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Oxm4.4
Oxymetholone (Anadrol) Research
Mostly mechanism / observationalLimited safety
7 peer-reviewed studies
What the evidence says
Mostly mechanism / observational
Most Oxymetholone (Anadrol) 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 2003–2017 with a typical study size of 31 participants.
Based on 7 studies · 1 meta-analysis · 4 RCTs · 188 total participants
Confidence
Moderate
By outcome
Hepatotoxicity
Mostly mechanism / observational7 studies
Lean mass, weight & strength
Mostly mechanism / observational5 studies
Anemia & erythropoiesis
Mostly mechanism / observational4 studies
Safety profile
Mostly mechanism / observational4 studies
Cholesterol & lipids
Too few graded studies2 studies
Older research base
Newest study from 2017 · Latest meta-analysis: 2014
200320102017
1Meta-Analysis2014
We found limited evidence ... to indicate that oxymetholone can increase haemoglobin (Hb) (MD 1.90 g/dL) ... alanine aminotransferase (ALT) (MD 54.50 U/L) ... and aspartate aminotransferase (AST) (MD 47.33 U/L); and decrease high-density lipoprotein (HDL) (MD -15.66 mg/dL).
Yang Q, Abudou M, Xie XS, Wu T · The Cochrane database of systematic reviews (2014)
Top-of-pyramid synthesis: a Cochrane systematic review and meta-analysis of randomized trials of androgens for the anaemia of chronic kidney disease (8 studies, 181 participants)
Oxymetholone raised haemoglobin (+1.90 g/dL) and haematocrit and improved albumin — supporting the approved anemia/erythropoietic indication
Quantifies the harms in the same review: large ALT (+54.5 U/L) and AST (+47.3 U/L) rises and a fall in HDL (−15.7 mg/dL) — hepatotoxicity and adverse lipids together
Oxymetholone led to a significant weight gain of 3.0 +/- 0.5 and 3.5 +/- 0.7 kg in the TID and BID groups ... The most important adverse event was liver-associated toxicity. Overall, 35% of patients in the TID, 27% of patients in the BID oxymetholone group and no patients in the placebo group had a greater than five times baseline increase for alanine aminotransferase.
Hengge UR, Stocks K, Wiehler H, Faulkner S, Esser S, Lorenz C, Jentzen W, Hengge D, Goos M, Dudley RE, Ringham G · AIDS (London, England) (2003)
The pivotal evidence point: a double-blind, randomized, placebo-controlled phase III RCT in 89 HIV-positive eugonadal women and men with wasting — oxymetholone 50 mg twice or three times daily vs placebo for 16 weeks
Produced significant gains in body weight (3.0–3.5 kg vs 1.0 kg on placebo) and body cell mass (12.4% and 7.4% of baseline), with improved appetite, well-being and reduced weakness
Same trial documents the dominant harm cleanly: liver toxicity was the most important adverse event, with >5× ALT rises in 27–43% of treated patients and none on placebo
There was a significantly greater increase in fat-free mass and handgrip strength and decrease in fat mass in the oxymetholone compared with the placebo group ... Liver enzyme rose significantly in the oxymetholone group ... but it also induced liver injury.
Supasyndh O, Satirapoj B, Aramwit P, Viroonudomphol D, Chaiprasert A, Thanachatwej V, Vanichakarn S, Kopple JD · Clinical journal of the American Society of Nephrology : CJASN (2013)
Randomized trial in 43 hemodialysis patients — oxymetholone vs placebo for 24 weeks, with muscle biopsies
Increased fat-free mass and handgrip strength, decreased fat mass, raised type-I muscle-fibre cross-sectional area, and upregulated muscle IGF-I and myosin-heavy-chain mRNA
Demonstrates the anabolic effect in a distinct supervised population (dialysis sarcopenia)
Total LBM increased by 0.0 +/- 0.6, 3.3 +/- 1.2, and 4.2 +/- 2.4 kg ... Alanine aminotransferase increased by 72 +/- 67 U/l in group 3 ... and HDL-cholesterol decreased by -19 +/- 9 and -23 +/- 18 mg/dl in groups 2 and 3.
Schroeder ET, Singh A, Bhasin S, Storer TW, Azen C, Davidson T, Martinez C, Sinha-Hikim I, Jaque SV, Terk M, Sattler FR · American journal of physiology. Endocrinology and metabolism (2003)
Randomized, placebo-controlled trial in 31 men aged 65–80 — placebo vs 50 or 100 mg/day oxymetholone for 12 weeks
Dose-related gains in total lean body mass (+3.3 to +4.2 kg), upper-body 1-rep-max strength, and reduced trunk fat
The same trial captures the trade-off: a marked ALT rise on 100 mg/day and significant HDL-cholesterol falls in both active groups
Oxymetholone significantly enhances the erythropoietic effects of rHuEPO and improves the nutritional status of CAPD patients. However, significant increases in liver enzymes need to be monitored closely.
Aramwit P, Palapinyo S, Wiwatniwong S, Supasyndh O · International journal of clinical pharmacology and therapeutics (2010)
Double-blind, placebo-controlled trial in 24 continuous-ambulatory-peritoneal-dialysis patients — erythropoietin plus oxymetholone 50 mg twice daily vs erythropoietin plus placebo for 6 months
Significantly raised haematocrit and haemoglobin over erythropoietin alone, and improved anthropometrics, albumin and lean body mass / body weight
Outcome anchor for the erythropoietic (anemia) benefit — oxymetholone augmenting EPO
Androgens are the main nontransplant therapy for bone marrow failure in dyskeratosis congenita and Fanconi anemia, reaching responses in up to 80% of cases. Danazol and oxymetholone are more commonly used, but virilization and liver toxicity are major adverse events.
Calado RT, Clé DV · Hematology. American Society of Hematology. Education Program (2017)
Outcome anchor for the approved/inherited-anemia indication: a review of non-transplant treatment of inherited bone-marrow-failure syndromes
Androgens including oxymetholone and danazol are the main nontransplant therapy and produce haematologic responses in up to ~80% of cases of Fanconi anemia and dyskeratosis congenita
Names the dominant harms in the same breath — virilization and liver toxicity are the major adverse events
Here, we present a young male patient with aplastic anemia, who had received long-term treatment with oxymetholone ... peliosis hepatis ... may cause fatal hepatic hemorrhage and liver failure ... massive intra-abdominal bleeding should also be considered.
Choi SK, Jin JS, Cho SG, Choi SJ, Kim CS, Choe YM, Lee KY · World journal of gastroenterology (2009)
Mandatory severe-harm counter-evidence: a case report of an aplastic-anemia patient on long-term oxymetholone who suffered spontaneous liver rupture