Nandrolone (Nandrolone Decanoate) - Indications and DosageNandrolone decanoate is a parenteral anabolic steroid. This agent is known to increase hemoglobin and red cell mass. With nandrolone undecanoate half life development of recombinant human erythropoietin, nandrolone decanoate use in anemia associated with chronic renal failure has declined. Some of the masculinizing effects in women can nandrolone decanoate injection usp irreversible. Nandrolone decanoate was approved by the FDA in and became a controlled substance in
USP Monographs: Nandrolone Decanoate Injection
Nandrolone decanoate is a parenteral anabolic steroid. This agent is known to increase hemoglobin and red cell mass.
With the development of recombinant human erythropoietin, nandrolone decanoate use in anemia associated with chronic renal failure has declined.
Some of the masculinizing effects in women can be irreversible. Nandrolone decanoate was approved by the FDA in and became a controlled substance in Nandrolone decanoate shares the actions of endogenous androgens such as testosterone.
Exogenous androgens such as nandrolone decanoate promote protein anabolism and stimulate appetite which results in a reversal of catabolic processes and negative nitrogen balance. Increases in lean body mass in patients with cachexia e. Blood glucose, erythrocyte production, and the balance of calcium are also affected by androgens. Increased erythrocyte production is apparently due to enhanced production of erythropoietic stimulating factor. Patients with anemia associated with renal disease will have increases in red blood cell volume and hemoglobin after receiving nandrolone decanoate.
Since nandrolone decanoate has actions similar to endogenous androgens, administration of nandrolone decanoate has the possibility of causing serious disturbances of growth and sexual development if given to young children and causing unwanted adverse effects in women. Exogenous androgens suppress gonadotropin-releasing hormone, thereby reducing the gonadotropic function of the pituitary through a negative-feedback mechanism.
This results in a reduction of endogenous testosterone, luteinizing hormone, and follicle-stimulating hormone. Exogenous androgens may also have a direct effect on the testes. Nandrolone decanoate is administered intramuscularly. In the systemic circulation, nandrolone decanoate is rapidly hydrolyzed to free nandrolone by plasma esterases.
Nandrolone has high lipid solubility and can rapidly diffuse into cells. Nandrolone is subsequently metabolized in the liver via reduction and oxidation which is similar to the metabolism of testosterone. Data on the excretion of the parent compound and metabolites are lacking. The plasma clearance of nandrolone is approximately 1. Following intramuscular injection, nandrolone decanoate is slowly released from the intramuscular depot at a relatively constant rate over approximately 4 days.
A mg dose produces peak serum concentrations in 3—6 days. Nandrolone Decanoate is used in the treatment of anemia resultant of renal insufficiency, as well as off-label for cachexia, osteoporosis, and wasting syndrome. Your health care provider needs to know if you have any of these conditions: You will need to have blood work done while you are taking this medicine.
This drug may affect blood sugar in patients with diabetes. Nandrolone decanoate injections are administered intramuscularly only. Do not inject via intravenous administration. Nandrolone decanoate contains benzyl alcohol.
Androgen therapy such as nandrolone can result in loss of diabetic control and should be used with caution in patients with diabetes mellitus. Close monitoring of blood glucose is recommended.
Nandrolone decanoate is absolutely contraindicated during pregnancy because of probable adverse effects on the fetus FDA pregnancy category X. Androgenic anabolic steroids are known to cause embryotoxicity, fetotoxicity, and masculinization of female animal offspring. Nandrolone decanoate is contraindicated in females who are or may become pregnant.
If nandrolone decanoate is used during pregnancy, or if the patient becomes pregnant while taking this drug, she should be apprised of the potential hazard to the fetus. It is not known if anabolic steroids are excreted in human milk. Nandrolone is not indicated in females of childbearing potential; use during breast-feeding should be avoided because of the potential for serious adverse reactions in nursing infants.
Alternative methods to breast-feeding are recommended. Use of androgens such as nandrolone in children should be undertaken only with extreme caution. Androgens may accelerate bone maturation without stimulating compensatory linear growth, sometimes resulting in compromised adult stature.
Radiographic examinations of the hand and wrist should be performed every 6 months to assess the rate of bone maturation and the effect of the drug on epiphyseal centers. Once the epiphyses have closed, growth is terminated. Even after discontinuation of treatment, epiphyseal closure can be enhanced for several months. Nandrolone decanoate can stimulate the growth of cancerous tissue and should not be used in male patients with prostate cancer or breast cancer. Patients with prostatic hypertrophy should be treated with caution because of the possible development of malignancy.
Androgens such as nandrolone can induce osteolysis and should be used with caution in patients with hypercalcemia. Androgen-induced hypercalcemia occurs especially in immobile patients and those with metastatic breast cancer. Alterations in the serum lipid profile consisting of decreased HDL and increased LDL occur with anabolic steroids including nandrolone.
