NANDROLONE DECANOATE

NANDROLONE DECANOATE
(nan'droe-lone)
Classifications: hormone; anabolic/androgen steroid;
Therapeutic: anabolic steroid

Prototype: Testosterone
Pregnancy Category: X
Controlled Substance: Schedule III

Availability

100 mg/mL, 200 mg/mL injection

Action

Synthetic steroid with high ratio of anabolic activity to androgenic activity. Actions last 3–4 wk.

Therapeutic Effect

Increases hemoglobin and red cell mass and increases lean body mass in patients with cachexia (muscle wasting).

Uses

Control of metastatic breast cancer, management of anemia of renal insufficiency.

Contraindications

Males with prostate or breast cancer; severe cardiac disease; liver dysfunction, severe renal disease; nephrotic syndrome, hypercalcemia; pregnancy (category X), lactation.

Cautious Use

Benign prostatic hypertrophy, history of MI; CAD; diabetes mellitus; heart failure; BPH; children.

Route & Dosage

Anemia (Decanoate)
Adult: IM 50–200 mg/wk
Child (2–13 y): IM 25–50 mg q3–4wk

Metastatic Breast Cancer
Adult: IM 50–100 mg/wk

Administration

Intramuscular
  • Inject drug deep IM, preferably into gluteal muscle in adult. Follow agency policy regarding IM site in small child.
  • Intermittent therapy is usually recommended (4-mo course of treatment followed by 6–8-wk rest period).

Adverse Effects (≥1%)

Body as a Whole: Muscle cramps. GI: Nausea, vomiting, diarrhea, anorexia, abdominal fullness, cholestatic jaundice, hepatic necrosis, hepatocellular neoplasms. Hematologic: Leukopenia. Metabolic: Sodium, chloride, water, potassium, phosphate, and calcium retention, ankle edema, glucose intolerance, increased cholesterol. CNS: Excitation, insomnia, chills, toxic confusion. Endocrine: Acne, virilization.

Interactions

Drug: May increase hypoprothrombinemic effects of warfarin; may decrease insulin and sulfonylurea requirements; corticosteroids may increase edema. Herbal: Echinacea may increase risk of hepatotoxicity.

Pharmacokinetics

Absorption: Slowly absorbed from IM injection site over 4 d. Peak: 3–6 d. Metabolism: In liver to active metabolite. Half-Life: 6–8 d.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Obtain baseline and periodic liver function evaluations and electrolyte levels.
  • Monitor for S&S of hepatic toxicity (see Appendix F) and electrolyte imbalance, especially hyperkalemia and hypercalcemia (see Appendix F).
  • Monitor diabetics for loss of glycemic control.

Patient & Family Education

  • Note: In women, the drug may cause virilization (e.g., increased facial and body hair, deepening of voice).

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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