Oxymetholone

Compound and historical use

Oxymetholone is a synthetic androgen, historically sold as Anadrol-50 and Anapolon. Its medical use centered on anemias caused by poor red-cell production, including aplastic anemia and some marrow disorders.^596,597,598

The 1983 withdrawal

In 1983, FDA withdrew several lower-strength oxymetholone products for lack of substantial evidence of effectiveness. The notice explicitly excluded Anadrol-50 50 mg for certain anemias. The strength and indication are essential to reading that history correctly.⁶⁰⁰

Records outside the US

South Korea's current MFDS product record lists a 50 mg oxymetholone tablet for aplastic anemia and marrow depletion due to myelofibrosis. Canada's two Anapolon 50 records are marked Cancelled Post Market.^601,602

Body composition and strength

The same trial recorded adverse changes

HDL cholesterol fell by an average of 19 and 23 mg/dL in the active groups. In the higher-exposure group, ALT rose by an average of 72 U/L.⁶⁰³

HIV-associated wasting

A 16-week trial enrolled 89 women and men with HIV-associated wasting. Oral treatment groups gained about 3.0 to 3.5 kg, compared with 1.0 kg on placebo, and reported better appetite and food intake. ALT rose above five times baseline in 35% of the three-times-daily group, 27% of the twice-daily group and 0% of placebo recipients.⁶⁰⁴

Dialysis research

In a 24-week randomized study of 44 people receiving hemodialysis, the oxymetholone group gained more fat-free mass and showed changes in insulin-resistance measures. Two of the 21 treated participants developed raised liver enzymes.⁶⁰⁵

The kidney-anemia review

A 2014 Cochrane review found insufficient evidence that androgen treatment benefits adults with kidney-disease anemia. Its eight small studies involved 181 people across different androgens. The single 24-person oxymetholone study reported higher hemoglobin alongside raised liver enzymes and lower HDL.⁶⁰⁶

The anemia evidence

Recent Thai follow-up

A 2025 observational analysis included 110 of 145 adults with aplastic anemia. Among those treated for at least 30 days, 56.4% met the response criteria at six months. Seventeen stopped because of adverse effects, including 15 with hepatitis. The analysis excluded 26 people treated for less than 30 days, including 12 who died, and nine others lost to follow-up.⁶⁰⁷

Disease severity changed the result

A separate retrospective analysis matched 74 treated patients by age, sex and time to treatment. One-year response was 54.1% in nonsevere aplastic anemia and 13.5% in severe or very severe disease. Both groups received oxymetholone; the comparison describes differences between severity groups.⁶⁰⁸

Japanese clinical studies

A 1978 Japanese series treated 35 people with aplastic anemia using oxymetholone or methenolone. Twenty-four improved and 18 reached partial or complete remission; the reported results pooled the two drugs. A later rehabilitation study enrolled 25 people with neurologic disease. Thirteen received oxymetholone during training and showed greater gains in nonparetic-limb strength and muscle area, while five developed raised AST or ALT.^609,610

Liver, hormones and interactions

Liver injury

The historical label warns about cholestatic hepatitis, peliosis hepatis and liver tumors. FDA's updated DILIrank dataset places oxymetholone in its highest liver-injury-concern category. A 2026 case report describes severe cholestatic injury after reported oxymetholone and testosterone use; both exposures and the untested products complicate attribution.^597,611,612

Hormonal effects

The label describes reduced testicular function and sperm production, menstrual changes, acne and virilization. Some changes in women, including voice deepening, can persist after treatment stops. Pregnancy is contraindicated because of fetal risk.⁵⁹⁷

Other medicines and fluid retention

The label calls for close clotting-test monitoring with warfarin. It also describes altered glucose-lowering requirements, thyroid-test changes and edema, especially in people with heart, kidney or liver disease. Corticosteroids or ACTH can add to fluid retention.⁵⁹⁷

Current products and sport

A study of 61 seized prison samples found widely varying steroid concentrations and multiple drugs in some samples; oxymetholone was the most frequently detected anabolic steroid. WADA names it in S1.1, prohibited at all times in the 2026 list and the published 2027 list, which takes effect January 1, 2027.^613,614,615

Common questions

The questions readers ask, answered from the studies.

