Review of Oxymetholone: A 17a-Alkylated Anabolic - AFBoard.com

13 Pages·2001·0.86 MB·English

LACINILC .LOVVSCITUEPAREHT 23, NO. 6,200l
weiveR of Oxymetholone: A 17a-Alkylated
Anabolic-Androgenic dioretS
Andrew M. ,sotulvaP MD,’ revilO ,ztluF BS,2 wehttaM J. Monberg, BS,2
and linA qktooV PharmD2
‘Northside ylimaF Medicine, Chicago, ,sionillI and SSECCA2 lacideM Group, ,dtL
notgnilrA Heights, sionillI
TCARTSBA
Background: enolohtemyxO -a5-lyhtem-71-]enelyhtemyxordyh[-2-yxordyh-B71(
)eno-3-natsordna si a detalyklaa71 cinegordna-cilobana diorets dna a citehtnys -avired
evit of .enoretsotset tI has neeb devorppa yb the SU dooF dna gurD noitartsinimdA for
the tnemtaert of saimena desuac yb tneicifed red llec .noitcudorp
Objectives: sihT weiver sezirammus the ,scitenikocamrahp tnerruc dna erutuf lacinilc
,snoitacilppa dna esrevda effects of .enolohtemyxo tnaveleR seiduts were deifitnedi gnisu
a search of @ENILDEM hguorht March 2001, detnemelppus yb ecnerefnoc stcartsba dna
.snoitatneserp
Results: esuaceB of sti cilobana ,seitreporp enolohtemyxo has neeb deiduts for the
tnemtaert of detaicossa-VIH ,gnitsaw nibmorbtitna III ,ycneicifed cirtaidep growth -mi
,tnemriap dna degamad ,muidracoym htiw gniyrav degrees of .sseccus yticixototapeH si
a rojam esrevda effect detaicossa htiw the esu of ,enolohtemyxo htiw citatselohc ecidnuaj
the tsom tnatropmi citapeh edis effect. Less nommoc citapeh edis effects detaicossa htiw
the esu of cinegordna-cilobana sdiorets edulcni sisoilep sitapeh dna noitamrof of citapeh
.sromut llA cinegordna-cilobana sdiorets nac esuac cinegordna edis effects, gnidulcni
,enca ,msitusrih riah ,ssol cillahp/larotilc ,tnemegralne lacov ,segnahc elitcere eussit -mits
,noitalu ,aitsamocenyg ,aehrronema dna segnahc ni odibil dna lauxes .ycnetop
:snoisulcnoC sA si the case htiw ynam cinegordna-cilobana ,sdiorets few -ikocamrahp
citen dna ytilibarelot seiduts were demrofrep erofeb s’enolohtemyxo lavorppa ni the
1960s. tI has ,devorp ,revewoh ot eb na etairporppa tnemtaert eciohc for detceles stneitap
htiw ,aimena fi ylluferac .derotinom
Key words: ,enolohtemyxo cinegordna-cilobana ,diorets ,enoretsotset ,gnitsaw .aimena
nilC( Ther: )108-987:32;1002
detpeccA for noitacilbup hcraM ,72 .1002
Printed in the .ASU Reproduction in whole or part si not permitted.
lKC.91$/10/8192-9410 789
LAClNlLC ’SCITUEPAREHT
NOITCUDORTNI :enoret yeht desaercni negortin ,noitneter
detalumits ,siseioporhtyre and devorpmi
With eht noitalosi fo enoretsotset ni ’,5391 lateleks muiclac .ekatpu yehT ,osla -woh
srehcraeser nageb ot erolpxe laitnetop -pa ,reve dessessop cinegordna ,stceffe -ni
snoitacilp fo enoretsotset ypareht desab gnidulc 4.noitaziliriv
no its cilobana and cinegordna .seitreporp ehT lykla-a71 sevitavired fo -sotset
ylraE seiduts fo yllaro ro yllaretnerap enoret etutitsnoc an tnatropmi class fo
deretsinimda enoretsotset erew -cusnu cinegordna-cilobana sdiorets erugiF( .)1
,lufssec ni trap esuaceb dipar citapeh -ba noitcudortnI fo eht lykla-a71 tneutitsbus
noitpros and noitadarged aiv esahp I otni eht enoretsotset elucelom stneverp
msilobatem detluser ni citueparehtbus cilobatem noitavitcani hguorht noitadixo
stnuoma fo eht enomroh gnihcaer tegrat fo eht yxordyh-71 puorg ot eht otek-71
tissues. oT emocrevo this ,noitatimil -set .puorg sihT egnahc swols msilobatem fo
enoretsot seugolana erew depoleved that eseht ,sdnuopmoc gnisaercni rieht -iffe
had rewols citapeh msilobatem and -orp ycac nehw deretsinimda 3.yllaro
decud regnol cimetsys .erusopxe rehtruF enolohtemyxO -yh[-2-yxordyh&71(
snoitacifidom erew demia at gniretla eht -mitsordna_a5-lyhtem-71-lenelyhtemyxord
cinegordna-cilobana oitar rof( devorpmi )eno-3 is an yllaro evitca detalykla-a71
