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Oxymetholone (Anadrol, Anapolon) — potent oral 17α-alkylated anabolic-androgenic steroid; DEA Schedule III controlled substance
A potent prescription ORAL anabolic-androgenic steroid (AAS) — brand Anadrol/Anapolon — and a DEA Schedule III CONTROLLED SUBSTANCE. Oxymetholone has a US FDA approval record for ANADROL-50 under NDA 016848. The 2026 Orange Book lists this product as discontinued. This record does not establish current availability or authorisation of another product or use. It has real randomized-trial evidence in supervised muscle-wasting settings: it adds body weight and lean/body cell mass in HIV-associated wasting, raises lean mass and strength in older men, and increases haemoglobin and muscle mass in dialysis patients; a Cochrane review found limited evidence, from one 24-person study, that it raises haemoglobin in the anaemia of chronic kidney disease, and judged the evidence insufficient. But it is 17α-alkylated and markedly HEPATOTOXIC — anabolic steroids as a class have been associated with cholestasis, peliosis hepatis with life-threatening liver failure or bleeding into the abdomen, and liver tumours, including reported fatal malignancies (historical Anadrol-50 US boxed warning, 2004). It also sharply lowers HDL and raises LDL cholesterol, suppresses the hypothalamic-pituitary-testicular axis, and virilizes. It is NOT a dietary supplement and NOT a longevity drug; non-medical bodybuilding use is unsupervised and carries those liver, lipid, and endocrine harms unmonitored. Described for harm-reduction information only — not a recommendation.
Prescription medication — not a dietary supplement
Oxymetholone (Anadrol) is a prescription (or investigational) drug, not a supplement. It is included here for reference because people research and discuss it (often used off-label) — not as a recommendation. Take it only under a qualified clinician's supervision and only as prescribed; do not source it from grey-market vendors, where identity, purity, and dosing are unverified. The evidence below reflects its clinical trials.
What the evidence says
Oxymetholone (Anadrol) doesn't have enough studies with structured effect-size data yet to pool a verdict. Browse the studies below for individual findings.
Most evidence is from high-quality meta-analyses and randomised trials published 1983–2022 with a typical study size of 181 participants.
Based on 12 studies · 1 meta-analysis · 8 RCTs · 182 total participants
Confidence
Moderate confidenceBy outcome
Oxymetholone has a US FDA approval record for ANADROL-50 under NDA 016848. The 2026 Orange Book lists this product as discontinued. This record does not establish current availability or authorisation of another product or use. Oxymetholone has genuine randomized-trial evidence in supervised, catabolic settings — a phase III HIV-wasting RCT shows weight and body-cell-mass gain, RCTs in older men and dialysis patients show lean-mass/strength gains, a dialysis trial and a Cochrane review (which itself judged the evidence insufficient) point to a haemoglobin increase. But it is a potent 17α-alkylated, markedly HEPATOTOXIC, DEA Schedule III controlled substance: anabolic steroids as a class have been associated with cholestasis, peliosis hepatis with life-threatening liver failure or bleeding into the abdomen, and liver tumours, including reported fatal malignancies (historical Anadrol-50 US boxed warning, 2004); it also lowers HDL, raises LDL, suppresses the HPTA and virilizes. It is a prescription drug, not a dietary supplement or longevity drug, and non-medical bodybuilding use is unsupervised — so it sits in the low-mid range, weighted up by real evidence and down hard by the hepatotoxicity, the other harms, and the legal status.
Oxymetholone (brand names Anadrol-50 and Anapolon) is a potent oral 17α-alkylated anabolic-androgenic steroid (AAS) — a synthetic derivative of dihydrotestosterone, modified at the 17-alpha position so it survives first-pass hepatic metabolism and can be taken by mouth.
It is a prescription drug in the United States and a Schedule III controlled substance under the Controlled Substances Act. It is widely used by bodybuilders for rapid mass and strength because it is one of the most strongly anabolic oral steroids.
