Natesto (testosterone) is a prescription drug that’s used for testosterone replacement. The drug comes as nasal gel you apply to the inside of your nostrils. It’s typically used three times per day.

Natesto is used in adult males* for low or missing testosterone that’s present at birth or occurs later in life.

It’s used as testosterone replacement for either:

  • primary hypogonadism
  • hypogonadotropic hypogonadism (secondary hypogonadism)

The active ingredient in Natesto is testosterone. Natesto belongs to a group of drugs called androgens.

This article describes the dosage of Natesto, as well as its strength and how to use it. To learn more about Natesto, see this in-depth article.

* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

This section describes the usual dosage of Natesto. Keep reading to learn more.

What is Natesto’s form?

Natesto is available as a nasal gel in a metered-dose pump that you apply to the inside of your nostrils.

What strength does Natesto come in?

Each pump of Natesto delivers 5.5 milligrams (mg) of testosterone. Each Natesto container has 11 grams (g) of gel to deliver 60 metered doses.

What are the usual dosages of Natesto?

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for testosterone replacement therapy

The typical recommended dosage of Natesto is 11 mg. You’ll give one pump of Natesto (5.5 mg) into each nostril. Natesto is typically used three times per day (in the morning, afternoon, and evening), about 6 to 8 hours apart. The total daily dosage of Natesto is 33 mg.

If you have questions about your dosage of Natesto, talk with your doctor to learn more.

Is Natesto used long term?

Yes, Natesto is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely use it long term.

Your doctor will check your testosterone levels before and during your Natesto treatment to determine whether the drug is working for you and how long you’ll continue treatment.

Natesto comes as a nasal gel that you’ll apply into each nostril three times per day, about every 6 to 8 hours. Each application takes about 10 seconds.

Before you use Natesto for the first time, you’ll need to prime (activate) the pump. To do this, hold the Natesto bottle upside down over a sink and press the pump 10 times.

Then each time you use Natesto, follow these steps:

  1. Blow your nose.
  2. Remove the cap from the Natesto pump and insert the tip of the pump into your left nostril using your right hand.
  3. Place the tip of the pump on the side of your nostril.
  4. Slowly press down on the pump with your index finger until it stops.
  5. Repeat this process with the right nostril using your left hand.

You’ll use one full dose (one pump into each nostril) three times per day.

If you have questions about how to use Natesto, talk with your doctor or pharmacist. The drug manufacturer also provides these step-by-step instructions.

For information on the expiration, storage, and disposal of Natesto, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you miss a dose of Natesto, use the dose as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and use your next dose at its usual time. You should not use two doses of Natesto at once to make up for a missed dose. This can increase your risk for side effects.

If you’re not sure whether you should use a missed dose, talk with your doctor or pharmacist.

If you need help remembering to give your dose of Natesto on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not use more Natesto than your doctor prescribes, as this can lead to harmful effects.

What to do in case you use too much Natesto

Call your doctor right away if you think you’ve used too much Natesto. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Natesto’s dosage.

Is Natesto’s dosage similar to the dosage of Jatenzo?

No. Although both drugs are used as testosterone replacement therapy, their dose in milligrams, available forms, and how often you use each drug are different.

Natesto comes a nasal gel that’s applied into each nostril three times per day for testosterone replacement. Testosterone undecanoate (Jantezo) comes as an oral capsule that’s taken twice daily.

Your doctor will prescribe the drug and the dosage that’s right for you. To learn more about how these drugs compare, talk with your doctor.

How long does it take for Natesto to start working?

Natesto starts to work after your first dose. You may notice some of the drug’s effects after around 3 weeks of treatment. But it may take longer to experience the full effects of Natesto.

Your doctor will check your testosterone levels during your treatment to see whether the drug is working for you.

If you have other questions about what to expect from your Natesto treatment, talk with your doctor.

The sections above describe the usual dosage provided by Natesto’s manufacturer. If your doctor recommends this drug, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Natesto without your doctor’s recommendation. Only use Natesto exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Would I need a dosage adjustment if I’m taking other medications to treat my condition?
  • How does the dosage of Natesto compare with that of testosterone pellets (Testopel)?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.