Usage
- Stanozolol is primarily prescribed for the treatment of hereditary angioedema, a genetic condition characterized by episodes of severe swelling in the face, limbs, airway, and gastrointestinal tract. It is also used to treat certain types of anemia, osteoporosis in postmenopausal women, and problems related to Behcet’s disease.
- Pharmacological Classification: Anabolic steroid, synthetic derivative of testosterone.
- Mechanism of Action: Stanozolol reduces the frequency and severity of angioedema attacks by decreasing the production or activity of bradykinin, a peptide that promotes inflammation and vascular permeability. It also increases protein synthesis and reduces protein breakdown, leading to increased muscle mass and bone tissue growth.
Alternate Names
- International/Regional Variations: Winstrol (brand name)
- Brand Names: Winstrol, Stromba
How It Works
- Pharmacodynamics: Stanozolol binds to androgen receptors, promoting the expression of genes involved in protein synthesis. It reduces the production or effects of bradykinin, decreasing vascular permeability and inflammation.
- Pharmacokinetics:
- Absorption: Well-absorbed orally and via intramuscular injection.
- Metabolism: Extensively metabolized in the liver.
- Elimination: Primarily eliminated via renal excretion (90%) with a small amount excreted in feces (6%).
- Mode of Action: Binds to androgen receptors, leading to increased protein synthesis and decreased protein catabolism. In hereditary angioedema, it reduces the effects of bradykinin.
- Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: Binds to androgen receptors. May inhibit the production or activity of bradykinin.
- Elimination Pathways: Primarily hepatic metabolism followed by renal excretion.
Dosage
Standard Dosage
Adults:
- Angioedema: Initial: 2 mg orally three times a day. Maintenance: 2 mg daily or on alternate days, or 2.5 mg three times weekly. Dosages may be adjusted as needed based on response and tolerability.
Children:
- Limited data available. Doses between 1-2 mg daily based on age and weight have been suggested, under strict medical supervision. Pediatric use requires careful monitoring of growth and development due to the potential for premature epiphyseal closure.
Special Cases:
- Elderly Patients: Use with caution due to increased risk of adverse effects. Dose adjustments may be required.
- Patients with Renal Impairment: Caution advised. Close monitoring and possible dose adjustments may be required.
- Patients with Hepatic Dysfunction: Contraindicated in severe hepatic impairment. Use with caution in mild to moderate impairment with close monitoring of liver function. Dosage adjustments or alternative therapies may be necessary.
- Patients with Comorbid Conditions (e.g., diabetes, cardiovascular disease): Close monitoring required due to potential for drug interactions and exacerbation of existing conditions.
Clinical Use Cases Stanozolol is not typically used in the clinical settings listed. Its primary indication is the treatment and prophylaxis of hereditary angioedema.
Dosage Adjustments: Dosages should be individualized based on patient response, tolerance, and clinical condition, including renal/hepatic function and the presence of comorbid conditions.
Side Effects
Common Side Effects:
- Acne
- Edema
- Insomnia
- Changes in libido
- Headache
- Nausea
Rare but Serious Side Effects:
- Peliosis hepatis (formation of blood-filled cysts in the liver)
- Hepatic necrosis (liver cell death)
- Hepatocellular carcinoma (liver cancer)
- Cholestatic jaundice
- Virilization (development of male characteristics in females)
- Gynecomastia (breast enlargement in males)
- Testicular atrophy
- Priapism (prolonged erection)
Long-Term Effects:
- Premature epiphyseal closure in children
- Cardiovascular disease
- Liver damage
- Psychiatric disturbances
Adverse Drug Reactions (ADR):
- Hepatic necrosis
- Anaphylaxis
- Severe virilization
Contraindications
- Pregnancy
- Breastfeeding
- Prostate cancer
- Male breast cancer
- Hypercalcemia
- Severe hepatic impairment
- Hypersensitivity to stanozolol
Drug Interactions
- Anticoagulants (e.g., warfarin): Enhanced anticoagulant effect.
- Insulin and Sulfonylureas: Enhanced hypoglycemic effect.
- Levothyroxine: Enhanced levothyroxine effect.
- Neuromuscular blockers: May cause resistance to their effects.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: X (Contraindicated)
- Fetal Risks: Virilization of female fetus.
- Drug Excretion in Breast Milk: Unknown, but potential risk to nursing infants.
Drug Profile Summary
- Mechanism of Action: Reduces bradykinin activity, promotes protein synthesis.
- Side Effects: Acne, edema, insomnia, virilization, liver toxicity, cardiovascular effects.
- Contraindications: Pregnancy, breast cancer, prostate cancer, severe liver disease.
- Drug Interactions: Anticoagulants, insulin, sulfonylureas, levothyroxine.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: Adults: 2-10 mg daily (adjusted based on condition and response). Children: 1-2 mg daily (under strict supervision).
- Monitoring Parameters: Liver function tests, lipid profile, blood pressure, hormonal levels.
Popular Combinations: Not generally used in combination therapy for its primary indication.
Precautions
- Monitor liver function, blood pressure, lipid profile, and hormonal levels.
- Caution in patients with cardiac, renal, or hepatic disease, diabetes mellitus, or epilepsy.
- Not recommended for premenopausal women.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Stanozolol?
A: Adults: Initial dose for hereditary angioedema is 2 mg three times a day, with maintenance doses adjusted based on response down to 2 mg daily. Children: 1-2 mg daily under strict supervision and based on weight and age.
Q2: What are the common side effects of Stanozolol?
A: Common side effects include acne, edema, insomnia, changes in libido, headache, and nausea.
Q3: Is Stanozolol safe during pregnancy?
A: No, Stanozolol is contraindicated during pregnancy due to the risk of virilization of the female fetus.
Q4: Can Stanozolol be used in patients with liver disease?
A: Stanozolol is contraindicated in patients with severe liver disease and should be used with caution in patients with mild to moderate liver impairment. Close monitoring of liver function tests is necessary.
Q5: How does Stanozolol work in hereditary angioedema?
A: It reduces the frequency and severity of angioedema attacks by decreasing the activity or production of bradykinin, thus reducing inflammation and vascular permeability.
Q6: What are the serious side effects of Stanozolol?
A: Serious side effects include liver damage (peliosis hepatis, hepatic necrosis, hepatocellular carcinoma), cholestatic jaundice, and virilization.
Q7: Does Stanozolol interact with any other medications?
A: Yes, it can interact with anticoagulants (e.g., warfarin), insulin, sulfonylureas, and levothyroxine.
Q8: Can Stanozolol be used in children?
A: Stanozolol can be used in children but with extreme caution due to the potential for premature epiphyseal closure and other adverse effects. Close monitoring of growth and development is essential.
Q9: What should patients be monitored for while taking Stanozolol?
A: Patients should be monitored for liver function, lipid profile, blood pressure, and hormonal changes. Regular monitoring helps identify and manage potential adverse effects early.
