Deca-Durabolin® (nandrolone decanoate)
Description:
Nandrolone decanoate is an injectable form of the anabolic steroid
nandrolone. The decanoate ester provides a slow release of nandrolone from
the site of injection, lasting for up to three weeks. Nandrolone is very
similar to testosterone in structure, although it lacks a carbon atom at the
19th position (hence its other name, 19- nortestosterone). Like testosterone,
nandrolone exhibits relatively strong anabolic properties. Unlike
testosterone, however, its tissue-building activity is accompanied by weak
androgenic properties. Much of this has to do with the reduction of
nandrolone to a weaker steroid, dihydronandrolone, in the same androgen-
responsive target tissues that potentate the action of testosterone (by
converting it to DHT). The mild properties of nandrolone decanoate have
made it one of the most popular injectable steroids worldwide, highly
favored by athletes for its ability to promote significant strength and lean
muscle mass gains without strong androgenic or estrogenic side effects.
History:
Nandrolone decanoate was first described in 1960,433 and became a
prescription medication in 1962. It was developed by the international
pharmaceuticals giant Organon, and sold under the brand name Deca-
Durabolin. The name Deca-Durabolin denotes that the product contains a
variant of Organon’s previously popular nandrolone injectable Durabolin
(nandrolone phenylpropionate) using an ester of 10 carbon atoms. Organon
expanded the market for nandrolone decanoate very rapidly following its
release. Probably owing to a combination of its favorable properties and the
large market presence of Organon, Deca-Durabolin soon became one of the
most widely distributed anabolic steroids in the world.
When first introduced to the United States, nandrolone decanoate (like
Durabolin) was prescribed for a variety of ailments. Listed indications
included pre- and postoperative use for building lean mass, osteoporosis,
advanced breast cancer, weight loss due to convalescence or disease,
geriatric states (general weakness and frailty), burns, severe trauma, ulcers,
adjunct therapy with certain forms of anemia, and selective cases of growth
and development retardation in children. The drug was initially sold in a
dosage of only 50 mg/ml, owing to the very low recommended doses
(usually 50-100 mg every 3-4 weeks). The drug was soon updated to
include a 100 mg/ml version, reflecting the need for higher doses in some
situations, particularly those with refractory anemia and advanced breast
cancer. Later, a 200 mg/ml product was released by Organon as well.
Although the drug had been applied favorably for a great many medical
uses for approximately a decade, by the mid-1970’s the indicated uses for
nandrolone decanoate were being refined, both in the U.S. and abroad. FDA
approved prescribing information from 1975 lists nandrolone decanoate as
“probably effective” as adjunct therapy in senile and postmenopausal
osteoporosis, as well as for treating pituitary-deficient dwarfism until
growth hormone is more available. It was also deemed “possibly effective”
in aiding the retention of lean mass, controlling advanced breast cancer, and
as adjunctive therapy for certain types of anemia. More time was given to
investigate the potential “less than effective” uses of the drug.
Modern (approved) medical applications for the drug are even more refined
than they were in the mid-1970’s. In the United States, the drug is now only
FDA approved for treating anemia, although it is often also used “off label”
to preserve lean mass in HIV positive patients and others suffering from
wasting diseases. Outside of the U.S., Organon seems to support the use of
this drug mainly with patients suffering from severe anemia, osteoporosis,
and advanced breast cancer. The Organon Deca-Durabolin brand of
nandrolone decanoate remains widely available today, now distributed by
new parent company Merck/MSD. In addition, nandrolone decanoate is
produced as a generic drug in many countries, and is also manufactured
under numerous other distinctive brand names, both for human and
veterinary use.
How Supplied:
Nandrolone decanoate is widely available in human and veterinary drug
markets. Composition and dosage may vary by country and manufacturer,
but usually contain 25 mg/ml, 50 mg/ml, 100 mg/ml, or 200 mg/ml of
steroid dissolved in oil.
