ナンドロロンデカン酸エステル
ナンドロロンデカン酸エステルは**注射用アナボリックステロイド**であり、過去には特定の貧血（慢性腎不全など）の患者における**赤血球生成**の促進や、食欲増進剤として使用されていました。現在ではより安全で効果的な代替薬（エリスロポエチンやミルタザピンなど）があるため、獣医療で推奨・使用されることは稀です。**スケジュールIII規制薬物 (C-III)**に指定されています。
作用機序: Nandrolone is a synthetic derivative of testosterone with enhanced anabolic and reduced androgenic properties. * **Anabolic Effects:** Binds to intracellular **androgen receptors (AR)** → translocates to the nucleus → alters gene transcription. In the presence of adequate protein and calories, it promotes body tissue-building processes and reverses catabolism. * **Erythropoiesis Stimulation:** Enhances red blood cell counts by directly stimulating red cell precursors in the bone marrow, increasing red cell **2,3-diphosphoglycerate (2,3-DPG)**, and stimulating **erythropoietin (EPO)** production in the kidneys. * **Endocrine Feedback:** Suppresses endogenous testosterone release by inhibiting **luteinizing hormone (LH)**. Large doses impede spermatogenesis via negative feedback inhibition of **follicle-stimulating hormone (FSH)**. * **Metabolic Effects:** Causes retention of nitrogen, sodium, potassium, and phosphorus, and decreases urinary excretion of calcium.
動物種別の用量
- FeLV-induced anemia or as a general bone marrow stimulant · 10-20 mg IM once weekly · IM · once weekly · Is of questionable benefit.
- Chronic anemia secondary to feline cardiomyopathy · 50 mg IM weekly · IM · weekly
- Adjunctive treatment of chronic idiopathic myelofibrosis · 2 mg/kg IM weekly · IM · weekly · 3 weeks · Used with prednisolone (2-3 mg/kg PO once daily for 3-4 weeks, then tapered). If anemia does not respond, azathioprine may be added.
- Disuse muscle atrophy secondary to immobilization · 1.5 mg/kg IM once weekly · IM · once weekly · up to 8 weeks · Start from the day of surgery/immobilization.
- Treatment of anemia in patients with chronic renal failure · 1-1.5 mg/kg IM once weekly · IM · once weekly · May require 2-3 months to achieve beneficial effects · Evidence to support use is poor.
- Treatment of anemia in patients with chronic renal failure · 5 mg/kg IM (maximum of 200 mg/week) every 2-3 weeks · IM · every 2-3 weeks
- Treatment of metabolic and endocrine anemias · 5 mg/kg IM once weekly · IM · once weekly · Maximum of 200 mg. Most resolve with correction of underlying disease process.
- Aplastic anemia · 1-3 mg/kg IM weekly · IM · weekly
- Appetite stimulant · 5 mg/kg IM weekly · IM · weekly · Maximum 200 mg/week.
投与経路
禁忌
- Hepatic dysfunction
- Hypercalcemia
- History of myocardial infarction
- Pituitary insufficiency
- Prostate carcinoma
- Mammary carcinoma
- Benign prostatic hypertrophy (BPH)
- Nephrotic stage of nephritis
- Pregnancy (FDA Category X - known teratogen)
有害事象
- Sodium, calcium, potassium, water, chloride, and phosphate retention
- Hepatotoxicity
- Behavioral changes (androgenic effects, e.g., increased aggression)
- Reproductive abnormalities (oligospermia, estrus suppression)
- Masculinization of female fetuses (teratogenic)
薬物相互作用
- Anticoagulants (e.g., warfarin) · Anabolic agents may potentiate the effects of anticoagulants; monitoring of INR and dosage adjustment of the anticoagulant are recommended.
- Corticosteroids, ACTH · Anabolics may enhance the edema that can be associated with ACTH or adrenal steroid therapy.
- Insulin · Anabolics may decrease blood glucose and decrease insulin requirements; diabetic patients may need dosage adjustments.
モニタリング
- Androgenic side effects (behavioral changes)
- Fluid and electrolyte status (especially sodium, potassium, calcium)
- Liver function tests (AST, ALT, ALP, bilirubin)
- Red blood cell count and indices
- Weight and appetite
過量投与
No specific information was located for this agent in veterinary species. In humans, **sodium and water retention** can occur after overdosage of anabolic steroids. * **Treatment:** Treat supportively. Monitor liver function and electrolyte status should an inadvertent overdose be administered.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。