Unusually for the compounds in this collection, oxymetholone has genuine randomized-controlled-trial evidence in supervised, catabolic-illness settings.
In HIV-associated wasting, a double-blind, randomized, placebo-controlled phase III trial in 89 eugonadal men and women (Hengge 2003, AIDS) found oxymetholone (50 mg twice or three times daily) produced significant gains in body weight (3.0–3.5 kg vs 1.0 kg on placebo) and body cell mass, with improved appetite and well-being.
In older community-dwelling men, a randomized placebo-controlled trial (Schroeder 2003) found 50 or 100 mg/day increased total lean body mass by 3.3–4.2 kg and raised upper-body 1-rep-max strength over 12 weeks.
In dialysis, a randomized trial in 43 hemodialysis patients (Supasyndh 2013, CJASN) showed oxymetholone increased fat-free mass and handgrip strength and decreased fat mass, and a double-blind trial in 24 continuous-ambulatory-peritoneal-dialysis patients (Aramwit 2010, not stated as randomized) found it enhanced the erythropoietic effect of erythropoietin — raising haematocrit and haemoglobin — and improved nutritional status.
A Cochrane systematic review and meta-analysis of androgens for the anaemia of chronic kidney disease (Yang 2014) found limited evidence, from one 24-person study, that oxymetholone raised haemoglobin and haematocrit, and concluded the evidence was insufficient to confirm benefit, and reviews of inherited bone-marrow-failure treatment (Calado 2017) note androgens including oxymetholone and danazol produce haematologic responses in up to ~80% of cases.
So the anabolic and erythropoietic signal in supervised indications is real. The honest counterweight defines the compound.
Because it is 17α-alkylated, oxymetholone is markedly hepatotoxic: the older-men and dialysis trials recorded significant transaminase rises (in the hemodialysis trial, values above three times normal did not differ from placebo); the Cochrane review quantified large ALT/AST increases (ALT mean difference +54.5 U/L) and an HDL fall (−15.7 mg/dL) on oxymetholone.
Beyond reversible transaminitis, anabolic-androgenic steroids are tied to cholestasis, peliosis hepatis — blood-filled hepatic cavities that can rupture: a documented case of an aplastic-anemia patient on long-term oxymetholone who suffered spontaneous liver rupture and life-threatening hemoperitoneum treated by hemihepatectomy (Choi 2009, he survived) — and hepatic adenoma and hepatocellular carcinoma.
It worsens the lipid profile (low HDL, high LDL), suppresses the hypothalamic-pituitary-testicular axis, and causes virilization (deepened voice, hirsutism, menstrual changes) that can be irreversible in women, plus marked water retention.
The score reflects genuine, randomized evidence in supervised anemia and muscle-wasting indications set against pronounced hepatotoxicity, an adverse lipid shift, HPTA suppression and virilization, plus the reality that this is a controlled substance, not a supplement, and that non-medical use for body composition carries those same harms without medical monitoring.
Oxymetholone is a synthetic DHT-derived androgen that binds and activates the androgen receptor in skeletal muscle and other tissues, driving the strong anabolic, protein-sparing signalling that underlies its weight-gain and muscle-wasting effects.
Androgens stimulate erythropoiesis — increasing erythropoietin drive and red-cell production — which is the basis of oxymetholone's use in aplastic and other deficient-production anemias and its haemoglobin-raising effect alongside erythropoietin in dialysis.
The 17α-alkyl group that makes oxymetholone orally active also makes it markedly hepatotoxic (dose-related transaminitis, cholestasis, and — for AAS broadly — peliosis hepatis and liver tumours). The same androgenic activity lowers HDL and raises LDL cholesterol, suppresses the hypothalamic-pituitary-testicular axis, virilizes, and causes water retention.
How Oxymetholone (Anadrol) works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Avoid — a controlled-substance prescription drug, not a supplement; marked hepatotoxicity, adverse lipids, HPTA suppression and virilization, and not for self-experimentation.
