Oxandrolone
Oxandrolone is a synthetic androgenic anabolic steroid. Oxandrolone is used for Weight gain after weight loss (adjunctive therapy), Offset protein catabolism from prolonged corticosteroids and Bone pain accompanying osteoporosis.
Pronunciation: pronunciation varies by local usage.
- Generic name
- oxandrolone
- Brand names
- Oxandrin
- Drug class
- Androgenic anabolic steroid
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only medicine. Note: US FDA withdrew approval of all oxandrolone tablet applications as of 28 June 2023; the historical US label is included for information.
Availability and supply rules vary by country
Trade names by country:
Australia: · Full directory
What oxandrolone is and how it works
Oxandrolone is a synthetic androgenic anabolic steroid. In the United States, FDA withdrew approval of all oxandrolone tablet applications effective 28 June 2023. The historical US label described use as adjunctive therapy to promote weight gain after weight loss from extensive surgery, chronic infections, severe trauma, or when a patient cannot gain or maintain normal weight; to offset protein catabolism linked to prolonged corticosteroid use; and to relieve bone pain associated with osteoporosis. (2) (3) (1)
Oxandrolone carries a boxed warning for peliosis hepatis, liver-cell tumours, and blood-lipid changes that raise cardiovascular risk. It is not a treatment for enhancing athletic ability. A clinician must assess individual eligibility, baseline laboratory values, and planned monitoring before considering use.
Mechanism of action: how oxandrolone works
Oxandrolone is a synthetic androgenic anabolic steroid that increases the amount of protein made by the body, which is used to build more muscle and increase body weight. (2) (3)
What is Oxandrolone used for?
Weight gain after weight loss (adjunctive therapy)
Historical US label: adjunctive therapy to promote weight gain after weight loss following extensive surgery, chronic infections, severe trauma, or in patients who fail to gain or maintain normal weight without a definite pathophysiologic reason. Oxandrolone is used together with a diet programme. (2) (1)
Offset protein catabolism from prolonged corticosteroids
Historical US label: used to offset the protein catabolism associated with prolonged administration of corticosteroids. (2)
Bone pain accompanying osteoporosis
Historical US label: used for the relief of bone pain frequently accompanying osteoporosis. (2) (1)
Before taking oxandrolone
Do not take / not appropriate for
- Do not take oxandrolone if you have known or suspected carcinoma of the prostate or male breast. (all products) (2)
- Do not take oxandrolone if you have breast cancer with hypercalcemia (androgenic anabolic steroids may stimulate osteolytic bone resorption). (all products) (2)
- Do not take oxandrolone if you are pregnant or could become pregnant; it may cause masculinisation of the fetus. (all products) (2) (1)
- Do not take oxandrolone if you have nephrosis or the nephrotic phase of nephritis, or hypercalcemia. (all products) (2)
Tell your clinician about
- Any history of high blood calcium, breast cancer, prostate cancer, or kidney disease.
- Any history of chronic obstructive pulmonary disease (COPD) or liver disease.
- Whether you or a family member has had high cholesterol, heart disease, heart attack, chest pain, or stroke.
- All prescription and over-the-counter medicines, vitamins, supplements, and herbal products you take.
- If you are pregnant, planning pregnancy, or breastfeeding. Oxandrolone may harm the fetus.
Oxandrolone dosage and how to take it
- Oxandrolone is taken by mouth as a tablet, usually two to four times a day.
- Take it around the same times each day. Follow the prescription label exactly; do not take more, less, or more often than prescribed.
- The prescribing clinician will typically set a course of 2 to 4 weeks; a longer course depends on your condition and response.
- Oxandrolone is adjunctive therapy — it is used together with a diet programme and does not replace conventional treatment.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2) (1) (3) (4)
Missed dose
Take the missed dose as soon as you remember. If it is almost time for the next dose, contact your prescriber or pharmacist for guidance on the missed dose and continue your regular schedule. do not take an extra dose to make up for a missed one.
Overdose
If an overdose is suspected, call the poison control helpline (US: 1-800-222-1222) or seek information at https://www.poisonhelp.org/help. If the person collapses, has a seizure, has trouble breathing, or cannot be woken, call emergency services (US: 911) immediately. Possible symptoms include swelling of the arms, hands, feet, ankles, or lower legs. The historical US label notes that no specific antidote is known and gastric lavage may be used; this decision must be made by a clinician or emergency service. (2) (1)
Oxandrolone side effects
Oxandrolone carries a boxed warning for peliosis hepatis, liver-cell tumours, and blood-lipid changes that may increase the risk of atherosclerosis and coronary artery disease. Report any unusual problems to the prescribing clinician promptly.
