MAXIBOLIN

Clinical safety rating: caution

Comprehensive clinical and safety monograph for MAXIBOLIN (MAXIBOLIN).

How it works

MAXIBOLIN (methandienone) is an anabolic steroid that binds to androgen receptors, increasing protein synthesis and nitrogen retention in muscle tissue. It also inhibits glucocorticoid receptors, reducing catabolism and promoting anabolic effects.

What the body does with it

Metabolism	Hepatic metabolism via 6β-hydroxylation and reduction, primarily by CYP3A4; excreted renally as conjugated metabolites.
Excretion	Primarily renal (90% as metabolites, 5% unchanged); biliary/fecal elimination accounts for approximately 10%.
Half-life	Terminal elimination half-life of 9-10 hours; supports every-other-day dosing in androgen replacement therapy.
Protein binding	Approximately 98% bound to sex hormone-binding globulin (SHBG) and albumin.
Volume of Distribution	0.5-0.8 L/kg, indicating distribution into total body water and some tissue binding.
Bioavailability	Oral: 40-60% due to first-pass metabolism; intramuscular: 100%.
Onset of Action	Oral: 2-4 hours for increase in protein synthesis and nitrogen retention; intramuscular: 1-2 hours.
Duration of Action	Clinical effects on muscle mass and strength persist for 2-3 days after a single dose; requires consistent dosing for sustained anabolic effect.

Classification & Brands

Dosing & administration

Oral: 2 mg three times daily; optimal response may require 4-8 mg daily for 2-3 weeks, then reduce to maintenance of 2-4 mg daily.

Dosage form	TABLET
Renal impairment	No specific guidelines; caution in severe impairment. GFR <30 mL/min: consider dose reduction to 50% of normal dose, monitor for fluid retention.
Liver impairment	Child-Pugh Class A: no adjustment; Class B: reduce dose by 50%; Class C: avoid use.
Pediatric use	Not recommended for pediatric use due to risk of premature epiphyseal closure and virilization.
Geriatric use	Use lowest effective dose (e.g., 2 mg daily) due to increased risk of fluid retention, prostatic hypertrophy, and hepatotoxicity.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for MAXIBOLIN (MAXIBOLIN).

Breastfeeding	Excretion into breast milk unknown; likely present. M/P ratio not available. Contraindicated during lactation due to potential virilizing effects on the infant and suppression of lactation.
Teratogenic Risk	MAXIBOLIN (oxandrolone) is an anabolic-androgenic steroid (AAS) classified as Category X in pregnancy. Teratogenic effects include virilization of female fetuses (clitoromegaly, labial fusion, urogenital sinus abnormalities) and potential for growth restriction. Avoid in all trimesters due to documented adverse fetal outcomes.

Warnings & precautions

■ FDA Black Box Warning

Anabolic steroids can cause serious cardiovascular and hepatic adverse effects. Peliosis hepatis, hepatocellular carcinoma, and lipid abnormalities have been reported. Prolonged use increases risk of atherosclerosis and myocardial infarction.

Side Effect Profile

Serious Effects

Absolute Contraindications

Hypersensitivity to any component, prostate or breast carcinoma in males, breast carcinoma in females, hypercalcemia, nephrotic syndrome, severe cardiac or hepatic disease, pregnancy, and lactation.

Clinical Precautions

Precautions

Monitor liver function, lipid profile, and cardiac status. Use caution in patients with pre-existing cardiac, renal, or hepatic disease. May cause virilization in women, priapism, and gynecomastia in men. Avoid in children due to premature epiphyseal closure.

Clinical Tips & Counseling

Drug interactions

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MAXIBOLIN

Clinical safety rating: caution

Comprehensive clinical and safety monograph for MAXIBOLIN (MAXIBOLIN).

How it works

What the body does with it

Metabolism	Hepatic metabolism via 6β-hydroxylation and reduction, primarily by CYP3A4; excreted renally as conjugated metabolites.
Excretion	Primarily renal (90% as metabolites, 5% unchanged); biliary/fecal elimination accounts for approximately 10%.
Half-life	Terminal elimination half-life of 9-10 hours; supports every-other-day dosing in androgen replacement therapy.
Protein binding	Approximately 98% bound to sex hormone-binding globulin (SHBG) and albumin.
Volume of Distribution	0.5-0.8 L/kg, indicating distribution into total body water and some tissue binding.
Bioavailability	Oral: 40-60% due to first-pass metabolism; intramuscular: 100%.
Onset of Action	Oral: 2-4 hours for increase in protein synthesis and nitrogen retention; intramuscular: 1-2 hours.
Duration of Action	Clinical effects on muscle mass and strength persist for 2-3 days after a single dose; requires consistent dosing for sustained anabolic effect.

Classification & Brands

Dosing & administration

Oral: 2 mg three times daily; optimal response may require 4-8 mg daily for 2-3 weeks, then reduce to maintenance of 2-4 mg daily.

Dosage form	TABLET
Renal impairment	No specific guidelines; caution in severe impairment. GFR <30 mL/min: consider dose reduction to 50% of normal dose, monitor for fluid retention.
Liver impairment	Child-Pugh Class A: no adjustment; Class B: reduce dose by 50%; Class C: avoid use.
Pediatric use	Not recommended for pediatric use due to risk of premature epiphyseal closure and virilization.
Geriatric use	Use lowest effective dose (e.g., 2 mg daily) due to increased risk of fluid retention, prostatic hypertrophy, and hepatotoxicity.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for MAXIBOLIN (MAXIBOLIN).

Breastfeeding	Excretion into breast milk unknown; likely present. M/P ratio not available. Contraindicated during lactation due to potential virilizing effects on the infant and suppression of lactation.
Teratogenic Risk	MAXIBOLIN (oxandrolone) is an anabolic-androgenic steroid (AAS) classified as Category X in pregnancy. Teratogenic effects include virilization of female fetuses (clitoromegaly, labial fusion, urogenital sinus abnormalities) and potential for growth restriction. Avoid in all trimesters due to documented adverse fetal outcomes.

Warnings & precautions

■ FDA Black Box Warning

Side Effect Profile

Serious Effects

Absolute Contraindications

Hypersensitivity to any component, prostate or breast carcinoma in males, breast carcinoma in females, hypercalcemia, nephrotic syndrome, severe cardiac or hepatic disease, pregnancy, and lactation.