| Name | Compounded Dehydroepiandrosterone (DHEA) & Branded DHEA (Intrarosa, Prasterone). |
| Uses | Hormone optimization, adrenal support, perimenopausal and menopausal therapy, sexual health, and anti-aging strategies. |
| Route Of Administration | Oral (capsules), sublingual, vaginal (suppository or cream), transdermal (cream or gel). |
| Frequency Of Use | Oral: Once daily. Vaginal: Once daily at bedtime. Transdermal: 1-2 applications daily as directed. |
| Concentration(s) | Oral: 5mg, 10mg, 25mg, 50mg capsules. Vaginal: 6.5mg suppository. Transdermal: 10mg/mL, 20mg/mL cream or gel. |
| Maximum Dosage (Day, Wk) | Oral: Max 50mg/day. Vaginal: Max 6.5mg/day. Transdermal: Max 20mg/day. |
| Contraindications | History of hormone-sensitive cancers (breast, ovarian, prostate), uncontrolled PCOS, severe adrenal dysfunction, pregnancy, lactation. |
| Possible Side Effects | Acne, oily skin, increased hair growth, voice deepening, mood swings, menstrual irregularities, insomnia. |
| Compatibility With Other Treatments/Drugs | Use caution with concurrent hormone replacement therapy (HRT), corticosteroids, and insulin (may affect glucose metabolism). |
| Allergies | Check for hypersensitivity to DHEA or excipients in compounded formulations. |
| Administration Time | Oral: Morning (to mimic natural hormone rhythms). Vaginal: Bedtime. Transdermal: Morning or evening as directed. |
| Dosing/Settings | Oral: 10-25mg/day, up to 50mg for adrenal insufficiency. Vaginal: 6.5mg suppository at bedtime. Transdermal: 10-20mg daily. |
| Test Spot Requirement | Transdermal: Initial application on a small skin area for 24 hours to monitor for irritation. |
| Pre-Treatment Guidelines | Baseline hormone panel (DHEA-S, testosterone, estradiol, progesterone), adrenal function assessment if indicated. |
| Provider Clearance Guidelines | Ensure no contraindications, verify hormone panel results, and assess necessity for ongoing therapy. |
| Pre-Treatment Screening Workflow | 1. Verify indication. 2. Assess contraindications. 3. Obtain informed consent. 4. Evaluate hormone levels if needed. |
| What To Do If Adverse Reaction Occurs | If mild (acne, mood changes): Lower dose and reassess. If severe (virilization, hormonal imbalance): Discontinue and consult specialist. |
| Clinic Implementation Guidelines | Confirm prescription, educate patient on proper use, document treatment details in EMR. |
| Photographic Documentation Protocol | Not required unless skin reaction occurs with transdermal formulations. |
| Post-Treatment Care | Monitor hormone levels every 3-6 months, adjust dosage as needed, assess for side effects. |
| Additional Documentation Requirements | Signed informed consent, treatment logs, prescription details, and adverse event documentation if applicable. |
| Special Notes | DHEA is a precursor hormone; dosing must be carefully managed to avoid androgenic side effects. |