Mechanism of effect
During exogenous administration of anabolic androgens, endogenous testosterone release is inhibited through inhibition of pituitary luteinizing hormone (LH). At large doses, spermatogenesis may be suppressed through feedback inhibition of pituitary follicle-stimulating hormone (FSH). Anabolic steroids have been reported to increase low-density lipoproteins and decrease high-density lipoproteins.
Pharmacodynamic
Androgens stimulate production of erythrocytes, apparently by enhancing production of erythropoietin . Inhibits protein catabolism induced by corticosteroids. Increases lean body mass, body cell mass, and muscle strength . Increases bone mineral density and content.
Pharmacokinetics
Well absorbed after oral administration, with peak serum concentrations attained in approximately 1 hour. Plasma Protein Binding is 95%. Partially metabolized via sulfation to 17-epioxandrolone; Excreted principally in urine as unchanged and unconjugated oxandrolone .
Dosage
Usual Adult Dose for Weight Loss : 2.5 to 10 mg orally 2 to 4 times daily.
Dose range : 2.5 to 20 mg per day. (To promote weight gain following weight loss associated with extensive surgery, chronic infections, or severe trauma, and in select patients who fail to gain or maintain normal weight. It is indicated to counter chronic corticosteroid-induced protein catabolism, and for relief of bone pain associated with osteoporosis.)
Usual Adult Dose for Alcoholic Liver damage : 2.5 to 10 mg orally 2 to 4 times daily. Dose range: 2.5 to 20 mg per day.
Usual Geriatric Dose for Weight Loss : 5 mg orally 2 times daily. Dose range: 2.5 to 20 mg perday.
Usual Pediatric Dose for Turner's Syndrome. Maximum dose : 0.1 mg/kg/day orally.
Alerts
- May cause fetal harm; potential for virilization of fetus.
- Potentially serious and/or life-threatening adverse hepatic effects (e.g., peliosis hepatis, hepatic adenomas, hepatocellular carcinoma) associated with prolonged use of high dosages of androgens .Monitor liver function periodically .
- Possible hypercalcemia resulting from osteolysis in women with metastatic carcinoma of the breast .Monitor urine and serum calcium concentrations frequently during the course of androgen therapy in women with metastatic breast cancer.
- Edema, with or without CHF, possible as a result of sodium and water retention and may be a serious complication in patients with preexisting cardiac, renal, or hepatic disease .
- Virilization, including baldness, clitoral enlargement, deepening of voice, hirsutism, and menstrual irregularities, may occur in females.
- Possible polycythemia, especially with high dosages of androgens.
- Anabolic steroids may suppress clotting factors II, V, VII, and X and prolong PT. Androgens may increase LDL-cholesterol and decrease HDL-cholesterol concentrations; consider the increased risk for cardiovascular disease .
Points of recommendation
Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you :
• if you are planning to become pregnant or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have an enlarged prostate; heart, blood vessel, kidney, or liver disease; or breast cancer
Oxandrolone may be taken with or without food.
If you miss a dose of oxandrolone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
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