STANOZOLOL
(stan-oh'zoe-lole)
Winstrol
Classifications: hormones and synthetic substitutes; androgen/anabolic steroid
Prototype: Testosterone
Pregnancy Category: X
Controlled Substance: Schedule III

Availability

2 mg tablets

Actions

Synthetic steroid with relatively strong anabolic and weak androgenic activity, similar to those for testosterone.

Therapeutic Effects

Increases protein metabolism and decreases catabolism through anabolic action. Can cause testicular atrophy. Androgenic activity controls secondary sex characteristics, adolescent growth spurts, as well as stimulation of renal production of erythropoietin.

Uses

Primarily to increase hemoglobin in selected cases of aplastic anemia, prophylaxis to decrease the frequency and severity of hereditary angioedema.

Contraindications

Male patients with carcinoma of the breast or with known or suspected carcinoma of the prostate; carcinoma of the breast in females with hypercalcemia; androgenic anabolic steroids may stimulate osteolytic resorption of bone; nephrosis, or the nephrotic phase of nephritis; pregnancy (category X)—use may be fatal; lactation.

Cautious Use

Diabetic patients; bleeding disorders, concurrent administration of anticoagulants; hepatic impairment; hypercholesterolemia.

Route & Dosage

Anemia
Adult: PO 2 mg t.i.d.; young women, 2 mg 1–2 times/d
Child: PO <6 y, 1 mg b.i.d.; 6–12 y, 2 mg t.i.d.

Administration

Oral

Adverse Effects (1%)

CNS: Excitation, insomnia. CV: Skin flushing and vascularization. GI: Nausea, vomiting, anorexia, diarrhea, gastric pain, jaundice. Hematologic: Leukopenia. Metabolic: Hypercalcemia, hypercholesterolemia, sodium and water retention (especially in older adults) with edema. Renal: Renal calculi (especially in the immobilized patient), bladder irritability. Urogenital: Increased libido. Skin: Acne, injection site irritation and sloughing. Body as a Whole: Hypersensitivity to testosterone, anaphylactoid reactions (rare). Hematologic: precipitation of acute intermittent porphyria. Endocrine: Female–Suppression of ovulation, lactation, or menstruation; hoarseness or deepening of voice (often irreversible); hirsutism; oily skin; clitoral enlargement; regression of breasts; male-pattern baldness (in disseminated breast cancer); flushing, sweating; vaginitis with pruritus, drying, bleeding; menstrual irregularities. Male–Prepubertal: premature epiphyseal closure, phallic enlargement, priapism. Postpubertal: Testicular atrophy, decreased ejaculatory volume, azoospermia, oligospermia (after prolonged administration or excessive dosage), impotence, epididymitis, priapism, gynecomastia.

Interactions

Drug: Prolongs action of succinylcholine and possibly other neuromuscular blocking agents due to inhibition of plasma pseudocholinesterase. Increases theophylline concentrations twofold. Cimetidine increases concentration of tacrine by 64%. May deplete iron stores; may increase risk of bleeding with oral anticoagulants. Herbal: Echinacea may increase risk of hepatotoxicity.

Pharmacokinetics

Metabolism: Metabolized in liver. See testosterone.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


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