Nandrolone 50mg/1ml solution for injection ampoules

BackgroundSevere burn injuries induce hypermetabolism, leading to protein catabolism, impaired wound healing, and increased infection risk. Burn patients often experience androgen depletion, exacerbating these issues. Oxandrolone, a synthetic anabolic steroid, has shown promise in counteracting these metabolic disturbances. This updated meta-analysis evaluates the efficacy and safety of oxandrolone in burn patients, incorporating recent studies, pediatric populations, long-term outcomes, and combination therapies.MethodsThis PRISMA 2020-compliant systematic review searched 9 databases (PubMed, Embase, Cochrane, WOS, WHO-ICTRP, CNKI, VIP, Wanfang, CBMdisc) for RCTs published between 2005 and 2025 using validated strategies combining controlled vocabulary (MeSH/Emtree) and free-text terms for burn/trauma AND androgen analogs (e.g., oxandrolone, nandrolone). Included trials compared androgen analogs vs. controls (placebo/standard care) in burn patients, reporting ≥ 1 predefined outcome: (1) Lean body mass (recovery phase, ≥ 14 days post-burn); (2) Mild side effects (hepatic dysfunction [ALT/AST ≥ 2 × ULN] or edema); (3) Infections; (4) Mortality; (5) Surgical procedures; (6) LOS/TBSA; (7) Absolute LOS. Dual-independent screening, data extraction, and risk-of-bias assessment (Cochrane RoB 2.0 per outcome) were performed. Random-effects meta-analyses generated standardized mean differences (SMD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% CIs.ResultsFourteen RCTs (2005-2025; n = 2822 patients: 1203 intervention vs. 1619 controls) demonstrated significant reductions in surgical procedures (SMD = - 1.25; 95% CI - 2.45 to - 0.04; p = 0.04; I2 = 97.2%) and length of stay normalized to TBSA (LOS/TBSA) (SMD = - 1.07; 95% CI - 2.43 to 0.29; p = 0.007; I2 = 98.1%), alongside enhanced anabolic recovery evidenced by increased weight gain (SMD = 0.58; 95% CI - 1.21 to 2.38; p 2 ≥ 95.0%). However, no mortality benefit was observed (RR = 1.04; 95% CI 0.47-2.32; p = 0.913; I2 = 66.5%), with unchanged infection rates (RR = 0.83; 95% CI 0.67-1.02; p = 0.639) and no improvement in donor site healing (SMD = - 1.48; 95% CI - 2.18 to 0.77; p = 0.116). Safety analysis revealed a non-significant increase in treatment-related side effects (hepatic dysfunction/edema; RR = 1.82; 95% CI 0.52-6.42; p = 0.34), notably higher transaminase elevations in adults (19% vs. 5% placebo; p = 0.002).ConclusionOxandrolone demonstrates clinical utility in burn management by significantly reducing surgical burden (SMD = - 1.25; p = 0.04), shortening hospitalization (LOS/TBSA SMD = - 1.07; p = 0.007), and enhancing anabolic recovery (weight gain SMD = 0.58; lean mass SMD = 1.30; both p 2 ≥ 95.0%) and temporal limitations necessitate cautious interpretation. Critically, it confers no mortality benefit (RR = 1.04; p = 0.913), fails to reduce infections (RR = 0.83; p = 0.639), and elevates hepatotoxicity risk in adults (19% vs. 5%; p = 0.002). These findings support its adjunctive role in metabolic rehabilitation but mandate risk-stratified implementation.

Abstract licence: CC BY-NC-ND

Postmenopausal osteoporosis is often accompanied by reduced muscle mass and chronic bone pain, amplifying fracture risk and functional decline. Nandrolone decanoate (ND), a synthetic anabolic steroid, has been proposed as a dual-acting agent that may benefit both bone and muscle through osteoanabolic and myoanabolic mechanisms, yet its therapeutic value in osteoporosis remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing ND with placebo in postmenopausal women with primary osteoporosis. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251147647). Seven trials with 293 participants were included, with sample sizes varying by outcome. ND reduced fracture risk compared with placebo (moderate-certainty evidence). It produced modest increases in bone mineral density (BMD; low certainty) and more substantial gains in forearm bone mineral content (BMC; moderate certainty). ND also reduced pain (moderate certainty) and increased muscle mass (moderate certainty). However, ND was associated with a higher incidence of mostly mild virilizing adverse events (hirsutism, acne, voice changes; low certainty). Given the small sample sizes and methodological limitations of older trials, ND may be considered as a potential adjuvant option for selected postmenopausal women, particularly when muscle loss or refractory bone pain is present, provided treatment occurs under close clinical and laboratory monitoring. Larger, contemporary randomized trials are needed to define ND's role within modern osteoporosis management.

