Nandrolone decanoate

{{See also|Anabolic steroid#Medical}}

Nandrolone decanoate is approved in the United States specifically for the treatment of anemia of chronic kidney disease and in the United Kingdom specifically for the treatment of osteoporosis in postmenopausal women.{{Cite web|url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3f059e04-1ebc-40bb-a49c-f9d90d41b1cb|title=NANDROLONE DECANOATE INJECTION, USP|website=Dailymed.nlm.nih.gov|access-date=24 March 2022}}{{cite web|url=https://www.medicines.org.uk/emc/files/pil.5374.pdf?filename=PIL.5374.pdf|title=Package leaflet: Information for the patient : ROLON 250 mg/ml Solution for Injection (Nandrolone decanoate)|website=Medicines.org.uk|access-date=24 March 2022|archive-date=13 December 2017|archive-url=https://web.archive.org/web/20171213142942/https://www.medicines.org.uk/emc/files/pil.5374.pdf?filename=PIL.5374.pdf|url-status=dead}} In Australia, it is approved specifically for the treatment of kidney failure, chronic kidney disease, anemia of kidney failure, aplastic anemia, osteoporosis (in women in whom estrogens are contraindicated), inoperable breast cancer, and for patients on long-term corticosteroid therapy.{{cite web |url= https://gp2u.com.au/static/pdf/D/DECA-DURABOLIN-PI.pdf |title=DECA-DURABOLIN (nandrolone decanoate) |website=gp2u.com.au |access-date=15 January 2022 |archive-url=https://web.archive.org/web/20190309024812/https://gp2u.com.au/static/pdf/D/DECA-DURABOLIN-PI.pdf |archive-date=9 March 2019 |url-status=dead}} In New Zealand, it is approved for osteoporosis, inoperable breast cancer, and as an adjunct to therapy for conditions characterized by a negative nitrogen balance. The drug is often used off-label to preserve lean mass in HIV/AIDS patients and in other wasting syndromes.

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. Starting in the 1970s, the indications of nandrolone decanoate were refined and use of the drug became more selective and restricted. Its use in medicine continues to decline and has become limited, with its sale having been discontinued in many countries.

Nandrolone esters can be used as a form of androgen replacement therapy for treatment of androgen deficiency in men. However, they have not generally been used for this purpose, and have instead mostly been used only as anabolic agents.{{cite book| vauthors = Becker KL |title=Principles and Practice of Endocrinology and Metabolism|url=https://books.google.com/books?id=FVfzRvaucq8C&pg=PA1185|year=2001|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-1750-2|pages=1185, 2146}}{{cite book| vauthors = Meikle AW |title=Hormone Replacement Therapy|url=https://books.google.com/books?id=ja2nBgAAQBAJ&pg=PA271|date=1 June 1999|publisher=Springer Science & Business Media|isbn=978-1-59259-700-0|pages=271–}} 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.{{cite journal | vauthors = Davis S | title = Androgen replacement in women: a commentary | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 84 | issue = 6 | pages = 1886–1891 | date = June 1999 | pmid = 10372681 | doi = 10.1210/jcem.84.6.5802 | doi-access = free }}{{cite journal | vauthors = Abraham D, Carpenter PC | title = Issues concerning androgen replacement therapy in postmenopausal women | journal = Mayo Clinic Proceedings | volume = 72 | issue = 11 | pages = 1051–1055 | date = November 1997 | pmid = 9374980 | doi = 10.4065/72.11.1051 | doi-access = free }}{{cite book| vauthors = Meikle AW |title=Endocrine Replacement Therapy in Clinical Practice|url=https://books.google.com/books?id=CA0HCAAAQBAJ&pg=PA519|date=24 April 2003|publisher=Springer Science & Business Media|isbn=978-1-59259-375-0|pages=519–}}{{cite journal | vauthors = Davis SR | title = The therapeutic use of androgens in women | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 69 | issue = 1–6 | pages = 177–184 | year = 1999 | pmid = 10418991 | doi = 10.1016/s0960-0760(99)00054-0 | s2cid = 23520067 }} It is one of only three androgens approved for androgen replacement in postmenopausal women, the others being testosterone (and esters) and methyltestosterone. 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.{{cite journal | vauthors = Wu C, Kovac JR | title = Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health | journal = Current Urology Reports | volume = 17 | issue = 10 | pages = 72 | date = October 2016 | pmid = 27535042 | doi = 10.1007/s11934-016-0629-8 | s2cid = 43199715 }}{{cite journal | vauthors = Pan MM, Kovac JR | title = Beyond testosterone cypionate: evidence behind the use of nandrolone in male health and wellness | journal = Translational Andrology and Urology | volume = 5 | issue = 2 | pages = 213–219 | date = April 2016 | pmid = 27141449 | pmc = 4837307 | doi = 10.21037/tau.2016.03.03 | doi-access = free }} 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.{{cite journal | vauthors = Long JE, Lee MS, Blithe DL | title = Male Contraceptive Development: Update on Novel Hormonal and Nonhormonal Methods | journal = Clinical Chemistry | volume = 65 | issue = 1 | pages = 153–160 | date = January 2019 | pmid = 30602479 | doi = 10.1373/clinchem.2018.295089 | doi-access = free }}{{cite journal | vauthors = Nieschlag E | title = Clinical trials in male hormonal contraception | journal = Contraception | volume = 82 | issue = 5 | pages = 457–470 | date = November 2010 | pmid = 20933120 | doi = 10.1016/j.contraception.2010.03.020 | url = http://www.kup.at/kup/pdf/10172.pdf }}

