prasterone enanthate

The combination of estradiol valerate and prasterone enanthate is used in menopausal hormone therapy to treat menopausal symptoms in peri- and postmenopausal women. Estradiol valerate serves as an estrogen in the preparation, while prasterone enanthate is intended to serve as a weak androgen. It is thought that the inclusion of prasterone enanthate in the formulation may provide additional psychotropic benefits.{{cite journal | vauthors = Lauritzen C | title = Erfahrungen in der Behandlung klimakterischer Beschwerden mit Depot-Injektionen von Östradiolvalerianat-Dehydroepiandrosteronönanthat | trans-title = Experience of treatment of climacteric symptoms with depot injections of estradiol valerianate-dehydroandrosterone enantate | journal = Die Therapiewoche | year = 1980 | volume = 30 | issue = 10 | pages = 1736–1742 | issn = 0040-5973 | url = https://scholar.google.com/scholar?cluster=4876387720777135191 | quote = A trial of estradiol valerianate-dehydroandrosterone oenantate (Gynodian-Depot) was conducted in 68 post-menopausal women. The treatment exerted a very favorable influence on the typical subjective disorders of the climacteric and on the atrophic alterations of the target organs. Owing to its estrogenic and dehydroepiandrosterone components, the compound also exerts a favorable psychotropic effect. It was tolerated well and caused no side effects of any significance.}}{{cite journal | vauthors = Jurczok F | title = [Treatment of the climacteric symptom complex with a new combined hormone preparation] | language = de | journal = Fortschritte der Medizin | volume = 94 | issue = 9 | pages = 524–527 | date = March 1976 | pmid = 134967 | trans-title = Treatment of the climacteric symptom complex with a new combined hormone preparation }}{{cite journal | vauthors = Dinulović D, Radonjić G | title = [Gynodian-depot in the treatment of castration-induced postmenopause] | language = hr | journal = Jugoslavenska Ginekologija I Perinatologija | volume = 27 | issue = 1–2 | pages = 37–40 | date = 1987 | pmid = 2960859 | trans-title = Gynodian-depot in the treatment of castration-induced postmenopause }}

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

{{See also|Estradiol valerate/prasterone enanthate}}

Prasterone enanthate is available only as a combination formulation of 4 mg estradiol valerate and 200 mg prasterone enanthate in oil for depot intramuscular injection.{{cite book|author=Muller|title=European Drug Index: European Drug Registrations, Fourth Edition|url=https://books.google.com/books?id=2HBPHmclMWIC&pg=PA566|date=19 June 1998|publisher=CRC Press|isbn=978-3-7692-2114-5|pages=566–}}

{{See also|Prasterone#Side effects}}

Prasterone enanthate, in combination with estradiol valerate at the dosages used clinically, has no masculinizing side effects. This is in contrast to combinations of estrogens with other androgens, such as testosterone esters.

The following is a list of possible side-effects that may occur in medicines that contain Estradiol Valerate / Prasterone Enanthate. This is not a comprehensive list. These side-effects are possible, but do not always occur. Some of the side-effects may be rare but serious. Consult your doctor if you observe any of the following side-effects, especially if they do not go away.

Dysmenorrhea

Vaginitis

Ovarian cancer

Endometrial hyperplasia

Endometrial cancer

Breast cancer

Stroke

Increase in blood pressure

Pulmonary embolism

Nausea

Vomiting

Abdominal cramps

Bloating

Cholestatic jaundice

Pruritus

Rash

Dizziness

Estradiol Valerate / Prasterone Enanthate may also cause side-effects not listed here.D. J. Portman, S. R. Goldstein & R. Kagan (2019) Treatment of moderate to severe dyspareunia with intravaginal prasterone therapy: a review, Climacteric, 22（1）, 65-72, https://doi.org/10.1080/13697137.2018.1535583

{{See also|Prasterone#Pharmacology}}

{{See also|Dehydroepiandrosterone#Biological activity}}

{{See also|Dehydroepiandrosterone#Biochemistry}}

File:Estradiol and dehydroepiandrosterone levels after a single intramuscular injection of Gynodian Depot in women.png | location = Stuttgart, Germany | language = de | isbn = 978-3137008019 | page = 122}}{{cite journal | vauthors = Düsterberg B, Wendt H | title = Plasma levels of dehydroepiandrosterone and 17 beta-estradiol after intramuscular administration of Gynodian-Depot in 3 women | journal = Hormone Research | volume = 17 | issue = 2 | pages = 84–89 | year = 1983 | pmid = 6220949 | doi = 10.1159/000179680 }}{{cite journal | vauthors = Rauramo L, Punnonen R, Kaihola LH, Grönroos M | title = Serum oestrone, oestradiol and oestriol concentrations in castrated women during intramuscular oestradiol valerate and oestradiolbenzoate-oestradiolphenylpropionate therapy | journal = Maturitas | volume = 2 | issue = 1 | pages = 53–58 | date = January 1980 | pmid = 7402086 | doi = 10.1016/0378-5122(80)90060-2 }}]]

The pharmacokinetics of prasterone enanthate have been assessed in a number of studies.{{cite journal | vauthors = Nyholm H, Plesner R | title = Serum testosterone, FSH/LH and urinary excretion of estrogens and corticoids during treatment with an injectable, longacting estrogen-DHEA preparation | journal = Acta Obstetricia et Gynecologica Scandinavica | volume = 58 | issue = 4 | pages = 385–388 | date = 1979 | pmid = 160742 | doi = 10.3109/00016347909154601 | s2cid = 25606982 }}

Prasterone enanthate is a prodrug of prasterone in the body. It is completely hydrolyzed into prasterone and heptanoic acid (enanthic acid) following absorption from the tissue depot after intramuscular injection.

