Anadrol (Oxymetholone): Medical History, Legal Status and Risks

Anadrol is the brand name for oxymetholone, a steroid pill. Unlike many steroids used in gyms, it was once a real medicine in the United States, approved to treat certain types of anemia. This page explains its medical history, its current status and the risks described on its own label.

Quick facts

Key facts: Oxymetholone is a steroid pill. Its US brand, Anadrol-50, was approved to treat anemias caused by low red blood cell production, and it is now listed as discontinued. It is a Schedule III controlled substance, and its label warned of liver cysts, liver tumors and harmful cholesterol changes.

What oxymetholone is

Oxymetholone is a lab-made steroid based on testosterone. Like other steroid pills, it carries a methyl group at position 17 (it is 17α-alkylated). That change lets it survive the liver when swallowed, but it also makes it toxic to the liver, as the Endocrine Connections review explains.

Medical history

Oxymetholone was approved in the United States as Anadrol-50 tablets. According to the drug's FDA label, it was used to treat anemias caused by deficient red blood cell production. The label named:

• acquired and congenital aplastic anemia
• myelofibrosis
• anemias caused by drugs that suppress the bone marrow

The label stressed that it should not replace other care, such as blood transfusions or correcting iron and vitamin deficiencies.

Today, Anadrol-50 is listed as discontinued in the FDA's Drugs@FDA database.

How it is misused

Among people who misuse steroids, oxymetholone is used to gain size and strength. In a Dutch study of 100 steroid users, 15% reported using it during a cycle.

Health risks

The most striking warnings come from oxymetholone's own label. It warned that:

• Peliosis hepatis can occur. In this condition, liver tissue is replaced with blood-filled cysts. It may cause no symptoms until the liver fails or bleeds, which can be deadly.
• Liver tumors have been reported. Most were benign, but fatal cancers also occurred. These tumors may be silent until they bleed.
• Cholesterol changes happen. "Good" HDL cholesterol falls, and "bad" LDL cholesterol sometimes rises. The label said these changes may be very marked and could raise the risk of heart disease.

The FDA label for testosterone enanthate lists the serious problems reported in people who misuse steroids. They include heart attack, heart failure, stroke, liver damage and serious mental health problems such as major depression, mania, paranoia and aggression. Men can get shrunken testicles and become infertile. Women can get a deeper voice, more facial and body hair, male-pattern baldness and changes to their periods. In teens, bones can stop growing too early.

Large studies back this up. In a Danish study, men who tested positive for steroids had three times the death rate of similar men. A heart study found weaker heart muscle and more plaque in the arteries of long-term users.

Illicit products carry another risk. When Dutch researchers tested steroids used by 100 people, only about half held the drug named on the label, according to a review in Endocrine Connections. Some held no active drug at all.

Legal status

In the United States, oxymetholone is a Schedule III controlled substance. It is named in the federal list of anabolic steroids, 21 CFR 1308.13. It is a federal crime to have or sell it without a valid prescription.

In sport, it is banned at all times, in and out of competition, by the World Anti-Doping Agency.

Frequently asked questions

Was Anadrol ever FDA-approved?

Yes. Anadrol-50 was approved to treat anemias caused by low red blood cell production. It is now listed as discontinued.

Is Anadrol legal?

Not without a prescription in the United States, and no Anadrol product is currently marketed. Oxymetholone is a Schedule III controlled substance.

What are the main risks of Anadrol?

Its label warned of blood-filled liver cysts, liver tumors including fatal cancers, and cholesterol changes that may raise the risk of heart disease.

Is oxymetholone a steroid pill?

Yes. It is an oral, 17α-alkylated steroid, the type most linked to liver damage.

Sources

• U.S. Food and Drug Administration: Anadrol-50 (oxymetholone) label, 2004
• U.S. Food and Drug Administration: Drugs@FDA, NDA 016848
• FDA-approved label: testosterone enanthate injection (Drug Abuse and Dependence)
• de Ronde W, Smit DL. Anabolic androgenic steroid abuse in young males. Endocr Connect. 2020
• Horwitz H, et al. Health consequences of androgenic anabolic steroid use. J Intern Med. 2019
• Baggish AL, et al. Cardiovascular toxicity of illicit anabolic-androgenic steroid use. Circulation. 2017
• U.S. Code of Federal Regulations: 21 CFR 1308.13, Schedule III
• World Anti-Doping Agency: Prohibited List