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For patients on long-term Nebido therapy, monitor testosterone levels every 3-6 months during the first year, then annually thereafter, with hematocrit/hemoglobin and PSA checked at the same intervals.
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Hematocrit elevation above 54% mandates immediate intervention including temporary discontinuation, therapeutic phlebotomy, and dose reduction.
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Perform prostate biopsy if PSA increases by 1.0 ng/mL or more within any 12-month period.
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Target serum testosterone levels in the mid- to upper-normal physiological range (450-600 ng/dL) measured midway between injections.
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Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025
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