01 What doses and durations were actually studied, and is there a human half-life?

Historical studies used oral oxymetholone in very different populations: a single 50 mg dose in healthy volunteers, 50 or 100 mg daily for 12 weeks in 31 older men, and 50 mg twice or three times daily for 16 weeks in 89 people with HIV-associated wasting. The human PK abstract reports a mean peak at 210 minutes but no terminal half-life; the 5.56-hour value comes from a single-gavage study in male rats.^{616,603,604,617}

02 What did human studies find for lean mass, strength, weight and water retention?

Lean mass includes water. In 31 men aged 65 to 80, 12 weeks increased lean mass by 3.3 kg and 4.2 kg in the two active groups versus 0.0 kg with placebo and improved upper-body strength; HDL fell by 19 and 23 mg/dL, and average ALT rose by 72 U/L in the higher-exposure group.⁶⁰³

03 Were injectable or sublingual forms studied like the historical tablet?

The verified human evidence behind this chapter concerns oral tablets. Injectable and sublingual formulations have no verified human clinical data in these sources.^597,616,603

04 What was oxymetholone used for, and is Anadrol-50 still marketed?

Oxymetholone was historically labeled for selected anemias caused by deficient red-cell production. Drugs@FDA currently lists the 50 mg Anadrol-50 oral tablet as Discontinued, while its application history and old label remain available.^597,599

05 Why do people ask about breast swelling if oxymetholone does not aromatize?

The historical label lists gynecomastia in males and edema, but that information is not enough to identify the mechanism behind breast swelling.⁵⁹⁷

06 What is known about appetite, nausea and stomach symptoms?

In the 89-person HIV-wasting trial, participants reported improved appetite and food intake during treatment. The historical label separately lists nausea, vomiting and diarrhea without reliable frequency estimates.^604,597

07 What harms were recorded in people?

Human studies recorded liver-enzyme rises, lower HDL, hormone suppression and edema alongside changes in weight, lean mass or blood counts. The historical label also warns about cholestatic hepatitis, peliosis hepatis, liver tumors, virilization and fluid retention.^{603,604,597,618,612}

08 Which interactions are documented, and what is unknown about combinations?

The historical label calls for close INR or prothrombin-time monitoring with warfarin and notes that glucose-lowering requirements and total T4 tests can change. The trials behind this chapter do not establish the safety of performance-drug combinations.⁵⁹⁷

09 Does an Anadrol label prove what is inside a current product?

No. The FDA record documents a historical product and application. Verifying the contents of a product sold now requires testing that product. A study of 61 seized prison samples found large variation in anabolic-steroid concentrations and multi-drug samples, but that sample cannot estimate the whole market.^599,613

10 What is known about libido, sperm production and hormone suppression?

The historical label lists inhibition of testicular function, testicular atrophy, low sperm production, menstrual changes and increased or decreased libido. It does not provide a typical recovery timeline after stopping.⁵⁹⁷

11 How serious are the documented liver risks?

In the 89-person HIV-wasting trial, ALT rose above five times baseline in 35% of the three-times-daily group, 27% of the twice-daily group and 0% of placebo during the double-blind phase. The historical label warns about cholestatic hepatitis, peliosis hepatis and liver tumors, and FDA places oxymetholone in its highest liver-injury-concern category.^604,597,611

12 What is known about mood, sleep, headaches and fatigue?

The historical label lists excitation and insomnia, along with increased or decreased libido. It does not give reliable rates for headache or fatigue.⁵⁹⁷

13 What did studies show about HDL, cholesterol and cardiovascular risk markers?

In the 31-man older-adult trial, HDL fell by an average of 19 mg/dL and 23 mg/dL in the two active groups over 12 weeks.⁶⁰³

14 Can oxymetholone affect hair or skin?

The historical label lists acne, hirsutism and male-pattern hair loss in women; their frequency was not reported.⁵⁹⁷

15 What did the human PK study measure about peak timing?

After one 50 mg oral dose, the human analytical study reported a mean peak concentration of 18.8 ng/mL at 210 minutes. Its abstract does not report food conditions, participant count or terminal half-life.⁶¹⁶