Abstract licence: CC BY

BackgroundIntensive care patients can experience significant long-term impairment in mobility and function caused by their critical illness. A potential contributory factor apart from critical illness polymyoneuropathy is the low levels of anabolic hormones in these patients. Testosterone levels in critically ill patients are extremely low, even in the latter recovery phase. A potential solution to critical illness myopathy may be to provide anabolic support in addition to standard care (early physiotherapy) to further improve gains in strength.Research questionThis project aims to test whether a synthetic testosterone (nandrolone) improves muscle strength in ICU survivors compared to placebo.MethodsGAINS 2.0 is a multicentre, randomised, double blinded placebo-controlled trial which will allocate ICU patients in a 1:1 ratio to nandrolone compared to placebo which commenced recruitment in July 2023. Adult patients admitted to the ICU, receiving nutrition for a minimum of 24 hours with an ICU stay of at least 5 days, or patients with significant weakness as result of their ICU stay (such that they are unable to mobilise independently) will be eligible to participate. Sample size will be 54 patients. Patients will be randomised to receive nandrolone 100mg (males) / 50mg(females) weekly for 3 weeks in addition to standard care. The co-primary outcomes are the time to walking with one person assisting (Intensive Care Mobility scale = 8 or more, in days from randomisation), change in muscle strength measured by the Medical Research Council (MRC) muscle strength sum score from enrolment to hospital discharge and number of days out of hospital up to day 90 post-discharge. Secondary outcomes are grip strength measured by hand-held dynamometry. SF-36 scores (quality of life and functional domains), and days to return to work, for those working pre-ICU, will be collected via a 3-month phone follow-up.ConclusionsA previous pilot feasibility trial showed that nandrolone is safe and feasible. We hypothesize nandrolone will improve muscle strength and physical functioning at hospital discharge and at follow-up. The results of this trial may have significant interest to clinicians and patients considering the large and increasing number of patients surviving intensive care but with physical impairment. This trial may have significant implications on lowering hospital costs and daily adjusted life years.Trial registryanzctr.org.au; No.: ACTRN12623000729628 URL: anzctr.org.au.

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Long-term use of anabolic androgenic steroids (AAS) in supratherapeutic doses is associated with severe adverse effects, including physical, mental, and behavioral alterations. When used for recreational purposes several AAS are often combined, and in scientific studies of the physiological impact of AAS either a single compound or a cocktail of several steroids is often used. Because of this, steroid-specific effects have been difficult to define and are not fully elucidated. The present study used male Wistar rats to evaluate potential somatic and behavioral effects of three different AAS; the decanoate esters of nandrolone, testosterone, and trenbolone. The rats were exposed to 15 mg/kg of nandrolone decanoate, testosterone decanoate, or trenbolone decanoate every third day for 24 days. Body weight gain and organ weights (thymus, liver, kidney, testis, and heart) were measured together with the corticosterone plasma levels. Behavioral effects were studied in the novel object recognition-test (NOR-test) and the multivariate concentric square field-test (MCSF-test). The results conclude that nandrolone decanoate, but neither testosterone decanoate nor trenbolone decanoate, caused impaired recognition memory in the NOR-test, indicating an altered cognitive function. The behavioral profile and stress hormone level of the rats were not affected by the AAS treatments. Furthermore, the study revealed diverse AAS-induced somatic effects i.e., reduced body weight development and changes in organ weights. Of the three AAS included in the study, nandrolone decanoate was identified to cause the most prominent impact on the male rat, as it affected body weight development, the weights of multiple organs, and caused an impaired memory function.

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The continuous consumption of various foods increases the risk of unintentional exposure to residual contaminants. Thus, improving premonitoring procedures to ensure food safety is critical. Herein, a rapid and efficient assay was developed to monitor residual contaminants in food, with a focus on banned doping substances. First, 73 doping compounds, including anabolic agents that can be ingested from food were selected, after which a gas chromatography-tandem mass spectrometry (GC-MS/MS) method was developed for their simultaneous screening. Based on the GC-MS/MS-determined food-matrix characteristics and types, a sample-preparation module was developed to optimize the sample-preparation method. Thereafter, the developed analytical method was validated using representative food matrices, and the results confirmed that the developed method obtained good recoveries (80-123% (limit of quantification: 0.01-20 μg kg-1)). To monitor residual doping substances in commercially available foods, the established method was applied to the analysis of 40 food samples, including meat. Notably, endogenous hormones, such as testosterone, nandrolone, 19-norandrosterone, and 19-noretiocholanolone, were detected in the meat samples, although they did not exceed the maximum residue limits. This approach enables the assessment of potential exposure levels to food-borne endogenous hormones, thereby supporting food safety and preventing unintentional doping incidents in athletes.

Abstract licence: CC BY-NC