Difficulty sleeping, breast enlargement, changes in sex drive or ability
What to notice: Trouble falling or staying asleep; breast tissue changes; altered libido or sexual function.
What to do: Tell your clinician if these symptoms are severe or do not go away. (1)
Signs of liver or spleen injury (peliosis hepatis, liver tumours)
What to notice: Upset stomach, extreme tiredness, unusual bruising or bleeding, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, flu-like symptoms, pale/cool/clammy skin, nausea or vomiting.
What to do: Call your clinician immediately. The prescribing clinician will assess the need for discontinuation and further investigation. (2) (1)
Fluid retention
What to notice: Swelling of the arms, hands, feet, ankles, or lower legs.
What to do: Call your clinician immediately. Fluid retention can be a serious complication, especially with pre-existing heart, kidney, or liver disease. (2) (1)
Androgenic effects in women
What to notice: New or worsening acne, enlargement of the clitoris, deepening of voice, increase in facial hair, baldness, abnormal or absent menstrual periods.
What to do: Call your clinician immediately. Some of these effects may not go away if not addressed promptly. (1)
Persistent or painful erections, testicular changes, or urinary symptoms in men
What to notice: Erections that happen too often or do not go away; enlarged penis; pain, swelling, or decreased size of testes; frequent, difficult, or painful urination; inability to control urination.
What to do: Call your clinician immediately. (1)
Serious warnings
Peliosis hepatis and liver-cell tumours — emergency
Symptoms: Blood-filled cysts in the liver (sometimes spleen) that may cause minimal initial symptoms but can lead to life-threatening liver failure or intra-abdominal bleeding. Liver-cell tumours (benign or malignant) may also occur and can cause life-threatening haemorrhage. Warning signs include upper-right stomach pain, yellowing of skin/eyes, severe fatigue, unusual bruising or bleeding, nausea or vomiting, flu-like symptoms, and pale/cool/clammy skin.
Action: Seek emergency medical attention immediately if these symptoms appear. The clinician managing your care will assess the need for discontinuation and urgent investigation. (2) (1)
Serious blood-lipid changes and cardiovascular risk — warning
Symptoms: Oxandrolone can decrease HDL (‘good cholesterol’) and sometimes increase LDL (‘bad cholesterol’); these changes may be marked and can increase the risk of atherosclerosis and coronary artery disease. Pre-existing personal or family history of high cholesterol, heart disease, heart attack, chest pain, or stroke increases concern.
Action: Keep all laboratory appointments for lipid monitoring. Tell the prescribing clinician about any personal or family cardiovascular history before starting and if any chest pain or other cardiovascular symptoms develop. (2) (1)
Effects on growth in children — warning
Symptoms: Androgen therapy can accelerate bone maturation without increasing final height, potentially reducing adult height. The risk is greater in younger children.
Action: The prescribing clinician will monitor bone age with wrist/hand X-rays every 6 months. Talk to the child’s clinician about the risks before treatment. (2) (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Adrenal corticosteroids or ACTH | Concomitant use may increase oedema, which can be a serious complication in patients with pre-existing cardiac, renal, or hepatic disease. | Ensure the prescriber knows about all corticosteroid or ACTH use; dose adjustments or extra monitoring may be needed. (2) |
| Other prescription and non-prescription medicines, vitamins, supplements, and herbal products | Interactions may require dose changes or extra monitoring. | Give the prescriber and pharmacist a complete list of everything you take before starting oxandrolone. (1) |
| Laboratory tests | Oxandrolone may affect the results of certain laboratory tests. | Tell the doctor and laboratory personnel that you are taking oxandrolone before any test. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
Androgen therapy can accelerate bone maturation without producing a compensatory gain in linear growth, which may reduce final adult height. The risk is greater in younger children. Bone age should be monitored by wrist/hand X-ray every 6 months. Historical US label: total daily paediatric dose is ≤0.1 mg per kg body weight or ≤0.045 mg per pound. Treatment is intermittent. Discuss the risks with the child’s clinician. (2) (1)
Older adults (geriatric use)
Older patients treated with androgenic anabolic steroids may be at increased risk for prostatic hypertrophy and prostatic carcinoma. Historical US label geriatric dose: 5 mg twice daily. A clinician must assess individual risks. (2)
Pregnancy and breastfeeding
Oxandrolone is contraindicated in pregnancy because of possible masculinisation of the fetus. It has caused embryotoxicity, fetotoxicity, infertility, and masculinisation in animal studies. Do not become pregnant during treatment. If pregnancy occurs, call your clinician immediately. Breastfeeding: discuss with your clinician. (2) (1)
People with pre-existing cardiac, renal, or hepatic disease
Oedema with or without congestive heart failure may be a serious complication. Concomitant adrenal corticosteroids or ACTH can worsen oedema. The prescriber must assess individual risk before treatment. (2)
Monitoring
Before starting
- Confirm the diagnosis and that no contraindications are present (prostate or male breast carcinoma, breast cancer with hypercalcemia, pregnancy, nephrosis, hypercalcemia).