ytilibarelot and ,)ycaciffe gnisaercni ni cinegordna-cilobana diorets tsrif -ed
oviv ,efil-flah and gnitatilicaf -artsinimda debircs yb dlogniR te a1.5 tI has a ylluf
3y*.noit sihT krow detluser ni eht -leved detarutas gnir-A ,erutcurts hcihw yam -er
tnempo fo >120 citehtnys enoretsotset ecud eht risk fo yticixototapeh erugiF(
.seugolana ehT stceffe fo eseht -moc 6.)2 ,oslA enolohtemyxo stibihxe rehgih
sdnuop erew ralimis ot esoht fo -sotset cilobana ytivitca and rewol cinegordna -ca
HO HO
H enolohtemyxO H enolordnaxO
o&;H2’cH2’6cH2cH;c?&_CH3
enolordnaN etaonaceD I; lolozonatS
erugiF 1. serutcurtS fo ylnommoc desu cinegordna-cilobana .sdiorets
790
W.3
_CH3
_
OH SchZinzer
from
; H
E
modified,
as
HO
OH permission,
Hydroxylase Decarboxylase with
I
H ;I
Reprinted
oxymetholone.
of
Ketoreductase
metabolism
: H
Hepatic
2.
HO.’
o~:l_I..=i.--;‘~~o~~~~tase
Figure
LACINILC ”SCITUEPAREHT
ytivit derapmoc htiw ,enoretsotsetlyhtem ralimis enoretsotset si yletelpmoc debrosba
,enoretsotset dna enoretsotset etanoiporp nehw deretsinimda 41.yllaro ehT -erutcurts
7.)elbaT( ytivitca pihsnoitaler dna lacinilc -irepxe
,yltnerruC enolohtemyxo si devorppa ecne htiw enolohtemyxo tseggus that ti si
yb the SU dooF dna gurD noitartsinimdA llew debrosba after laro .noitartsinimda
)ADF( for the tnemtaert of saimena desuac nO gniretne the ,maertsdoolb -ohtemyxo
yb tneicifed red llec .noitcudorp nI -da enol seogrednu htob phase I dna phase II
,noitid deriuqca or latinegnoc citsalpa 3.msilobatem hguohtlA enolohtemyxo -ni
,aimena ,sisorbifoleym dna citsalpopyh teracts htiw the emorhcotyc 054P (CYP)
saimena eud ot the noitartsinimda of metsys ni ,ortiv ti si ton dezilobatem yb
cixotoleym sgurd netfo dnopser ot siht these .semyzne 5l stI noitcaretni htiw
8.noitacidem Researchers osla evah -duts CYP2D6, ,A3PYC ,2AlPYC or 91C2PYC
dei enolohtemyxo ni the tnemtaert of stluser ni weak noitibihni dna smees ot evah
a yteirav of ,snoitidnoc gnidulcni -VIH elttil lacinilc 5i.ecnacifingis rehtruF lacinilc
detaicossa 9,gnitsaw nibmorhtitna III -ifed seiduts are deriuqer ot elur tuo lla elbissop
O‘,ycneic growth tnemriapmi ni -lihc detaler-PYC gurd 51.snoitcaretni
21,11,nerd dna degamad muidracoym ni ehT yramirp phase I cilobatem -caer
heart 31.eruliaf snoit evlovni noitadixo at ,2C noitcuder at
sihT weiver sezirammus the -ocamrahp ,3C dna noitalyxordyh at C17.16 -xorppA
,scitenik tnerruc dna erutuf lacinilc -ilppa yletami 5% of enolohtemyxo has neeb
,snoitac dna esrevda effects of -htemyxo derevocer ni eniru as setagujnoc of -ulg
.enolo tnaveleR selcitra were deifitnedi cinoruc 71.dica owT rojam detagujnocnu
gnisu a search of @ENILDEM hguorht cidica setilobatem were retal detalosi ni
March 2001, detnemelppus yb ecnerefnoc ,eniru dna 5 ronim cidica ,setilobatem 4
stcartsba dna .snoitatneserp of meht lausunu seco ,sdiorets evah neeb
characterized.‘*J9 ehT effects of these
setilobatem evah ton neeb ,denimreted tub
SCITENIKOCAMRAHP
yeht are ylekilnu ot eb detaler ot -otapeh
detimiL noitamrofni si elbaliava no the cixot effects ni 91.snamuh
citenikocamrahp eliforp of .enolohtemyxo nI ,snamuh laner noitercxe of negortin
hguohtlA ekatpu seiduts of enolohtemyxo gnirud cilobatem sisatsoemoh nac tciderp
evah ton neeb ,detcudnoc the yllarutcurts the cilobana ytivitca of cinegordna-cilobana
.elbaT cinegordna-cilobanA soitar of ylnommoc desu cinegordna-cilobana sdiorets ni -ina
lam 93v7.sledom
negordnA cinegordnA ytivitcA cilobanA ytivitcA
enolohtemyxO 0.45 3.2
enolordnaxO 0.24 3.22
enolorlcnaN etaonaced 14.0-13.0 29.4-92.3
lolozonatS 0.3 2.3-0.2
Values are relative to methyltestosterone, testosterone, or testosterone propionate.
