Deca (anabolic)

Overdose

The acute toxicity of nandrolone decanoate in animals is very low. There are no reports of acute overdosage with Deca (ANABOLIC) in the human.

Contraindications

Pregnancy.

Breast-feeding

Porphyria

Hypersensitivity to the active substance or to any of the excipients, including arachis oil. Deca (ANABOLIC) is therefore contraindicated in patients allergic to peanuts or soya.

Incompatibilities

None known

Undesirable effects

Due to the nature of Deca (ANABOLIC), side effects cannot be quickly reversed by discontinuing medication. Injectables in general, may cause local reaction at the injection site.

Deca (ANABOLIC) at the recommended dosages is unlikely to produce virilising effects. High dosages, prolonged treatment and/or too frequent administration may cause:

System Organ Class

MedDRA term*

Endocrine disorders

Virilism

Metabolism and nutrition disorders

Lipids abnormal1

Psychiatric disorders

Libido increased

Vascular disorders

Hypertension

Respiratory, thoracic and mediastinal disorders

Dysphonia

Gastrointestinal disorders

Nausea

Hepatobiliary disorders

Hepatic function abnormal

Peliosis hepatis

Liver tumours

Skin and subcutaneous tissue disorders

Acne

Pruritus

Hirsutism

Renal and urinary disorders

Urine flow decreased

Reproductive system and breast disorders

Enlarged clitoris

General disorders and administration site conditions

Oedema

Injection site reaction

Sodium retention

Investigations

Haemoglobin increased

* MedDRA version 15.0.

1. Decrease in serum LDL-C, HDL-C and triglycerides.

Virilisation which appears in sensitive women as hoarseness, acne, hirsutism and increase of libido. Hoarseness may be the first symptom of vocal change which may end in long-lasting, sometimes irreversible deepening of the voice.

The terms used to describe the undesirable effects above are also meant to include synonyms and related terms.

Preclinical safety data

Toxicity studies in animals after repeated dosing did not indicate a safety risk for humans. No formal studies to assess reproduction toxicity, genotoxicity and carcinogenicity have been conducted by the company. As a class, anabolic steroids are considered to be probably carcinogenic to humans (IARC Group 2a).

The use of androgens in different species has resulted in virilisation of the external genitals of female foetuses. Investigations into the genotoxic potential of nandrolone showed it to be positive in an in vitro micronucleus assay and an in vivo micronucleus assay in mouse but not rat, and in the comet assay of mouse and rat. The clinical relevance of these findings is unknown, therefore the risk to patients cannot be ruled out.

Therapeutic indications

For use in osteoporosis in post-menopausal women

Established osteoporosis should have been diagnosed by the following parameters:

i) crush or wedge fractures of the vertebrae

ii) other osteoporotic fractures

iii) established reduction in bone mineral content as measured by accepted BMC measurements.

Pharmacotherapeutic group

Anabolic steroids. ATC code: A14A B01

Pharmacodynamic properties

Pharmacotherapeutic group: Anabolic steroids. ATC code: A14A B01

Nandrolone is chemically related to testosterone and shows enhanced anabolic and a reduced androgenic activity.

In humans Deca (ANABOLIC) has been shown to positively influence calcium metabolism and to increase bone mass in osteoporosis.

Androgenic effects (e.g. virilisation) are relatively uncommon at the recommended dosages. Nandrolone lacks the C17 alpha-alkyl group which is associated with the occurrence of liver dysfunction and cholestasis.

Pharmacokinetic properties

Absorption

Nandrolone decanoate is slowly released from the injection site into the blood with a half-life of 6 days.

Distribution

The ester is rapidly hydrolysed to nandrolone in the blood with a half-life of one hour or less. The half-life for the combined process of hydrolysis of nandrolone decanoate and of distribution and elimination of nandrolone is 4.3 hours.