It has also been proposed for masculinizing hormone therapy in some nonbinary people assigned female at birth who want the body shape effects of testosterone without androgenic hair growth.{{cite journal | vauthors = Cocchetti C, Ristori J, Romani A, Maggi M, Fisher AD | title = Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals | journal = Journal of Clinical Medicine | volume = 9 | issue = 6 | page = 1609 | date = May 2020 | pmid = 32466485 | pmc = 7356977 | doi = 10.3390/jcm9061609 | doi-access = free }}

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.{{cite journal | vauthors = Morley JE, Perry HM | title = Androgens and women at the menopause and beyond | journal = The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences | volume = 58 | issue = 5 | pages = M409–M416 | date = May 2003 | pmid = 12730248 | doi = 10.1093/gerona/58.5.M409 | doi-access = free }}{{cite book| vauthors = Lobo RA, Kelsey J, Marcus R |title=Menopause: Biology and Pathobiology|url=https://books.google.com/books?id=i9HXKhjvNVAC&pg=PA454|date=22 May 2000|publisher=Academic Press|isbn=978-0-08-053620-0|pages=454–}}{{cite book| vauthors = Bagatell C, Bremner WJ |title=Androgens in Health and Disease|url=https://books.google.com/books?id=vDcBCAAAQBAJ&pg=PA374|date=27 May 2003|publisher=Springer Science & Business Media|isbn=978-1-59259-388-0|pages=25,146,374,408–409}} 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.{{cite journal | vauthors = Khorram O | title = Potential therapeutic effects of prescribed and over-the-counter androgens in women | journal = Clinical Obstetrics and Gynecology | volume = 44 | issue = 4 | pages = 880–892 | date = December 2001 | pmid = 11600868 | doi = 10.1097/00003081-200112000-00025 | s2cid = 40818075 }} 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. Dosages in men and for other uses have also been described.

{{Androgen replacement therapy formulations and dosages used in women}}

{{Androgen/anabolic steroid dosages for breast cancer}}

Nandrolone decanoate has been available in 25 mg/mL, 50 mg/mL, 100 mg/mL, and 200 mg/mL formulations in oil solution for intramuscular injection.

{{See also|Anabolic steroid#Enhancing performance}}

Nandrolone decanoate is used for physique- and performance-enhancing purposes by competitive athletes, bodybuilders, and powerlifters. It is consumed by bodybuilders as per 8–12 weeks bulking cycles with some form of testosterone as a base{{Cite web|title=Deca Durabolin Cycle: The most effective ways to use Deca|url=https://myleanbody.net/cycles.html|access-date=2020-10-09|website=myleanbody.net|language=en-US}} 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.{{cite journal | vauthors = Barone R, Pitruzzella A, Marino Gammazza A, Rappa F, Salerno M, Barone F, Sangiorgi C, D'Amico D, Locorotondo N, Di Gaudio F, Cipolloni L, Di Felice V, Schiavone S, Rapisarda V, Sani G, Tambo A, Cappello F, Turillazzi E, Pomara C | display-authors = 6 | title = Nandrolone decanoate interferes with testosterone biosynthesis altering blood-testis barrier components | journal = Journal of Cellular and Molecular Medicine | volume = 21 | issue = 8 | pages = 1636–1647 | date = August 2017 | pmid = 28244681 | pmc = 5542904 | doi = 10.1111/jcmm.13092 | publisher = Wiley-Blackwell }} 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. 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.{{Cite web|title=Side Effects of Deca Durabolin|url=https://myleanbody.net/sideeffects.html|access-date=2020-10-09|website=myleanbody.net|language=en-US}}

