AndroGel Cannabis Interaction Profile

Is there a known interaction between AndroGel and cannabis?

The drug interactions section of the generic 1.62% testosterone gel label lists insulin, oral anticoagulants, and corticosteroids or ACTH. It does not name cannabis [1]. A missing listing does not show that the combination is safe. It means no interaction has been described there. The label is for a generic 1.62% gel, not AndroGel brand labeling, and not the 1% gel, which has different dosage and administration instructions [1].

What does the label warn about that matters with cannabis?

The label has a blood pressure warning. In an ambulatory blood pressure study of the 1.62% gel, mean 24-hour systolic/diastolic blood pressure rose 1.9/1.3 mm Hg after 16 weeks. In men with hypertension already on blood pressure medicine, the rise was 3.0/2.2 mm Hg [1]. The label says to measure blood pressure periodically and says the gel is not recommended in men with uncontrolled hypertension [1].

A 2024 position statement from the Association of Ringside Physicians says chronic cannabis use can increase risk for heart and lung disease and can reduce testosterone in men [3]. It describes chronic cannabis use, not a measured interaction with testosterone gel.

Does cannabis lower testosterone?

The human evidence is not settled. A 2019 systematic review of cannabis and male fertility found inconclusive effects on testosterone levels, lowered luteinizing hormone levels, and unchanged follicle-stimulating hormone levels [2]. A 2021 review said animal models show the endocannabinoid system can negatively modulate testosterone secretion, but clinical evidence on cannabis and male reproductive health is inconclusive [4]. These reviews describe cannabis and testosterone in general, not testosterone gel specifically.

Could cannabis and testosterone gel both affect fertility?

Both have fertility signals. The label says exogenous androgens may lead to azoospermia [1]. A 2019 systematic review found that cannabis may reduce sperm count and concentration, cause abnormal sperm morphology, reduce motility and viability, and impair capacitation [2]. The label also says children and women should avoid contact with unwashed or unclothed application sites in men using the gel [1].