If an androgen-associated adverse reaction occurs, treatment should be interrupted and, after disappearance of the symptoms, be resumed at a lower dosage. Patients with latent or overt cardiac failure, renal dysfunction, hypertension, epilepsy or migraine (or a history of these conditions) should be monitored, since androgens may occasionally induce salt and fluid retention. Androgens should be used cautiously in pre-pubertal boys to avoid premature epiphyseal closure or precocious sexual development. A decrease in protein bound iodine (PBI) may occur,but this has no clinical significance. Treatment of male patients over the age of approximately 50 years with androgens should be preceded by a thorough examination of prostate and baseline measurement of prostate-specific antigen serum concentration.