Contraindications for nandrolone decanoate include pregnancy, breastfeeding, prostate cancer, male breast cancer, breast cancer in women with hypercalcemia, hypersensitivity (to nandrolone decanoate or excipients such as arachis (peanut) oil; includes those with peanut and soy allergies), nephrosis or nephritis, liver disease with impaired bilirubin excretion, and heart failure. High dosages may also be considered contraindicated in women due to their high potential for virilization.

{{See also|Anabolic steroid#Adverse effects}}

The side effects of nandrolone decanoate are dependent on dosage, duration of treatment, and individual sensitivity. A number of common, uncommon, and rare side effects have been observed with the medication at recommended dosages. While less common or severe than with many other AAS, the most common side effect of nandrolone decanoate is virilization (masculinization) in women. Uncommon side effects of nandrolone decanoate at recommended dosages include fluid retention, inhibition of spermatogenesis, testicular atrophy, erectile dysfunction, gynecomastia, increased frequency of penile erections, increased penis size in pre-pubertal boys, clitoral hypertrophy, increased pubic hair growth, oligomenorrhea, amenorrhea, hyperlipidemia, decreased HDL cholesterol, increased hemoglobin (to abnormal high levels), hypertension, nausea, epididymitis, bladder irritability, reduced urine flow, benign prostatic hyperplasia, priapism, premature epiphyseal closure (in children), and acne. Rare side effects include abnormal liver function, jaundice, peliosis hepatis, liver tumors, oily skin, greasy hair, rash, pruritus, exanthema, urticaria at the injection site, and furunculosis. Local injection site reactions may also occur.

Unlike 17α-alkylated AAS such as methyltestosterone, nandrolone decanoate is not associated with liver toxicity.{{cite book| vauthors = Hohl A |title=Testosterone: From Basic to Clinical Aspects|url=https://books.google.com/books?id=Et6TDgAAQBAJ&pg=PA394|date=30 March 2017|publisher=Springer|isbn=978-3-319-46086-4|pages=394–}}

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. Clitoral enlargement is an uncommon symptom of virilization that can occur. 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. Hoarseness is often the first sign of voice changes. Although said to be only slightly androgenic, nandrolone decanoate may still occasionally cause virilization at recommended dosages in women, especially with long-term treatment. 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. Conversely, long-term (>1 year) studies have shown significant virilization in women even at a dosage of 50 mg every 2 or 3 weeks.

The acute toxicity of nandrolone esters in animals is very low and there are no reports of acute overdosage with nandrolone decanoate in humans. There are no specific recommendations for the management of nandrolone decanoate.

Antiestrogens like aromatase inhibitors (e.g., anastrozole) and selective estrogen receptor modulators (e.g., tamoxifen, raloxifene) can interfere with and prevent the estrogenic effects of nandrolone decanoate. 5α-Reductase inhibitors like finasteride and dutasteride can prevent the inactivation of nandrolone in so-called "androgenic" tissues like the skin, hair follicles, and prostate gland, and may therefore considerably increase its androgenic side effects. This is opposite to the case of most other AAS, which are either potentiated by 5α-reductase in such tissues or are not substrates of 5α-reductase. Antiandrogens like cyproterone acetate, spironolactone, and bicalutamide can block both the anabolic and androgenic effects of AAS like nandrolone decanoate.

File:Nandrolone.svg, the active form of nandrolone decanoate.]]

{{Relative androgenic to anabolic activity in animals}}

Nandrolone decanoate is a nandrolone ester, or a prodrug of nandrolone. As such, it is an androgen and anabolic steroid, or an agonist of the AR, the biological target of androgens like testosterone and DHT.{{cite journal | vauthors = Gao W, Bohl CE, Dalton JT | title = Chemistry and structural biology of androgen receptor | journal = Chemical Reviews | volume = 105 | issue = 9 | pages = 3352–3370 | date = September 2005 | pmid = 16159155 | pmc = 2096617 | doi = 10.1021/cr020456u }} Relative to testosterone, nandrolone decanoate has enhanced anabolic effects and reduced androgenic effects. 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. 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. 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. For this reason, they are considered to be among the most appropriate AAS for use in women and children.