High caution even when prescribed — virilizing effects (voice deepening, hirsutism, clitoral enlargement) can be permanent; discontinue at the first androgenic sign.
Major interaction — requires clinician-managed anticoagulant dose reduction and frequent INR checks.
Avoid entirely — androgenic; causes fetal virilization.
Oxymetholone markedly potentiates warfarin, raising INR and bleeding risk; anticoagulant doses often need substantial reduction with close INR monitoring under a clinician.
Oxymetholone is itself markedly hepatotoxic; combining it with other hepatotoxic agents or alcohol compounds the risk of transaminitis, cholestatic injury and peliosis hepatis.
Anabolic steroids can alter glucose handling and insulin sensitivity, potentially requiring antidiabetic-dose adjustment.
Stacking androgenic agents compounds hepatic burden, HPTA suppression and the adverse lipid shift; the combined risk is additive and uncharacterised in non-medical use.
Tip: Liver injury is a serious risk. New yellow skin or eyes, dark urine or persistent upper abdominal pain needs medical assessment today. Severe abdominal pain, collapse or major bleeding needs emergency help now. Follow the product’s stop instructions and seek urgent advice from the treating team about the next dose.
Tip: Anabolic-androgenic steroids as a class are linked to peliosis hepatis (which can rupture, causing life-threatening intra-abdominal bleeding), hepatic adenoma and hepatocellular carcinoma; risk rises with prolonged or high-dose use. There is no safe self-monitoring framework for non-medical use.
Tip: Lowered HDL and raised LDL cholesterol are consistent on treatment and work against cardiovascular health; reversibility depends on discontinuation.
Tip: Suppresses endogenous testosterone and virilizes — deepened voice, hirsutism, menstrual disruption and clitoral enlargement in women may be irreversible; it is also strongly estrogenic/fluid-retaining (oedema, hypertension). Stop at the first sign of voice change in women.
Oxymetholone (Anadrol) has an evidence score of 4.4/10 — emerging evidence based on 12 indexed studies, including 1 meta-analysis. A potent prescription ORAL anabolic-androgenic steroid (AAS) — brand Anadrol/Anapolon — and a DEA Schedule III CONTROLLED SUBSTANCE. Oxymetholone has a US FDA approval record for ANADROL-50 under NDA 016848. The 2026 Orange Book lists this product as discontinued. This record does not establish current availability or authorisation of another product or use. It has real randomized-trial evidence in supervised muscle-wasting settings: it adds body weight and lean/body cell mass in HIV-associated wasting, raises lean mass and strength in older men, and increases haemoglobin and muscle mass in dialysis patients; a Cochrane review found limited evidence, from one 24-person study, that it raises haemoglobin in the anaemia of chronic kidney disease, and judged the evidence insufficient. But it is 17α-alkylated and markedly HEPATOTOXIC — anabolic steroids as a class have been associated with cholestasis, peliosis hepatis with life-threatening liver failure or bleeding into the abdomen, and liver tumours, including reported fatal malignancies (historical Anadrol-50 US boxed warning, 2004). It also sharply lowers HDL and raises LDL cholesterol, suppresses the hypothalamic-pituitary-testicular axis, and virilizes. It is NOT a dietary supplement and NOT a longevity drug; non-medical bodybuilding use is unsupervised and carries those liver, lipid, and endocrine harms unmonitored. Described for harm-reduction information only — not a recommendation. Representative study: PMID 25300168.
Dosing for Oxymetholone (Anadrol): SupStack recommends no self-directed oxymetholone dose. Any prescribed treatment must follow the exact product’s prescribing information and the treating clinician’s plan. Historical trial doses are not safe ceilings.
Timing is flexible for Oxymetholone (Anadrol) — consistent daily use matters more than the time of day. Oxymetholone requires clinical supervision and appropriate safety monitoring.