792
A.M. PAVLATOS ET AL.
.sdiorets enolohtemyxO has neeb nwohs .ainepotycobmorht tnemevorpmI retfa
ot eb roirepus ot enoretsotsetlyhtem ni tnemtaert htiw enolohtemyxo derrucco ni
smret fo negortin 02.noitneter tneitapretnI all 4 fo eseht .stneitap
and tneitapartni ytilibairav ekam ti -iffid ehT tifeneb fo negordna ypareht was
tluc ot enimreted a esnopser-esod ,evruc nees ni 3 stneitap htiw deriuqca citsalpa
enolohtemyxO has neeb nwohs ot esaercni 32,aimena ni mohw a tcerid pihsnoitaler
yraniru niteioporhtyre slevel up ot 02.dlof-5 was devresbo neewteb enolobtemyxo esod
and doolb llec .stnuoc ehT rebmun fo -htyre
,setycor ,slihportuen and steletalp deirav
LACINILC SESU
htiw enolohtemyxo ,egasod htiw eht -xe
Acquired dna latinegnoC Anemia noitpec fo eht teletalp tnuoc ni 1 .tneitap
ehT esu fo enolohtemyxo ni 5 nerdlihc
enolohtemyxO has neeb tsom -roht htiw citsalpa aimena was debircsed ni -na
ylhguo deiduts ni eht tnemtaert fo citsalpa rehto tes fo esac ”.stroper llA 5 ,nerdlihc
.aimena ynaM fo eht stceffe fo -htemyxo gnidulcni 2 ohw erew yrotcarfer ot -sotset
,enolo ,revewoh erew yllanigiro detroper enoret ,tnemtaert had a yrotcafsitas enob
ni dehsilbup esac seiduts gnivlovni small worram and lacinilc .esnopser -htemyxO
srebmun fo ;stneitap emos fo eseht era enolo deraeppa ot evah retaerg -orhtyre
dessucsid ni this .noitces esuaceB fo small gnitalumits-citeiop tceffe than -sotset
tneitap ,srebmun emos fo eseht esac stud- ,enoret an noitavresbo that deerga htiw
sei did ton evirra at yllacitsitats -ifingis suoiverp data.25,26
tnac .snoisulcnoc ,sselehtenoN yeht -med nI a ,dezimodnar revossorc lacinilc lairt
etartsno eht yteirav fo uses fo -yxo gnivlovni 143 72,stneitap enolohtemyxo
enolohtem that evah neeb .derolpxe was 1 fo 4 cinegordna-cilobana sdiorets
noissimeR fo ,aimena as detacidni yb desu ot taert aimena ni stneitap gniviecer
sesaercni ni nibolgomeh ot ~12 ,Ld/g -ni .sisylaidomeh ehT nem erew detaert htiw
sesaerc ni etycoluciter ,tnuoc and -mi enolordnan ,etaonaced ,enoretsemyxoulf
tnemevorp ni srebmun fo slihportuen and ,enolohtemyxo ro enoretsotset ,etahtnane
,steletalp has neeb detartsnomed retfa saerehw eht nemow deviecer all drugs -xe
tnemtaert htiw .enolohtemyxo sesaercnI tpec enoretsotset .etahtnane nI all, %71 fo
ni enob worram ytiralullec gnirud -simer eht nem dednopser ot tnemtaert htiw
nois evah neeb .devresbo tnenamreP -er enolohtemyxo esaercni( ni tircotameh fo
,snoissim as llew as snoissimer lasting up ,)%58 derapmoc htiw %4 fo nemow -vah
ot 5 sraey retfa noitassec fo ,ypareht evah gni hcus an .esaercni laretneraP -cilobana
neeb 12.detnemucod cinegordna diorets ypareht was retteb -lot
ehT esnopser ot enolohtemyxo -nimda detare than laro .ypareht saerehW eht laro
deretsi rof 3r shtnom was deiduts ni 45 snoitaraperp erew reisae ot retsinimda and
stneitap htiw evitarefilorpopyh ro -negera had rewef edis stceffe ,ge( ,amotameh
evitare 22.aimena stneitaP htiw -ullecopyh ,)niap yeht osla erew detaicossa htiw a
ral worram had eht tseb ,esnopser htiw 13 yltnacifingis rehgih ecnedicni fo revil -xot
laitrap ro lluf snoissimer ni 18 .sesac A ytici and gniziliriv stceffe P( < .)50.0 larO(
