What is the recommended dose of oxandrolone (anabolic steroid) for burn patients?

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Oxandrolone Dosing in Burn Patients

The recommended dose of oxandrolone for burn patients with severe burns (>20% total body surface area) is 10 mg twice daily (20 mg/day) to improve muscle protein metabolism, accelerate wound healing, and reduce hospital length of stay. 1

Indications and Benefits

Oxandrolone is strongly indicated for patients with:

  • Severe burns (>20% total body surface area)
  • Need for improved lean body mass preservation
  • Requirement for accelerated donor site healing

The benefits of oxandrolone in burn patients include:

  • Decreased length of hospital stay (31.6 days vs 43.3 days in placebo) 2
  • Reduced weight loss (3 kg vs 8 kg in placebo) 3
  • Improved donor site healing (9 days vs 13 days in placebo) 3
  • Decreased nitrogen loss 3
  • Maintenance of lean body mass 1

Dosing Protocol

  1. Standard dose: 10 mg twice daily (20 mg/day) 1, 4
  2. Timing: Begin around day 6-7 post-burn injury 4
  3. Duration: Typically 26-31 days 4, or until transfer to rehabilitation facility
  4. Monitoring: Regular liver function tests (transaminases) 2

Nutritional Considerations with Oxandrolone

Oxandrolone should be administered as part of a comprehensive nutritional approach:

  • Protein intake: 1.5-2 g/kg/day for burn patients 5, 1
  • Early enteral nutrition within 24 hours of injury 1
  • Consider glutamine supplementation for burns >20% body surface area (0.3-0.5 g/kg/day) 5

Safety Considerations

  • Transitory elevation of hepatic enzymes may occur but rarely reaches clinically significant levels 4
  • In a study of 50 burn patients receiving oxandrolone at 20 mg/day, only 2.4% of ALT and 4.6% of GGT measurements reached clinically significant levels, and none required cessation of treatment 4
  • Monitor hepatic transaminases throughout treatment 2

Clinical Evidence

The efficacy of oxandrolone has been demonstrated in multiple studies:

  • A multicenter prospective randomized double-blind trial showed that oxandrolone at 10 mg every 12 hours significantly reduced length of hospital stay (31.6 days vs 43.3 days) 2
  • Another study showed oxandrolone decreased weight loss (3 kg vs 8 kg), reduced nitrogen loss, and improved donor site healing time (9 days vs 13 days) 3
  • A 2019 study confirmed the safety of oxandrolone at 20 mg/day as part of a metabolic bundle approach 4

Oxandrolone has become a standard of care in burn centers worldwide due to its significant benefits in improving outcomes for severely burned patients 1.

References

Guideline

Burn Patient Care

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Effects of oxandrolone on outcome measures in the severely burned: a multicenter prospective randomized double-blind trial.

Journal of burn care & research : official publication of the American Burn Association, 2006

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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