Natesto® Nasal Gel Pump – Bill It Right!

Pharmacies have begun to see more prescriptions for Natesto® (testosterone) nasal gel. Natesto® is indicated for primary hypogonadism and hypogonadotropic hypogonadism, whether those conditions were congenital or acquired. At this time, it is not approved for age-related hypogonadism or for male patient populations less than 18 years old.

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NDC NCPDP Billing Unit and

Package Size

Number of Actuations

in Package

Sprays Per Day
42667-5511-01 7.32 gm (Tube) 60 6

The recommended dose is 11 mg of testosterone (5.5 mg testosterone per nostril actuation) three times daily, preferably at the same time daily. Therefore, each package should be billed as a 10 days’ supply and a quantity of three packages would be dispensed for a 30 days’ supply, if prescribed as such. Despite needing to prime prior to initial use, no priming is necessary for the remainder of use and priming does not need to be factored in when computing the billed days’ supply.

PAAS Tips:

  • Natesto® is a Schedule III controlled substance. Ensure the hard copy is adherent to both your state and DEA requirements
  • Prescription should contain specific dosing, including indicating “in each nostril”, and frequency of use
  • Despite the package indicating “total contents: 11 g/ dispenser”, ensure your computer system accurately reflects the proper NCPDP billing unit and package size
  • Reference the PAAS Nasal Inhalers chart on the PAAS Member Portal

Meredith Thiede, PharmD