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Normethandrone, also known as methylestrenolone or methylnortestosterone and sold under the brand name Metalutin among others, is a progestin and androgen/anabolic steroid (AAS) medication which is used in combination with an estrogen in the treatment of amenorrhea and menopausal symptoms in women.[1][2][3][4] It is taken by mouth.[5]

Normethandrone
Methylestrenolone.svg
Clinical data
Trade namesMetalutin, others
Other namesNormetandrone; Methylestrenolone; Methyloestrenolone; Methylnortestosterone; Normethyltestosterone; Normethandrolone; Normethisterone; Methylnandrolone; NMT; 17α-Methyl-19-nortestosterone; 17α-Methylestr-4-en-17β-ol-3-one; P-6051; RU-598; NSC-10039
Routes of
administration
By mouth
Drug classProgestin; Progestogen; Androgen; Anabolic steroid
ATC code
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.007.440 Edit this at Wikidata
Chemical and physical data
FormulaC19H28O2
Molar mass288.42 g/mol g·mol−1
3D model (JSmol)

Side effects of normethandrone include symptoms of masculinization like acne, increased hair growth, voice changes, and increased sexual desire.[6] It can also cause liver damage.[7] Normethandrone is a progestin, or a synthetic progestogen, and hence is an agonist of the progesterone receptor, the biological target of progestogens like progesterone.[5] It is also a synthetic AAS and hence is an agonist of the androgen receptor, the biological target of androgens like testosterone and dihydrotestosterone (DHT).[4][8] It has some estrogenic activity as well and no other important hormonal activity.[9][1][3]

Normethandrone was introduced for medical use by 1957.[10] It is available only in a few countries, including Brazil, Indonesia, and Venezuela, and is available only in combination with methylestradiol or estradiol valerate.[2][1]

Medical usesEdit

Normethandrone is used in combination with an estrogen, either methylestradiol or estradiol valerate, in the treatment of amenorrhea and menopausal symptoms in women.[1][2][11] It has also been used to treat dysmenorrhea in women.[12] Normethandrone has been used successfully to inhibit libido in men with sexual deviance.[13] Although normethandrone can be classified as an AAS and has strong such effects at sufficiently high doses, it is not typically used as such and is instead used medically only as a progestin.[3][1][4] This is because it is so highly progestogenic in comparison.[4]

Androgen replacement therapy formulations and dosages used in women

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 25–100 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 μg testosterone 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.

Androgen/anabolic steroid dosages for breast cancer

Route Medication Form Dosage
Oral Methyltestosterone Tablet 30–200 mg/day
Fluoxymesterone Tablet 10–40 mg 3x/day
Calusterone Tablet 40 mg 4x/day
Normethandrone Tablet 40 mg/day
Buccal Methyltestosterone Tablet 25–100 mg/day
Injection (IM or SC) Testosterone propionate Oil solution 50–100 mg 3x/week
Testosterone enanthate Oil solution 200–400 mg 1x/2–4 weeks
Testosterone cypionate Oil solution 200–400 mg 1x/2–4 weeks
Mixed testosterone esters Oil solution 250 mg 1x/week
Methandriol Aqueous suspension 100 mg 3x/week
Androstanolone (DHT) Aqueous suspension 300 mg 3x/week
Drostanolone propionate Oil solution 100 mg 3x/week
Nandrolone decanoate Oil solution 50–100 mg 1x/1–3 weeks
Nandrolone phenylpropionate Oil solution 50–100 mg/week
Note: Dosages are not necessarily equivalent. Sources: See template.

Available formsEdit

Normethandrone is marketed in combination with methylestradiol in the form of oral tablets containing 5 mg normethandrone and 0.3 mg methylestradiol.[11][14]

Side effectsEdit

PharmacologyEdit

PharmacodynamicsEdit

Normethandrone shows high progestogenic activity.[5] With sublingual administration in women, it has at least 150 times the potency of sublingual progesterone and 50 times the potency of sublingual ethisterone.[5] It also has 10 times the potency of injected progesterone via this route.[5] The oral potency of normethandrone in terms of endometrial transformation is similar to that of norethisterone.[16] In addition to its progestogenic activity, normethandrone has anabolic and androgenic activity and can produce effects associated with this activity.[1][4] It has a high ratio of anabolic to androgenic activity.[17] The anabolic potency of normethandrone is similar to that of norethandrolone and is much greater than that of nandrolone or metandienone.[8] It is also greater than that of ethylestrenol.[8] In addition to its progestogenic and androgenic/anabolic activity, normethandrone has estrogenic activity via aromatization into methylestradiol.[3]

