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Oxymetholone

Oxymetholone (Anadrol), is a synthetic anabolic steroid developed by Syntex in 1960. Its primary clinical applications include treatment of osteoporosis and anaemia, as well as stimulating muscle growth in undernourished or underdeveloped patients. The drug was approved for human use by the FDA. However, later non-steroidal drugs such as Epogen were developed and proven to be more effective as a treatment for anaemia and osteoporosis without the side-effects of oxymtholone. more...

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The drug remained available despite this, and eventually found a new use in treating HIV wasting syndrome. While classified as a Schedule III drug under the Controlled Substances Act, it remains available via prescription as Anadrol (registered as a trademark of Unimed Pharmaceuticals.)

Presented most commonly as a 50mg tablet, Oxymetholone is the strongest androgenic steroid available. Similarly, it also poses the greatest risk of side effects of any steroid. Despite very low binding affinity with the androgen receptor, oxymetholone is highly effective in promoting extensive gains in body mass, mostly by greatly improving muscular water retention. For this reason, it is often used illegally by bodybuilders and athletes. Many athletes also use Oxymetholone as a method of protection for the joints under heavy loads. Due to the high water retention users experience from this drug, it similarily lubricates the joints and helps protect them from injury.

Side effects

The side-effects of short-term use of the drug itself include nausea, bloating, acne, and masculinising effects such as deepening of the voice, growth of facial hair and clitoral hypertrophy . In addition, oxymetholone is readily aromatized by aromatase to form a progestagen, and unless selective estrogen receptor modulators such as Nolvadex or Clomid are taken in conjunction with the drug, there is a significant risk of the appearance of estrogenic effects such as gynaecomastia over time. Because of its 17α-alkylated structure, oxymetholone is highly hepatoxic. Long term use of the drug can cause a variety of serious ailments, including hepatitis, liver cancer, and cirrhosis. It is very dangerous to take Oxymetholone in high dosages for periods of time exceeding six weeks, and is commonly used by bodybuilders during the start of a steroid cycle to help gain mass and increase serum levels of androgens quickly.

Use with other steroids

To further increase its effectiveness as an anabolic agent, bodybuilders typically stack (see steroid stack) oxymetholone with other anabolic steroids. Since it is already a very potent androgen, many users will combine it with drugs such as nandrolone, Boldenone and Oxandrolone to further their gains.

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Anabolic Agents And Lean Body Mass Restoration In Hiv-Infected Patients
From Nutrition Research Newsletter, 1/1/00 by Kathleen Mulligan

Body wasting and loss of lean body mass (LBM) have been associated with increased mortality and disease progression and reduced quality of life in patients with human immunodeficiency virus (HIV) infection. Research has shown that it is not as simple as increasing energy intake to restore this LBM. Health care professionals believed that the protease inhibitors (PI) would reverse wasting by effectively suppressing the HIV virus. However, it appears that patients gained mostly fat from PI therapy.

The failure of many treatments to help restore LBM has inspired investigations of protein anabolic agents, including recombinant human growth hormone (rhGH), insulinlike growth factor I (rhIGF-I), and synthetic testosterone derivatives. A group of researchers recently gathered to explore the possibilities of these anabolic agents in the restoration of LBM in HIV-infected patients.

The research showed that growth hormone did result in sustained increases in weight and LBM. Overall, treatment with these pharmacologic doses of rhGH (0.1 mg/kg/day) was well tolerated in patients with HIV-associated wasting and did not affect progression of AIDS, viral load, or death over the short study periods. Some researchers speculated that insulin-like growth factor I (IGF-I) would be a more effective treatment than growth hormone. However, findings are in agreement that there is no reason to pursue rhIGF-I as a possible therapy. Researchers then reviewed the effects of a combination of growth hormone and insulin-like growth factor, finding that there is little justification for using a combination of these two drags.

Use of synthetic testosterone derivatives such as nandrolone decanoate, oxandrolone, and oxymetholone has increased, but there remain few published studies on the efficacy or safety of these agents in HIV-associated wasting. Nandrolone decanoate has been approved for use in anemia associated with end-stage renal disease and has shown to increase LBM in these patients as well. Placebo-controlled trials are underway for this derivative in HIV-infected patients but the results are not yet published. Several open-label studies suggests that nandrolone could aid in weight increase and acquisition of LBM. Oxandrolone and oxymetholone also proved mildly successful in producing weight gain in patients with HIV-associated weight loss. However, further studies need to be performed.

It is agreed that reversal of wasting could improve survival and quality of life while decreasing mortality in patients with HIV. From the limited results that are available, it also appears that anabolic therapy can increase LBM but no data is available that proves this therapy could improve survival rates or increase quality of life. Further research is needed to determine the appropriate dosing and maintenance regimens to limit side effects and costs of these treatments.

Kathleen Mulligan, Viva W. Tai, and Morris Schambelan, Use of Growth Hormone and Other Anabolic Agents in AIDS Wasting, Journal of Parenteral and Enteral Nutrition 23: S202 - S209 (November-December 1999) [Correspondence: Kathleen Mulligan, PhD, Division of Endocrinology, San Francisco General Hospital, Building 100, Room 321, 1001 Potrero Ave., San Francisco, CA 94110]

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