OXYMETHOLONE
(ox-i-meth'oh-lone)
Anadrol, Anadrol-50, Anapolon

Classifications: hormones and synthetic substitutes; androgen/anabolic steroid
Prototype: Testosterone
Pregnancy Category: X
Controlled Substance: Schedule III

Availability

50 mg tablets

Actions

Potent steroid with anabolic activity. Mechanism of action in refractory anemias is unclear but may be due to direct stimulation of bone marrow, protein anabolic activity, or to androgenic stimulation of erythropoiesis.

Therapeutic Effects

Promotes body tissue building and inhibits tissue-depleting processes; supports nitrogen, potassium, chloride, and phosphorus conservation. Enhances weight gain and combats depression and weakness in debilitating conditions. Stimulates bone growth, aids in bone matrix reconstitution, and may support calcification of metastatic lesions of breast cancer.

Uses

Aplastic anemia.

Unlabeled Uses

Osteoporosis, catabolic conditions.

Contraindications

Prostatic hypertrophy with obstruction; pregnancy (category X); prostatic or male breast cancer; cardiac, renal, hepatic decompensation; nephrosis; premature infant; use during lactation is not established.

Cautious Use

Prepubertal males; geriatric male patients; diabetes mellitus; coronary disease; patient taking ACTH, corticosteroids, anticoagulants.

Route & Dosage

Aplastic Anemia
Adult/Child: PO 1–5 mg/kg/d

Administration

Oral

A course of therapy for treatment of osteoporosis is 7–21 d.
For treatment of anemias, a minimum trial period of 3–6 mo is recommended, since response tends to be slow.
Store at 15°–30° C (59°–86° F). Protect from heat and light.

Adverse Effects (1%)

Endocrine: Androgenic in women: Suppression of ovulation, lactation, or menstruation; hoarseness or deepening of voice (often irreversible); hirsutism; oily skin; acne; clitoral enlargement; regression of breasts; male-pattern baldness (in disseminated breast cancer). Hypoestrogenic effects in women: Flushing, sweating; vaginitis with pruritus, drying, bleeding; menstrual irregularities. Men: prepubertal: premature epiphyseal closure, phallic enlargement, priapism. Postpubertal: testicular atrophy, decreased ejaculatory volume, azoospermia, oligospermia (after prolonged administration or excessive dosage), impotence, epididymitis, gynecomastia. CV: Edema, skin flush. GI: Nausea, vomiting, anorexia, diarrhea, jaundice, hepatotoxicity. Urogenital: Bladder irritability. Metabolic: Hypercalcemia.

Interactions

Drug: May enhance hypoprothrombinemic effects of warfarin. Herbal: Echinacea may increase risk of hepatotoxicity.

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Metabolism: Metabolized in liver. Elimination: Excreted in urine. Half-Life: 9 h.

Nursing Implications

Assessment & Drug Effects

Monitor patient with a history of seizures closely because an increase in their frequency may be noted.
Monitor periodically for edema that may develop with or without CHF.
Monitor for hypercalcemia (see Appendix F), especially in women with breast cancer.
Lab tests: Periodic serum calcium; periodic liver function tests are especially important for the older adult patient. Drug should be stopped with first sign of liver toxicity (jaundice).

Patient & Family Education

Monitor blood glucose for loss of glycemic control if diabetic.
Women: Notify physician of signs of virilization.
Do not breast feed while taking this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug