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La hepatitis colestásica y la ictericia ocurren con andrógenos 17-alfa-alquilados a dosis relativamente bajas. También puede estar asociado con agrandamiento hepático agudo y dolor del cuadrante superior derecho, que se ha confundido con obstrucción aguda (quirúrgica) del conducto biliar. La ictericia inducida por medicamentos suele ser reversible cuando se suspende el medicamento. Algunos cambios virilizantes en las mujeres son irreversibles incluso después de la interrupción inmediata de la terapia y no se previenen mediante el uso concomitante de estrógenos. Después de la remisión, algunos pacientes pueden mantenerse sin el medicamento, otros pueden mantenerse en una dosis diaria más baja establecida. Debido a que se ha observado anemia por deficiencia de hierro en algunos pacientes tratados con oximetolona, se recomienda la determinación periódica del hierro sérico y la capacidad de unión al hierro. Anapolon Los esteroides anabólicos / androgénicos deben usarse con mucha precaución en niños y solo por especialistas que conozcan sus efectos sobre la maduración ósea. Debido a la hepatoxicidad asociada con el uso de andrógenos 17-alfa-alquilados, las pruebas de función hepática deben obtenerse periódicamente. En pacientes con cáncer de mama, la terapia con esteroides anabólicos puede causar hipercalcemia al estimular la osteólisis. Si se detecta deficiencia de hierro, debe tratarse adecuadamente con hierro suplementario. La hemoglobina y el hematocrito deben revisarse periódicamente para detectar policitemia en pacientes que están recibiendo altas dosis de anabólicos. La insulina o la dosis hipoglucemiante oral pueden necesitar ajustes en pacientes diabéticos que reciben esteroides anabólicos. En ratas macho, no se clasificaron efectos como neoplásicos en respuesta a dosis de hasta a hundred and fifty mg/kg/día (5 veces exposiciones terapéuticas con 5 mg/kg basadas en la superficie corporal). Se ha observado leucemia en pacientes con anemia aplásica tratados con oximetolona. El papel, en su caso, de la oximetolona no está claro porque se ha observado una transformación maligna en pacientes con discrasias sanguíneas y se ha notificado leucemia en pacientes con anemia aplásica que no han sido tratados con oximetolona. El edema con o sin insuficiencia cardíaca congestiva puede ser una complicación grave en pacientes con enfermedad cardíaca, renal o hepática preexistente. La administración concomitante con esteroides suprarrenales o ACTH puede aumentar el edema. Esto generalmente se puede controlar con una terapia diurética y / o digital adecuada. Pruebas De Laboratorio Debido a la hepatoxicidad asociada con la administración de oximetolona, se recomiendan pruebas periódicas de función hepática. Las mujeres con carcinoma de mama diseminado deben tener una determinación frecuente de los niveles de orina y calcio sérico durante el curso de la terapia con esteroides anabólicos androgénicos (ver ADVERTENCIA). La dosis diaria recomendada en niños y adultos es de 1-5 mg/kg de peso corporal por día. La dosis efectiva habitual es de 1-2 mg/kg/día, pero pueden requerirse dosis más altas y la dosis debe individualizarse. La respuesta no suele ser inmediata, y se debe realizar un ensayo mínimo de tres a seis meses. Después de la remisión, algunos pacientes pueden mantenerse sin el medicamento, otros pueden mantenerse en una dosis diaria más baja establecida. Peliosis hepatis, una condición en la cual el hígado y, a veces, el tejido esplénico se reemplaza con quistes llenos de sangre, se ha informado en pacientes que reciben terapia con esteroides anabólicos androgénicos. Estos quistes a veces están presentes con una disfunción hepática mínima, pero en otras ocasiones se han asociado con insuficiencia hepática. A menudo no se reconocen hasta que se desarrolla insuficiencia hepática potencialmente mortal o hemorragia intraabdominal. La retirada del medicamento generalmente resulta en la desaparición completa de las lesiones. Periódicos (cada 6 meses) exámenes de rayos X de la edad ósea deben hacerse durante el tratamiento de pacientes prepuberales para determinar la tasa de maduración ósea y los efectos de la terapia con esteroides anabólicos androgénicos en los centros epifisarios. Se ha informado que los esteroides anabólicos reducen el nivel de lipoproteínas de alta densidad y elevan el nivel de lipoproteínas de baja densidad. Otras experiencias clínicas notificadas no han identificado diferencias en las respuestas entre los pacientes de edad avanzada y los pacientes más jóvenes. Las mujeres deben ser observadas para detectar signos de virilización (profundización de la voz, hirsutismo, acné y clitoromegalia). Para prevenir un cambio irreversible, la terapia con medicamentos debe suspenderse cuando se detecta por primera vez un virilismo leve. Tal virilización es traditional después del uso de esteroides anabólicos androgénicos en dosis altas.

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