Estradiol benzoate/testosterone isobutyrate

Estradiol benzoate /
testosterone isobutyrate

Estradiol benzoate (top) and testosterone isobutyrate (bottom)
Combination of
Estradiol benzoate	Estrogen
Testosterone isobutyrate	Androgen; Anabolic steroid
Clinical data
Trade names	Femandren M, Folivirin
Other names	EB/TiB; EB/TiB
Routes of administration	Intramuscular injection
Identifiers
CAS Number	72708-14-6

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]

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]

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Androgen replacement therapy formulations and dosages used in women

Route	Medication	Major brand names	Form	Dosage
Oral	Testosterone undecanoate	Andriol, Jatenzo	Capsule	40–80 mg 1x/1–2 days
	Methyltestosterone	Metandren, Estratest	Tablet	0.5–10 mg/day
	Fluoxymesterone	Halotestin	Tablet	1–2.5 mg 1x/1–2 days
	Normethandrone^a	Ginecoside	Tablet	5 mg/day
	Tibolone	Livial	Tablet	1.25–2.5 mg/day
	Prasterone (DHEA)^b	–	Tablet	10–100 mg/day
Sublingual	Methyltestosterone	Metandren	Tablet	0.25 mg/day
Transdermal	Testosterone	Intrinsa	Patch	150–300 μg/day
		AndroGel	Gel, cream	1–10 mg/day
Vaginal	Prasterone (DHEA)	Intrarosa	Insert	6.5 mg/day
Injection	Testosterone propionate^a	Testoviron	Oil solution	25 mg 1x/1–2 weeks
	Testosterone enanthate	Delatestryl, Primodian Depot	Oil solution	25–100 mg 1x/4–6 weeks
	Testosterone cypionate	Depo-Testosterone, Depo-Testadiol	Oil solution	25–100 mg 1x/4–6 weeks
	Testosterone isobutyrate^a	Femandren M, Folivirin	Aqueous suspension	25–50 mg 1x/4–6 weeks
	Mixed testosterone esters	Climacteron^a	Oil solution	150 mg 1x/4–8 weeks
		Omnadren, Sustanon	Oil solution	50–100 mg 1x/4–6 weeks
	Nandrolone decanoate	Deca-Durabolin	Oil solution	25–50 mg 1x/6–12 weeks
	Prasterone enanthate^a	Gynodian Depot	Oil solution	200 mg 1x/4–6 weeks
Implant	Testosterone	Testopel	Pellet	50–100 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

• Estradiol benzoate/progesterone
• List of combined sex-hormonal preparations
• List of sex-hormonal aqueous suspensions

References

1. "FOLIVIRIN Injekční suspenze, Příbalová Informace - Informace Pro Uživatele" [FOLIVIRIN Suspension for injection, Package Information - Information For Users] (PDF). Biotika A.S. (in Czech). Czech Republic: State Institute for Drug Control. Archived from the original (PDF) on 2019-05-20. Retrieved 2019-05-20.
2. Kubíková D (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. Josef M (14 May 2010). "Farmakoterapie endokrinních onemocnění a léčba kortikosteroidy" [Pharmacotherapy of endocrine diseases and treatment with corticosteroids]. Farmakoterapie vnitřních nemocí [Pharmacotherapy of internal diseases] (4th ed.). 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. Arends G, Zörnig H, Hager H, Frerichs G, Kern W (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. Hager HH, Kern W, List PH, Roth HJ (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 FU (1953). "Kombinierte Androgen-Oestrogenbehandlung mit Kristallsuspensionen". Gynecologic and Obstetric Investigation. 136 (5): 290–295. doi:10.1159/000308340. ISSN 1423-002X.
8. Horsky J, Presl J (6 December 2012). "Climacteric and Menopause". Ovarian Function and its Disorders: Diagnosis and Therapy. Springer Science & Business Media. pp. 146–. ISBN 978-94-009-8195-9.
9. Ufer J (1 January 1978). Hormontherapie in der Frauenheilkunde: Grundlagen und Praxis [Hormone Therapy in Gynecology: Principles and Practice] (in German) (5th ed.). de Gruyter. p. 276. ISBN 978-3110066647. OCLC 924728827.
10. "Estradiol: Uses, Dosage & Side Effects". Drugs.com.
11. "Testosterone Injections: Uses, Side Effects & Warnings". Drugs.com.
12. Sweetman SC, 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. "Home". 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. S2CID 260092180.
15. Schreiber V (6 December 2012). "Thyroxine Binding to Anterior Pituitary Proteins in Vitro: Correlation with Anterior Pituitary Growth". In Lissak K (ed.). Hormones and Brain Function. Springer Science & Business Media. pp. 145–. doi:10.1007/978-1-4684-2007-4_14. ISBN 978-1-4684-2007-4.
16. "Folivirin Injection". bbpharma.sk.
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 HA (1956). "Behandlung der Menstruationsstörungen". Konservative Therapie der Frauenkrankheiten. Springer. pp. 1–85. doi:10.1007/978-3-7091-5694-0_1. ISBN 978-3-7091-5696-4.