POME

Testosterone Undecanoate

Two routes, one molecule: how undecanoate rewrote the oral testosterone playbook and what the TRAVERSE trial actually proved about heart safety.

Testosterone undecanoate is the only ester available as both a long-acting injectable (Aveed, Nebido) and a twice-daily oral (Jatenzo, Kyzatrex). Its lymphatic absorption bypasses the liver entirely, solving the hepatotoxicity problem that killed earlier oral steroids. The TRAVERSE trial confirmed cardiovascular non-inferiority, but flagged atrial fibrillation and kidney injury signals that demand ongoing monitoring.