Effects of oxandrolone, an anabolic steroid, on hemostasis

This study evaluated the short-term effects of oxandrolone, an anabolic androgenic synthetic steroid, on blood coagulation and the hemostatic/ fibrinolytic system in healthy individuals. Subjects (n = 14) were administered oxandrolone (10 mg twice daily) for 14 days. Blood was obtained on days 0, 1, 3, 7, 9, 14, and then at day 42 (28 days after discontinuation of the drug). Samples were analyzed for the plasma plasminogen, plasminogen activator inhibitor (PAI-1), fibrinogen, and coagulation factors (II, V, VII, VIII, and X). After 7 days of administration of oxandrolone, the plasma plasminogen level significantly increased [100% ± 21% to 174% ± 21% (P < 0.0001)]. PAI-1 was significantly decreased at day 3 [16 ± 9 to 7 ± 4 mg/dL (P < 0.01)]. Coagulation factors II and V significantly increased at day 14 [88 ± 15 to 122 ± 11 (P < 0.005) and 105 ± 21 to 179 ± 36% (P < 0.0001)], respectively. Factor VII level decreased by day 3 [91% ± 26% to 83% ± 18%, NS], but after 14 days factor VII level returned to baseline (91% ± 26% to 93% ± 19%, NS). The increase of factor VIII level was not significant (111% ± 64% to 125% ± 55%, NS). Factor X increased steadily over 14 days of drug treatment [96% ± 11% to 107% ± 25%, NS] and after discontinuation, decreased and returned to baseline by day 42 [107% ± 25% to 89% ± 25%, NS]. Fibrinogen decreased by 22% ± 12%, (NS). Administration of oxandrolone, to healthy young men was associated with a significant increase in select blood coagulation factors and plasminogen. These changes create a state of potential hypercoagulability that appears to be counterbalanced by increased fibrinolytic activity to maintain homeostasis.