Oxandrolone
Clinical data | |
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Trade names | Oxandrin, Anavar, others[1] |
Other names | Var; CB-8075; NSC-67068; SC-11585; Protivar; 17α-Methyl-2-oxa-4,5α-dihydrotestosterone; 17α-Methyl-2-oxa-DHT; 17α-Methyl-2-oxa-5α-androstan-17β-ol-3-one |
AHFS/Drugs.com | Monograph |
MedlinePlus | a604024 |
Pregnancy category |
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Routes of administration | By mouth |
Drug class | Androgen; Anabolic steroid |
ATC code | |
Legal status | |
Legal status |
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Pharmacokinetic data | |
Bioavailability | 97%[4] |
Protein binding | 94–97%[4] |
Metabolism | Kidneys (primarily), liver[6][4] |
Elimination half-life | Adults: 9.4–10.4 hours[4][5] Elderly: 13.3 hours[5] |
Excretion | Urine: 28% (unchanged)[5] Feces: 3%[5] |
Identifiers | |
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JSmol) | |
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Oxandrolone is an androgen and synthetic anabolic steroid (AAS) medication to help promote weight gain in various situations, to help offset protein catabolism caused by long-term corticosteroid therapy, to support recovery from severe burns, to treat bone pain associated with osteoporosis, to aid in the development of girls with Turner syndrome, and for other indications.[7][8][9] It is taken by mouth.[7] It was sold under the brand names Oxandrin and Anavar, among others.[1]
The drug is a
Oxandrolone was first described in 1962 and introduced for medical use in 1964.
Medical uses
Oxandrolone has been researched and prescribed as a treatment for a wide variety of conditions. It was FDA-approved for treating
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.[18] Data analysis confirms oxandrolone's significant advantage in promoting skin healing as an adjunct therapy for adult burn patients.[19] Oxandrolone improves weight regain, bone mineral density, lean body mass, and accelerates wound healing for donor graft sites.[20] Oxandrolone is recommended as an adjunctive therapy, alongside insulin, metformin, and closely monitored propranolol, in severe burn patients, for metabolic and nutritional support.[21][22] 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.[8][9] 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.[23]
As of 2016,[needs update] oxandrolone was prescribed off-label for the development of girls with Turner syndrome,[medical citation needed] and counteract HIV/AIDS-induced wasting.[medical citation needed]
As of 2012, oxandrolone was used in the treatment of idiopathic short stature, anemia, hereditary angioedema,[24] hypogonadism and alcoholic hepatitis.[25][needs update]
Medical research established the effectiveness of oxandrolone in aiding the development of girls with
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.[22]
Non-medical uses
Oxandrolone has been used illicitly by bodybuilders and athletes for its muscle-building effects as
Contraindications
Like other AASs, oxandrolone may worsen
Side effects
As of 2004 it was thought that "uniquely" among 17α-alkylated AASs, oxandrolone showed little to no
Women who are administered oxandrolone may experience
Unlike some AASs, oxandrolone does not generally cause
Interactions
As of 2004 it was known that oxandrolone greatly increases
Pharmacology
Pharmacodynamics
Medication | Ratioa |
---|---|
Testosterone | ~1:1 |
Androstanolone (DHT) | ~1:1 |
Methyltestosterone | ~1:1 |
Methandriol | ~1:1 |
Fluoxymesterone | 1:1–1:15 |
Metandienone | 1:1–1:8 |
Drostanolone | 1:3–1:4 |
Metenolone | 1:2–1:30 |
Oxymetholone | 1:2–1:9 |
Oxandrolone | 1:3–1:13 |
Stanozolol | 1:1–1:30 |
Nandrolone | 1:3–1:16 |
Ethylestrenol | 1:2–1:19 |
Norethandrolone | 1:1–1:20 |
Notes: In rodents. Footnotes: a = Ratio of androgenic to anabolic activity. Sources: See template. |
Like other AASs, oxandrolone is an agonist of the androgen receptor, similar to androgens such as testosterone and DHT.
