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:
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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.