Oxandrolone
Mechanism :
Anabolic steroids are synthetic derivatives of testosterone. Complete dissociation of anabolic and androgenic effects has not been achieved. The actions of anabolic steroids are therefore similar to those of male sex hormones with the possibility of causing serious disturbances of growth and sexual development if given to young children. Anabolic steroids suppress the gonadotropic functions of the pituitary and may exert a direct effect upon the testes.
Indication :
- Short stature in Turner’s syndrome
- Weight gain
- Delayed puberty in males
Contraindications :
Contraindicated in severe hepatic impairment, in patients with a history of diabetes, malignancy, cardiac, hepatic or renal impairment. Monitor skeletal maturation in young patients. Also contraindicated in carcinoma of the breast in females with hypercalcemia, pregnancy, because of possible masculinization of the fetus, nephrosis, and in hypercalcemia.
Dosing :
Orally give 0.1 mg/kg/day in 2-3 divided doses. In Turner’s syndrome may start with 0.05 mg/kg/day.
Adverse Effect :
Males: Gynecomastia, impotence, priapism, bladder irritability, inhibition of testicular function.
Females: Hirsutism, virilisation, male pattern baldness, menstrual irregularities.
Other: Sodium retention with edema, premature epiphyseal closure, jaundice (if given for long periods), neoplasm of liver, increased risk of atherosclerosis, acne, habituation.
Interaction :
Warfarin: Effect may be enhanced.
Oral Hypoglycemic Agents: Oxandrolone may inhibit the metabolism of oral hypoglycemic agents.
Adrenal Cortical Steroids: In patients with edema, concomitant administration with adrenal cortical steroids or ACTH may increase the edema.
Anabolic Steroids: May decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged. In addition, a decrease in PBI and radioactive iodine uptake may occur.
Hepatic Dose :
A reduced dose is advisable for patients with impaired hepatic function.