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Hoarseness, acne, changes in menstrual periods, or more facial hair. All patients: Nausea, vomiting, changes in skin color, or ankle swelling. Geriatric Use: Certain geriatric use information is protected by marketing exclusivity. Women with disseminated breast carcinoma should have frequent determination of urine and serum calcium levels during the course of therapy (see WARNINGS ). Because of the hepatotoxicity associated with the use of 17-alpha-alkylated androgens, liver function tests should be obtained periodically. Periodic (every 6 months) x-ray examinations of bone age should be made during treatment of children to determine the rate of bone maturation and the effects of androgen therapy on the epiphyseal centers. Androgenic anabolic steroids have been reported to increase low-density lipoproteins and decrease high-density lipoproteins. Therefore, caution is required when administering these agents to patients with a history of cardiovascular disease or who are at risk for cardiovascular disease. Serum determination of lipid levels should be performed periodically and therapy adjusted accordingly. Hemoglobin and hematocrit should be checked periodically for polycythemia in patients who are receiving high doses of anabolic steroids. Anabolic steroids may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may have to be decreased in order to maintain desired prothrombin time. Patients receiving oral anticoagulant therapy require close monitoring, especially when anabolic steroids are started or stopped. A multidose study of Oxandrolone, given as 5 or 10 mg BID in 15 healthy subjects concurrently treated with warfarin, resulted in a mean increase in S-warfarin half-life from 26 to 48 hours and AUC from 4. Microscopic hematuria (9/15) and gingival bleeding (1/15) were also observed. When Oxandrolone therapy is initiated in a patient already receiving treatment with warfarin, the INR or prothrombin time (PT) should be monitored closely and the dose of warfarin adjusted as necessary until a stable target INR or PT has been achieved, trenaject 100 mg injectable steroids $59.00 trenbolone acetate. Furthermore, in patients receiving both drugs, careful monitoring of the INR or PT, and adjustment of the warfarin dosage if indicated are recommended when the Oxandrolone dose is changed or discontinued. Patients should be closely monitored for signs and symptoms of occult bleeding. Oral Hypoglycemic Agents: Oxandrolone may inhibit the metabolism of oral hypoglycemic agents. Adrenal Steroids or ACTH: In patients with edema, concomitant administration with adrenal cortical steroids or ACTH may increase the edema. Anabolic steroids may decrease levels of thyroxine-binding globulin, resulting in decreased total T 4 serum levels and increased resin uptake of T 3 and T 4. Free thyroid hormone levels remain unchanged. In addition, a decrease in PBI and radioactive iodine uptake may occur. Carcinogenesis, Mutagenesis, Impairment of Fertility. Oxandrolone has not been tested in laboratory animals for carcinogenic or mutagenic effects.
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