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. 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. 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.

In addition to its anabolic and androgenic activity, nandrolone decanoate has low estrogenic activity (via its metabolite estradiol) and moderate progestogenic activity. This may result in side effects such as fluid retention and gynecomastia. Like other AAS, nandrolone decanoate has antigonadotropic effects. 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. Both the androgenic activity and the progestogenic activity of nandrolone decanoate may contribute to its antigonadotropic potency. Relative to testosterone, due to its lower estrogenic potency, much less of the antigonadotropic potency of nandrolone decanoate is derived from its estrogenic activity.

{{Relative affinities of nandrolone and related steroids}}

{{Relative affinities of nandrolone and related steroids at the androgen receptor}}

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.{{cite book| vauthors = Thomas JA |title=Drugs, Athletes, and Physical Performance|url=https://books.google.com/books?id=9u0pBgAAQBAJ&pg=PA27|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-1-4684-5499-4|pages=27–29}} Once in the circulation, it is converted into nandrolone, which is the active form of the drug. 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. 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. Like testosterone, nandrolone is highly protein-bound and is present in the blood in both bound and free fractions. It has very low affinity for sex hormone-binding globulin (SHBG), about 5% of that of testosterone and 1% of that of DHT.{{cite journal | vauthors = Saartok T, Dahlberg E, Gustafsson JA | title = 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 | journal = Endocrinology | volume = 114 | issue = 6 | pages = 2100–2106 | date = June 1984 | pmid = 6539197 | doi = 10.1210/endo-114-6-2100 }}

Nandrolone decanoate is rapidly hydrolyzed in the blood by esterases into nandrolone, with a terminal half-life of one hour or less. It does not appear to be hydrolyzed in muscle or fat.{{cite journal | vauthors = Kalicharan RW, Bout MR, Oussoren C, Vromans H | title = Where does hydrolysis of nandrolone decanoate occur in the human body after release from an oil depot? | journal = International Journal of Pharmaceutics | volume = 515 | issue = 1–2 | pages = 721–728 | date = December 2016 | pmid = 27989828 | doi = 10.1016/j.ijpharm.2016.10.068 }} The metabolism of nandrolone occurs in the liver and is very similar to that of testosterone, including reduction by 5α-reductase and 5β-reductase, dehydrogenation by 3α-hydroxysteroid dehydrogenase, 3β-hydroxysteroid dehydrogenase, and 17β-hydroxysteroid dehydrogenase, and conjugation. The metabolites of nandrolone include 5α-dihydronandrolone, 19-norandrosterone, and 19-noretiocholanolone, with 19-norandrosterone being the major metabolite. Other metabolites include 19-norandrostenedione, 19-norandrostanediols, 19-norepiandrosterone, and conjugates. Nandrolone also undergoes aromatization into estradiol similarly to testosterone, though at a rate of only about 20% of that of testosterone or possibly even less; one study found virtually no aromatization of nandrolone in men.{{cite journal | vauthors = Behre HM, Kliesch S, Lemcke B, von Eckardstein S, Nieschlag E | title = Suppression of spermatogenesis to azoospermia by combined administration of GnRH antagonist and 19-nortestosterone cannot be maintained by this non-aromatizable androgen alone | journal = Human Reproduction | volume = 16 | issue = 12 | pages = 2570–2577 | date = December 2001 | pmid = 11726576 | doi = 10.1093/humrep/16.12.2570 | doi-access = free }}

The elimination half-life of nandrolone decanoate administered by intramuscular injection is approximately 6 to 12 days. 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.{{cite journal | vauthors = Vermeulen A | title = Longacting steroid preparations | journal = Acta Clinica Belgica | volume = 30 | issue = 1 | pages = 48–55 | date = 1975 | pmid = 1231448 | doi = 10.1080/17843286.1975.11716973 }}{{cite book| vauthors = Dorfman RI |title=Steroidal Activity in Experimental Animals and Man|url=https://books.google.com/books?id=uizgBAAAQBAJ&pg=PA68|date=5 December 2016|publisher=Elsevier Science|isbn=978-1-4832-7300-6|pages=68–}} The blood half-life for the combined process of hydrolysis into nandrolone and elimination of nandrolone is 4.3 hours. Nandrolone and its metabolites are excreted in the urine, mainly in the form of conjugates.

