What is oxandrolone (anabolic steroid)?

From the Guidelines

Oxandrolone is a synthetic anabolic steroid medication that plays a crucial role in promoting weight gain and muscle mass in patients with severe burns, as well as those suffering from muscle wasting due to various medical conditions, as evidenced by a recent study published in 2023 1. The medication works by increasing protein synthesis in the body, which helps build muscle mass.

• Oxandrolone is typically prescribed at doses of 2.5 to 20 mg daily, divided into 2-4 doses, with treatment duration usually ranging from 2 to 4 weeks, though it may be extended under medical supervision.
• The medication is available as oral tablets and is classified as a Schedule III controlled substance due to its potential for abuse.
• Common side effects include liver problems, changes in cholesterol levels, acne, hair growth, and menstrual irregularities in women, as reported in a study published in 2021 1.
• In men, it may cause decreased sperm count, enlarged breasts, and shrinking testicles.
• Oxandrolone should only be used under medical supervision as it carries risks of serious side effects, particularly with long-term use or at high doses, as highlighted in a study published in 2021 1. Key benefits of oxandrolone include reduced weight loss, increased lean body mass, improved donor-site healing, and reduced length of stay in hospital, without increasing the risk of infection, hyperglycemia, or liver dysfunction, as demonstrated in a meta-analysis cited in a study published in 2023 1. It's essential to note that non-medical use of oxandrolone for athletic performance enhancement or bodybuilding is illegal and dangerous.
• A personalized approach to nutrition and exercise, as well as the use of anabolic agents like oxandrolone, may be critical in improving outcomes for patients with muscle wasting due to various medical conditions.
• Further research is needed to fully understand the benefits and risks of oxandrolone in different patient populations, as emphasized in a study published in 2023 1.

From the FDA Drug Label

Oxandrin® oral tablets contain 2.5 mg or 10 mg of the anabolic steroid oxandrolone. Oxandrolone is 17β-hydroxy-17α-methyl-2-oxa-5α-androstan-3-one

• Oxandrolone is an anabolic steroid.
• It is classified as a controlled substance under the Anabolic Steroids Control Act of 1990 and has been assigned to Schedule III (non-narcotic) 2.
• The chemical structure of oxandrolone is 17β-hydroxy-17α-methyl-2-oxa-5α-androstan-3-one 2.

From the Research

Definition and Uses of Oxandrolone

• Oxandrolone is an anabolic androgenic steroid (AAS) used to promote anabolism in clinical settings for patients with chronic wasting conditions, such as HIV-related muscle wasting, severe burn injury, trauma following major surgery, neuromuscular disorders, and alcoholic hepatitis 3.
• It is US FDA-approved for restitution of weight loss after severe trauma, major surgery or infections, malnutrition due to alcoholic cirrhosis, and Duchenne's or Becker's muscular dystrophy 3.

Efficacy and Safety of Oxandrolone

• Studies have shown that oxandrolone is effective in improving body composition, muscle strength and function, status of underlying disease or recovery from acute catabolic injury, and nutritional status in patients with catabolic disorders 3.
• Oxandrolone has been reported to be generally well tolerated, with common adverse effects including transient elevations in transaminase levels and reductions in high-density lipoprotein cholesterol level 3.
• Unlike other orally administered C17alpha-alkylated AASs, oxandrolone has a novel chemical configuration that confers resistance to liver metabolism and marked anabolic activity, without serious hepatotoxic effects 3.

Oxandrolone in Burn Injuries

• Oxandrolone has been shown to be beneficial in the treatment of burn injuries, decreasing length of hospital stay, improving weight regain, bone mineral density, and percent lean body mass, and reducing wound healing time for donor graft sites 4, 5.
• Oxandrolone does not appear to increase the risk of progressive or transient liver injury in burn patients, although monitoring liver enzymes is recommended 4.
• Preclinical studies have also demonstrated that oxandrolone protects against the development of multiorgan failure, modulates the systemic inflammatory response, and promotes wound healing during burn injury 6.

Oxandrolone in AIDS-Wasting Myopathy

• Oxandrolone has been shown to have a positive impact on the weight and well-being of HIV-seropositive patients suffering from wasting and weakness, with significant improvements in appetite and activity 7.
• However, measurable improvement in muscle strength was not noted at the doses employed in the study, and additional studies using higher doses of oxandrolone may be warranted 7.