Contraindications: Magnus Pharmaceuticals Sustanon 250 is contraindicated in individuals with androgen-dependent cancers (prostate or breast), active polycythaemia, untreated severe obstructive sleep apnoea, or known hypersensitivity to any of the four testosterone ester fractions or the arachis oil excipient. Not indicated for use by women of childbearing potential or individuals under 21 years of age.
Side Effects: Exogenous testosterone suppresses endogenous LH and FSH, resulting in testicular atrophy and spermatogenesis reduction proportional to dose and duration. Aromatisation to oestradiol at supraphysiological doses may produce gynaecomastia, water retention, and increased cardiovascular risk markers. Androgenic effects include accelerated scalp hair thinning in genetically predisposed individuals and acne at injection sites and sebaceous-gland-dense skin areas. Erythrocytosis (elevated haematocrit) requires haematological monitoring every eight to twelve weeks during active cycles.
Monitoring: Baseline bloodwork before cycle initiation should include total testosterone, free testosterone, oestradiol (LC-MS/MS method preferred), LH, FSH, haematocrit, haemoglobin, PSA (males over 35), and lipid panel. Repeat the same panel at four weeks and at cycle conclusion. Blood pressure monitoring twice weekly is recommended at doses above 500 mg/week. Liver enzymes (ALT/AST) are not the primary concern with injectable testosterone but should be included in the baseline panel.
PCT: Post-cycle therapy should commence after the decanoate fraction has sufficiently cleared — typically 21 days after the final injection, guided by a serum testosterone assay confirming declining levels. Standard PCT protocols employ a SERM (tamoxifen 20–40 mg/day or clomiphene 25–50 mg/day) for four to six weeks. HCG at 500–1000 IU every other day for two to three weeks before SERM introduction supports Leydig cell recovery when cycle duration exceeds twelve weeks.