etelpmoc noissimer was deton ylno ni snoitaraperp hcus as enolohtemyxo -med
stneitap ohw did ton evah .ainepotycnap etartsno rehgih yticixototapeh than -rap
fO 7 stneitap htiw ,sisorbifoleym 4 had laretne seipareht esuaceb rehgih gurd
793
LACINILC ’SCITUEPAREHT
snoitartnecnoc are detneserp ot the revil ,enol ,revewoh did ton evorpmi rehtie the
no tsrif pass.) ehT srotagitsevni dedulcnoc ytilauq of esnopser or mret-trohs .lavivrus
that laro cinegordna-cilobana sdiorets
dluohs eb devreser for esu ni sisylaid -ap
Myelojihosis
stneit who are elbanu ot etarelot laretnerap
.snoitaraperp nevelE stneitap htiw decnavda -ifoleym
thgie-ytneif stneitap htiw cinorhc -er sisorb were deiduts ni a retnecitlum
yrotcarf aimena morf enob worram eruliaf evitcepsorp .yduts 3o noitazilamroN of the
were deiduts erofeb dna after tnemtaert larehpirep doolb or laitnatsbus -evorpmi
htiw .enolohtemyxo 2o niteioporhtyrE -xe tnem 3>( g )Ld/nibolgomeh was devresbo
noiterc was decnahne dlof-5> evoba the after 9 of 15 sesruoc of .enolohtemyxo
expected tircotameh level ni 70% of -ap ehT deen for doolb snoisufsnart ceased
.stneit nI 23% of ,stneitap red llec ssam yletelpmoc ni lla 5 stneitap who had -er
was desaercni yb .%02~ ,enolohtemyxO deriuq meht erofeb the .lairt nehW -yxo
,revewoh did ton evorpmi the noitidnoc of enolohtem tnemtaert was decuder or -ni
stneitap who deriuqer tneuqerf red llec ,detpurret 4 stneitap ,despaler hguohtla 2
.snoisufsnart ehT srotagitsevni -mocer of meht dednopser ot a dewener esruoc of
dednem that the esu of enolohtemyxo eb .enolohtemyxo Based no these ,sgnidnif
devreser for stneitap htiw erom etaredom enolohtemyxo yam eb of eulav ni -da
degrees of enob worram eruliaf dna -pmys decnav cases of sisorbifoleym htiw -ena
citamot .aimena saim gniriuqer .noisufsnart
enolohtemyxO was deretsinimda for 2~
shtnom ot 7 stneitap htiw elkcis llec -ena
Myelosuppression
82.aim xiS stneitap showed a dlof-5> -ni
crease ni yraniru ,niteioporhtyre htiw na muihtiL etanobrac sulp enolohtemyxo
esaercni ni red llec ssam gnignar morf was derapmoc htiw muihtil enola ni the
17% ot 75% evoba the lortnoc .eulav ehT tnemtaert of decudni-yparehtomehc -oleym
srohtua detseggus that enolohtemyxo .noisserppus 31 eno-ytneveS stneitap were
thgim eb lufesu ni detceles tluda stneitap dedulcni ni the muihtil ,puorg 63 ni the
htiw elkcis llec esaesid ni mohw ereves tnemtaert-denibmoc ,puorg dna 79 ni the
aimena was gnitubirtnoc ot the ytidibrom lortnoc .puorg hguohtlA the noitidda of
of the .esaesid enolohtemyxo did ton yllaitnatsbus nessel
nI rehtona ,yduts 134 stneitap htiw -ca noisserppusoleym ni tsom ,stneitap ti -mi
deriuq citsalpa aimena were dezimodnar devorp ’stneitap etiteppa dna ydob .thgiew
ot eviecer etycohpmylitna nilubolg dna ehT ytirojam of stneitap ni the muihtil
enolosinderplyhtem htiw or tuohtiw -yxo dna lortnoc spuorg tsol ,thgiew whereas
92.enolohtem ehT esnopser rate at 4 those gniviecer enolohtemyxo deniag
shtnom was yltnacifingis greater ni the thgiew naidem( ydob thgiew ,niag 1.25 ;gk
stneitap gniviecer enolohtemyxo (57% P < 0.001).