Structural Characteristics:
Nandrolone decanoate is a modified form of nandrolone, where a
carboxylic acid ester (decanoic acid) has been attached to the 17-beta
hydroxyl group. Esterified steroids are less polar than free steroids, and are
absorbed more slowly from the area of injection. Once in the bloodstream,
the ester is removed to yield free (active) nandrolone. Esterified steroids are
designed to prolong the window of therapeutic effect following
administration, allowing for a less frequent injection schedule compared to
injections of free (unesterified) steroid. Nandrolone decanoate provides a
sharp spike in nandrolone release 24-48 hours following deep intramuscular
injection, which steadily declines to near baseline levels approximately two
weeks later. The half-life of nandrolone decanoate is 7-12 days.
Figure 1. Pharmacokinetics of 200 mg Nandrolone Decanoate injection.
Source:
Pharmacokinetic
parameters
of
nandrolone
(19-
nortestosterone) after intramuscular administration of nandrolone
decanoate (Deca-Durabolin®) to healthy volunteers. Wijnand H, Bosch
A, Donker C. Acta Endocrinol 1985 supp 271 19-30.
Side Effects (Estrogenic):
Nandrolone has a low tendency for estrogen conversion, estimated to be
only about 20% of that seen with testosterone.434 This is because while the
liver can convert nandrolone to estradiol, in other more active sites of
steroid aromatization such as adipose tissue nandrolone is far less open to
this process.435 Consequently, estrogen-related side effects are a much
lower concern with this drug than with testosterone. Elevated estrogen
levels may still be noticed with higher dosing, however, and may cause side
effects such as increased water retention, body fat gain, and gynecomastia.
An anti-estrogen such as clomiphene citrate or tamoxifen citrate may be
necessary to prevent estrogenic side effects if they occur. One may
alternately use an aromatase inhibitor like Arimidex® (anastrozole), which
more efficiently controls estrogen by preventing its synthesis. Aromatase
inhibitors can be quite expensive in comparison to anti-estrogens, however,
and may also have negative effects on blood lipids.
It is of note that nandrolone has some activity as a progestin in the body.436
Although progesterone is a c-19 steroid, removal of this group as in 19-
norprogesterone creates a hormone with greater binding affinity for its
corresponding receptor. Sharing this trait, many 19-nor anabolic steroids are
shown to have some affinity for the progesterone receptor as well.437 The
side effects associated with progesterone are similar to those of estrogen,
including negative feedback inhibition of testosterone production and
enhanced rate of fat storage. Progestins also augment the stimulatory effect
of estrogens on mammary tissue growth. There appears to be a strong
synergy between these two hormones here, such that gynecomastia might
even occur with the help of progestins, without excessive estrogen levels.
The use of an anti-estrogen, which inhibits the estrogenic component of this
disorder, is often sufficient to mitigate gynecomastia caused by nandrolone.
Side Effects (Androgenic):
Although classified as an anabolic steroid, androgenic side effects are still
possible with this substance, especially with higher doses. This may include
bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic
steroids may also aggravate male pattern hair loss. Women are warned of
the potential virilizing effects of anabolic/androgenic steroids. These may
include a deepening of the voice, menstrual irregularities, changes in skin
texture, facial hair growth, and clitoral enlargement. Nandrolone is a steroid
with relatively low androgenic activity relative to its tissue-building actions,
making the threshold for strong androgenic side effects comparably higher
than
with
more
androgenic
agents
such
as
testosterone,
methandrostenolone, or fluoxymesterone. It is also important to point out
that due to its mild androgenic nature and ability to suppress endogenous
testosterone, nandrolone is prone to interfering with libido in males when
used without another androgen.
Note that in androgen-responsive target tissues such as the skin, scalp, and
prostate, the relative androgenicity of nandrolone is reduced by its reduction
to dihydronandrolone (DHN).438 439 The 5-alpha reductase enzyme is
responsible for this metabolism of nandrolone. The concurrent use of a 5-
alpha reductase inhibitor such as finasteride or dutasteride will interfere
with site-specific reduction of nandrolone action, considerably increasing
the tendency of nandrolone to produce androgenic side effects. Reductase
inhibitors should be avoided with nandrolone if low androgenicity is
desired.
