Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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 effects of warfarin by anticoagulation. Avoid or Use Alternate Drug.
Monitor Closely (3)
- 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%.
- valoctocogene roxaparvovec
oxymetholone and valoctocogene roxaparvovec both increase Other (see comment). Use Caution/Monitor. Medications that may cause hepatotoxicity when combined with valoctogene roxaparvovec may potentiate the risk of elevated liver enzymes. Closely monitor these medications and consider alternative medications in case of potential drug interactions.
Minor (37)
- 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.
- 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.
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
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
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.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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Formulary
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