Nandrolone decanoate was first described in 1960 and was introduced for medical use in 1962.[3] It was the second nandrolone ester to be introduced, following nandrolone phenylpropionate (NPP) in 1959, and is one of the most widely used nandrolone esters.[3][16] It is also one of the most widely used AAS worldwide.[3] In addition to its medical use, nandrolone decanoate is used to improve physique and performance, and is said to be the most widely used AAS for such purposes.[3][17] The drug is a controlled substance in many countries and so non-medical use is generally illicit.[3]
In the past, nandrolone decanoate has also been indicated and used for a variety of other conditions and situations including pre- and postoperative use for increasing lean mass, treating weight loss due to convalescence or disease, geriatric states (e.g., general weakness, fatigue), burns, severe trauma, ulcers, and selected cases of growth failure in children.[3] Starting in the 1970s, the indications of nandrolone decanoate were refined and use of the drug became more selective and restricted.[3] Its use in medicine continues to decline and has become limited, with its sale having been discontinued in many countries.[3]
Nandrolone esters can be used as a form of androgen replacement therapy for treatment of androgen deficiency in men.[20] However, they have not generally been used for this purpose, and have instead mostly been used only as anabolic agents.[20][21][22] In any case, nandrolone decanoate has widely been used at low doses as a means of androgen replacement in postmenopausal women, for instance to maintain or increase bone mineral density and decrease the risk of osteoporosis.[23][24][25][26] It is one of only three androgens approved for androgen replacement in postmenopausal women, the others being testosterone (and esters) and methyltestosterone.[26] Nandrolone esters have more recently been proposed for more widespread treatment of androgen deficiency in men due to favorable properties including their high ratio of anabolic to androgenic effect and hence lower or negligible risk of scalp hair loss, prostate enlargement, and prostate cancer relative to testosterone.[20][27][28] Nandrolone esters and related compounds such as trestolone and dimethandrolone undecanoate have also been studied as means of androgen replacement in investigational male contraceptive regimens.[20][29][30]
A dosage of nandrolone decanoate of 25 to 50 mg once every 6 to 12 weeks (working out to an average exposure of about 2 to 8 mg per week) by intramuscular injection is considered to be appropriate for general androgen replacement therapy in women.[32][33][20] A dosage of 50 mg once every 2 to 4 weeks by intramuscular injection is used in the prevention and treatment of postmenopausal osteoporosis and in the palliative treatment of inoperative breast cancer.[2][6][34] For children aged 2 to 13 years, the average dosage for anemia of chronic kidney disease is 25 to 50 mg every 3 to 4 weeks by intramuscular injection.[18] Dosages in men and for other uses have also been described.[18][19][6][2][3]
Notes:Premenopausal women produce about 230 ± 70 μg testosterone per day (6.4 ± 2.0 mg testosterone per 4 weeks), with a range of 130 to 330 μg per day (3.6–9.2 mg per 4 weeks). Footnotes:a = Mostly discontinued or unavailable. b = Over-the-counter. Sources: See template.
Nandrolone decanoate is used for physique- and performance-enhancing purposes by competitive athletes, bodybuilders, and powerlifters.[3] It is consumed by bodybuilders as per 8–12 weeks bulking cycles with some form of testosterone as a base[35] because, according to the studies if consumed solo (i.e., without a base) it shuts down the natural production of testosterone by altering blood–testis barrier components.[36] Despite this fact, nandrolone decanoate is one of the most popular injectable AAS worldwide, and nandrolone esters have been said to be the most popular AAS used by bodybuilders and in sports.[3][17] This is in part due to the high ratio of anabolic to androgenic effect of nandrolone and its weak propensity for androgenic and estrogenic side effects.[3][37]
Nandrolone decanoate causes virilization as a common side effect in women, including acne, hoarseness of the voice, hirsutism (excessive facial/body hair growth), and libido changes, among others.[6]Clitoral enlargement is an uncommon symptom of virilization that can occur.[6] Virilization is especially prevalent and marked at high dosages of nandrolone decanoate and/or with long-term treatment, and some aspects of virilization like voice deepening can be irreversible.[6][19][3] Hoarseness is often the first sign of voice changes.[6] Although said to be only slightly androgenic, nandrolone decanoate may still occasionally cause virilization at recommended dosages in women, especially with long-term treatment.[3] A minor though statistically insignificant incidence of virilization has been observed in women treated with nandrolone decanoate short-term at a dosage of 100 mg every 2 weeks for 12 weeks.[3] Conversely, long-term (>1 year) studies have shown significant virilization in women even at a dosage of 50 mg every 2 or 3 weeks.[3]
Overdose
The acute toxicity of nandrolone esters in animals is very low and there are no reports of acute overdosage with nandrolone decanoate in humans.[2][6] There are no specific recommendations for the management of nandrolone decanoate.[6]
Notes: In rodents. Footnotes:a = Ratio of androgenic to anabolic activity. Sources: See template.
