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Oxa4.7
Oxandrolone (Anavar) Research
Mostly mechanism / observationalLimited safety
8 peer-reviewed studies
What the evidence says
Mostly mechanism / observational
Most Oxandrolone (Anavar) studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from medium-quality meta-analyses and randomised trials published 1984–2019 with a typical study size of 133 participants.
Based on 8 studies · 1 meta-analysis · 5 RCTs · 856 total participants
Confidence
Moderate
By outcome
Wound healing & burns
Mostly mechanism / observational4 studies
Liver & hepatotoxicity
Mostly mechanism / observational4 studies
Lean mass & muscle wasting
Mostly mechanism / observational3 studies
Hormones & virilization
Mostly mechanism / observational3 studies
Safety profile
Mostly mechanism / observational3 studies
Cholesterol & lipids
Too few graded studies1 study
Older research base
Newest study from 2019 · Latest meta-analysis: 2016
198420012019
1Meta-Analysis2016
Oxandrolone treatment led to an additional gain in lean body mass of 3.99% (3.08, 4.89) after 6 months and 10.78% (9.92, 11.64) after 12 months in patients with severe burns, with all P<0.00001.
Li H, Guo Y, Yang Z, Roy M, Guo Q · Burns (2016)
Top-of-pyramid synthesis: a systematic review and meta-analysis of 15 RCTs (806 participants) in severe burns
Oxandrolone shortened length of stay and donor-site healing time, reduced weight loss and nitrogen loss in the catabolic phase, and added ~4% lean body mass at 6 months and ~11% at 12 months
Did not significantly affect mortality, infection, or liver dysfunction across the pooled trials (RR for liver dysfunction 1.15, 95% CI 0.83-1.59)
Length of stay was shorter in the oxandrolone group (31.6 +/- 3.1 days) than placebo (43.3 +/- 5.3 days; P < .05) ... treatment using oxandrolone should be considered for use in the severely burned while hepatic transaminases are monitored.
Wolf SE, Edelman LS, Kemalyan N, Donison L, Cross J, Underwood M, Spence RJ, Noppenberger D, Palmieri TL, Greenhalgh DG, et al. · Journal of burn care & research (2006)
The pivotal multicenter, prospective, randomized, double-blind RCT in 81 adults with 20-60% TBSA burns — oxandrolone 10 mg every 12 hours vs placebo
Length of hospital stay was significantly shorter on oxandrolone; the difference strengthened when indexed to burn size and when deaths were excluded
Stopped early at planned interim analysis because of the significant benefit between groups
Oxandrolone administration is effective in promoting dose-dependent gains in body weight and BCM in HIV-infected men with weight loss ... accompanied by significant increases in transaminases and low-density lipoprotein as well as decreases in high-density lipoprotein.
Grunfeld C, Kotler DP, Dobs A, Glesby M, Bhasin S · Journal of acquired immune deficiency syndromes (2006)
Randomized, double-blind, placebo-controlled trial in 262 HIV-infected men with weight loss — placebo vs 20, 40, or 80 mg/day oxandrolone
Produced dose-dependent gains in body weight and body cell mass (a second approved muscle-wasting indication)
Same dataset captures the harms cleanly: significant rises in transaminases and LDL, falls in HDL, and suppression of SHBG, LH, FSH and total and free testosterone
Compared with GH+Pl, GH+Ox 0.03 increased adult height gain ... (9.5 +/- 4.7 vs. 7.2 +/- 4.0 cm, P = 0.02) ... more girls reported virilization on GH+Ox 0.06 than on GH+Pl (P < 0.001).
Menke LA, Sas TC, de Muinck Keizer-Schrama SM, Zandwijken GR, de Ridder MA, Odink RJ, Jansen M, et al. · The Journal of clinical endocrinology and metabolism (2010)
Randomized, placebo-controlled, double-blind dose-response trial in 133 girls with Turner syndrome — growth hormone plus placebo vs low (0.03) or conventional (0.06 mg/kg/day) oxandrolone
Low-dose oxandrolone modestly increased adult height gain over GH alone (~2.3 cm), a distinct approved-context benefit
Honest dose caveat: the conventional dose did not add height (accelerated bone maturation) and caused more virilization, so the authors discouraged it
Although neither steroid improved short-term survival, oxandrolone therapy was associated with a beneficial effect on long-term survival. This was especially true in patients with moderate disease.
Mendenhall CL, Anderson S, Garcia-Pont P, Goldberg S, Kiernan T, Seeff LB, Sorrell M, Tamburro C, Weesner R, Zetterman R, et al. · The New England journal of medicine (1984)
Cooperative randomized trial in 263 patients with moderate or severe alcoholic hepatitis — oxandrolone vs prednisolone vs placebo for 30 days
Neither steroid improved 30-day survival, but oxandrolone was associated with improved long-term survival, most clearly in moderate disease (conditional 6-month death rate 3.5% vs 19-20% on placebo, P = 0.02)
An NEJM RCT showing a genuine but qualified benefit — long-term not short-term, moderate not severe — in a catabolic-illness setting
Lean body mass was significantly improved in the oxandrolone and exercise, oxandrolone alone, and placebo and exercise group compared with the group only receiving placebo.
Overall 28 out of 66 (42%) patients developed transaminitis ... Oxandrolone induced transaminitis is occurring in patients significantly more frequently than previously reported.
Kiracofe B, Coffey R, Jones LM, Bailey JK, Thomas S, Porter K, Murphy CV · Burns (2019)
Counter-evidence on the dominant harm: a single-center retrospective analysis of 66 burn patients on oxandrolone
42% developed transaminitis (AST or ALT >100), significantly more than previously reported — concomitant hepatotoxic medications raised the risk
Quantifies oxandrolone's most common adverse effect in real-world use and argues for clearer monitoring requirements
Relevant concern has been raised by the AAS hepatotoxicity including adenoma, hepatocellular carcinoma, cholestasis, and peliosis hepatis.
Solimini R, Rotolo MC, Mastrobattista L, Mortali C, Minutillo A, Pichini S, Pacifici R, Palmi I · European review for medical and pharmacological sciences (2017)
Mandatory class-level counter-evidence on non-medical use: a review of the hepatotoxic effects of anabolic-androgenic steroids in doping/athlete and general-population misuse
AAS hepatotoxicity spans hepatic adenoma, hepatocellular carcinoma, cholestasis and peliosis hepatis — the severe end of the liver-injury spectrum
Notes AAS are frequently present in over-the-counter 'dietary supplements' without label declaration, leaving consumers unaware of the risk