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The doses of anabolic androgenic anabolic steroids ought to be controlled in rigorous and full accordance with the clinical directionsand the recommendations of the International Commission on Drug Policy in effect at the time the patient takes the drug.
The dose of the anabolic steroids is adjusted according to the dose of each dose class and according to the clinical treatment of the patient (including the frequency, duration and intensity of the drug therapy).
In general, an amount equal to one third of the recommended minimum dose (4) of anabolic orrogenic steroids should be used to achieve therapeutic levels in those patients for whom the appropriate therapeutic drugs (e.g. a drug specifically designed to correct an abnormal growth pattern) are not sufficient.
2.1 Dose Control
Doses of anabolic androgenic anabolic steroids are controlled according to a dosage schedule that is based on the clinical indications and that ensures optimal drug absorption, retention and metabolism.
Doses and dosing protocols that are consistent with the guidelines of the International Commission on Drug Policy (ICDP) are recommended to achieve a therapeutic level of anabolic orrogenic steroids in those patients for whom the appropriate therapeutic drugs are not adequate.
2.2 Monitoring of Dosage Control
2.2.1 Monitoring Informed Patient Care
Informed patient care regarding the dose of drugs is critical and all health care providers are obligated to use reasonable means to ensure that patient care is coordinated.
2.2.2 Monitoring Proportional Treatment
In case of clinical suspicion of underdosing treatment should be initiated where appropriate in those patients and where the patient’s medical history, physical condition and general medical history are suitable, such as in the case of steroid-induced acne, or with suspected hypothyroidism, or for severe fatigue.
The indication for monitoring is based on the presence of at least one of the following signs:
Informal test showing abnormal growth or a growth pattern characteristic for hypothyroidism and/or an irregular menstrual cycle
Informal test showing normal growth or growth pattern characteristic for hypothyroidism and/or an irregular menstrual cycle
Informal test showing abnormal testicular development on histologic examination of the testis, or in the case of a gonadotropin-releasing hormone (GnRH) antagonist therapy, or an abnormality in pituitary function that limits the secretion of either gonadotrophin
Informal test showing abnormal pituitary function or hormonal abnormalities (with or without pituitary hyperstimulation)
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