Biotransformation and excretion

Nandrolone is metabolised by the liver. 19-norandrosterone, 19-noretiocholanolone and 19-norepiandrosterone have been identified as metabolites in the urine. It is not known whether these metabolites display a pharmacological action.

Name of the medicinal product

Deca (ANABOLIC)

Qualitative and quantitative composition

Nandrolone

Special warnings and precautions for use

Medical examination:

Physicians should consider monitoring patients receiving Deca (ANABOLIC) before the start of treatment, at quarterly intervals for the first 12 months and yearly thereafter for the following parameters:

- Hematocrit and hemoglobin to exclude polycythemia.

Conditions that need supervision:

Patients, especially the elderly, with the following conditions should be monitored for:

- Tumours - Mammary carcinoma, hypernephroma, bronchial carcinoma and skeletal metastases. In these patients hypercalcaemia or hypercalciuria may develop spontaneously, and also during androgen therapy. Nevertheless, the hypercalcaemia or hypercalciuria should first be treated appropriately and after restoration of normal calcium levels, if judged necessary and taking into account the risks and benefits on a case by case basis, hormone therapy can be resumed, with caution.

- Pre-existing conditions-In patients with pre-existing cardiac, renal or hepatic insufficiency/disease or epilepsy or migraine anabolic steroid treatment may cause complications characterized by oedema with or without congestive heart failure. In such cases treatment must be stopped immediately. Patients who experienced myocardial infarction, cardiac-, hepatic- or renal insufficiency, hypertension, epilepsy, or migraine should be monitored due to the risk of deterioration of or reoccurrence of disease. In such cases treatment must be stopped immediately.

- Diabetes mellitus - Deca (ANABOLIC) can improve glucose tolerance in diabetic patients.

- Anti-coagulant therapy - Deca (ANABOLIC) can enhance the anti-coagulant action of coumarin-type agents (see also section 4.5).

- Liver dysfunction - caution should be used in patients with severe hepatic impairment and Deca (ANABOLIC) 50mg/ml should only be used if the benefits outweigh the risks.

Adverse events:

If anabolic steroid-associated adverse reactions occur , treatment with Deca (ANABOLIC) should be discontinued and, upon resolution of complaints, treatment can be resumed.

Virilisation:

Patients should be informed about the potential occurrence of signs of virilisation. In particular, singers and women with speech professions should be informed about the risk of deepening of the voice.

If signs of virilisation develop, the risk/benefit ratio has to be newly assessed with the individual patient.

(Mis) use in sports:

Nandrolone is classified as a prohibited substance under the Olympic Movement Anti- doping Code (OMAC 1999). The misuse of Nandrolone and other anabolic steroids to enhance ability in sports carries serious health risks and is to be discouraged.

Excipients:

Deca (ANABOLIC) contains arachis oil (peanut oil) and should not be taken/applied by patients known to be allergic to peanut. As there is a possible relationship between allergy to peanut and allergy to soya, patients with soya allergy should also avoid Deca (ANABOLIC).

Deca (ANABOLIC) 50mg/ml contains 100 mg benzyl alcohol per ml solution and must not be given to premature babies or neonates. Benzyl alcohol may cause anaphylactoid reactions in infants and children up to 3 years old.

Paediatric Population:

Safety and efficacy have not been adequately determined in children and adolescents. In pre-pubertal children statural growth and sexual development should be monitored since anabolic steroids in general and Deca (ANABOLIC) in high dosages may accelerate epiphyseal closure and sexual maturation.

Effects on ability to drive and use machines

Deca (ANABOLIC) has no influence on the ability to drive and use machines.

Dosage (Posology) and method of administration

Posology:

Post-menopausal women

50mg every three weeks

The duration of treatment depends on the clinical response and the possible occurrence of side-effects.

We would recommend that the effectiveness of therapy be monitored with the appropriate methods for osteoporosis on a 6-12 monthly basis.

Method of administration:

Deca (ANABOLIC) should be administered by deep intramuscular injection

Special precautions for disposal and other handling

No special requirements for disposal.