed and marketed by the Swiss pharmaceutical company Ciba and was introduced for medical use by 1953,[6] following the development of testosterone isobutyrate in 1952.[14] It was intermittently manufactured by Spofa[15] and then Biotika[3] and is now manufactured by BB Pharma.[10][11][16]

The effect of EB/TiB on gonadotropin levels in postmenopausal women have been studied.[17]

An oral tablet product with the same brand name of Femandren, containing ethinylestradiol and methyltestosterone, was marketed around the same time as Femandren M, and should not be confused with the injectable formulation.[18][4][5]

Androgen replacement therapy formulations and dosages used in women
RouteMedicationMajor brand namesFormDosage
OralTestosterone undecanoateAndriol, JatenzoCapsule40–80 mg 1x/1–2 days
MethyltestosteroneMetandren, EstratestTablet0.5–10 mg/day
FluoxymesteroneHalotestinTablet1–2.5 mg 1x/1–2 days
NormethandroneaGinecosideTablet5 mg/day
TiboloneLivialTablet1.25–2.5 mg/day
Prasterone (DHEA)b–Tablet10–100 mg/day
SublingualMethyltestosteroneMetandrenTablet0.25 mg/day
TransdermalTestosteroneIntrinsaPatch150–300 μg/day
AndroGelGel, cream1–10 mg/day
VaginalPrasterone (DHEA)IntrarosaInsert6.5 mg/day
InjectionTestosterone propionateaTestovironOil solution25 mg 1x/1–2 weeks
Testosterone enanthateDelatestryl, Primodian DepotOil solution25–100 mg 1x/4–6 weeks
Testosterone cypionateDepo-Testosterone, Depo-TestadiolOil solution25–100 mg 1x/4–6 weeks
Testosterone isobutyrateaFemandren M, FolivirinAqueous suspension25–50 mg 1x/4–6 weeks
Mixed testosterone estersClimacteronaOil solution150 mg 1x/4–8 weeks
Omnadren, SustanonOil solution50–100 mg 1x/4–6 weeks
Nandrolone decanoateDeca-DurabolinOil solution25–50 mg 1x/6–12 weeks
Prasterone enanthateaGynodian DepotOil solution200 mg 1x/4–6 weeks
ImplantTestosteroneTestopelPellet50–100 mg 1x/3–6 months
Notes: Premenopausal women produce about 230 ± 70 μg testosterone per day (6.4 ± 2.0 mg testosterone per 4 weeks), with a range of 130 to 330 μg per day (3.6–9.2 mg per 4 weeks). Footnotes: a = Mostly discontinued or unavailable. b = Over-the-counter. Sources: See template.

See also

References
  1. http://www.sukl.cz/download/pil/PI15789.pdf
  2. Kubíková, Drahomíra (2014). "Menopauzální symptomy a hormonální substituční terapie" [Menopausal symptoms and hormone replacement therapy]. Praktické Lékárenství (in Czech). 10 (2): 68–73. ISSN 1801-2434.
  3. Marek Josef; a kolektiv (14 May 2010). Farmakoterapie vnitřních nemocí: 4., zcela přepracované a doplněné vydání. Grada Publishing a.s. pp. 380–. ISBN 978-80-247-9524-9. In addition, testosterone isobutyrate in FOLIVIRIN, Biotika, an injection containing 25 mg testosterone isobutyrate and 2.5 mg estradiol benzoate is available. It is applied every 4-6 weeks depending on the effect.
  4. Georg Arends; Heinrich Zörnig; Hermann Hager; Georg Frerichs, Walther Kern (14 December 2013). Hagers Handbuch der pharmazeutischen Praxis: Für Apotheker, Arzneimittelhersteller, Drogisten, Ärzte u. Medizinalbeamte. Springer-Verlag. pp. 1163–. ISBN 978-3-662-36329-4.
  5. Hans Hermann Julius Hager; Walther Kern; Paul Heinz List; Hermann Josef Roth (29 July 2013). Hagers Handbuch der Pharmazeutischen Praxis: Für Apotheker, Arzneimittelhersteller, Ärzte und Medizinalbeamte: Wirkstoffgruppen II Chemikalien und Drogen (A-AL). Springer-Verlag. pp. 109, 141, 178, 185. ISBN 978-3-662-25655-8.
  6. Ciba Symposium: 1953/57:Index. Ciba. 1953. p. 197. Femandren M. C'est le nom des nouvelles ampoules cristallines destinées au traitement associé œs- trogène-androgène. Elles renferment, sous forme de microcristaux, 2,5 mg de mono- benzoate d'œstradiol et 50 mg d'isobutyra- te de testostérone ; elles sont indiquées pour traiter les cas où il convient d'administrer simultanément de l'hormone femelle et de l'hormone mâle et où il importe aussi d'obtenir un effet prolongé, par exemple lors de symptômes d'insuffisance à la ménopause ou après castration. L'effet d'une injection se prolonge pendant 3-6 semaines.
  7. Aeppli, H.; Herrmann, F.U. (1953). "Kombinierte Androgen-Oestrogenbehandlung mit Kristallsuspensionen". Gynecologic and Obstetric Investigation. 136 (5): 290–295. doi:10.1159/000308340. ISSN 1423-002X.
  8. J. Horsky; J. Presl (6 December 2012). Ovarian Function and its Disorders: Diagnosis and Therapy. Springer Science & Business Media. pp. 146–. ISBN 978-94-009-8195-9.
  9. Ufer, Joachim (1 January 1978). Hormontherapie in der Frauenheilkunde: Grundlagen und Praxis [Hormone Therapy in Gynecology: Principles and Practice] (in German) (5 ed.). de Gruyter. p. 276. ISBN 978-3110066647. OCLC 924728827.
  10. https://www.drugs.com/international/estradiol.html
  11. https://www.drugs.com/international/testosterone.html
  12. Sweetman, Sean C., ed. (2009). "Sex hormones and their modulators". Martindale: The Complete Drug Reference (36th ed.). London: Pharmaceutical Press. pp. 2133–2134. ISBN 978-0-85369-840-1.
  13. https://www.micromedexsolutions.com/
  14. Drescher H (April 1952). "Unsere Erfahrungen mit einer neuartigen Testosteron-isobutyrat-Kristallsuspension" [Experiences with a New Testosterone Isobutyrate Crystal Suspension]. Dtsch. Med. Wochenschr. (in German). 77 (14): 431–2. doi:10.1055/s-0028-1115985. PMID 12988767.
  15. K. Lissak (6 December 2012). Hormones and Brain Function. Springer Science & Business Media. pp. 145–. ISBN 978-1-4684-2007-4.
  16. http://www.bbpharma.sk/hormones/folivirin-injection
  17. Talas M, Gazárak F, Stehliková J, Lubuský D, Fingerová H (1975). "FSH- und LH-Spiegel im Serum von Frauen nach chirurgischer Kastration und bei hormonaler Behandlung von Ausfallsbeschwerden" [Serum FSH and LH levels in women following surgical castration and during hormonal management of menopause symptoms]. Zentralbl Gynakol (in German). 97 (25): 1580–7. ISSN 0044-4197. PMID 1227215.
  18. Kahr, H.; Müller, H. A. (1956). "Behandlung der Menstruationsstörungen": 1–85. doi:10.1007/978-3-7091-5694-0_1. Cite journal requires |journal= (help)



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