Nandrolone decanoate is a nandrolone ester, or a prodrug of nandrolone.[6][39][3][13] As such, it is an androgen and anabolic steroid, or an agonist of the AR, the biological target of androgens like testosterone and DHT.[6][3][13][39] Relative to testosterone, nandrolone decanoate has enhanced anabolic effects and reduced androgenic effects.[6][39][13] It is considered to have strong anabolic effects but weak androgenic effects, with respective potency ratios of 3.29–4.92 and 0.31–0.41 (index value 10.6–12.1 or about an 11:1 ratio of myotrophic to androgenic effect) relative to testosterone propionate.[3][13][28] This is defined specifically on the basis of a rodent model in which change in the weights of the rat bulbocavernosus/levator ani muscle ("anabolic" or "myotrophic" activity) and the rat ventral prostate or seminal vesicles ("androgenic" activity) are compared with testosterone and then used to form a ratio.[13] Along with oxandrolone (which has a ratio of about 10:1), nandrolone esters are thought to have the highest ratio of anabolic to androgenic effect of any other AAS.[3][27] For this reason, they are considered to be among the most appropriate AAS for use in women and children.[3][14]
Androgenic effects like virilization are relatively uncommon with nandrolone decanoate at recommended dosages, though may still occur especially at higher dosages or with extended use.[3][6] The low androgenicity of nandrolone decanoate is thought to be due to the fact that whereas many other AAS like testosterone are potentiated via transformation by 5α-reductase into more potent AR agonists like DHT in specific tissues including the skin, hair follicles, prostate gland, liver, and brain, nandrolone is instead inactivated by 5α-reductase via transformation into the low-affinity AR ligand 5α-dihydronandrolone in such tissues.[4][3][13] This is thought to result in a much lower incidence and magnitude of facial/body hair growth, scalp hair loss, and possibly prostate issues like prostate enlargement and prostate cancer with nandrolone esters relative to testosterone.[3][27][28]
In addition to its anabolic and androgenic activity, nandrolone decanoate has low estrogenic activity (via its metaboliteestradiol) and moderate progestogenic activity.[3] This may result in side effects such as fluid retention and gynecomastia.[3] Like other AAS, nandrolone decanoate has antigonadotropic effects.[3] It has been found to suppress testosterone levels by 57% at a dosage of 100 mg/week and by 70% at a dosage of 300 mg/week in men following 6 weeks of treatment.[3] Both the androgenic activity and the progestogenic activity of nandrolone decanoate may contribute to its antigonadotropic potency.[3] Relative to testosterone, due to its lower estrogenic potency, much less of the antigonadotropic potency of nandrolone decanoate is derived from its estrogenic activity.[3]
Notes: Values are percentages (%). Reference ligands (100%) were progesterone for the PRTooltip progesterone receptor, testosterone for the ARTooltip androgen receptor, estradiol for the ERTooltip estrogen receptor, dexamethasone for the GRTooltip glucocorticoid receptor, aldosterone for the MRTooltip mineralocorticoid receptor, dihydrotestosterone for SHBGTooltip sex hormone-binding globulin, and cortisol for CBGTooltip corticosteroid-binding globulin. Sources: See template.
Upon intramuscular injection in oil, which results in the formation of a long-lasting depot in the muscle, nandrolone decanoate is stored unchanged and is slowly absorbed into the body.[4] Once in the circulation, it is converted into nandrolone, which is the active form of the drug.[2] There is a sharp spike in nandrolone levels 24 to 48 hours after an intramuscular injection of nandrolone decanoate, followed by a steady decline to baseline levels within approximately two or three weeks.[3][6] The bioavailability of nandrolone decanoate is 53 to 73% with intramuscular injection and varies with the site of injection, with the highest bioavailability seen when injected into the gluteal muscle.[1] Like testosterone, nandrolone is highly protein-bound and is present in the blood in both bound and free fractions.[4] It has very low affinity for sex hormone-binding globulin (SHBG), about 5% of that of testosterone and 1% of that of DHT.[4][40]
The elimination half-life of nandrolone decanoate administered by intramuscular injection is approximately 6 to 12 days.[2][3] Studies that have assessed the duration of nandrolone decanoate via its anabolic effects, for instance on nitrogen balance, have found that a single 50 to 100 mg intramuscular injection had a duration of about 18 to 25 days.[43][44] The blood half-life for the combined process of hydrolysis into nandrolone and elimination of nandrolone is 4.3 hours.[2] Nandrolone and its metabolites are excreted in the urine, mainly in the form of conjugates.[4]
Although nandrolone decanoate is usually administered by intramuscular injection, it has been found to be similarly effective when administered by subcutaneous injection.[45] The pharmacokinetics of nandrolone decanoate via subcutaneous injection closely resemble those of intramuscular injection.[45] However, subcutaneous injection is considered to be easier, more convenient, and less painful compared to intramuscular injection.[45] In addition, research suggests that most intramuscular injections in practice are in fact subcutaneous injections.[45]
Note: All are via i.m. injection. Footnotes:a = TP, TV, and TUe. b = TP and TKL. c = TP, TPP, TiCa, and TD. d = Studied but never marketed. e = Developmental code names. Sources: See template.