Although nandrolone decanoate is usually administered by intramuscular injection, it has been found to be similarly effective when administered by subcutaneous injection.{{cite journal | vauthors = Singh GK, Turner L, Desai R, Jimenez M, Handelsman DJ | title = Pharmacokinetic-pharmacodynamic study of subcutaneous injection of depot nandrolone decanoate using dried blood spots sampling coupled with ultrapressure liquid chromatography tandem mass spectrometry assays | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 99 | issue = 7 | pages = 2592–2598 | date = July 2014 | pmid = 24684468 | doi = 10.1210/jc.2014-1243 | doi-access = free }} The pharmacokinetics of nandrolone decanoate via subcutaneous injection closely resemble those of intramuscular injection. However, subcutaneous injection is considered to be easier, more convenient, and less painful compared to intramuscular injection. In addition, research suggests that most intramuscular injections in practice are in fact subcutaneous injections.

{{Parenteral durations of androgens/anabolic steroids}}

{{Hormone levels with nandrolone esters by intramuscular injection}}

{{See also|Nandrolone#Chemistry|Androgen ester|List of androgen esters#Nandrolone esters}}

Nandrolone decanoate, or nandrolone 17β-decanoate, is a synthetic estrane steroid and a derivative of testosterone. It is an androgen ester; specifically, it is the C17β decylate (decanoate) ester of nandrolone (19-nortestosterone), which itself is the 19-demethylated analogue of testosterone.

{{Structural properties of major anabolic steroid esters}}

Nandrolone decanoate was first described in the literature in 1960. It was developed by Organon and was introduced for medical use under the brand name Deca-Durabolin in 1962.{{cite book|title=Consolidated List of Products Whose Consumption And/or Sale Have Been Banned, Withdrawn, Severely Restricted Or Not Approved by Governments|url=https://books.google.com/books?id=leVCukUgNlsC&pg=PA153|year=1983|publisher=United Nations Publications|isbn=978-92-1-130230-1|pages=153–154}}{{Dead link|date=March 2024 |bot=InternetArchiveBot |fix-attempted=yes }} Shortly thereafter it became one of the most widely used AAS in the world. Nandrolone decanoate was the second form of nandrolone to be introduced, having been preceded by nandrolone phenylpropionate in 1959.

Nandrolone decanoate is the generic name of the drug and its {{abbrlink|USAN|United States Adopted Name}} and {{abbrlink|BAN|British Approved Name}}. It has also been referred to as nandrolone decylate.

Nandrolone decanoate is or has been marketed under the brand names Deca-Durabolin, Deca-Durabol, Decaneurabol, Metadec, and Retabolil, among others.

Nandrolone decanoate is available widely throughout the world, including in the United Kingdom, other European countries, Australia, New Zealand, Latin America, Asia, and elsewhere in the world. It has been discontinued in United States and Canada.{{cite web | title = Drugs@FDA: FDA Approved Drug Products | publisher = United States Food and Drug Administration | access-date = 17 December 2016 | url = https://www.accessdata.fda.gov/scripts/cder/daf/}}{{cite web | title = Drug Product Database - Health Canada | date = 18 March 2010 | publisher = Health Canada | url = http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php | access-date = 13 December 2017}} Its availability is becoming increasingly limited with time.

Nandrolone decanoate, along with other AAS, is a schedule III controlled substance in the United States under the Controlled Substances Act.{{cite book| vauthors = Karch SB |title=Drug Abuse Handbook, Second Edition|url=https://books.google.com/books?id=ZjrMBQAAQBAJ&pg=PA30|date=21 December 2006|publisher=CRC Press|isbn=978-1-4200-0346-8|pages=30–}}