The drug should be used cautiously in patients with hypercholesterolemia and in those with cardiac disease especially in those with arteriosclerosis, coronary artery disease, and myocardial infarction. Monitoring of lipoprotein concentrations is recommended. During treatment with androgens, edema can occur because of sodium retention. Thus, this another reason to use nandrolone cautiously in patients with heart failure, peripheral edema, or severe cardiac disease.
During treatment with androgens, edema occurs because of fluid retention in association with sodium retention. Nandrolone decanoate is therefore contraindicated in patients withsevere hepatic disease and should be avoided in patients with severe renal disease because of possible exacerbation of these conditions.
In addition, patients with nephrosis or nephrotic phase of nephritis should be treated with caution. Because androgenic anabolic steroids have been associated the development of peliosis hepatis and benign and malignant liver tumors e. Patients with hepatic disease or hepatic dysfunction also can be at risk of drug accumulation because of reduced clearance. This list may not describe all possible interactions.
Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Some items may interact with your medicine.
Androgens can enhance the effects of anticoagulants. When anabolic steroid or androgen therapy is started or stopped in patients on anticoagulant therapy, close monitoring is required. Additionally, nandrolone decanoate may generate a pharmacodynamic interaction with warfarin by independently affecting the activity of circulating coagulation proteins.
Androgens reduce the amount or activity of circulating coagulant proteins thereby enhancing the anticoagulant effect of warfarin. The actions of androgens could be antagonized by 5-alpha reductase inhibitors i. Drug interactions with Saw palmetto, Serenoa repens have not been specifically studied or reported.
Saw palmetto extracts appear to have antiandrogenic effects. Exogenously administered androgens testosterone derivatives or anabolic steroids have variable effects on blood glucose control in patients with diabetes mellitus. In general, low testosterone concentrations are associated with insulin resistance.
Further, when hypogonadal men with or without diabetes are administered exogenous androgens, glycemic control typically improves as indicated by significant reductions in fasting plasma glucose concentrations and HbA1c. Significant reductions in HbA1c and fasting plasma glucose concentrations did not occur in patients taking placebo.
Hypoglycemia or hyperglycemia can occur; dosage adjustments of the antidiabetic agent may be necessary. Based on case reports with methyltestosterone and danazol, androgens may increase plasma concentrations of cyclosporine, leading to a greater risk of nephrotoxicity. Increased fluid retention may occur with concomitant nandrolone decanoate and corticosteroid use.
Corticosteroids with greater mineralocorticoid activity such as fludrocortisone are more likely to cause edema. Androgens may be necessary to assist in the growth response to human growth hormone, but excessive doses of androgens in prepubescent males can accelerate epiphyseal maturation.
Goserelin 17 and leuprolide 18 inhibit steroidogenesis. Concomitant use of nandrolone decanoate with goserelin or leuprolide is relatively contraindicated and would defeat the purpose of goserelin or leuprolide therapy. Androgens are known to stimulate erythropoiesis. Concurrent administration of androgens can increase the patient's response to epoetin alfa, reducing the amount required to treat anemia.
Because adverse reactions to epoetin alfa have been associated with an abrupt increase in blood viscosity, this drug combination should be avoided, if possible. Further evaluation of this combination needs to be made.
In vitro, both genistein and daidzein inhibit 5 alpha-reductase isoenzyme II, resulting in decreased conversion of testosterone to the potent androgen 5-alpha-dihydrotestosterone DHT and a subsequent reduction in testosterone-dependent tissue proliferation. Theoretically, because the soy isoflavones appear to inhibit type II 5-alpha-reductase, the soy isoflavones may counteract the activity of the androgens.
This list may not include all possible drug interactions. Also tell them if you smoke, drink alcohol, or use illegal drugs. Change in sex drive or performance; diarrhea; hair loss; headache; trouble sleeping. This list may not describe all possible side effects. Call your health care provider immediately if you are experiencing any signs of an allergic reaction: Menstrual irregularity can occur with nandrolone decanoate therapy in females.
Disruption of the regular menstrual cycle secondary to nandrolone decanoate-induced suppression of gonadotropin secretion can lead to amenorrhea or oligomenorrhea. When androgens such as nandrolone are given to women, virilization, manifested by acne, hirsutism, clitoromegaly, male pattern baldness, reduced breast size, and deepening of the voice or hoarseness, can occur.
If treatment is discontinued when these symptoms first appear, they usually subside. Prolonged treatment can lead to irreversible masculinity, so the benefit of treatment should be measured against the risk. Androgens can cause teratogenesis.
Androgens are classified as pregnancy category X, and are absolutely contraindicated during pregnancy because of probable adverse effects on the fetus.
Androgenic anabolic steroids such as nandrolone decanoate are known to cause embryotoxicity, fetotoxicity, and masculinization of female animal offspring.
Nandrolone decanoate is contraindicated in women who are or may become pregnant.