Dose-normalized nandrolone exposure (serum level divided by dose administered) with nandrolone decanoate in oil solution by intramuscular or subcutaneous injection in men.[49][50]
Nandrolone decanoate was first described in the literature in 1960.[3] It was developed by Organon and was introduced for medical use under the brand name Deca-Durabolin in 1962.[3][51] Shortly thereafter it became one of the most widely used AAS in the world.[3] Nandrolone decanoate was the second form of nandrolone to be introduced, having been preceded by nandrolone phenylpropionate in 1959.[51]
Society and culture
Generic names
Nandrolone decanoate is the generic name of the drug and its USANTooltip United States Adopted Name and BANTooltip British Approved Name.[8][9][10][11] It has also been referred to as nandrolone decylate.[8][9][10][11]
Brand names
Nandrolone decanoate is or has been marketed under the brand names Deca-Durabolin, Deca-Durabol, Decaneurabol, Metadec, and Retabolil, among others.[8][9][10][11]
Nandrolone decanoate has been studied in the treatment of bone loss in men, but in contrast to testosterone esters, was found to be ineffective.[55][56] In short-term (6- to 8-week) studies in healthy male bodybuilders, nandrolone decanoate did not alter bone mineral density.[57][58][59] However, the short duration of these studies limits conclusions on the influence of nandrolone decanoate on bone in men.[58][59]
^Minto CF, Howe C, Wishart S, Conway AJ, Handelsman DJ (April 1997). "Pharmacokinetics and pharmacodynamics of nandrolone esters in oil vehicle: effects of ester, injection site and injection volume". The Journal of Pharmacology and Experimental Therapeutics. 281 (1): 93–102. PMID9103484.
^ abcWu C, Kovac JR (October 2016). "Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health". Current Urology Reports. 17 (10): 72. doi:10.1007/s11934-016-0629-8. PMID27535042. S2CID43199715.
^Saartok T, Dahlberg E, Gustafsson JA (June 1984). "Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin". Endocrinology. 114 (6): 2100–2106. doi:10.1210/endo-114-6-2100. PMID6539197.
^Kalicharan RW, Bout MR, Oussoren C, Vromans H (December 2016). "Where does hydrolysis of nandrolone decanoate occur in the human body after release from an oil depot?". International Journal of Pharmaceutics. 515 (1–2): 721–728. doi:10.1016/j.ijpharm.2016.10.068. PMID27989828.
^Bagchus WM, Smeets JM, Verheul HA, De Jager-Van Der Veen SM, Port A, Geurts TB (2005). "Pharmacokinetic evaluation of three different intramuscular doses of nandrolone decanoate: analysis of serum and urine samples in healthy men". J. Clin. Endocrinol. Metab. 90 (5): 2624–30. doi:10.1210/jc.2004-1526. PMID15713722.
^Minto CF, Howe C, Wishart S, Conway AJ, Handelsman DJ (1997). "Pharmacokinetics and pharmacodynamics of nandrolone esters in oil vehicle: effects of ester, injection site and injection volume". J. Pharmacol. Exp. Ther. 281 (1): 93–102. PMID9103484.
^Belkien L, Schürmeyer T, Hano R, Gunnarsson PO, Nieschlag E (May 1985). "Pharmacokinetics of 19-nortestosterone esters in normal men". J. Steroid Biochem. 22 (5): 623–9. doi:10.1016/0022-4731(85)90215-8. PMID4010287.
^Kalicharan RW, Schot P, Vromans H (February 2016). "Fundamental understanding of drug absorption from a parenteral oil depot". Eur J Pharm Sci. 83: 19–27. doi:10.1016/j.ejps.2015.12.011. PMID26690043.
^Lippi G, Franchini M, Banfi G (May 2011). "Biochemistry and physiology of anabolic androgenic steroids doping". Mini Reviews in Medicinal Chemistry. 11 (5): 362–373. doi:10.2174/138955711795445952. PMID21443514.
^ abHartgens F, Van Marken Lichtenbelt WD, Ebbing S, Vollaard N, Rietjens G, Kuipers H (April 2001). "Body composition and anthropometry in bodybuilders: regional changes due to nandrolone decanoate administration". International Journal of Sports Medicine. 22 (3): 235–241. doi:10.1055/s-2001-18679. PMID11354529. S2CID260193226.
Further reading
Geusens P (September 1995). "Nandrolone decanoate: pharmacological properties and therapeutic use in osteoporosis". Clinical Rheumatology. 14 (Suppl 3): 32–39. doi:10.1007/bf02210686. PMID8846659. S2CID24365057.
Velema MS, Kwa BH, de Ronde W (March 2012). "Should androgenic anabolic steroids be considered in the treatment regime of selected chronic obstructive pulmonary disease patients?". Current Opinion in Pulmonary Medicine. 18 (2): 118–124. doi:10.1097/MCP.0b013e32834e9001. PMID22189453. S2CID6155275.
Wu C, Kovac JR (October 2016). "Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health". Current Urology Reports. 17 (10): 72. doi:10.1007/s11934-016-0629-8. PMID27535042. S2CID43199715.