Analogously to nandrolone and norethandrolone, 5α-dihydronormethandrone, the 5α-reduced metabolite of normethandrone, shows reduced affinity for the androgen receptor relative to normethandrone.[18][19] Its affinity for the androgen receptor is specifically about 33 to 60% of that of normethandrone.[18]

Normethandrone has been found to increase nitrogen retention, a measure of anabolic effect, at a dosage of 30 mg/day.[20]

Relative affinities (%) of normethandrone and metabolites

Compound PR AR ER GR MR SHBG CBG
Normethandrone 75–125 125–150 <1 1–5 <1 ? ?
5α-Dihydronormethandrone 15–25 50–75 ? <1 ? ? ?
Notes: Values are percentages (%). Reference ligands (100%) were progesterone for the PR, testosterone for the AR, estradiol for the ER, dexamethasone for the GR, and aldosterone for the MR. Sources: See template.

PharmacokineticsEdit

Normethandrone is metabolized by aromatase into methylestradiol in small quantities, similarly to methyltestosterone and metandienone.[3][21][22] The metabolites of normethandrone have not been well-studied, but 5α-dihydronormethandrone is a likely metabolite formed by 5α-reductase.[23][24]

The pharmacokinetics of normethandrone have been reviewed.[25]

ChemistryEdit

Normethandrone, also known as 17α-methyl-19-nortestosterone or as 17α-methylestr-4-en-17β-ol-3-one, is a synthetic estrane steroid and a 17α-alkylated derivative of nandrolone (19-nortestosterone; 19-NT). It is specifically the 17α-methyl derivative of nandrolone as well as the 17α-methyl variant of norethandrolone (17α-ethyl-19-NT) and norethisterone (17α-ethynyl-19-NT).[26]

SynthesisEdit

Chemical syntheses of normethandrone have been published.[25]

HistoryEdit

Normethandrone has been marketed for medical use since 1957.[10] The combination of normethandrone and methylestradiol was introduced by at least 1966.[14]

Society and cultureEdit

Generic namesEdit

Normethandrone has not been assigned an INN or other formal name designations.[26][27][2] It is also known as methylestrenolone, methylnortestosterone, normethandrolone, and normethisterone.[26][27][2]

Brand namesEdit

Brand names of normethandrone include Batynid, Ginecosid, Ginecoside, Gynomin, Lutenin, Matronal, Mediol, Metalutin, Methalutin, Orgasteron, Orosteron, and Renodiol.[26][27][2][1][28][11]

AvailabilityEdit

Normethandrone is marketed in Brazil, Indonesia, and Venezuela in combination with methylestradiol or estradiol valerate.[2][1]