Levels of DHEA peak at about 9 ng/mL within 1 to 4 days of an injection of prasterone enanthate. Subsequently, DHEA levels return to baseline by about 18 days following the injection. Prasterone enanthate has an elimination half-life of about 9 days. The plasma half-life of DHEA/prasterone enanthate following an intravenous injection is about 44 minutes. The half-lives of DHEA metabolites range up to 3.6 days.

Within 30 days, 91% of a dose of prasterone enanthate is eliminated. Approximately 94% is excreted in urine and 6% in feces. Prasterone enanthate is eliminated mainly in the form of metabolites and conjugates.

{{See also|Androgen ester|List of androgen esters#Esters of other natural AAS}}

Prasterone enanthate, also known as 5-dehydroepiandrosterone 3β-enanthate or as androst-5-en-3β-ol-17-one 3β-heptanoate, is a synthetic androstane steroid and the C3β heptanoate (enanthate) ester of prasterone (5-dehydroepiandrosterone).{{cite book| vauthors = Elks J |title=The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies|url=https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA641|date=14 November 2014|publisher=Springer|isbn=978-1-4757-2085-3|pages=641–}}{{cite book| vauthors = Blunt JW, Munro MH |title=Dictionary of Marine Natural Products with CD-ROM|url=https://books.google.com/books?id=w1bLBQAAQBAJ&pg=PA1075|date=19 September 2007|publisher=CRC Press|isbn=978-0-8493-8217-8|pages=1075–}}{{cite book|author=William Andrew Publishing|title=Pharmaceutical Manufacturing Encyclopedia, 3rd Edition|url=https://books.google.com/books?id=_J2ti4EkYpkC&pg=PA1208|date=22 October 2013|publisher=Elsevier|isbn=978-0-8155-1856-3|pages=1208–}}

{{See also|Prasterone#History}}

Prasterone enanthate was patented by Schering in 1968 and 1971. The combination of estradiol valerate and prasterone enanthate was developed and marketed by Schering, was first tested clinically as early as 1966, was first described in the scientific literature in 1972, and was first introduced for medical use in April 1975.{{cite journal | vauthors = Picha E, Weghaupt K | title = [Experience with a new hormone combination for menopausal disorders] | language = de | journal = Medizinische Klinik | volume = 67 | issue = 11 | pages = 382–386 | date = March 1972 | pmid = 4259772 | trans-title = Experience with a new hormone combination for menopausal disorders | quote = A new hormone combination for menopausal complaints. Since the treatment of menopausal complaints with estrogens as well as with the combination of estrogens and androgens causes undesired side effects such as bleeding, mammary changes and masculinisation, dehydroepiandrosteron (DHEA), a precursor of testosteron, has been synthesised, which has only a low conversion rate to free testosteron and no masculinising effect. The substance has been tested in combination with estrogen (200 mg DHEA-enanthate and 4 mg estradiolvalerianate per 1 ml) in 266 women with menopausal complaints. The duration of treatment has been up to 6 years with an injection interval of 3 to 8 weeks. The therapeutic results were as good as with estrogen-androgen-combinations, but there was no masculinising effect. Changes of voice, hair and libido caused by pretreatment partly disappeared. Side effects [such] as acne, mastodynia, and sensation of repletion were of transitory nature. This preparation seems to be a true alternative to the traditional estrogen-androgen-combinations. }}{{cite book| vauthors = Sauer F |title= Erfolgsfaktoren für das marktorientierte Management patentgeschützter Arzneimittel: eine Analyse der Produktwahrnehmung niedergelassener Vertragsärzte unter der Berücksichtigung unsicherer Therapieergebnisse |url= https://books.google.com/books?id=C9k9qsEyTaMC&pg=PA37 |date=February 2008|publisher=BoD – Books on Demand|isbn=978-3-936863-12-3|pages=37,346}}{{cite book| vauthors = Kaufmann M, Costa SD, Scharl A | title = Die Gynäkologie|url=https://books.google.com/books?id=1pwiBgAAQBAJ&pg=PA917|date=27 November 2013|publisher=Springer-Verlag|isbn=978-3-662-11496-4|pages=917–}}{{cite book| vauthors = Kleemann A, Engel J, Kutscher B, Reichert D |title=Pharmaceutical Substances, 5th Edition, 2009: Syntheses, Patents and Applications of the most relevant APIs|url=https://books.google.com/books?id=fO2IAwAAQBAJ&pg=PT2441|date=14 May 2014|publisher=Thieme|isbn=978-3-13-179525-0|pages=1172–1174, 2441–2442}}

The major brand name of the combination of estradiol valerate and prasterone enanthate is Gynodian Depot. Other brand names of this formulation include Binodian Depot, Cidodian Depot, Klimax, and Supligol NF.

The combination of estradiol valerate and prasterone enanthate is marketed widely throughout Europe, and is also available in several Latin American countries and in Egypt.{{cite web| url=https://www.micromedexsolutions.com/ | title=Micromedex products | access-date=2024-02-19}} In Europe, it is available in Austria, the Czech Republic, Germany, Italy, Poland, Russia, Spain, and Switzerland. In Latin America, it is available in Argentina, Chile, Mexico, and Venezuela. The medication is not available in any predominantly English-speaking countries, including the United States, Canada, the United Kingdom, Ireland, Australia, New Zealand, or South Africa.

• Estradiol valerate/prasterone enanthate

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