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Not medical advice. The Atlas is not a substitute for a clinician who can examine you.

Oxymetholone

Anadrol / Anadrol-50; oral 17aa AAS

Evidence grade 3 of 5, Mixed. Read how the Atlas grades evidence.

The written rationale for this grade is still being prepared.

FDA
FDA-approved (Anadrol-50) for anemias of deficient red-cell production; Schedule III
WADA
Prohibited at all times (S1 Anabolic Agents).

Reference only. Not medical advice.

This is something to take to a clinician. The Atlas can tell you what is known about oxymetholone in general. It cannot tell you what is happening in your body, and the difference matters most for exactly the symptoms that bring people to this page.

Oxymetholone (Anadrol-50) is an oral 17-alpha-alkylated DHT-derivative that remains FDA-approved for anemias due to deficient red-cell production (acquired and congenital aplastic anemia, myelofibrosis, hypoplastic anemias from myelotoxic drugs). It is one of the most powerful, and most hepatotoxic, oral steroids; despite being non-aromatizing, it produces estrogen-like effects (water retention, gynecomastia) through other mechanisms. Its liver risk (cholestasis, peliosis hepatis, hepatic tumors) and marked HDL suppression are central to its harm profile.

A potent anemia drug and one of the most hepatotoxic oral steroids.

What people take it for

These are the reasons people give for taking it. They are not effects it has been shown to have.

  • Aplastic and hypoplastic anemias; myelofibrosis (approved)
  • HIV-wasting (historical/off-label study)
  • Illicit physique 'bulking' use
Anemias of deficient red-cell production
The approved indication: acquired/congenital aplastic anemia, myelofibrosis, and hypoplastic anemias from myelotoxic drugs.
HIV-associated wasting (studied)
Investigated for catabolic weight loss in HIV.

How it is supposed to work

Oxymetholone strongly stimulates erythropoiesis (its therapeutic basis) and drives muscle protein synthesis via the androgen receptor. It does not aromatize, yet causes water retention and gynecomastia, attributed to direct estrogen-receptor interaction and/or progestogenic-like activity rather than aromatization.

A DHT-derived steroid with a 2-hydroxymethylene group and 17-alpha-alkylation (oral activity and hepatotoxicity).

Estrogenic effects without aromatization, and serious liver risk

Oxymetholone illustrates that 'non-aromatizing' does not mean 'no estrogenic side effects': it can cause water retention and gynecomastia through non-aromatase mechanisms. More importantly, it is among the most hepatotoxic AAS, with label warnings for peliosis hepatis and liver-cell tumors, and it sharply depresses HDL.

Safety in detail

This intervention involves significant physiological effects and requires evaluation and monitoring by a qualified physician. Self-administration without medical oversight carries documented health risks.

  • High 17aa hepatotoxicity: cholestasis, peliosis hepatis, hepatic tumors (per label).
  • Severe HDL suppression.
  • Water retention, hypertension, gynecomastia despite non-aromatization.
  • HPTA suppression; virilization in women.
  • Polycythemia from strong erythropoietic effect.

Replacement is not the same as a cycle

Approved anemia dosing is hematologist-supervised with monitoring. Physique use is supraphysiological and unmonitored, amplifying hepatic, lipid and cardiovascular risk. No dosing guidance is provided here.

What it does to fertility

Suppresses LH/FSH and spermatogenesis; subfertility during use, with variable recovery afterward.

What has to be monitored

The bloodwork this needs, and the reason it belongs with a clinician rather than a website.

  • Liver function
  • Lipid panel
  • Hematocrit/hemoglobin
  • LH/FSH, testosterone
  • Blood pressure

What people get wrong

  • Often said'Anadrol does not aromatize, so no bloat or gyno'

    ActuallyIt is non-aromatizing yet still causes water retention and gynecomastia via other mechanisms, plus severe HDL suppression and high hepatotoxicity.

  • Often said'It is fine because it is still an FDA drug'

    ActuallyApproval is for serious anemias under hematologist supervision; physique use applies far higher, unmonitored exposure with documented hepatic and cardiovascular risk.

Who profits, and who pushes back

Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.

How we got here

Oxymetholone was introduced around 1960 (Syntex; Anadrol-50). It became a standard androgen therapy for aplastic and other anemias before recombinant erythropoietin and modern hematologic options reduced its role, and it retains an FDA anemia indication. It simultaneously became a notorious 'bulking' oral in physique culture.

  1. ~1960Oxymetholone introduced (Syntex, Anadrol-50)
  2. 1960s-80sMainstay androgen for aplastic/hypoplastic anemias
  3. 1990sStudied in HIV-wasting; partly displaced by EPO in anemia
  4. PresentRetains FDA anemia indication; widely misused illicitly

At a glance

Class
Oral 17a-alkylated DHT-derivative
Half-life
~8-9 hours
FDA indication
Anemias of deficient red-cell production
Aromatization
None (yet estrogen-like effects occur)

What this entry does not yet cover

What follows is unfinished work on our side, not a finding about Oxymetholone. A short entry is not a safe entry.

  • Cost and market. We have not documented what it sells for or who sells it.
  • Supply chain. We have not mapped where it is made.
  • Who uses it. We have not documented the user groups.
  • What could change. No forward-looking summary yet.
  • How it compares. We have not set it against the alternatives.
  • Children and teenagers. We have not checked what is known about younger people.
  • What can go wrong. We have not written the risk line for this one. Read the safety section below rather than treating its absence as reassurance.
  • Where we land. We have not taken a position on this yet.

Sources

The studies below are named and described, but not linked. You cannot open them from here and check our reading against them, which means this page is our summary of the literature rather than a document you can verify. Weigh it accordingly until the links exist.

The studies that matter

  • Review of oxymetholone as a 17a-alkylated AAS (Pavlatos et al., Clin Ther)2001

    Summarized efficacy in anemia and HIV-wasting alongside hepatotoxicity and lipid risks.

  • Anadrol-50 FDA label warningsongoing

    Carries boxed/serious warnings for peliosis hepatis and hepatic tumors.