Atrevis Hydrogel and Testosterone: Why the Base Changes the Prescription
Independent testing reports that one topical base moved 2.73 times as much testosterone through human skin as another. If that is true, then writing the same strength in two different bases is not writing the same prescription, and that has consequences worth understanding before you switch a patient between them.
What Atrevis Hydrogel is
Atrevis Hydrogel is a proprietary topical compounding base from PCCA, and described as using a hydrogel polymer network together with natural enhancers to carry testosterone through skin. It is an excipient, not a drug.
That distinction matters and it is stated on the product itself. The patent covering Atrevis is designated for use as an excipient. The base does nothing on its own. It carries whatever active a prescriber writes for, and what it contributes is how much of that active reaches where it is going.
Physically it is a smooth cream gel with a glossy sheen, off white to very faint beige, with a pH range of 4.5 to 7.0. It is one of several bases we work with, alongside options such as VersaBase and the Lipoderm family.
What the delivery testing reports
PCCA publishes results from independent percutaneous absorption testing comparing Atrevis against two alternatives. The numbers are specific, and they are worth quoting precisely rather than loosely.
| Comparison | Reported result |
|---|---|
| Versus a competitor base | Atrevis delivered 2.73 times as much testosterone through the skin |
| Versus a hydro alcoholic surfactant solution | Atrevis delivered 1.62 times as much testosterone through the skin |
The method behind those figures is stated in the published figure legends. Percutaneous absorption of testosterone was measured through ex vivo human torso skin over thirty hours from a single application, reported as mean flux in micrograms per square centimetre per hour, with a mean taken across three skin donors.
How to read that data correctly
This is a laboratory permeation study, not a clinical trial, and the difference is not a technicality. A Franz diffusion cell measures how much drug crosses a piece of skin into a receptor fluid. It does not measure how a patient feels, what their serum level does, or whether symptoms change.
Three donors is also a small number, which is normal and accepted for this type of in vitro permeation testing but is worth knowing when you see a ratio quoted as though it were a clinical effect size.
It establishes that under controlled laboratory conditions, more testosterone crossed human skin from this base than from the two comparators. It does not establish that a patient will respond better, that symptoms will improve, or that any clinical outcome follows. Those are different questions requiring different studies, and nothing on this page claims otherwise.
We think stating that plainly is more useful than repeating a number without its method. A prescriber deciding between bases is better served by knowing what was measured.
Why this changes the prescription
Here is the part that has practical consequences. If bases differ substantially in how much drug they carry through skin, then the base is a prescribing variable rather than a packaging detail.
Consider a patient stable on a testosterone cream in one base. A prescription is rewritten at the same percentage strength but in a different base. On paper nothing changed. In terms of how much testosterone crosses the skin, something may have changed considerably.
That runs both directions. Moving to a base with greater reported delivery is not automatically better, because more delivered drug from the same written strength is a change in exposure. Moving away from one is not automatically worse. Both are changes, and both are worth the prescriber knowing about deliberately rather than discovering at the next set of labs.
If you are switching a patient's base, treat it as a formulation change rather than a like for like refill. Note the base on the prescription rather than leaving it to the pharmacy, and consider whether your usual monitoring interval should apply. Call us before you write it and we will tell you what we know about the bases involved.
What it is formulated without
PCCA states that Atrevis is formulated without alcohol, parabens or mineral oil. The alcohol point is the one with a stated rationale behind it.
According to the manufacturer, the absence of alcohol reduces the risk of evaporation, helps maintain chemical stability, and avoids drying the skin. The base is also described as absorbing quickly when rubbed in, leaving a smooth texture without greasy residue.
Cosmetic properties sound like a minor consideration and are not. A daily topical that feels unpleasant gets applied inconsistently or abandoned, and an abandoned preparation delivers nothing regardless of what a permeation study says.
Beyond testosterone
Atrevis is marketed principally for testosterone, but PCCA's published science on the base also covers minoxidil. That work sits in the hair loss space rather than hormone therapy.
The published studies include an in vitro evaluation of skin distribution and human dermal papilla cell proliferation for a minoxidil 5 percent topical lotion hydrogel, presented at the Society for Investigative Dermatology annual meeting and published as a conference abstract in the Journal of Investigative Dermatology.
As with the testosterone data, this is in vitro work on cells and skin distribution rather than a clinical trial in patients. If hair loss is the question, our guide to compounded hair loss options covers what is approved and what the evidence supports.
The published clinical work
PCCA lists one journal article under Atrevis with a clinical component, published in Pharmaceutics, and it is important to describe it accurately. The paper is a multidisciplinary study of compounded testosterone topical gels spanning clinical, biological and analytical work.
The clinical portion assessed one male patient in his seventies retrospectively, using serum total testosterone and a validated androgen deficiency questionnaire. The biological portion evaluated skin permeation in vitro using the Franz finite dose model and human cadaver skin. The analytical portion validated a stability indicating assay supporting beyond use dating for compounded testosterone gels.
That is genuinely useful work, particularly the stability component, which is what allows a defensible beyond use date on a compounded preparation. It is not evidence of effectiveness across a population, and a single retrospective case cannot be.
