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| Clinical data | |
|---|---|
| Trade names | Withestradiol valerate: Gynodian Depot, others |
| Other names | DHEA enanthate; Prasterone heptanoate; DHEA heptanoate; DHEA-E; EDHEA; SH-90300-D; SH-70833-D (withEVTooltip estradiol valerate); Androst-5-en-3β-ol-17-one 3β-heptanoate |
| Routes of administration | Intramuscular injection |
| Drug class | Androgen;Anabolic steroid;Androgen ester;Estrogen;Neurosteroid |
| ATC code | |
| Legal status | |
| Legal status |
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| Pharmacokinetic data | |
| Bioavailability | IM: 100%[1] |
| Metabolites | •Prasterone (DHEA)[1] • Others[1] |
| Eliminationhalf-life | IM: 9 days[1] IV: 44 minutes[1] |
| Duration of action | 18 days[2] |
| Excretion | Urine,feces[1] |
| Identifiers | |
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| CAS Number | |
| PubChemCID | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.041.777 |
| Chemical and physical data | |
| Formula | C26H40O3 |
| Molar mass | 400.603 g·mol−1 |
| 3D model (JSmol) | |
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Prasterone enanthate, also known asdehydroepiandrosterone enanthate (DHEA-E) and sold in combination withestradiol valerate under the brand nameGynodian Depot among others, is a weakandrogen,estrogen, andneurosteroid medication which is used as a component ofmenopausal hormone therapy to treatmenopausal symptoms in women.[3][1][4][5][6][7][8][9][10] It is available only as aninjectable preparation in combination withestradiol valerate.[3][11][12][13] The medication is given byinjection into muscle typically once every 4 weeks.[3][1][4]
Prasterone enanthate is asyntheticandrogen,estrogen, andneurosteroid.[3][1][4] It is asteroid ester and a long-lastingprodrug ofprasterone (dehydroepiandrosterone; DHEA) in the body.[3][1][4] Prasterone is anaturally occurringprohormone of androgens and estrogens and hence is anagonist of theandrogen andestrogen receptors, the respectivebiological targets of androgens liketestosterone and estrogens likeestradiol.[14][15] Prasterone also has a variety of activities of its own, including neurosteroid and other activities.[15] An injection of prasterone enanthate has aduration of action in terms of elevated prasterone levels of about 18 days.[3][1][4]
The combination of estradiol valerate and prasterone enanthate was developed as early as 1966 and was introduced for medical use in 1975.[16][17] The formulation is marketed widely throughoutEurope, and is also available in severalLatin American countries and inEgypt.[11][12][18][13][19] It is not available in any predominantlyEnglish-speaking countries.[11][19]
The combination ofestradiol valerate and prasterone enanthate is used inmenopausal hormone therapy to treatmenopausal symptoms inperi- andpostmenopausal women.[3][16] Estradiol valerate serves as an estrogen in the preparation, while prasterone enanthate is intended to serve as a weak androgen.[3][16] It is thought that the inclusion of prasterone enanthate in the formulation may provide additionalpsychotropic benefits.[16][20][21][22]
| Route | Medication | Major brand names | Form | Dosage |
|---|---|---|---|---|
| Oral | Testosterone undecanoate | Andriol, Jatenzo | Capsule | 40–80 mg 1x/1–2 days |
| Methyltestosterone | Metandren, Estratest | Tablet | 0.5–10 mg/day | |
| Fluoxymesterone | Halotestin | Tablet | 1–2.5 mg 1x/1–2 days | |
| Normethandronea | Ginecoside | Tablet | 5 mg/day | |
| Tibolone | Livial | Tablet | 1.25–2.5 mg/day | |
| Prasterone (DHEA)b | – | Tablet | 10–100 mg/day | |
| Sublingual | Methyltestosterone | Metandren | Tablet | 0.25 mg/day |
| Transdermal | Testosterone | Intrinsa | Patch | 150–300 μg/day |
| AndroGel | Gel, cream | 1–10 mg/day | ||
| Vaginal | Prasterone (DHEA) | Intrarosa | Insert | 6.5 mg/day |
| Injection | Testosterone propionatea | Testoviron | Oil solution | 25 mg 1x/1–2 weeks |
