Anadrol

Pharmacological Effects

• Anabolic Effects: Promotes protein synthesis and muscle growth. Increases red blood cell (RBC) production via stimulation of erythropoietin. Enhances nitrogen retention, leading to a positive nitrogen balance.
• Androgenic Effects: Binds to androgen receptors, exerting masculinizing effects such as deepening of the voice and increased body hair growth. May cause virilization in women (e.g., clitoral enlargement, menstrual irregularities).
• Hematopoietic Effects: Used in certain anemias (e.g., aplastic anemia) due to its ability to stimulate bone marrow function and RBC production.

Indications

• Aplastic Anemia: Used to stimulate erythropoiesis (red blood cell production) in acquired or congenital aplastic anemia, particularly when bone marrow hypofunction is present.
• Other Refractory Anemias: May be used in certain cases of myelodysplastic syndromes (MDS) or bone marrow failure syndromes where anemia is unresponsive to conventional treatments.
• Osteoporosis (Limited Use – Historical): Previously used for osteoporosis management due to anabolic bone-strengthening effects, but rarely used now due to safer alternatives.

Key Considerations (BP Guidelines):

• Not a first-line treatment — used only when other therapies (e.g., erythropoietin, transfusions) are ineffective.
• Requires strict monitoring (liver function, hematocrit, lipid profile, and signs of virilization in women).
• Avoid in non-medical use (e.g., bodybuilding) due to severe hepatotoxicity and cardiovascular risks.

Recommended Dose

• Standard Dosage (Adults):
  • Aplastic & Refractory Anemias: 1–2 mg/kg/day (typically 50–100 mg/day in divided doses).
  • Maintenance: After hematologic response, reduce to 25–50 mg/day.
  • Duration: 3–6 months maximum (prolonged use increases hepatotoxicity risk).
• Elderly or Debilitated Patients: 0.5–1 mg/kg/day (lower dose due to toxicity risk).
• Pediatric Use (Specialist Supervision): 1–5 mg/kg/day with close monitoring for growth and androgenic effects.

Administration Guidelines (BP):

• Administer orally, usually in divided doses (2–3 times daily with food to reduce GI irritation).

Side Effects

• Hepatotoxicity (jaundice, peliosis hepatis, liver tumors).
• Polycythemia and hypertension.
• Fluid retention and edema.
• Gynecomastia and testicular atrophy.
• Viriliza