Testosterone safety and status
The base does not change anything about the drug it carries. Every consideration that applies to compounded testosterone applies here.
Compounded testosterone preparations are not FDA approved and are prepared only against a valid, patient specific prescription. Testosterone is a Schedule III controlled substance and its labeling carries a warning regarding abuse and dependence. FDA has retained limitation of use language stating that safety and efficacy are not established for low testosterone attributed to aging alone. Testosterone can raise red blood cell counts, labeling carries a warning that testosterone products increase blood pressure, and warnings about blood clots in veins remain. Testosterone given from outside the body suppresses sperm production, which matters for any man who wants to father children. This is not a complete account of the labeling, and the prescriber determines suitability and monitoring.
Sending a prescription to Mixwell
Name the base on the prescription rather than leaving it to the pharmacy. Given everything above, the base is information the prescriber should be specifying.
- Write the active and strength, and name the base, for example Atrevis Hydrogel, or write pharmacist's choice if you want us to select.
- State the total quantity and the directions including the application site.
- Transmit per Schedule III requirements for testosterone.
- Call (909) 378-7301 if you are switching a patient between bases and want to talk it through first.
Switching a patient's base, or deciding between bases for a new prescription?
Call (909) 378-7301Serving prescribers and patients in California
Mixwell Compounding Pharmacy is located in Chino, CA and works with men's health, urology and primary care prescribers across the Inland Empire, Los Angeles County and Orange County. Patients can collect at the Chino pharmacy, and delivery is available across California.
- Chino
- Chino Hills
- Ontario
- Rancho Cucamonga
- Upland
- Pomona
- Diamond Bar
- Corona
- Riverside
- Eastvale
- Brea
- Fullerton
Common questions
What is Atrevis Hydrogel?
Atrevis Hydrogel is a proprietary topical compounding base from PCCA, described by the manufacturer as using a hydrogel polymer network with natural enhancers to carry testosterone through skin. It is an excipient rather than a drug, and the patent covering it is designated for use as an excipient.
Does Atrevis really deliver more testosterone than other bases?
PCCA publishes independent testing reporting that Atrevis delivered 2.73 times as much testosterone through skin as a competitor base and 1.62 times as much as a hydro alcoholic surfactant solution. That testing measured percutaneous absorption through ex vivo human torso skin over thirty hours from a single application, across three donors. It is a laboratory permeation study rather than a clinical trial.
Does more delivery mean better results?
Not necessarily, and the testing does not show that. A permeation study measures how much drug crosses skin in a laboratory apparatus. It does not measure serum levels, symptoms, or clinical outcomes in patients. Those are different questions requiring different studies.
Can I switch my patient's base at the same strength?
Treat it as a formulation change rather than a like for like refill. If bases differ in how much drug they carry through skin, the same written strength in a different base may not deliver the same amount. Name the base on the prescription and consider whether your usual monitoring applies. Call us to discuss before writing.
Is Atrevis used for anything other than testosterone?
PCCA's published science on the base also covers minoxidil, including in vitro work on skin distribution and human dermal papilla cell proliferation for a minoxidil 5 percent topical lotion hydrogel. That is laboratory work rather than a clinical trial.
Are compounded testosterone creams FDA approved?
No. Compounded preparations are not FDA approved and are prepared only against a valid, patient specific prescription. Testosterone is a Schedule III controlled substance, and FDA has retained limitation of use language stating that safety and efficacy are not established for low testosterone attributed to aging alone.
Does Mixwell accept insurance?
Mixwell does not accept insurance. Call (909) 378-7301 to discuss current pricing.
Key Takeaways
- Atrevis Hydrogel is a PCCA proprietary topical base, an excipient rather than a drug, developed principally for testosterone delivery.
- Published independent testing reports Atrevis delivered 2.73 times as much testosterone through skin as a competitor base and 1.62 times as much as a hydro alcoholic surfactant solution.
- That testing was percutaneous absorption through ex vivo human skin across three donors, which is a laboratory permeation study rather than evidence of clinical outcomes.
- Because bases differ in delivery, the same strength written in a different base is a formulation change and is worth specifying on the prescription deliberately.
- Compounded testosterone is not FDA approved, is a Schedule III controlled substance, and carries all the usual labeling considerations regardless of which base is used.
Sources
- PCCA. Atrevis Hydrogel product information, including independent percutaneous absorption testing results and figure legends describing ex vivo human torso skin methodology. pccarx.com
- Testosterone therapy for late onset hypogonadism: a clinical, biological, and analytical approach using compounded testosterone 0.5 to 20 percent topical gels. Pharmaceutics. mdpi.com
- In vitro evaluation of skin distribution and human dermal papilla cells proliferation for minoxidil 5 percent topical lotion hydrogel. Journal of Investigative Dermatology, conference abstract, 2022 Society for Investigative Dermatology Annual Meeting.
- PCCA Science, publications index by product. pccarx.com/science
- U.S. Food and Drug Administration. Testosterone product labeling and class wide labeling changes, February 2025.