Sustanon 250 mg is a trade name consisting of:
- 100 mg of Testosterone decanoate
- 60 mg of Testosterone isacaproate
- 60 mg of Testosterone phenylpropionate
- 30 mg of Testosterone propionate
All these four components are testosterone hormone esters. The drug is available as an emulsion, and it consists of 1 ml of arachis oil. Testosterone is a hormone produced naturally by humans. It is responsible for the androgenic characteristics in males as well as maintaining the nitrogen balance. Some of the secondary sex characteristics in adolescents include:
- Deepening of voice.
- Development of muscles and bones.
- Growth of body hair
Hence, it is essential in improving muscle mass and assist in the healing of tissues. Testosterone has both anabolic and androgenic roles. Part of the anabolic functions include stimulation of erythrocyte production.
Table of Contents
Clinical Benefits
Sustanon 250 mg/ml injection is useful in managing conditions characterized by low testosterone levels in males. Such conditions are hormonal imbalances, hypo-gonadism, impotence, and delayed puberty. In females, the drug is vital in the management of certain breast cancers. Apart from breast tumor management, testosterone therapy is crucial in:
- Adjunct therapy among transgender, mostly females, to males
- Correcting low libido
- Management of bone loss
- Managing depression and tiredness
In the management of hypogonadism in men, Sustanon 250 causes a rise in:
- Testosterone
- Androstenedione
- Estradiol
- Dihydrotestosterone plasma concentration
There will also be a boost in sex hormone-binding globulin plasma concentration. However, FSH and luteinizing hormone will get back to the physiological limits. This therapy’s resultant effect is reducing body fat, increased lean mass, and increase in bone mineral density.
Before initiating Sustanon therapy to manage hypogonadism, separate blood tests are necessary for the definitive diagnosis alongside the above symptoms. As an anabolic steroid, testosterone therapy may help treat HIV wasting syndrome, correct anemias, improve vertical growth, and managing prolonged catabolic state, secondary to prolonged usage of corticosteroids. As an anabolic steroid, sports-people, mostly athletes, use Sustanon therapy in improving their physique and improving physical performance.
Side Effects
The acute side effects of Sustanon 250 mg/1ml include acne, skin color change, redness and swollen skin, sexual aggressiveness, difficulty in falling asleep, loss of hair, dizziness, headache, nausea, and vomiting. If any of these symptoms exacerbate, reach out to your physician or pharmacist as soon as possible. While on testosterone therapy, you may also experience irregular heartbeats, yellowing of the skins and eyes, abdominal discomfort, testicular tenderness, change in the shape and size of the testicles, and difficulty in urinating. Some patients on Sustanon therapy report hostility, increased aggression, depression, lethargy, insomnia, weight gain, edema of the ankles and feet, and enlarged breast.
If you experience any of these symptoms, you should reach out to your pharmacist or clinician promptly for assistance. You may experience more severe side effects when on testosterone therapy. They include abrupt vision changes, weakness on one side of your body, difficulty speaking, severe headaches, swollen groin, dizziness, confusion, abnormal sweating, jaw and chest pains, as well as shortness of breath.
Testosterone therapy has adverse effects on the reproductive system. These include benign prostate hyperplasia, persistent erection, oligospermia leading to infertility, gynecomastia, and ejaculation disorders. In case of priapism in males lasts more than four hours, discontinue the drug and seek medical assistance. Laboratory investigations reveal elevated hemoglobin levels, red blood cells, increased hematocrit and PSA, as well as abnormal lipid profiles.
For diabetic patients on insulin, testosterone therapy will lead to reduced glucose levels. As a diabetic patient on Sustanon therapy, be ready to manage lower blood glucose levels. The following symptoms will indicate reduced glucose levels: excessive sweating, rapid pulse, nervousness, and shakiness. If you experience any of these hypoglycemic effects, consult your doctor to help you adjust the diabetes medication dosages.
Allergic reactions associated with testosterone therapy are swollen throat, tongue, and face. Rashes, difficulty in breathing, and severe dizziness are also present. However, it is paramount to note that it is impractical to reverse so promptly by discontinuing the drug because of Sustanon’s nature. Testosterone injection, just like any other injectables, irritate the administration site. Testosterone therapy may cause premature closure of the epiphyseal, enlargement of phallic, persistent erections, and precocious sexual development in pediatrics.