[39/69] sv 40% ;]56/62[ P < 0.04). The
tnemevorpmi ni esnopser rate was erom
detaleR-VIH Wasting
decnuonorp ni nemow htiw wol lihportuen
stnuoc naht ni elbarapmoc nem (78% sv hguohtlA cinegordna-cilobana sdiorets
;%72 P < 0.03). noitiddA of -ohtemyxo evah neeb desu for sraey ni gnitsaw -noc
794
.M.A SOTALVAP TE .LA
snoitid hcus as citorhpen ,emordnys nI a keew-21 tolip 43,yduts 32 -VIH
cinorhc revil ,esaesid and 33923,recnac rieht evitisop nem deviecer enolohtemyxo ni
esu ni VIH noitcefni is ylevitaler .wen noitidda ot gniogno ralucsumartni -cejni
enolohtemyxO was deretsinimda enola snoit fo .enoretsotset ’stneitaP naem ydob
and ni noitanibmoc htiw nefitotek a( his- thgiew desaercni ylthgils morf %001 ot
,enimat tsinogatna htiw romut-itna -orcen %401 fo laedi ydob .thgiew reviL -cnuf
sis ahpla-rotcaf )ytivitca ot stneitap htiw noit tset ,stluser doolb dipil ,slevel VIH
detaler-VIH wasting ni an ,lebal-nepo RNA ,retit and CD4+ stnuoc erew -inom
evitcepsorp 9.lairt ytrihT stneitap erew ,derot and on tnacifingis esrevda stceffe
ylmodnar assigned ot enolohtemyxo erew .devresbo At pu-wollof ,stisiv -ap
yparehtonom n( = )41 ro enolohtemyxo stneit detroper yltnacifingis less ,aixerona
plus nefitotek n( = ,)61 and eht stluser ,noisserped and eugitaf than erofeb -taert
erew derapmoc htiw esoht ni a puorg fo tnem P( < .)50.0
30 detaertnu slaudividni ohw tem eht eggneH te aP5 detcudnoc an sisylana fo
noisulcni .airetirc nI noitidda ot ydob eht yticixototapeh fo enolohtemyxo ni 30
,thgiew eht yksfomaK elacs a( erusaem fo stneitap htiw decnavda VIH esaesid -nu
ytilauq fo )efil was desu ot rehtruf -ulave gniogred mret-gnol enolohtemyxo -taert
eta eht esnopser ot .ypareht .tnem nI eht s’yduts laitini ,esahp hcihw
ehT naem gain ni ydob thgiew was 8.2 kg detsal 30 ,skeew 2 dednilbnon spuorg -er
)%5.41( ni eht enolohtemyxo puorg P( c deviec rehtie enolohtemyxo enola ro
,)lOO.O 6.1 kg )%9.01( ni eht -noitanibmoc enolohtemyxo plus .nefitotek retfA eht
ypareht puorg P( < ,)500.0 and 8.1- kg laitini ,esahp 25 fo eht lanigiro 30 stneitap
thgiew( )ssol ni detaertnu .slortnoc ehT erew dewollof ni an lebal-nepo .esahp
naem emit ot kaep ydob thgiew was 19.6 ytnewT stneitap deunitnoc tnemtaert rof
skeew htiw enolohtemyxo ,yparehtonom lr raey at an egareva enolohtemyxo esod
derapmoc htiw 20.8 skeew htiw -anibmoc fo 50 .d/gm ehT tsom nommoc yrotarobal
noit .ypareht ehT naem yksfonraK ,erocs ytilamronba gnirud eht laitini esahp was a
hcihw serusaem eht ytiliba ot mrofrep -ca slight noitavele ni esarefsnartlymatulg-y
seitivit fo yliad gnivil no a elacs morf %0 )TGG( ni %73 )11( fo ;stneitap retfa -noc
)tsewol( ot %001 ,)tsehgih( devorpmi gnillort rof gnidnuofnoc ,selbairav this
yllauqe ni htob ,spuorg morf %65 erofeb detnuoma ot an noitavele fo TGG ni %71
tnemtaert ot %76 retfa 20 skeew fo -taert )5( fo detaert-enolohtemyxo .stneitap -giS
tnem P( c .)50.0 sgnidniF no rehto -ytilauq tnacifin snoitavele ni latot niburilib erew
efil-fo serusaem erew evitisop as .llew deton ni %01 )3( fo .stneitap enO tneitap
ehT efil-yliad-fo-seitivitca erocs devorpmi depoleved a revil romut that dluoc evah neeb
ni %86 fo stneitap ni htob tnemtaert spuorg sisoilep .sitapeh mureS nimubla -artnecnoc
P( < ,)50.0 saerehw noitirtun/etiteppa snoit erew desaercni ni %02 )6( fo .stneitap
serocs devorpmi yb %19 ni htob spuorg
P( c .)10.0 ehT srotagitsevni detroper that
enolohtemyxo was llew detarelot and -orp Antithrombin ZZZD eficiency
