NANDROLONE DECANOATE

Known commonly as "Deca", this androgenic/anabolic steroid (AAS) is easy on the liver and promotes good size and strength gains while reducing body fat. This drug is unique in that 5a -reductase, the enzyme which converts testosterone to the more-potent DHT, actually converts Nandrolone to a less-potent compound. Therefore, this is somewhat deactivated in the skin, scalp, and prostate, and these tissues experience an effectively-lower androgen level than the rest of the body.

For those particularly concerned with less activity in the scalp, skin, and prostate Deca is a good alternative in androgen therapy. Its effectiveness at the androgen receptor of muscle tissue is better and binds better than testosterone. Yet, it gives only about half the muscle-building results per milligram. This is a due to it being less effective or entirely ineffective in non-AR-mediated mechanisms for muscle growth. It also appears less effective in activity on nerve cells, specifically on the nerve cells responsible for erectile function. Use of Deca as the sole AAS often results in complete inability to perform sexually. These problems can be solved by combining it with a drug that supplies the missing activity: e.g. testosterone.

Nandrolone is proven to be a progestin. This is important in bodybuilding, because moderate Deca-only use actually lowers estrogen levels as a consequence of reducing natural testosterone levels; thus allowing the aromatase enzyme less substrate to work with, Deca nonetheless can cause gynecomastia in some individuals.

To some extent, Nandrolone aromatizes to estrogen, and it does not appear that this can be entirely blocked by use of aromatase inhibitors - indeed, aromatase may not be involved at all in this process (there is no evidence in humans that such occurs) with the enzyme CYP 2C11 being the more likely candidate for this activity. Cytadren, an aromatase inhibitor, has not been found effective in avoiding aromatization of Nandrolone.

The long half-life of Deca-Durabolin makes it unsuited for short alternating cycles, but suitable for more traditional cycles, with a built-in self-tapering effect in the weeks following the last injection.

Theraputic action: Testosterone analogue; promotes body tissue–building processes and reverses catabolic or tissue-depleting processes; increases Hgb and red cell mass.

How Taken - Administration by deep intermuscular Injection

Possible Side Effects - Water retention (edema), Gynecomastia, Numbness, Inhibited natural testosterone production, Elevated blood pressure , Elevated blood lipid profiles, Accelerated hair loss , Aggression, moodiness , Acne.

Contraindications/cautions
Known sensitivity to nandrolone or anabolic steroids; prostate or breast cancer in males; benign prostatic hypertrophy; breast cancer (females); pituitary insufficiency; MI (contraindicated because of effects on cholesterol); nephrosis; liver disease; hypercalcemia; pregnancy; lactation.

Warnings/Precautions - Your doctor should check your progress at regular visits and should check liver profiles at least twice a year.

Instructions to follow for your safety:

• This drug can only be given IM; mark calendar indicating days to return for injection.
• The following side effects may occur: nausea, vomiting, diarrhea, burning of the tongue (small, frequent meals); body hair growth, baldness, deepening of the voice, loss of libido, impotence; (most effects are reversible); excitation, confusion, insomnia (avoid driving, performing tasks that require alertness); swelling of the ankles, fingers (request medication).
• This drug is associated with severe fetal effects; do not use drug during pregnancy; use of barrier contraceptives is advised.
• Report ankle swelling, skin color changes, severe nausea, vomiting, hoarseness, body hair growth, deepening of the voice, acne, menstrual irregularities (women).
• Tell any healthcare provider who is taking care of you that you are on this drug.

For diabetic patients:
This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests you should check with your doctor for further analysis.

Missed Dose - Do not double up on medication. Missed doses should be added to the end of cycle.
Pregnancy - Anabolic steroids are not recommended during pregnancy. They may cause the development of male features in the female fetus and premature growth and development of male features in the male fetus. Be sure you have discussed this with your doctor.

Storage - Store in a cool, dry place. Keep the liquid form of this medicine from freezing.

Clinically important interactions

Drug-drug:
• Potentiation of oral anticoagulants with anabolic steroids
• Decreased need for insulin, oral hypoglycemia agents with anabolic steroids

Drug-lab test
• Altered glucose tolerance tests
• Decrease in thyroid function tests, which may persist for 2–3 wk after stopping therapy
• Increased creatinine, creatinine clearance, which may last for 2 wk after therapy

Nursing considerations - Assessment

History: Sensitivity to nandrolone or anabolic steroids; prostate or breast cancer in males; benign prostatic hypertrophy; breast cancer in females; pituitary insufficiency; MI; nephrosis; liver disease; hypercalcemia; pregnancy; lactation

Physical: Skin color, texture; hair distribution pattern; affect, orientation; abdominal exam, liver evaluation; serum electrolytes, serum cholesterol levels, glucose tolerance tests, thyroid function tests, long-bone x-ray (in children)

Interventions
• Ensure that patient is not pregnant before administering; advise the use of barrier contraceptives during therapy.
• Inject nandrolone deeply into gluteal muscle.
• Intermittent administration decreases adverse effects.
• Monitor effect on children with long-bone x-rays every 3–6 mo; discontinue drug well before the bone age reaches the norm for the patient's chronologic age.
• Monitor patient for edema; arrange for diuretic therapy.
• Monitor liver function, serum electrolytes, and consult with physician for appropriate corrective measures.
• Measure cholesterol levels periodically in patients with high risk for CAD.
• Monitor diabetic patients closely because glucose tolerance may change; adjustments may be needed in insulin, oral hypoglycemic dosage, and diet.

Drug-specific teaching points
• This drug can only be given IM; mark calendar indicating days to return for injection.

The following side effects may occur:
nausea, vomiting, diarrhea, burning of the tongue (small, frequent meals); body hair growth, baldness, deepening of the voice, loss of libido, impotence; (most effects are reversible); excitation, confusion, insomnia (avoid driving, performing tasks that require alertness); swelling of the ankles, fingers (request medication).

• This drug is associated with severe fetal effects; do not use drug during pregnancy; use of barrier contraceptives is advised.

• Diabetic patients—monitor urine sugar closely because glucose tolerance may change. Report any abnormalities to physician, so corrective action can be taken.

• Report ankle swelling, skin color changes, severe nausea, vomiting, hoarseness, body hair growth, deepening of the voice, acne, menstrual irregularities (women).