ReferencesEdit

  1. ^ a b c d e f g h https://www.medicinescomplete.com/about/
  2. ^ a b c d e f g https://www.drugs.com/international/normethandrone.html
  3. ^ a b c d e Friedl KE (1990). "Reappraisal of the health risks associated with the use of high doses of oral and injectable androgenic steroids". NIDA Res. Monogr. 102: 142–77. PMID 1964199.
  4. ^ a b c d e H.-L. Krüskemper (22 October 2013). Anabolic Steroids. Elsevier. pp. 10–. ISBN 978-1-4832-6504-9.
  5. ^ a b c d e Ferin J (1956). "A new substance with progestational activity; comparative assays in ovariectomized women; clinical results". Acta Endocrinol. 22 (4): 303–17. doi:10.1530/acta.0.0220303. PMID 13354223.
  6. ^ a b Lundberg, P O (1962). "Migraine Prophylaxis with Progestogens". European Journal of Endocrinology. 40 (4 Suppl): S5–S22. doi:10.1530/acta.0.040S0005. ISSN 0804-4643.
  7. ^ a b Delorimier AA, Gordan GS, Lowe RC, Carbone JV (1965). "Methyltestosterone, Related Steroids, and Liver Function". Arch. Intern. Med. 116: 289–94. doi:10.1001/archinte.1965.03870020129023. PMID 14315662.
  8. ^ a b c Brueggemeier, Robert W. (2006). "Sex Hormones (Male): Analogs and Antagonists": 42. doi:10.1002/3527600906.mcb.200500066. Cite journal requires |journal= (help)
  9. ^ Erich Heftmann (1970). Steroid Biochemistry. Academic Press. p. 72. Normethandrone (Fig. 49) is a 19-nortestosterone derivative having progestational as well as androgenic and anabolic activity.
  10. ^ a b United States. Patent Office (1957). Official Gazette of the United States Patent Office. U.S. Patent Office.
  11. ^ a b c Unlisted Drugs. Pharmaceutical Section, Special Libraries Association. 1982. Batynid. C. Each dragee contains: normethandrone, 5 mg.; and methylestradiol, 0.3 mg. E. (Formerly) Gynaekosid. M. Boehringer Biochemia, Florence. A. Estrogenic; Rx of secondary amenorrhea. R. Notiz Med Farm 32;295, Nov-Dec 81.
  12. ^ Begni-Calvet, D. (1959). "Two properties of methylestrenolone (17-alpha-methyl-19-nortestosterone): Its effectiveness in the treatment of dysmenorrhea, its anabolic action". Gynecologie pratique. 10: 261–272. PMID 13798272.
  13. ^ Servais, J. (1973). "A clinical study of cases of psychosexual disturbances in men treated by a libido inhibitor: Methylestrenolone". Archives of Sexual Behavior. 2 (4): 387–390. doi:10.1007/BF01541012. ISSN 0004-0002.
  14. ^ a b Akingba JB, Ayodeji EA (February 1966). "Amenorrhea as a leading symptom of choriocarcinoma". J Obstet Gynaecol Br Commonw. 73 (1): 153–5. doi:10.1111/j.1471-0528.1966.tb05137.x. PMID 5948541.
  15. ^ Feldman, Elaine Bossak; Carter, Anne C.; Kossa, Jane L.; Mccarrick, James F.; Schwartz, Harold L. (1960). "Endocrinologic and metabolic effects of 17α-methyl-19-nortestosterone in women". The Journal of Clinical Endocrinology & Metabolism. 20 (6): 842–857. doi:10.1210/jcem-20-6-842. ISSN 0021-972X.
  16. ^ Horský, Jan; Presl, Jiří (1981). "Hormonal Treatment of Disorders of the Menstrual Cycle". In J. Horsky; J. Presl (eds.). Ovarian Function and its Disorders: Diagnosis and Therapy. Springer Science & Business Media. pp. 309–332. doi:10.1007/978-94-009-8195-9_11. ISBN 978-94-009-8195-9.
  17. ^ Charles D. Kochakian (6 December 2012). Anabolic-Androgenic Steroids. Springer Science & Business Media. pp. 379–. ISBN 978-3-642-66353-6.
  18. ^ a b Ojasoo T, Delettré J, Mornon JP, Turpin-VanDycke C, Raynaud JP (1987). "Towards the mapping of the progesterone and androgen receptors". J. Steroid Biochem. 27 (1–3): 255–69. doi:10.1016/0022-4731(87)90317-7. PMID 3695484.
  19. ^ Behre HM, Kliesch S, Lemcke B, von Eckardstein S, Nieschlag E (December 2001). "Suppression of spermatogenesis to azoospermia by combined administration of GnRH antagonist and 19-nortestosterone cannot be maintained by this non-aromatizable androgen alone". Hum. Reprod. 16 (12): 2570–7. doi:10.1093/humrep/16.12.2570. PMID 11726576.
  20. ^ Ralph I. Dorfman (5 December 2016). Steroidal Activity in Experimental Animals and Man. Elsevier Science. pp. 68–. ISBN 978-1-4832-7300-6.
  21. ^ Detlef Thieme; Peter Hemmersbach (18 December 2009). Doping in Sports. Springer Science & Business Media. pp. 470–. ISBN 978-3-540-79088-4.
  22. ^ William Llewellyn (2011). Anabolics. Molecular Nutrition Llc. pp. 444–454, 533. ISBN 978-0-9828280-1-4.
  23. ^ Fragkaki AG, Angelis YS, Tsantili-Kakoulidou A, Koupparis M, Georgakopoulos C (May 2009). "Schemes of metabolic patterns of anabolic androgenic steroids for the estimation of metabolites of designer steroids in human urine". J. Steroid Biochem. Mol. Biol. 115 (1–2): 44–61. doi:10.1016/j.jsbmb.2009.02.016. PMID 19429460.
  24. ^ Schjølberg, T. H. (2013). In Vitro Synthesis of Metabolites of three Anabolic Androgenic Steroids, by Human Liver Microsomes (Master's thesis, Institutt for bioteknologi). https://brage.bibsys.no/xmlui/handle/11250/246018
  25. ^ a b Die Gestagene. Springer-Verlag. 27 November 2013. pp. 12–13, 282. ISBN 978-3-642-99941-3.
  26. ^ a b c d J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. pp. 888–. ISBN 978-1-4757-2085-3.
  27. ^ a b c I.K. Morton; Judith M. Hall (6 December 2012). Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media. pp. 202–. ISBN 978-94-011-4439-1.
  28. ^ Martin Negwer; Hans-Georg Scharnow (2001). Organic-chemical drugs and their synonyms: (an international survey). Wiley-VCH. p. 1831. ISBN 978-3-527-30247-5.