Dosage of Sustanon
Sustanon 250 is available as depot formulation. It is administered deep into the arm, thigh, or gluteus muscle, where it occurs as a testosterone reservoir, slowly releasing testosterone into the bloodstream. For testosterone replacement therapy, it is given once in three weeks. For the female to male transgender, the administration is once in two to four weeks. The drug should be kept below 30-degree Celsius but not under refrigeration. It should remain in its original package, protected from light. In case you miss testosterone injection at the scheduled time, consult your physician or nurse immediately. Do not give double doses to cater for the missed ones.
Pharmacokinetic.
The four testosterone esters present in Sustanon 250 have varying durations of actions. Immediately the drug gets into the general circulation. The esters get hydrolyzed into their respective natural hormones, which is testosterone. A dose of 250 mg/1ml causes a peak testosterone plasma concentration of 70 nmol/l. After about 21 days, the testosterone plasma concentration will fall below the standard range.
Abuse.
Abuse or misuse of testosterone injection has harmful effects, including improper growth of bone in adolescents, unusual behavior in drug-seeking, mental problems, liver diseases, stroke, and heart disease. Do not increase the dosage. Neither should you prolong the usage of the drug without seeking your doctor’s advice. Abuse of Sustanon is also associated with withdrawal symptoms such as tiredness, irritability, and depression. Characteristics of chronic testosterone overdose are priapism and polycythemia. If these symptoms occur, discontinue the therapy and resume upon the signs’ disappearance at lower doses
Drug Interactions
In case you are on certain medications, it is proper to inform your doctor before beginning testosterone therapy. It would be best to make your medication history clear, whether on herbal products, prescription, or non-prescription medicines. Take note of the following drugs:
Anticoagulants
Testosterone therapy will elevate the coumarins’ anti-blood-clotting effects of drugs such as phenindione and warfarin. If you are taking any of these anticoagulants concurrently with testosterone injection, you need to monitor their levels to achieve their therapeutic target regularly.
Corticosteroids
If you administer testosterone therapy concurrently with corticosteroids, it will likely lead to edematous conditions. Such corticosteroid is dexamethasone. Patients having chronic kidney disease, liver diseases, and congestive heart failure should take precautions if there is a need to use Sustanon. Edema will exacerbate these chronic conditions.
Antidiabetics.
Patients on antidiabetics may have to reduce the dosages for antidiabetic tablets or insulin. It is necessary to avoid hypoglycemic situations because testosterone tends to lower glucose levels.
It is also vital to remember that testosterone therapy will likely interfere with laboratory tests such as creatinine levels and thyroid function tests. It may lead to false results, hence informing your doctor or laboratory specialist about the medication.
Precautions.
Before getting a Sustanon injection, it is advisable to inform your doctor if you are allergic to the medication or of any allergies you experience. The drug contains excipients that are may elicit allergic reactions. Hence, the need for proper guidance from the physician. Before receiving the injection, open up if you have a medical history of cancer of the bone, hypertension, apnea, obesity, epilepsy, lung disease, high cholesterol, diabetes, chronic kidney disease, stroke, liver disease, and benign prostate hyperplasia.
Take caution if you have problems with blood clotting. Thrombophilia predisposes one to thrombosis, which is the formation of clots within the blood vessels. The risk factors for blood clots include old age, family history of thrombophilia, and immobility. Others are cancer, obesity, smoking, and previous blood clots within the veins. In recognizing the blood clots, you will experience sudden breathlessness, abrupt vision loss, abdominal pains, severe light-headedness, sharp chest pains, coughing out blood, reddish or pale swellings on the skin.
Older male patients on testosterone therapy are at risk of having cancer of the prostate. Children are greatly affected by the side effects of the Sustanon. Hence, the need to monitor them closely while regularly determining their heights.
Females should avoid testosterone therapy because of the risk of acne and hair changes on the body. You should consult your pharmacist or physician as soon as you notice masculinization symptoms. While on testosterone therapy, monitor the production and concentration of red blood cells. Polycythemia may result in other complications.
Because Sustanon formulation contains benzyl alcohol, do not administer formulations containing benzyl alcohol to neonates and premature babies. Benzyl alcohol has an allergic toxic reaction in kids and infants up to the age of three years.
Effect on Lactation, Pregnancy, and Fertility.
Sustanon 250 therapy does not apply to pregnant women because of fetus virilization risk. In the case of pregnancy, discontinue the medication. Just like in pregnancy, testosterone therapy is not appropriate during lactation. Androgen therapy in males may cause infertility because of the inhibition of sperm production. In females, androgenic medication results in an irregular menstrual cycle.