Side Effects (Hepatotoxicity):
Nandrolone is not c-17 alpha alkylated, and not known to have hepatotoxic
effects in healthy subjects. Liver toxicity is unlikely.
Side Effects (Cardiovascular):
Anabolic/androgenic steroids can have deleterious effects on serum
cholesterol. This includes a tendency to reduce HDL (good) cholesterol
values and increase LDL (bad) cholesterol values, which may shift the HDL
to LDL balance in a direction that favors greater risk of arteriosclerosis. The
relative impact of an anabolic/androgenic steroid on serum lipids is
dependant on the dose, route of administration (oral vs. injectable), type of
steroid (aromatizable or non-aromatizable), and level of resistance to
hepatic metabolism. Studies administering 600 mg of nandrolone decanoate
per week for 10 weeks demonstrated a 26% reduction in HDL cholesterol
levels.440 This suppression is slightly greater than that reported with an
equal dose of testosterone enanthate, and is in agreement with earlier
studies showing a slightly stronger negative impact on HDL/LDL ratio with
nandrolone
decanoate
as
compared
to
testosterone
cypionate.441
Nandrolone decanoate should still have a significantly weaker impact on
serum lipids than c-17 alpha alkylated agents. Anabolic/androgenic steroids
may also adversely affect blood pressure and triglycerides, reduce
endothelial relaxation, and support left ventricular hypertrophy, all
potentially increasing the risk of cardiovascular disease and myocardial
infarction.
To help reduce cardiovascular strain it is advised to maintain an active
cardiovascular exercise program and minimize the intake of saturated fats,
cholesterol, and simple carbohydrates at all times during active AAS
administration. Supplementing with fish oils (4 grams per day) and a
natural cholesterol/antioxidant formula such as Lipid Stabil or a product
with comparable ingredients is also recommended.
Side Effects (Testosterone Suppression):
All anabolic/androgenic steroids when taken in doses sufficient to promote
muscle gain are expected to suppress endogenous testosterone production.
Studies administering 100 mg per week of nandrolone decanoate for 6
weeks have demonstrated an approximate 57% reduction in serum
testosterone levels during therapy. At a dosage of 300 mg per week, this
reduction reached 70%.442 It is believed that the progestational activity of
nandrolone notably contributes to the suppression of testosterone synthesis
during therapy, which can be marked in spite of a low tendency for estrogen
conversion.443 Without the intervention of testosterone-stimulating
substances, testosterone levels should return to normal within 2-6 months of
drug secession. Note that prolonged hypogonadotrophic hypogonadism can
develop secondary to steroid abuse, necessitating medical intervention.
The above side effects are not inclusive. For more detailed discussion of
potential side effects, see the Steroid Side Effects section of this book.
Administration (Men):
For general anabolic effects, early prescribing guidelines recommend a
dosage of 50-100 mg every 3-4 weeks for 12 weeks. To treat renal anemia,
the prescribing guidelines for nandrolone decanoate recommend a dosage of
100- 200 mg per week. The usual dosage for physique- or performance-
enhancing purposes is the range of 200-600 mg per week, taken in cycles 8
to 12 weeks in length. This level is sufficient for most users to notice
measurable gains in lean muscle mass and strength.It is often stated that
nandrolone decanoate will exhibit its optimal effect (best gain/side effect
ratio) at 2 mg per pound of bodyweight/weekly, although individual
differences in response will likely dictate varying ideal doses for different
users. Deca is not known as a very “fast” builder. The muscle-building
effect of this drug is quite noticeable, but not dramatic. In general, one can
expect to gain muscle weight at about half the rate of that with an equal
amount of testosterone.
Nandrolone decanoate is often combined with other steroids for an
enhanced effect. A combination of 200-400 mg/week of nandrolone
decanoate and 10-20 mg daily of Winstrol®, for example, is noted to
greatly enhance the look of muscularity and definition when dieting/cutting.