Nandrolone decanoate has been studied in the treatment of bone loss in men, but in contrast to testosterone esters, was found to be ineffective.{{cite journal | vauthors = Hamdy RC, Moore SW, Whalen KE, Landy C | title = Nandrolone decanoate for men with osteoporosis | journal = American Journal of Therapeutics | volume = 5 | issue = 2 | pages = 89–95 | date = March 1998 | pmid = 10099043 | doi = 10.1097/00045391-199803000-00006 | s2cid = 25222622 }}{{cite journal | vauthors = Crawford BA, Liu PY, Kean MT, Bleasel JF, Handelsman DJ | title = Randomized placebo-controlled trial of androgen effects on muscle and bone in men requiring long-term systemic glucocorticoid treatment | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 88 | issue = 7 | pages = 3167–3176 | date = July 2003 | pmid = 12843161 | doi = 10.1210/jc.2002-021827 | doi-access = free }} In short-term (6- to 8-week) studies in healthy male bodybuilders, nandrolone decanoate did not alter bone mineral density.{{cite journal | vauthors = Lippi G, Franchini M, Banfi G | title = Biochemistry and physiology of anabolic androgenic steroids doping | journal = Mini Reviews in Medicinal Chemistry | volume = 11 | issue = 5 | pages = 362–373 | date = May 2011 | pmid = 21443514 | doi = 10.2174/138955711795445952 }}{{cite journal | vauthors = van Marken Lichtenbelt WD, Hartgens F, Vollaard NB, Ebbing S, Kuipers H | title = Bodybuilders' body composition: effect of nandrolone decanoate | journal = Medicine and Science in Sports and Exercise | volume = 36 | issue = 3 | pages = 484–489 | date = March 2004 | pmid = 15076791 | doi = 10.1249/01.MSS.0000117157.06455.B0 | doi-access = free | hdl = 1893/28179 | hdl-access = free }}{{cite journal | vauthors = Hartgens F, Van Marken Lichtenbelt WD, Ebbing S, Vollaard N, Rietjens G, Kuipers H | title = Body composition and anthropometry in bodybuilders: regional changes due to nandrolone decanoate administration | journal = International Journal of Sports Medicine | volume = 22 | issue = 3 | pages = 235–241 | date = April 2001 | pmid = 11354529 | doi = 10.1055/s-2001-18679 | s2cid = 260193226 }} However, the short duration of these studies limits conclusions on the influence of nandrolone decanoate on bone in men.

{{Reflist}}

{{refbegin}}

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• {{cite book | vauthors = Hemmersbach P, Grosse J | chapter = Nandrolone: A Multi-Faceted Doping Agent | title = Doping in Sports | series = Handbook of Experimental Pharmacology | volume = 195 | issue = 195 | pages = 127–154 | date = 2010 | publisher = Springer | pmid = 20020363 | doi = 10.1007/978-3-540-79088-4_6 | isbn = 978-3-540-79087-7 }}
• {{cite journal | vauthors = Velema MS, Kwa BH, de Ronde W | title = Should androgenic anabolic steroids be considered in the treatment regime of selected chronic obstructive pulmonary disease patients? | journal = Current Opinion in Pulmonary Medicine | volume = 18 | issue = 2 | pages = 118–124 | date = March 2012 | pmid = 22189453 | doi = 10.1097/MCP.0b013e32834e9001 | s2cid = 6155275 }}
• {{cite journal | vauthors = Busardò FP, Frati P, Sanzo MD, Napoletano S, Pinchi E, Zaami S, Fineschi V | title = The impact of nandrolone decanoate on the central nervous system | journal = Current Neuropharmacology | volume = 13 | issue = 1 | pages = 122–131 | date = January 2015 | pmid = 26074747 | pmc = 4462037 | doi = 10.2174/1570159X13666141210225822 }}
• {{cite journal | vauthors = Wu C, Kovac JR | title = Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health | journal = Current Urology Reports | volume = 17 | issue = 10 | pages = 72 | date = October 2016 | pmid = 27535042 | doi = 10.1007/s11934-016-0629-8 | s2cid = 43199715 }}
• {{cite journal | vauthors = Pan MM, Kovac JR | title = Beyond testosterone cypionate: evidence behind the use of nandrolone in male health and wellness | journal = Translational Andrology and Urology | volume = 5 | issue = 2 | pages = 213–219 | date = April 2016 | pmid = 27141449 | pmc = 4837307 | doi = 10.21037/tau.2016.03.03 | doi-access = free }}

{{refend}}

• [https://web.archive.org/web/20161229221316/http://anabolic.org/deca-durabolin-nandrolone-decanoate/ Deca-Durabolin (nandrolone decanoate) - William Llewellyn's Anabolic.org]

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