detom thgiew gain ni citcehcac stneitap evah neeb lareves esac stroper fo
There
htiw decnavda VIH .noitcefni ehT -idda eht noituloser fo ibmorht ni stneitap
noit fo nefitotek did ton ecudorp rehtruf detaert htiw enolohtemyxo ni -anibmoc
thgiew gain. noit htiw tnalugaocitna O‘.ypareht oT eht
795
LACINILC ”SCITUEPAREHT
tseb of ruo ,egdelwonk there evah neeb on phase, there was a yllacitsitats tnacifingis
seiduts of enolohtemyxo tnemtaert for -na ecnereffid ni growth rate neewteb the
nibmorhtit III .ycneicifed ehT stluser of yparehtonom dna ypareht-noitanibmoc
the case reports, ,revewoh yam tnarraw spuorg (4.7% sv ;%1.8 P c .)50.0 These re-
rehtruf .noitagitsevni stlus etacidni that ti si elbissop ot esaercni
enob noitazilarenim yldipar ni -alubmanon
yrot citoropoetso nerdlihc htiw tnettimretni
Zmpaired Growth ni Children
enolohtemyxo dna ediroulf .ypareht
ehT effects of enolohtemyxo ni -htworg
retarded, thgiewrednu nerdlihc were -ni
Damaged Myocardium ni Heart Failure
detagitsev ni a ,dnilb-elbuod -obecalp
dellortnoc .yduts 1 1 evif-ytnewT nerdlihc A llams yduts reported the effects of
were dezimodnar ot enolohtemyxo dna 29 enolohtemyxo no the laudiser -oym
ot .obecalp retfA 12 shtnom of ,tnemtaert muidrac of the detalid gniliaf Itraeh
a yllacitsitats tnacifingis ecnereffid ni evlewT stneitap deviecer enolohtemyxo
naem thgieh esaercni was devresbo ni the for 3 .shtnom segnahC ni tfel ralucirtnev
enolohtemyxo puorg derapmoc htiw the (LV) ecnamrofrep were detaulave desab
obecalp puorg (8.2 sv 5.6 ;mc P < .)20.0 no yhpargoidracohce dna amsalp -necnoc
,ylralimiS a yllacitsitats tnacifingis -reffid snoitart of 1airta citeruirtan editpep )PNA(
ecne ni ydob thgiew niag was deton -eb dna niarb citeruirtan editpep (BNP).
neewt the enolohtemyxo puorg derapmoc stnemevorpmI ni LV snoisnemid tuohtiw
htiw the obecalp puorg (2.81 sv 1.75 ;gk cilotsaid noitcnufsyd were .devresbo -nU
P < 0.01). erehT were on tnacifingis -eb ,yldetcepxe LV ssam decreased htiw
puorg-neewt secnereffid ni enob age -fe .enolohtemyxo nI ,noitidda tnacifingis -er
fects. nI siht ,yduts wol doses 92.0-11.0( snoitcud ni naem amsalp PNA 82-(
)d/gk/gm of enolohtemyxo decudorp a )Lm/gp dna PNB 25-( )Lm/gp were nees
thgils tub tnacifingis esaercni ni growth ni P( c 0.001). ehT snoitcuder ni LV ssam
ezisrednu nerdlihc tuohtiw gnisuac a -gis dna amsalp PNB slevel detcelfer -cuder
tnacifin esaercni ni lateleks age susrev noit ni LV niarts dna tnemevorpmi ni LV
thgieh age. laidracoym .noitcnuf ehT effects of -yxo
ehT effect no enob growth of -yxo enolohtem were ralimis ni stneitap htiw
enolohtem htiw dna tuohtiw ediroulf was yhtapoymoidrac dna emulov ,daolrevo
deiduts ni yrotalubmanon citoropoetso gnitseggus the ytilibacilppa of -yxo
*‘.nerdlihc ytnewT stneitap deviecer -moc enolohtem ot htob seirogetac of .stneitap
noitanib ypareht htiw enolohtemyxo dna
,ediroulf dna 20 deviecer enolohtemyxo ADVERSE EFFECTS
.yparehtonom retfA 18 ,shtnom the naem
rate of enob growth denimreted( yb -oidar Hepatotoxicity
cihparg gnilacs of the gnol sixa of the SO
)siclac htiw the noitanibmoc ypareht was yticixototapeH si a suoires esrevda
8.7%, whereas enolohtemyxo -rehtonom effect detaicossa htiw the esu of -a71
ypa desaercni the rate of enob growth yb detalykla cinegordna-cilobana .sdiorets
7.0%. sihT ecnereffid was ton yllacitsitats citatselohC ecidnuaj si the rojam citapeh
.tnacifingis gniruD a htnom-21 pu-wollof edis effect dna si htob dose dna noitarud -ed
796
A.M. PAVLATOS ET AL.
