oxymetholone (Rx)

Brand and Other Names:Anadrol-50
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet: Schedule III

  • 50mg

Anemia Due to Deficient Red Cell Production

1-5 mg/kg PO qDay for 3-6 months  

1-2 mg/kg PO qDay usually effective

Includes acquired aplastic anemia, congenital anemia, myelofibrosis, & hypoplastic anemia due to admin of myelotoxic drugs

Off-label: HIV-associated wasting

Dosage Forms & Strengths

tablet: Schedule III

  • 50mg

Anemia Due to Deficient Red Cell Production

1-5 mg/kg PO qDay for 3-6 months

1-2 mg/kg PO qDay usually effective

Includes acquired aplastic anemia, congenital anemia, myelofibrosis, & hypoplastic anemia due to admin of myelotoxic drugs

Off-label: HIV-associated wasting

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Interactions

Interaction Checker

and oxymetholone

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (4)

              • cyclosporine

                oxymetholone increases effects of cyclosporine by decreasing metabolism. Avoid or Use Alternate Drug.

              • pexidartinib

                oxymetholone and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pretomanid

                oxymetholone, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              • warfarin

                oxymetholone increases levels of warfarin by decreasing metabolism. Avoid or Use Alternate Drug.

              Monitor Closely (2)

              • carbamazepine

                oxymetholone increases toxicity of carbamazepine by decreasing metabolism. Use Caution/Monitor.

              • nicotine intranasal

                oxymetholone decreases levels of nicotine intranasal by Other (see comment). Use Caution/Monitor. Comment: Nasal vasoconstrictors prolong the time to peak concentrations by ~40% and decreases peak concentration by ~20%.

              Minor (38)

              • acarbose

                oxymetholone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • androstenedione

                androstenedione increases effects of oxymetholone by pharmacodynamic synergism. Minor/Significance Unknown.

              • budesonide

                oxymetholone, budesonide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • chlorpropamide

                oxymetholone increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

              • clobetasone

                oxymetholone, clobetasone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • cortisone

                oxymetholone, cortisone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • deflazacort

                oxymetholone, deflazacort. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • dexamethasone

                oxymetholone, dexamethasone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • epoetin alfa

                oxymetholone increases effects of epoetin alfa by pharmacodynamic synergism. Minor/Significance Unknown. Androgens may be used to decrease necessary dose of epoetin alfa.

              • fludrocortisone

                oxymetholone, fludrocortisone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • glimepiride

                oxymetholone increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

              • glipizide

                oxymetholone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • glyburide

                oxymetholone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrocortisone

                oxymetholone, hydrocortisone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • insulin aspart

                oxymetholone increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin detemir

                oxymetholone increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin glargine

                oxymetholone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin glulisine

                oxymetholone increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin lispro

                oxymetholone increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin NPH

                oxymetholone increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

              • insulin regular human

                oxymetholone increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

              • metformin

                oxymetholone increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

              • methylprednisolone

                oxymetholone, methylprednisolone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • miglitol

                oxymetholone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

              • nateglinide

                oxymetholone increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

              • pioglitazone

                oxymetholone increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

              • prednisolone

                oxymetholone, prednisolone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • prednisone

                oxymetholone, prednisone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • repaglinide

                oxymetholone increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

              • rosiglitazone

                oxymetholone increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

              • saw palmetto

                saw palmetto decreases effects of oxymetholone by pharmacodynamic antagonism. Minor/Significance Unknown.

              • saxagliptin

                oxymetholone increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

              • sitagliptin

                oxymetholone increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

              • tacrolimus

                oxymetholone increases effects of tacrolimus by decreasing metabolism. Minor/Significance Unknown.

              • tolazamide

                oxymetholone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

              • tolbutamide

                oxymetholone increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

              • triamcinolone acetonide injectable suspension

                oxymetholone, triamcinolone acetonide injectable suspension. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May enhance edema formation.

              • vildagliptin

                oxymetholone increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Males

              • Pre-pubertal phallic enlargement with increased frequency of erection
              • Postpubertal inhibition of testicular function with testicular atrophy & azospermia
              • Impotency
              • Priapism
              • Epididymitis
              • Bladder irritability

              Females

              • Alopecia
              • Virilism
              • Menstrual irregularities
              • Male-like voice

              Pediatrics

              • Premature closure of epiphyses

              Depression

              Excitation

              Habituation

              Insomnia

              Acne

              Gynecomastia

              Change in libido

              Diarrhea

              Nausea

              Vomiting

              Electrolyte & water retention

              Decr glucose tolerance

              Incr LDL

              Decr HDL

              Bleeding in pts on anticoagulant tx

              Cholestatic jaundice

              Muscle cramps

              Incr serum CPK

              Incr creatine/creatinine excretion

              Possibility of leukemia

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              Warnings

              Black Box Warnings

              Peliosis Hepatis

              • Peliosis hepatitis has been reported w/ androgenic anabolic steroid therapy In this condition, the liver & sometimes splenic tissue is replaced w/ blood-filled cysts
              • These cysts sometimes present with minimal hepatic dysfunction but have been associated with liver failure
              • Often not detected until life-threatening liver failure or intra-abdominal hemorrhage develops
              • Discontinuing an anabolic steroid usually results in complete disappearance of lesions

              Liver Cell Tumors

              • Liver cell tumors have been reported
              • Typically, these tumors are benign & androgen-dependent, but fatal malignant tumors have been reported
              • Discontinuing anabolic steroids often result in regression or arrested progression of tumor Important to recognize that hepatic tumors associated w/ androgens or anabolic steroids are much more vascular than other hepatic tumors & may be silent until life-threatening intra-abdominal hemorrhage develops

              Blood Lipid Changes

              • May cause blood lipid changes associated w/ increased risk of atherosclerosis
              • Lipid changes include decreased HDL & sometimes increased LDL; changes may be very marked & could have serious impact on risk for atherosclerosis & coronary artery disease

              Contraindications

              Males: known or suspected prostate or breast CA

              Females: breast cancer with hypercalcemia; pregnancy

              Nephrosis or nephrotic phase of nephritis

              Hypersensitivity

              Severe hepatic dysfunction

              Cautions

              Peliosis hepatitis has been reported in pts receiving androgenic anabolic steroid therapy; may be associated with life-threatening liver failure or intra-abdominal hemorrhage; condition usually resolves completely with drug D/C

              Liver cell tumors have been reported- most often benign and androgen-dependent but fatal malignant tumors have been reported

              Cholestatic hepatitis & jaundice may occur at low doses

              Caution in cardiac disease, DM, hepatic disease, renal, elderly, pediatric patients, women, edematour conditions

              Concomitant administration of adrenal corticoid steroid or ACTH, oral anticoagulants

              Hypercalcemia may occur in breast CA patients

              Decr. total T4 serum levels, incr. T3/T4 resin uptake, unchanged free thyroid hormone levels, & no clinical evidence for thyroid dysfunction

              May accelerate bone maturation in children

              Increases Prothrombin time; suppresses clotting factors V, VII, and X

              May increases LDL & decreases HDL

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              Pregnancy & Lactation

              Pregnancy Category: X

              Lactation: Unknown if excreted; not recommended

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Anabolic steroid; promotes body tissue building, increases production of erythropoietin in patients with anemia resulting from bone marrow failure or from deficient red cell production

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.