Orally administered testosterone (T) is ineffective in the treatment of male androgen deficiency syndromes due to extensive presystemic first-pass metabolism. In contrast, the lipophilic long-chain ester testosterone undecanoate (TU) exhibits androgenic activity that has been attributed to formation of T via systemic hydrolysis of lymphatically transported TU. However, there are no definitive data regarding the oral bioavailability of TU or the extent to which lymphatically transported TU contributes to the systemic availability of T after oral TU administration. This report describes the application of stable isotope methodology in a thoracic lymph duct-cannulated dog model to study the oral bioavailability and lymphatic transport of TU after postprandial administration. When administered as either Andriol or Andriol Testocaps, the mean (ϮS.E., n ϭ 4) absolute bioavailability of TU was 3.25 Ϯ 0.48 and 2.88 Ϯ 0.88%, respectively, and lymphatically transported TU accounted for between 91.5 and 99.7% of the systemically available ester. Model-independent pharmacokinetic analysis indicated that 83.6 Ϯ 1.6 and 84.1 Ϯ 8.2% of the systemically available T, resulting from Andriol or Andriol Testocaps, respectively, was due to systemic hydrolysis of lymphatically transported TU. These data demonstrate that intestinal lymphatic transport of TU produces increased systemic exposure of T by avoiding the extensive first-pass effect responsible for the inactivation of T after oral administration.The oral administration of testosterone (T) is ineffective in the treatment of male androgen deficiency syndromes because T is subject to almost quantitative presystemic firstpass metabolism mediated by the gut wall and liver (Daggett et al., 1978). Conversely, the lipophilic ester prodrug testosterone undecanoate (TU) demonstrates androgenic activity after oral administration to rats and humans (Hirschhauser et al., 1975;Maisey et al., 1981;Skakkebaek et al., 1981). Because oral administration of TU results in the appearance of TU (and the metabolite 5␣-dihydrotestosterone undecanoate; DHTU) in lymph of thoracic duct-cannulated rats Noguchi et al., 1985) and humans (for whom a thoracic duct cannula was inserted after neck dissection surgery; Horst et al., 1976), the androgenic activity of orally administered TU is generally attributed to T (and 5␣-dihydrotestosterone; DHT) formed during the systemic metabolic elimination of TU, which escaped the presystemic first-pass effect due to intestinal lymphatic absorption and transport Horst et al., 1976).Although it is accepted that lymphatic absorption of TU likely contributes to systemic T exposure after oral TU administration, the extent of that contribution has not been quantitatively determined. Indirect evidence of lymph transport of TU in humans was reported where the systemic exposure of T increased after oral TU administration in the fed state, compared with administration in the fasted state (Frey et al., 1979;Bagchus et al., 2003). However, human studies cannot determine ...