.tnednep A llams rebmun of case reports htiw noitalyklaa71 gnidulcni( -ohtemyxo
evah neeb dehsilbup gnitnemucod the -co )enol evah neeb nwohs ot ecudorp -fingis
ecnerruc of citatselohc ecidnuaj ni -ap tnaci sesaercni ni amsalp negonimsalp
stneit treated htiw 73T63.enolohtemyxo factor, gnidael ot citylonirbif 34.ytivitca
lanoitcnuF revil eruliaf dna citapeh -orcen Based no 1 case ““,troper the esu of -yxo
sis evah ton neeb devresbo htiw -a71 enolohtem htiw stnalugaocitna yam ton
detalykla cinegordna-cilobana sdiorets eb yletulosba ,detacidniartnoc tub rieht
nehw a elgnis tnega was ,desu hguohtla esu seriuqer luferac gnitset htiw llams
ADF gnilebal snoitaluger eriuqer a ssalc doses of tnalugaocitna ot enimreted the
tnemetats tuoba these .sksir nI ,noitidda mumixam detarelot dose of enolohtemyxo
laro snoitaraperp hcus as enolohtemyxo ni laudividni .stneitap
evah rehgih yticixototapeh naht laretnerap
cinegordna-cilobana ,sdiorets esuaceb
aimedipilrepyH
rehgih gurd snoitartnecnoc are detneserp
ot the revil no tsrif pass. elbisreveR aimedipilrepyh has neeb -er
sisoileP ,sitapeh na lausunu citsyc noisel ported after 5 2/l weeks of enolohtemyxo
of the ,revil si a rare edis effect detaicossa ypareht ni a tneitap gniviecer mret-gnol
htiw enolohtemyxo 93v83.esu ehT ecnerrucco 54.sisylaidomeh
of sisoilep sitapeh si of greater lacinilc -noc
nrec after noitaunitnocsid of tnemtaert naht
nommoC Side Effects of
.erofeb sisoileP sitapeh si a gninetaerht-efil
Anabolic-Androgenic Steroids
esrevda ;tneve for siht ,nosaer the ADF -nam
dates noisulcni of etairporppa sgninraw ni llA cinegordna-cilobana sdiorets yam
the gnibircserp noitamrofni for lla -cilobana esuac cinegordna edis effects hcus as ,enca
cinegordna .sdiorets ,msitusrih riah ,ssol cillahp/larotilc -ne
ngineB dna tnangilam citapeh romut ,tnemegral lacov ,segnahc elitcere eussit
noitamrof has neeb detaicossa htiw the ,ytilibalumits ,aitsamocenyg ,aehrronema
esu of detalyklaa71 cinegordna-cilobana dna segnahc ni odibil dna lauxes .ycnetop
.sdiorets ehT ecnedicni of -enegiromut nI ,noitidda cinegordna-cilobana sdiorets
sis appears ot esaercni htiw the noitarud yam erefretni htiw serusaem of dioryht
dna tnetxe of .erusopxe romuT noisserger noitcnuf dna riapmi etardyhobrac -batem
has derrucco after noitassec of -cilobana .msilo yehT yam etarelecca enob -arutam
cinegordna diorets 14,04.ypareht ,noit gnitluser ni growth .tnemriapmi -lA
snaicisyhP gnibircserp -ordna-cilobana hguoht ynam of these edis effects are
eineg sdiorets dluohs eb trela ot -pmys elbisrever no gurd ,noitaunitnocsid -rec
smot of yticixototapeh htiw mret-gnol esu niat effects, hcus as growth ,tnemriapmi
dna rotinom revil noitcnuf 24.yllacidoirep ,msitusrih dna larotilc or cillahp -egralne
,tnem yam eb 8.elbisreverri
Decreased tnalugaocitnA Tolerance
EGASOD
noisserppuS of gnittolc factors ,II V,
,IIV dna X yb cinegordna-cilobana sdiorets enolohtemyxO si detacidni for the -taert
si a nwonk-llew dna yllacinilc tnacifingis tnem of saimena desuac yb tneicifed red
edis effect. cinegordna-cilobanA sdiorets llec ,noitcudorp gnidulcni deriuqca -salpa