No consumer dose of Oxymetholone (Anadrol) is endorsed, so there is no dose at which it can be called safe. Talk to a healthcare provider before taking it. Reported side effects include peliosis hepatis / hepatic tumour (AAS class), hepatic transaminitis / cholestatic liver injury, adverse lipid shift (low HDL, high LDL), HPTA suppression, virilization & water retention. How often they occur is not established for all of them. Use caution if any of these apply to you: Anyone seeking it for body composition or athletic performance without a prescription — a DEA Schedule III controlled substance; it is not a dietary supplement, and laws on supply, possession, import and use depend on the country and circumstances; Pre-existing liver disease or elevated liver enzymes — 17α-alkylated and markedly hepatotoxic (transaminitis, cholestasis, peliosis hepatis); Known or suspected prostate or male breast carcinoma; hypercalcemia; nephrosis.
Epicatechin
Mixed evidenceDark chocolate flavanol with consistent human evidence for improved endothelial function and modest blood pressure reduction. Muscle-building claims are not supported in humans.
Oxandrolone (Anavar)
Too few graded studiesA prescription oral anabolic-androgenic steroid (AAS) — brand Anavar/Oxandrin — and a DEA Schedule III CONTROLLED SUBSTANCE. It has genuine randomized-trial evidence in formerly FDA-approved (withdrawn June 2023), supervised muscle-wasting settings: it adds lean body mass, speeds wound healing and shortens hospital stay in severe burns, raises body weight in HIV-associated wasting, and modestly increases adult height in Turner syndrome. But it is 17α-alkylated and hepatotoxic (dose-related transaminase rises, cholestasis, and — with anabolic steroids generally — peliosis and liver tumours), it sharply lowers HDL and raises LDL cholesterol, and it suppresses the hypothalamic-pituitary-testicular axis and virilizes. It is NOT a dietary supplement and NOT a longevity drug; non-medical bodybuilding use is unsupervised and carries real liver, lipid, and endocrine harm. Described for harm-reduction information only — not a recommendation.
Nandrolone (Deca-Durabolin)
Too few graded studiesAn injectable anabolic-androgenic steroid (AAS) — brand Deca-Durabolin, the long-acting decanoate ester of 19-nortestosterone — and a DEA Schedule III CONTROLLED SUBSTANCE. It has genuine randomized-trial evidence in supervised, catabolic-illness settings: it adds lean body mass and weight in HIV-associated wasting, adds muscle mass and physical function in dialysis patients, and raises hemoglobin in dialysis anemia (a historic FDA-approved indication, since largely replaced by erythropoietin). But it suppresses the hypothalamic-pituitary-gonadal axis — and because it is a long-ester 19-nortestosterone with progestogenic activity, that suppression and the resulting sexual dysfunction ('deca dick') can be prolonged. It worsens the lipid profile (lowers HDL), is associated with cardiac remodelling/cardiomyopathy and premature atherosclerosis in long-term high-dose users, and virilizes. It is NOT a dietary supplement and NOT a longevity drug; non-medical bodybuilding/performance use is unsupervised and carries real cardiovascular, endocrine and sexual harm. Described for harm-reduction information only — not a recommendation.
Stanozolol (Winstrol)
Too few graded studiesA prescription oral anabolic-androgenic steroid (AAS) — brand Winstrol — and a DEA Schedule III CONTROLLED SUBSTANCE. Its one approved indication is prophylaxis of hereditary angioedema (HAE), where decades of cohort and systematic-review evidence confirm it reduces attack frequency. But it is 17α-alkylated and hepatotoxic (cholestasis, and — for AAS as a class — peliosis and liver tumours), and it causes one of the most DRAMATIC HDL crashes of any drug studied — a classic crossover trial measured a 33% fall in HDL, a 71% fall in HDL2, and a 29% rise in LDL. It also suppresses the HPTA and virilizes. It is NOT a dietary supplement and NOT a longevity drug; non-medical bodybuilding ('cutting') use is unmonitored. Described for harm-reduction information only — not a recommendation.
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Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 13 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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