Sublingual Oxandrolone Dosing
There is no established sublingual formulation or dosing regimen for oxandrolone—the FDA-approved oral formulation should be swallowed, not administered sublingually, with standard adult dosing of 2.5-20 mg daily in 2-4 divided doses. 1
FDA-Approved Oral Dosing
The FDA label specifies oxandrolone as an oral medication with the following parameters:
- Adult dose: 2.5-20 mg daily, divided into 2-4 doses 1
- Pediatric dose: <0.1 mg/kg/day (or <0.045 mg/pound) 1
- Treatment duration: Typically 2-4 weeks, repeated intermittently as indicated 1
- Dose titration: Start with as little as 2.5 mg daily and increase based on response, with some patients requiring up to 20 mg daily 1
Context-Specific Dosing from Guidelines
Hereditary Angioedema Prophylaxis
The American Academy of Allergy, Asthma, and Immunology provides specific dosing:
- Adults: 10 mg/day (range 2.5 mg every 3 days to 20 mg/day) 2
- Pediatric patients: 0.1 mg/kg/day (range 2.5 mg/week to 7.5 mg/day) 2
- Key principle: Dose should be titrated to the lowest amount consistent with freedom from attacks 3
Severe Burn Injury
Clinical studies in burn patients have used:
- Standard regimen: 10 mg orally twice daily (total 20 mg/day) 4, 5
- Duration: Throughout acute recovery phase and rehabilitation 4, 5
- Outcomes: This dosing improved wound healing, restored lean body mass, and accelerated weight gain 4, 5
Critical Pitfalls to Avoid
Sublingual administration is not validated: No pharmacokinetic data, bioavailability studies, or clinical trials support sublingual use of oxandrolone. The oral formulation is designed for gastrointestinal absorption 1.
Dose-related adverse effects: Most side effects (virilization, hirsutism, voice deepening, hepatic abnormalities, menstrual irregularities) are dose-dependent and increase significantly above danazol-equivalent doses of 200 mg/day 3, 6. Always use the minimum effective dose 3, 6.
Contraception requirement: Women of reproductive age can still ovulate on oxandrolone and must use additional contraceptive methods during treatment 6.
Monitoring requirements: Regular assessment for hepatic abnormalities, cardiovascular risk, and virilization effects is essential, particularly with prolonged use 3.
Why Sublingual Route Is Not Recommended
Oxandrolone is a 17-alpha-alkylated androgen designed for oral administration with hepatic first-pass metabolism 1. There are no published data on:
- Sublingual bioavailability compared to oral administration
- Appropriate sublingual dosing adjustments
- Safety profile with sublingual absorption
- Pharmacokinetic parameters via sublingual route
If swallowing difficulties exist, consider alternative anabolic agents with validated sublingual or transdermal formulations rather than attempting off-label sublingual administration of oral oxandrolone.