797
LACINILC ”SCITUEPAREHT
cit ,aimena latinegnoc citsalpa ,aimena lanoitiddA lacinilc snoitacilppa of -yxo
,sisorbifoleym dna the citsalpopyh -ena enolohtem are yltnerruc gnieb ,detagitsevni
saim detaicossa htiw noitartsinimda of dna research seunitnoc ni those areas ni
cixotoleym .sgurd ehT dednemmocer hcihw the gurd has nwohs .esimorp ehT
yliad dose of enolohtemyxo si 1 ot 5 elbissop tifeneb ni stneitap htiw -VIH
gk/gm ydob thgiew per yad ni nerdlihc detaicossa gnitsaw si gnieb rehtruf -ulave
dna stluda htiw saimena desuac yb -ifed ated. cilobanA diorets ypareht yam -ilicaf
tneic red llec .noitcudorp ehT lausu -ceffe tate enob growth dna laidracoym .riaper
evit dose si 1 ot 2 gk/gm per ,yad tub ,revewoH erutuf lacinilc snoitacilppa of
rehgih doses yam eb ,deriuqer dna the enolohtemyxo lliw dneped no hguoroht
dose dluohs eb .dezilaudividni ehT -er noitaulave of sti ytilibarelot dna ycaciffe
esnops yam ton eb ,etaidemmi dna ypareht dna tnemssessa of sti sksir susrev .stifeneb
dluohs eb nevig a muminim lairt of 3 ot 6 enolohtemyxO si etairporppa ni ynam
.shtnom retfA ,noissimer emos stneitap stneitap htiw saimena detaicossa htiw red
yam eriuqer on rehtruf enolohtemyxo llec ,ycneicifed dna ti yam eb na noitpo
,ypareht whereas others yam eriuqer a -er for the tnemtaert of other .snoitidnoc -lA
decud ecnanetniam dose. A ecnanetniam hguoht other ,stnega hcus as -ioporhtyre
dose si yllausu deriuqer ni stneitap htiw ,nite yam eb preferred for the tnemtaert of
latinegnoc citsalpa *.aimena ,aimena enolohtemyxo yam eb lufesu ni
niatrec tneitap ,snoitalupop ylralucitrap
those who are elbanu ot etarelot dradnats
SNOISULCNOC
.seipareht
enolohtemyxO si na yllaro evitca -cilobana
cinegordna diorets that has neeb deiduts
TNEMGDELWONKCA
yllacinilc ni suoirav sesaesid ecnis the
1960s. sA si the case htiw ynam -cilobana sihT paper was detroppus yb na -acude
cinegordna ,sdiorets hcum of the data lanoit tnarg morf deminU -ituecamrahP
no enolohtemyxo was dehsilbup ni the ,slac ,cnI ,dleifreeD .sionillI
1960s dna few citenikocamrahp dna -relot
ytiliba seiduts were demrofrep erofeb the
SECNEREFER
s’gurd lavorppa yb the .ADF nI ,noitidda
ynam snoitacilbup evah neeb case reports divaD ,K esnamegniD E, duerF J, rueuqaL
ni llams srebmun of ,stneitap hcihw -erp E. rebii senillatsirk sehcilnnam nomroh
dedulc tnemniatta of yllacitsitats tnacifingis aus nedoh ,)noretsotset( remaskriw sla aus
nrah redo niretselohc setetiereb -sordna
.stluser larO cinegordna-cilobana diorets
.noret Hoppe Seylers Z Physiol Chem.
snoitaraperp hcus as enolohtemyxo evah
1935;233:281-282.
detartsnomed rehgih yticixototapeh naht
laretnerap ,snoitaraperp esuaceb rehgih
gurd snoitartnecnoc are detneserp ot the idihahS NT. cilobanA cinegordna -roh
revil no tsrif pass. ruO weiver of the -aretil .senom Am I. Med. 1977;62:546-548.
,erut ,revewoh stseggus that enolohtemyxo
yam eb na etairporppa ypareht ni niatrec rezniihcS .W msilobateM fo cilobana -na
stneitap who are ylluferac detceles dna cinegord .sdiorets nilC .mehC 1996;42:
.derotinom 1001-1020.
798