Oxymetholone, sold as Anadrol-50, is one of the few anabolic steroids still approved as a prescription medicine in North America. Its approved job is treating anemia. Its reputation in gyms is fast strength and size. Both come from the same powerful oral compound, and so do its risks.
- Oxymetholone is a 17-alpha-methylated derivative of DHT, active by mouth.
- The Anadrol-50 label for anemia uses 1 to 5 mg per kilogram of body weight a day, with results usually seen over three to six months.
- It is one of the hardest oral steroids on the liver, with rare but serious complications in long-term medical use.
- Despite not converting to estrogen through aromatase, it often causes water retention and estrogen-like effects.
An anemia drug first
Oxymetholone was introduced in the early 1960s. It stimulates red blood cell production, partly by increasing erythropoietin, and was used for anemias caused by bone marrow failure and kidney disease. It has also been studied in HIV-related wasting. Its medical use has narrowed as newer treatments arrived, but the label remains a useful reference for what the drug does to the body.
Why it is used for strength
Many users report sharp strength gains within the first couple of weeks along with rapid weight gain. Some of that weight is water and glycogen. Oxymetholone also raises red-cell production, which in medicine is the point and in lifters is a risk, because a high hematocrit thickens the blood.
The estrogen puzzle
Oxymetholone is a DHT derivative and cannot be aromatised to estrogen. Yet users commonly report water retention, raised blood pressure and even gynecomastia. Researchers believe the molecule may act on the estrogen receptor directly or through its metabolites. The practical point is that an aromatase inhibitor may not prevent these effects.
Side effects
Liver
The label warns about peliosis hepatis (blood-filled cysts in the liver), liver tumours and cholestatic jaundice with long-term use. Liver enzymes often rise within weeks. These are the reasons oral steroids are kept to short periods and liver bloodwork is essential.
Blood pressure and blood count
Water retention and a rising red-cell count both push blood pressure and clot risk up. Our article on tracking blood pressure explains how to measure it properly at home.
Cholesterol
HDL falls and LDL rises, as with other oral steroids.
Other effects
Headaches, nosebleeds linked to blood pressure, reduced appetite in some users, acne and suppression of natural testosterone are commonly reported.
Yellowing skin or eyes, dark urine, pale stools, pain under the right ribs, severe headaches or a blood pressure reading well above your normal are reasons to stop and see a doctor promptly.
Who should not use oxymetholone
The prescribing information lists situations where it should never be used: men with prostate or breast cancer, women who are or may be pregnant, people with severe liver disease and people with nephrosis. It also warns that it increases the effect of blood thinners such as warfarin and can change blood sugar control in diabetes. Those warnings apply just as much outside medicine.
Why short use matters with this compound
In medicine, oxymetholone was used for months under close monitoring because anemia can be life-threatening and the benefit justified the risk. Healthy people do not have that trade-off. The liver complications described on the label became more likely with longer exposure, which is why any use outside medicine is kept brief and checked with bloodwork.
Anadrol compared with Dianabol
Both are fast oral mass builders. Anadrol is generally considered stronger per tablet and harder on the liver; Dianabol produces its estrogen through aromatase. Read Anadrol vs Dianabol for the full comparison.
Bloodwork to discuss with a doctor
Liver panel (ALT, AST, GGT, bilirubin, alkaline phosphatase), complete blood count with hematocrit, lipid panel, kidney markers and blood pressure, before and during use.
Zionova, 50 mg tabletsAnadrol 50 (Oxymetholone)View product
Frequently asked questions
Is Anadrol still prescribed?
It remains approved for certain anemias in some countries, though it is rarely the first choice today.
Why does Anadrol cause water retention if it doesn’t aromatise?
It appears to have direct estrogen-like activity, so water retention and gynecomastia can occur without aromatase being involved.
How long does Anadrol take to work?
Users often notice strength changes within one to two weeks. In anemia, the label describes responses over three to six months.
Educational information only. Nothing here is medical advice or a recommendation to use any product. Anabolic steroids are Schedule IV under the Controlled Drugs and Substances Act. Talk to a doctor and get bloodwork before and after using any compound.