Compared to testosterone and many other AASs, oxandrolone is less androgenic relative to its strength as an anabolic.[7][37] Oxandrolone has as much as 6 times the anabolic potency of testosterone.[7] Still, and has significantly reduced androgenic potency in comparison:[7] oxandrolone exhibits significantly lower virilizing androgenic properties compared to testosterone, with a relative potency of only 5%.[38]
Compared to methyltestosterone, oxandrolone has about 322 to 633% of the anabolic potency and 24% of the androgenic potency.[7]
The reduced ratio of anabolic to androgenic activity of oxandrolone often motivates its medical use in children and women because less androgenic effect implies less risk of virilization.[7] The bodybuilding community also considers this fact when choosing between AASs.[7]
As of 2003 and 2011 Oxandrolone was thought to be "uniquely" far less hepatotoxic than other 17α-alkylated AASs, which was thought to be due to differences in metabolism.[29][7][6][5] This turned out not to be the case in the long run, which is why it was taken off the US market in 2023.[11][improper synthesis?][speculation?]
Steroid configuration
Oxandrolone is based on the tetracyclic steroid framework, which consists of three cyclohexane rings (A, B, and C) and one cyclopentane ring (D). This is a common structure shared by all steroids.[39]
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.[40]
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.
As oxandrolone is already 5α-reduced (have a single bond between carbons 4 and 5), it is not a
Pharmacokinetics
The oral
Chemistry
Oxandrolone is a
History
Oxandrolone was first made by Raphael Pappo and Christopher J. Jung while at
It was prescribed to promote muscle regrowth in disorders which cause involuntary weight loss, and is used as part of treatment for HIV/AIDS.[7] It had also been shown to be partially successful in treating cases of osteoporosis.[7] However, in 1989, in part due to bad publicity from its illicit use by bodybuilders, production of Anavar was discontinued by Searle Laboratories.[7] It was picked up by Bio-Technology General Corporation, which changed its name to Savient Pharmaceuticals. In 1995, following successful clinical trials, Savient released it under the brand name Oxandrin.[7] As of 2011 BTG subsequently had won approvals for orphan drug status by the Food and Drug Administration for treating alcoholic hepatitis, Turner syndrome, and HIV-induced weight loss and as an offset to protein catabolism caused by long-term administration of corticosteroids.[7]
Society and culture
Generic names
Oxandrolone is the
Brand names
The original brand name of oxandrolone was Anavar, which was marketed in the United States and the Netherlands.[7][49] 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.[7][50] Oxandrolone has also been sold under the brand names Antitriol (Spain), Anatrophill (France), Lipidex (Brazil), Lonavar (Argentina, Australia, Italy), Protivar, and Vasorome (Japan), among others.[43][49][51][7] As of 2016, among those using oxandrolone for nonmedical purposes, it has been referred to colloquially as "Var", a shortened form of the old brand name Anavar.[52][53] Additional brand names existed for products that were manufactured for the steroid black market.[7]
Availability
United States
As of 2017, Oxandrolone was one of the few AASs that remained available for medical use in the United States.[50]
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.[11]
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.[50]
Other countries
Outside of the United States, the availability of oxandrolone is also quite limited.[7][47] It is no longer available in Europe.[7][54] Oxandrolone is available in some less-regulated markets in Asia such as Malaysia and in Mexico.[7]
Historically, oxandrolone has been marketed in Argentina, Australia, Brazil, France, Italy, Japan, and Spain,[7][43][49] but it appears to no longer be available in these countries.[47]
Legal status
In the United States, oxandrolone was categorized as a
References
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- ^ a b c d e FDA (2023-09-13). "Determination That Oxandrin (Oxandrolone) Tablets, 2.5 Milligrams and 10 Milligrams, Were Withdrawn From Sale for Reasons of Safety or Effectiveness" (PDF). federalregister.gov. Archived (PDF) from the original on 2024-03-18. Retrieved 2024-03-18.
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- ^ a b "List of most commonly encountered drugs currently controlled under the misuse of drugs legislation - GOV.UK". www.gov.uk. Archived from the original on 2019-12-08. Retrieved 2017-01-14.
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- ^ "Oxandrin (oxandrolone tablets, USP)" (PDF). Drugs@FDA. BTG Pharmaceuticals, U.S. Food and Drug Administration. 21 April 2003. Archived (PDF) from the original on 1 March 2017. Retrieved 21 June 2016.
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External links
- Oxandrin Homepage, savientpharma.com (via archive.org)
- Oxandrin Label, fda.gov (retrieved 23 October 2009)
- "Oxandrolone Side Effects, Interactions and Information". drugs.com.