Classifications: hormone; androgen/anabolic steroid;
Therapeutic: anabolic steroid

Prototype: Testosterone
Pregnancy Category: X
Controlled Substance: Schedule III


50 mg tablets


Potent steroid with anabolic activity. Mechanism of action in refractory anemias is unclear but may be due to direct stimulation of bone marrow, protein anabolic activity, or to androgenic stimulation of erythropoiesis.

Therapeutic Effect

Stimulates formation of red blood cells in the bone marrow. Stimulates bone growth, aids in bone matrix reconstitution.


Aplastic anemia.

Unlabeled Uses

Osteoporosis, catabolic conditions.


Prostatic hypertrophy with obstruction; pregnancy (category X); prostatic or male breast cancer; cardiac, renal, hepatic decompensation; nephrosis; premature infant; use during lactation is not established.

Cautious Use

Prepubertal males; geriatric male patients; diabetes mellitus; coronary disease; patient taking ACTH, corticosteroids, anticoagulants.

Route & Dosage

Aplastic Anemia
Adult/Child: PO 1–5 mg/kg/d


  • A course of therapy for treatment of osteoporosis is 7–21 d.
  • For treatment of anemias, a minimum trial period of 3–6 mo is recommended, since response tends to be slow.
  • Store at 15°–30° C (59°–86° F). Protect from heat and light.

Adverse Effects (≥1%)

Endocrine: Androgenic in women: Suppression of ovulation, lactation, or menstruation; hoarseness or deepening of voice (often irreversible); hirsutism; oily skin; acne; clitoral enlargement; regression of breasts; male-pattern baldness (in disseminated breast cancer). Hypoestrogenic effects in women: Flushing, sweating; vaginitis with pruritus, drying, bleeding; menstrual irregularities. Men: prepubertal: premature epiphyseal closure, phallic enlargement, priapism. Postpubertal: testicular atrophy, decreased ejaculatory volume, azoospermia, oligospermia (after prolonged administration or excessive dosage), impotence, epididymitis, gynecomastia. CV: Edema, skin flush. GI: Nausea, vomiting, anorexia, diarrhea, jaundice, hepatotoxicity. Urogenital: Bladder irritability. Metabolic: Hypercalcemia.


Drug: May enhance hypoprothrombinemic effects of warfarin. Herbal: Echinacea may increase risk of hepatotoxicity.


Absorption: Readily from GI tract. Metabolism: In liver. Elimination: In urine. Half-Life: 9 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor patient with a history of seizures closely because an increase in their frequency may be noted.
  • Monitor periodically for edema that may develop with or without CHF.
  • Monitor for hypercalcemia (see Appendix F), especially in women with breast cancer.
  • Lab tests: Periodic serum calcium; periodic liver function tests are especially important for the older adult patient. Drug should be stopped with first sign of liver toxicity (jaundice).

Patient & Family Education

  • Monitor blood glucose for loss of glycemic control if diabetic.
  • Women: Notify physician of signs of virilization.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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