| Testosterone enanthate | Delatestryl, Primodian Depot | Oil solution | 25–100 mg 1x/4–6 weeks | |
| Testosterone cypionate | Depo-Testosterone, Depo-Testadiol | Oil solution | 25–100 mg 1x/4–6 weeks | |
| Testosterone isobutyratea | Femandren M, Folivirin | Aqueous suspension | 25–50 mg 1x/4–6 weeks | |
| Mixed testosterone esters | Climacterona | Oil solution | 150 mg 1x/4–8 weeks | |
| Omnadren, Sustanon | Oil solution | 50–100 mg 1x/4–6 weeks | ||
| Nandrolone decanoate | Deca-Durabolin | Oil solution | 25–50 mg 1x/6–12 weeks | |
| Prasterone enanthatea | Gynodian Depot | Oil solution | 200 mg 1x/4–6 weeks | |
| Implant | Testosterone | Testopel | Pellet | 50–100 mg 1x/3–6 months |
| Notes:Premenopausal women produce about 230 ± 70 μgtestosterone per day (6.4 ± 2.0 mg testosterone per 4 weeks), with a range of 130 to 330 μg per day (3.6–9.2 mg per 4 weeks).Footnotes:a = Mostly discontinued or unavailable.b =Over-the-counter.Sources: See template. | ||||
Prasterone enanthate is available only as acombinationformulation of 4 mgestradiol valerate and 200 mg prasterone enanthate inoil fordepotintramuscular injection.[12][13][11]
Prasterone enanthate, in combination with estradiol valerate at the dosages used clinically, has nomasculinizingside effects.[16] This is in contrast to combinations ofestrogens with otherandrogens, such astestosterone esters.[16]
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.
DysmenorrheaVaginitisOvarian cancerEndometrial hyperplasiaEndometrial cancerBreast cancerStrokeIncrease in blood pressurePulmonary embolismNauseaVomitingAbdominal crampsBloatingCholestatic jaundicePruritusRashDizziness
Estradiol Valerate / Prasterone Enanthate may also cause side-effects not listed here.[23]
Thepharmacokinetics of prasterone enanthate have been assessed in a number of studies.[2][25]
Prasterone enanthate is aprodrug ofprasterone in the body.[3][1][2] It is completelyhydrolyzed into prasterone andheptanoic acid (enanthic acid) followingabsorption from the tissue depot after intramuscular injection.[1]
Levels of DHEA peak at about 9 ng/mL within 1 to 4 days of an injection of prasterone enanthate.[1] Subsequently, DHEA levels return to baseline by about 18 days following the injection.[1] Prasterone enanthate has anelimination half-life of about 9 days.[1] The plasma half-life of DHEA/prasterone enanthate following anintravenous injection is about 44 minutes.[1] The half-lives of DHEAmetabolites range up to 3.6 days.[1]
Within 30 days, 91% of a dose of prasterone enanthate iseliminated.[1] Approximately 94% isexcreted inurine and 6% infeces.[1] Prasterone enanthate is eliminated mainly in the form ofmetabolites andconjugates.[1]
Prasterone enanthate, also known as 5-dehydroepiandrosterone 3β-enanthate or as androst-5-en-3β-ol-17-one 3β-heptanoate, is asyntheticandrostanesteroid and the C3βheptanoate (enanthate)ester ofprasterone (5-dehydroepiandrosterone).[26][27][18]
Prasterone enanthate waspatented bySchering in 1968 and 1971.[13][18] 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.[16][17][28][13]
The major brand name of the combination of estradiol valerate and prasterone enanthate is Gynodian Depot.[11][12][13][19] Other brand names of this formulation include Binodian Depot, Cidodian Depot, Klimax, and Supligol NF.[11][12][13][19]
The combination of estradiol valerate and prasterone enanthate is marketed widely throughoutEurope, and is also available in severalLatin American countries and inEgypt.[11][12][18][13][19] In Europe, it is available inAustria, theCzech Republic,Germany,Italy,Poland,Russia,Spain, andSwitzerland.[11][12][18][13][19] In Latin America, it is available inArgentina,Chile,Mexico, andVenezuela.[11][19] The medication is not available in any predominantlyEnglish-speaking countries, including theUnited States,Canada, theUnited Kingdom,Ireland,Australia,New Zealand, orSouth Africa.[11][19]
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.
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.