A strong non-aromatizing androgen like Halotestin® or trenbolone could
also be used, again providing an enhanced level of hardness and density to
the muscles. Being a moderately strong muscle builder, nandrolone can also
be incorporated into bulk cycles with acceptable results. The classic “Deca
and D-bol” stack (usually 200-400 mg of nandrolone decanoate per week
and 15-25 mg of Dianabol per day) has been a bodybuilding basic for
decades, and always seems to provide excellent muscle growth. A stronger
androgen such as Anadrol 50® or testosterone could also be substituted,
producing greater results, but with more water retention.
Administration (Women):
For general anabolic effects, early prescribing guidelines recommend a
dosage of 50-100 mg every 3-4 weeks for 12 weeks. To treat renal anemia,
the prescribing guidelines for nandrolone decanoate recommend a dosage of
50-100 mg per week. When used for physique- or performance-enhancing
purposes, a dosage of 50 mg per week is most common, taken for 4-6
weeks. Although only slightly androgenic, women are occasionally
confronted with virilization symptoms when taking this compound. Studies
have demonstrated high tolerability (minor but statistically insignificant
incidence of virilizing side effects) with a dose of 100 mg every other week
for 12 weeks,444 while long-term studies (+12 months of use) have
demonstrated virilizing side effects on a dose as low as 50 mg every 2-3
weeks.445 Should virilizing side effects become a concern, nandrolone
decanoate should be discontinued immediately to help prevent their
permanent appearance. After a sufficient period of withdrawal, the shorter-
acting nandrolone Durabolin® might be considered a safer option. This
drug stays active for only several days, greatly reducing the withdrawal
time if indicated.
Availability:
Nandrolone decanoate continues to decline in prominence as a
pharmaceutical product due to its limited use in clinical medicine. The drug
is presently unavailable in the United States. Many Western nations
continue to market the drug, though its production is increasingly being
shifted to less regulated markets in Asia. Legitimate pharmaceutical forms
are highly sought after on the black market, and thus subject to a great deal
of counterfeiting. In reviewing some of the more popular products and
changes on the global pharmaceutical market, we have made the following
observations.
In November 2009, Organon (a subsidiary of ScheringPlough since 2007)
became part of Merck/MSD. All Organon products are expected to
transition over to this label. It is unknown what (if any) changes to expect in
the global distribution of Deca-Durabolin products.
Brand name Deca-Durabolin is not available in the United States. All
products bearing this label are counterfeit. Watson Labs and Schein
Pharmaceuticals generics have also been discontinued. This drug is
presently unavailable in the U.S.
Norma Hellas Deca (100 mg/mL nandrolone decanoate in 2 mL vials) from
Greece is available, but also widely counterfeited. The firm uses a patented
photochromic
label
to
deter
counterfeiting,
which
carries
a
metallic/holographic watermark of the Norma Hellas logo.
Greek Deca-Durabolin (formerly from Organon) has been another widely
counterfeited product. It is one of only a handful of European nandrolone
injectables to be found in multi-dosed vials, making it an easy target for
counterfeiters that lack the capacity to produce glass ampules. This product
should be considered fake unless it comes in a box with the proper Greek
drug ID sticker. As with all Greek drugs, the sticker should show a hidden
mark under UV light.
Greek Extraboline may be in circulation. It is also a common target of
counterfeiting. As with all Greek drugs, this product should contain a peel-
off pharmacy sticker that reveals a hidden watermark under UV lighting.
All Extraboline in circulation will also carry a holographic image directly
on the vial label.
Deca-Pronabol from P&B Labs India is no longer in production. The
company currently markets only a 25 mg/mL version of this drug in 1 mL
ampules. Many counterfeits of the former 100 mg/mL product are still in
circulation.
Decabolic from Asia Pharma (Malaysia) is now approved for sale through
pharmacies in Thailand, and is fairly popular on the black market. Each box
should carry a scratch-off security sticker, which will display a code that
can be validated on the company website.
Balkan Pharmaceuticals (Moldova) makes the product Nandrolona D. It is
prepared in both 1 mL ampules and multi-dose vials.