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Co-administration with glucocorticoids or adrenocorticotropic hormone may exacerbate fluid retention and oedema; similarly, potent CYP3A4 inhibitors could raise serum testosterone concentrations, whereas 5-alpha-reductase inhibitors counteract androgenic activity, highlighting the importance of comprehensive medication reconciliation at each visit. Androgen therapy can potentiate the hypoglycaemic effect of insulin and oral antidiabetic agents, necessitating closer monitoring of fasting glucose and possible dose reductions when testosterone replacement is initiated in diabetic patients. It must not be administered to patients with hypersensitivity to testosterone, grapeseed oil or any component of the formulation, or to women who are pregnant, could become pregnant or are breastfeeding owing to the risk of virilization and other fetal or neonatal harm. After deep intramuscular injection the lipophilic ester diffuses slowly from the oil depot, undergoes enzymatic cleavage to free testosterone and enters the systemic circulation, where roughly 98 % is reversibly bound to sex-hormone-binding globulin and albumin while the unbound fraction translocates across cell membranes to activate androgen receptors. Deep intramuscular administration into the gluteal muscle using a 22-gauge needle is recommended, and patients who self-inject must be trained in aseptic technique, site rotation and safe sharps disposal to reduce infection and tissue-injury risk.