Appropriate Use of Nandrolone Decanoate (Deca-Durabolin) in Males
Nandrolone decanoate (Deca-Durabolin) should only be used in males for FDA-approved indications such as anemia of renal disease, at doses of 100-200 mg per week administered by deep intramuscular injection into the gluteal muscle. 1
FDA-Approved Indications and Dosing
- Nandrolone decanoate is approved for the treatment of anemia of renal disease in adult males at a dosage of 100-200 mg per week via deep intramuscular injection 1
- For pediatric patients (2-13 years), the recommended dose is 25-50 mg every 3-4 weeks 1
- Treatment should be discontinued if no hematologic improvement is seen within six months 1
- Therapy should be regarded as adjunctive and intermittent rather than continuous 1
Administration Guidelines
- Injections must be administered deep intramuscularly, preferably into the gluteal muscle 1
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration 1
- The medication should be considered adjunctive therapy, with adequate nutrients required to obtain maximal therapeutic effects 1
Adverse Effects and Monitoring
Cardiovascular Effects
- Nandrolone use is associated with deleterious effects on cardiac tissue that may not be reversible even after discontinuation 2
- Monitoring for cardiovascular risk factors is essential, as anabolic steroids can negatively affect lipid profiles 3
Reproductive Effects
- Nandrolone significantly disrupts spermatogenesis and reduces testosterone levels 4
- Men should be informed that fertility will be greatly compromised during therapy due to down-regulation of gonadotropins 5
- Testicular size and consistency often diminish during treatment 5
Hepatic Effects
- While intramuscular injections of testosterone do not appear to be associated with hepatic dysfunction, routine monitoring with liver function tests is recommended 5
Other Potential Side Effects
- Fluid retention, though uncommon and generally mild 5
- Breast tenderness and swelling in some men 5
- Local pain, soreness, bruising, erythema, swelling, or nodules at injection sites 5
Important Contraindications
- Nandrolone should not be used for bodybuilding or performance enhancement purposes, as these are not FDA-approved indications 1, 2
- Men who are trying to conceive should avoid nandrolone due to its negative effects on spermatogenesis 4
- Caution is advised in patients with cardiovascular disease due to potential negative effects on lipid profiles 3
Clinical Pearls and Pitfalls
- Nandrolone should never be used for treating erectile dysfunction; PDE5 inhibitors are the first-line treatment for ED 5
- For men with hypogonadism, testosterone replacement therapy rather than nandrolone is the appropriate treatment 5
- Avoid using nandrolone in men with prostate cancer, as androgen deprivation therapy rather than androgen supplementation is indicated 5
- The medication should be discontinued if no clinical benefit is observed within the expected timeframe 1