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Oxandrolone

Oxandrolone (Oxandrin) is an anabolic steroid created by Searle Laboratories under the trademark Anavar, and introduced into the US in 1964. It is taken orally, and unlike other steroids delivered in this manner, most of which are Class II steroids, the majority of its effects are due to reaction with the androgen receptor. In sufficient dosage, Oxandrolone is highly likely to bind well with the receptor, and is therefore a Class I steroid, while having few other side-effects. more...

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The drug was prescribed for a number of medical disorders causing involuntary weight loss, in order to promote muscle regrowth. It had also been shown to be partially successful in treating cases of osteoporosis. However, in part due to bad publicity from its illegal use by bodybuilders, Oxandrolone was discontinued by Searle Laboratories in 1989. It was picked up by Bio-Technology General Corporation who, following successful clinical trials in 1995, released it under the tradename Oxandrin. It was approved for orphan drug status by the FDA in treating alcoholic hepatitis, Turner's syndrome, and weight loss caused by HIV. In addition, the drug has shown positive results in treating anaemia and hereditary angioedema. Clinical studies however have shown links between prolonged use of the drug and problems of liver toxicity similar to those found with other 17α-alkylated steroids. Even in small dosages, many users reported gastro-intestinal problems such as bloating, nausea, and diarrhoea.

Before the Controlled Substances Act was passed to restrict the production, sale, and usage of anabolic steroids, Oxandrolone's characteristics lent itself well towards use by female athletes. Its specificity targeting the androgen receptor meant that, unlike many other steroids, it had not been reported to cause stunted growth in younger users, and at typical dosage rarely caused noticeable masculinising effects outside of stimulating muscle growth. In addition, Oxandrolone does not aromatise at any dosage, and is not easily metabolised into DHT or oestrogen. As such, a typical dose of 20-30 mg provided elevated androgen levels for up to eight hours. To increase effectiveness, bodybuilders typically "stacked" the drug with others such as Dianabol, further enhancing body mass gain.

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The Anabolic Agent, Oxandrolone, Reverses The Weight Loss Associated With Copd - chronic obstructive pulmonary disease - Abstract
From CHEST, 10/1/00 by D Lee

D Lee, MD; T Kramer, MD(*); S Yeh, MD; H Corelli, MD; G Serfilippi, MD; G Giessel, MD; M Gotfried, MD and along with the M012 study group. Wilmington Health Associates, Wilmington, NC; BTGC, Iselin, NJ; VAMC, Northport, NY; Pulmonary Consultants of North Idaho, Coeur'd Alene, ID; Capital Pulmonary & Critical Care Services, Albany, NY; Pulmonary Associates, Richmond, VA and, Phoenix, AZ.

PURPOSE: Involuntary weight loss is a common complication of COPD, associated with negative outcomes independent of the degree of airflow limitation. Weight restoration has been associated with improved outcomes. We evaluated the effects of the oral anabolic agent, oxandrolone (OX), as an adjunct to restoring weight in COPD-associated weight loss.

METHODS: This prospective, open-label, 4-month, multicenter, community-based clinical trial enrolled patients with moderate-to-severe COPD as defined by one-second forced expiratory volume (FEV1) less than 50% predicted and FEV1/forced vital capacity ratio less than 070, along with significant involuntary weight loss (weight [is greater than or equal to] 90% ideal body weight). Patients were provided oral OX 10mg BID. A diet with sufficient calories and protein was advised, as was exercise as tolerated. Body weight, body composition by bioelectric impedance analysis (BIA), spirometry (PFT), and six-minute walking distance (6MWD) were measured. Data for 79 patients at 2 months and 51 patients at 4 months are presented.

RESULTS: At month 2, 87% of patients had gained a mean of 6 lbs, and 13% had no change or had lost a mean of 1.7 lbs. At month 4, 84% had gained a mean of 6.3 lbs, and 16% had no change or lost a mean of 2 lbs. The increases in weight were significant, p=0.0001. BIA at month 4 showed the weight to be primarily lean tissue, with a mean increase in body cell mass of 3 lbs (p=0.0001), and a mean increase in fat of 1.3 lbs (p=0.08). Mean 6MWD increased 11 meters. There was no significant change in PFTs. OX was generally well tolerated, and appetite was significantly increased (p=0.0002). Early dropouts were mainly due to intercurrent illness, primarily COPD exacerbation.

CONCLUSION: This final analysis of the completed study confirms the interim data previously reported. Oxandrolone is effective as an adjunct in restoring weight/or patients with COPD-associated weight loss. Weight gain is primarily lean mass, in contrast to the predominantly adipose tissue accrued with use of appetite stimulants or progestational agents. Although functional outcomes were not affected in this trial, an ongoing randomized, double-blind, placebo control study may ultimately reveal such improvements.

CLINICAL IMPLICATIONS: The oral anabolic agent, oxandrolone, can facilitate wei ht restoration inpatients who have lost weight due to COPD, and should be a consideration in the comprehensive care of such patients.

GRANT SUPPORT: Supported by Bio-Technology General Corp.

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