Oxandrolone

DEA Class; Rx

Common Brand Names; Oxandrin

Oral synthetic anabolic steroid with anabolic potency 3 to 13 times that of testosterone
Indicated as adjunctive therapy to offset the protein catabolism associated with prolonged corticosteroid use, and for the relief of the bone pain due to osteoporosis
Abuse for androgenic actions can lead to serious side effects

Known or suspected prostate or breast CA in males

Females: breast cancer with hypercalcemia

Pregnancy

Nephrosis or the nephrotic phase of nephritis

Hypercalcemia

Males

• Gynecomastia

• Inhibition of testicular function

• Impotence

• Priapism

• Bladder irritability

Females

• Hirsutism

• Male-pattern baldness

• Menstrual irregularities

• Virilism

Serious

• Neoplasm of liver, Peliosis hepatis

• Premature epiphyseal closure, Children

Edema

Increased risk of atherosclerosis

Habituation

Changes in libido

Acne

Retention of electrolytes

Serum lipid levels

Cholestatic hepatitis

Hepatic d/o

Jaundice

Androgenic anabolic steroids may stimulate osteolytic bone resorption; contraindicated in carcinoma of the breast in females with hypercalcemia

Cholestatic hepatitis and jaundice may occur with 17-alpha-alkylated androgens at a relatively low dose; if cholestatic hepatitis with jaundice appears or if liver function tests become abnormal, this drug should be discontinued and the etiology determined; drug-induced jaundice is reversible when medication is discontinued

In patients with breast cancer, anabolic steroid therapy may cause hypercalcemia by stimulating osteolysis; this drug should be discontinued if hypercalcemia occurs

Edema with or without congestive heart failure may be a serious complication in patients with pre-existing cardiac, renal, or hepatic disease; concomitant administration of adrenal cortical steroid or ACTH may increase the edema

In children, androgen therapy may accelerate bone maturation without producing compensatory gain in linear growth; this adverse effect results in compromised adult height; the younger the child, the greater the risk of compromising final mature height

Effect on bone maturation should be monitored by assessing bone age of left wrist and hand every 6 months

Geriatric patients treated with androgenic anabolic steroids may be at an increased risk for development of prostatic hypertrophy and prostatic carcinoma

Concurrent dosing with warfarin may result in unexpectedly large increases in the International Normalized Ratio (INR) or prothrombin time (PT); when prescribed to patients being treated with warfarin, doses of warfarin may need to be decreased significantly to maintain desirable INR level and diminish risk of potentially serious bleeding

Women should be observed for signs of virilization (deepening of voice, hirsutism, acne, clitoromegaly); discontinuation of drug therapy at time of evidence of mild virilism is necessary to prevent irreversible virilization

Some virilizing changes in women are irreversible even after prompt discontinuance of therapy and are not prevented by concomitant use of estrogens; menstrual irregularities may also occur

Anabolic steroids may cause suppression of clotting factors II, V, VII, and X, and an increase in prothrombin time

Does not improve athletic performance

Shown to cause embryotoxicity, fetotoxicity, infertility, and masculinization of female animal offspring when given in doses 9 times the human dose; contraindicated in pregnancy

Not known whether anabolic steroids are excreted in human milk; because of potential of serious adverse reactions in nursing infants from this drug, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother