Oxandrolone

Androgen and anabolic steroid

Drugbox
| Verifiedfields = verified
| verifiedrevid = 462266722
| IUPAC name = (1S,3aS,3bR,5aS,9aS,9bS,11aS) 1 hydroxy 1,9a,11a trimethyl 2,3,3a,3b,4,5,5a,6,9,9b,10,11 dodecahydroindeno[4,5 h]isoch
| image = Oxandrolone. svg
| width = 225px
| image2 = Oxandrolone molecule ball. png
| width2 = 235px

| tradename = Oxandrin, Anavar, others
| Drugs. com =
| MedlinePlus = a604024
| pregnancy category = X
| legal BR = C5
| legal BR comment =
| legal CA = Schedule IV
| legal US = Schedule III
| routes of administration = By mouth
| class = Androgen; Anabolic steroid

| bioavailability = 97%
| protein bound = 94–97%Elderly: 13.3 hours
Side effects of oxandrolone include severe cases of peliosis hepatis, sometimes associated with liver failure and intra abdominal hemorrhage; liver tumors, sometimes fatal; and blood lipid changes associated with increased risk of atherosclerosis. Additional warnings include the risks associated with cholestatic hepatitis, hypercalcemia in patients with breast cancer, and increased risk for the development of prostatic hypertrophy and prostatic carcinoma in older patients. Oxandrolone is used to quicken recovery from severe burns. In the management of severe burn injuries, numerous clinical trials have demonstrated the therapeutic advantages of oxandrolone, and it was widely adopted as a standard treatment protocol in burn centers globally. Meta analyses of clinical trials substantiate the efficacy of oxandrolone in severe burn cases: the benefits are manifold and significant, and include a reduction in catabolic weight loss, augmentation of lean body mass, enhancement of donor site wound healing, and a decrease in the duration of both intensive care unit (ICU) and overall hospital stay. These benefits do not appear to be accompanied by an increased risk of infection, hyperglycemia, or hepatic dysfunction, which underscores the safety profile of oxandrolone in severe burn patient population. Oxandrolone improves weight regain, bone mineral density, lean body mass, and accelerates wound healing for donor graft sites. Oxandrolone is recommended as an adjunctive therapy, alongside insulin, metformin, and closely monitored propranolol, in severe burn patients, for metabolic and nutritional support. Oxandrolone improves both short term and long term outcomes in people recovering from severe burns and was well established as a safe treatment for this indication. One of the underlying mechanisms in burn management is that oxandrolone helps reduce hypermetabolic response, which is characterized by increased energy expenditure, elevated stress hormones levels such as cortisol, insulin resistance, muscle wasting, and impaired wound healing; this response is reduced by improving whole body nitrogen balance as well as preserving lean body mass during recovery. As of 2019, oxandrolone was prescribed off label for the development of girls with Turner syndrome, and counteract wasting of diverse origin. hypogonadism and alcoholic hepatitis. Medical research established the effectiveness of oxandrolone in aiding the development of girls with Turner syndrome. Although oxandrolone had long been used to accelerate growth in children with idiopathic short stature, it is unlikely to increase adult height, and in some cases may even decrease it As of 2015, oxandrolone had, therefore, largely been replaced by growth hormone for this use. However, a 2019 Cochrane review comparing effects of adding oxandrolone to growth hormone treatment to growth hormone alone found moderate quality evidence that the addition of oxandrolone led to an increase in final adult height of girls with Turner syndrome, and low quality evidence showed no increase in adverse effects. When the same review assessed the effects of adding oxandrolone to growth hormone treatment on speech, cognition and psychological status, the results were inconclusive due to very low quality evidence. Oxandrolone shows positive effects on cardiometabolic health and visual, motor, and psychosocial functions in adolescent males with preserved testosterone production, such as those with Klinefelter syndrome. However, elevated liver enzymes have been observed in some people, particularly with high doses and/or prolonged treatment, although sometimes returning to normal ranges following discontinuation. Oxandrolone can also reduce males' fertility, another side effect common among androgens. However, although no reports of gynecomastia were made in spite of widespread use, oxandrolone was reported in a publication in 1991 to have been associated with 33 cases of gynecomastia in adolescent boys treated with it for short stature. The gynecomastia developed during oxandrolone therapy in 19 of the boys and after the therapy was completed in 14 of the boys, and 10 of the boys had transient gynecomastia, while 23 had persistent gynecomastia that necessitated mastectomy. In April 2004, Savient Pharmaceuticals published a safety alert through the FDA warning healthcare professionals of this. Oxandrolone also inhibits the metabolism of oral hypoglycemic agents. Activation of the androgen receptor stimulates protein synthesis, which increases muscle growth, lean body mass, and bone mineral density. Oxandrolone has as much as 6 times the anabolic potency of testosterone. Compared to methyltestosterone, oxandrolone has about 322 to 633% of the anabolic potency and 24% of the androgenic potency. The oxygen atom in the lactone bridge replaces a carbon atom at position 2 of the steroid nucleus, classifying oxandrolone as an 2 oxa steroid. There is a hydroxyl group ( OH) attached at stereo direction β to carbon 17, which is a characteristic of 17β hydroxy steroids. The overall structure of oxandrolone is distinguished by these modifications to the standard steroid skeleton, which contribute to its unique properties as an anabolic steroid. The presence of the lactone bridge, i. e., the 2 oxa steroid classification, is particularly noteworthy, as it is not commonly found in the steroid family. This structural element is what gives oxandrolone its distinctive chemical identity within the class of anabolic steroids. They were immediately interested in oxandrolone's very weak androgenic effects relative to its anabolic effects.

The original brand name of oxandrolone was Anavar, which was marketed in the United States and the Netherlands. This product was eventually discontinued and replaced in the United States with a new name of Oxandrin, which as of 2011 was the sole remaining brand name for oxandrolone in the United States. Additional brand names existed for products that were manufactured for the steroid black market. In June 2023, the FDA formally withdrew approval for oxandrolone for all indications, stating that possible adverse effects of the drug were sufficiently serious to warrant removal from the US market. The FDA decision was for reasons of safety or effectiveness, following a 2019 letter from Gemini, a drug manufacturer, stating that the product was no longer being marketed. As of August 2023, the AASs that remained available for medical use in the US were testosterone, testosterone cypionate, testosterone enanthate, testosterone undecanoate, methyltestosterone, fluoxymesterone, and oxymetholone. Oxandrolone is available in some less regulated markets in Asia such as Malaysia and in Mexico. In 2017, it was a Schedule IV controlled substance in Canada, and a Schedule 4 controlled drug in the United Kingdom.