Anadrol (Oxymetholone) — Potent Oral Anabolic Steroid — Anabolic Steroids
FDA-approved oral AAS for anemia, one of the most potent mass-building steroids. Significant hepatotoxicity and estrogenic effects.
Overview
Oxymetholone (Anadrol-50) is a potent 17-alpha-alkylated oral anabolic steroid FDA-approved for the treatment of anemia caused by deficient red blood cell production, including aplastic anemia, myelofibrosis, and hypoplastic anemia. It is one of the most powerful oral AAS available, with an anabolic:androgenic ratio of 320:45. Oxymetholone was developed by Syntex in 1960 and has remained in clinical use for anemias, though its use has declined with the availability of recombinant erythropoietin. In HIV/AIDS wasting, oxymetholone at 100-150 mg daily for 16 weeks demonstrated significant lean mass gains (+3.8 kg vs placebo) in clinical trials. Despite being a DHT derivative that cannot aromatize, oxymetholone produces significant estrogenic effects (gynecomastia, water retention) through a poorly understood mechanism — possibly direct activation of estrogen receptors by oxymetholone or its metabolites. This is a unique pharmacological feature not shared by other DHT derivatives. Hepatotoxicity is the major safety concern: oxymetholone is strongly associated with peliosis hepatis (blood-filled cysts in the liver), cholestatic jaundice, and hepatocellular carcinoma with prolonged use. It is one of the most hepatotoxic AAS in clinical use.
Indications
- FDA-approved: Anemia due to deficient red blood cell production
- Off-label: HIV/AIDS wasting syndrome
- Unapproved: Rapid mass gain (bodybuilding use)
- Unapproved: Strength enhancement
Mechanism of Action
Oxymetholone activates the androgen receptor with high potency, dramatically increasing protein synthesis and nitrogen retention in skeletal muscle
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| Oxymetholone (Anadrol-50) | 50 mg | Once daily | FDA-approved starting dose for anemia |
| Oxymetholone | 1-5 mg/kg/day | Once daily | FDA-approved dosing range for anemia |
| Oxymetholone | 50-100 mg | Once daily | Common bodybuilding dose — typically used for 4-6 weeks only |
Safety & Contraindications
- Severe hepatotoxicity: peliosis hepatis, cholestatic jaundice, hepatocellular carcinoma
- 17-alpha-alkylated — significant first-pass liver stress
- Estrogenic effects despite being non-aromatizable — gynecomastia, water retention
- Significant water retention and blood pressure elevation
- Hematocrit elevation — polycythemia risk
- Severe HPG axis suppression
- Schedule III controlled substance
- Not recommended beyond 3-6 months continuous use