- Assess baseline liver function, lipid profile (LDL/HDL), and cardiovascular risk factors including personal and family history.
- Review all concomitant medicines, especially corticosteroids, ACTH, and any agents that may interact.
- In children, obtain baseline bone-age assessment.
During treatment
- Monitor liver function tests and lipid profile as directed; the prescribing clinician decides to discontinue oxandrolone and investigate if cholestatic hepatitis with jaundice appears or liver function tests become abnormal (drug-induced jaundice is usually reversible on discontinuation).
- Watch for signs of peliosis hepatis, liver tumours, hypercalcemia, oedema, or androgenic side effects.
- In children, assess bone age of the left wrist and hand every 6 months to track bone maturation.
- Reassess the need for continued treatment and use intermittent courses as appropriate.
Storage
Keep oxandrolone in the container it came in, tightly closed, and out of reach of children. Store at room temperature, away from excess heat and moisture (not in the bathroom). Dispose of unneeded medication through a medicine take-back programme; do not flush down the toilet.
Professional information
Clinician-facing context only. Note: US FDA withdrew approval of all oxandrolone tablet applications as of 28 June 2023. The information below reflects the historical US label and should not be treated as a current prescribing recommendation. Always use current local prescribing information where the product is authorised.
United States (historical label)
Indication: Weight gain, protein catabolism offset, bone pain of osteoporosis
Dose summary: Adults: 2.5 mg to 20 mg daily in 2 to 4 divided doses. A course of 2 to 4 weeks is usually adequate; may be repeated intermittently. Geriatric: 5 mg twice daily. Children: total daily dose ≤0.1 mg/kg or ≤0.045 mg/lb. Therapy should be intermittent and adjunctive to conventional treatment.
Renal context: No renal-dose adjustment is described in the historical US label; oxandrolone was contraindicated in nephrosis and the nephrotic phase of nephritis. (2)
Hepatic guidance
17-alpha-alkylated androgens such as oxandrolone can cause cholestatic hepatitis and jaundice at relatively low doses. Peliosis hepatis and liver-cell tumours (benign and malignant) are boxed-warning risks. The prescribing clinician decides to discontinue oxandrolone and investigate if liver function tests become abnormal.
Overdose note
No specific symptoms or signs of overdose established in the historical label. Sodium and water retention may occur. No specific antidote; gastric lavage may be considered by the treating clinician. Contact a poison centre for guidance. (2) (3)
Frequently asked questions
Is oxandrolone still FDA-approved in the United States?
No. The FDA withdrew approval of all oxandrolone tablet applications (brand and generic) effective 28 June 2023. The historical prescribing information is included for reference, but the product is no longer marketed in the US through these approved applications. (3) (4)
Can oxandrolone improve athletic performance?
No. Anabolic steroids have not been shown to enhance athletic ability. Using them for this purpose carries serious health risks. (2)
What are the most serious risks of oxandrolone?
The US label carried a boxed warning for peliosis hepatis (blood-filled cysts in the liver and sometimes spleen that can cause life-threatening liver failure or internal bleeding), liver-cell tumours (some fatal), and marked blood-lipid changes that increase the risk of atherosclerosis and coronary artery disease. Liver injury signs include upper-right stomach pain, yellowing of skin/eyes, severe fatigue, and unusual bruising or bleeding — seek emergency care immediately. (2) (1)
What is the mechanism of action of oxandrolone?
Oxandrolone is a synthetic androgenic anabolic steroid that increases the amount of protein made by the body, which is used to build more muscle and increase body weight. (2) (3)
References
- Oxandrolone: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-10-13 · source 1
- OXANDRIN (oxandrolone) tablets, for oral use — prescribing informationDailyMed, U.S. National Library of Medicine · United States · dated 2007 · accessed 2026-10-13 · source 2
- Oxandrolone Tablets; Withdrawal of Approval of New Drug ApplicationU.S. Food and Drug Administration · United States · dated 2023-06-28 · accessed 2026-10-13 · source 3
- Determination That OXANDRIN (Oxandrolone) Tablets, 2.5 Milligrams and 10 Milligrams, Were Withdrawn From Sale for Reasons of Safety or EffectivenessU.S. Food and Drug Administration · United States · dated 2023-09-13 · accessed 2026-10-13 · source 4
Brand names by country
Single-ingredient oxandrolone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.