FDA Removed Oxandrin (oxandrolone) tablets from the list of drug products published in the Orange Book

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madman

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Pathetic!

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On September 12, 2023, FDA issued a notice entitled, Determination That Oxandrin (Oxandrolone) Tablets, 2.5 Milligrams and 10 Milligrams, Were Withdrawn from Sale for Reasons of Safety or Effectiveness. FDA determined that Oxandrin (oxandrolone) tablets, 2.5 milligrams (mg) and 10 mg, were withdrawn from sale for reasons of safety or effectiveness. Thus, the agency will not accept or approve abbreviated new drug applications (ANDAs) for Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg




SUMMARY:
The Food and Drug Administration (FDA, Agency, or we) has determined that Oxandrin (oxandrolone) tablets, 2.5 milligrams (mg) and 10 mg, were withdrawn from sale for reasons of safety or effectiveness. The Agency will not accept or approve abbreviated new drug applications (ANDAs) for Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg.




Novitium Pharma LLC submitted a citizen petition dated April 6, 2022 (Docket No. FDA2022-P-0558), under 21 CFR 10.30, requesting that the Agency determine whether Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, were withdrawn from sale for reasons of safety or effectiveness. The petitioner has identified no data or other information suggesting that Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, were withdrawn from sale for reasons of safety or effectiveness.

After considering the citizen petition and reviewing Agency records and based on the information we have at this time, FDA has determined under § 314.161 that Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, were withdrawn for reasons of safety or effectiveness. We have carefully reviewed our files for records concerning the withdrawal of Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, from sale. We have also independently evaluated relevant literature and data for possible postmarketing adverse events.

Our records show that FDA’s Endocrinologic and Metabolic Drugs Advisory Committee met and discussed anabolic steroids in January 1984. The advisory committee unanimously concluded that there was no evidence of efficacy for oxandrolone.2

As communicated in the product labeling for Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, multiple safety warnings and precautions are associated with the use of this product including peliosis hepatis, sometimes associated with liver failure and intra-abdominal hemorrhage; liver cell tumors, sometimes fatal; and blood lipid changes that are known to be associated with increased risk of atherosclerosis.3 Per the product labeling, additional warnings with using this product include the risks associated with cholestatic hepatitis, hypercalcemia in patients with breast cancer, and increased risk for the development of prostatic hypertrophy and prostatic carcinoma in geriatric patients.4 Considering the safety concerns associated with the use of oxandrolone noted in the labeling, the Agency concluded that the benefit-risk profile of the drug product is unfavorable without substantial evidence to support effectiveness.

Based on a thorough evaluation of the information we have available to us and an evaluation of the latest version of the drug products’ approved labeling, we have determined that the drug products would not be considered safe and effective if they were reintroduced to the market today. New clinical studies would first need to be conducted to address the concerns described above. Thus, after considering the citizen petition and reviewing Agency records and based on the information we have at this time, FDA has determined under § 314.161 that Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, were withdrawn for reasons of safety or effectiveness. Accordingly, the Agency will remove Oxandrin (oxandrolone) tablets, 2.5 mg and 10 mg, from the list of drug products published in the Orange Book per § 314.162. FDA will not accept or approve ANDAs that refer to this drug product.

Dated: September 8, 2023.


Lauren K. Roth,

Associate Commissioner for Policy.
 
Defy Medical TRT clinic doctor
Unreal!


4 Considering the safety concerns associated with the use of oxandrolone noted in the labeling, the Agency concluded that the benefit-risk profile of the drug product is unfavorable without substantial evidence to support effectiveness.

Based on a thorough evaluation of the information we have available to us and an evaluation of the latest version of the drug products’ approved labeling, we have determined that the drug products would not be considered safe and effective if they were reintroduced to the market today. New clinical studies would first need to be conducted to address the concerns described above.
 
 
Unreal!


4 Considering the safety concerns associated with the use of oxandrolone noted in the labeling, the Agency concluded that the benefit-risk profile of the drug product is unfavorable without substantial evidence to support effectiveness.

Based on a thorough evaluation of the information we have available to us and an evaluation of the latest version of the drug products’ approved labeling, we have determined that the drug products would not be considered safe and effective if they were reintroduced to the market today. New clinical studies would first need to be conducted to address the concerns described above.
Not that we needed any more proof that the FDA only cares about maximizing profits for big pharma. They just don't care if they harm patients in the process. The statements they made to support their decision are ridiculous and easily proven to be false. There is loads of study data showing benefit for burn victims and wasting diseases. This particularly egregious for women, as other anabolic steroids are much more androgenic. Additionally it will further feed the misinformed view of physicians that anabolic steroids are dangerous and ineffective for treating medical conditions. I think we would all be better off if the FDA were just shut down. Their regulations are doing more harm than any benefit provided.
 
Alexandria Fujisaki
Regulatory Counsel, CDER
Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
United States

Dear Ms. Fujisaki,

I am writing to express deep concern over the recent decision to notify oxandrolone manufacturers that the FDA believes the potential risks associated with this drug are severe enough to warrant its removal from the market. As an informed citizen and long-term HIV advocate, I would like to present a case that highlights the important positive and safe uses of oxandrolone for various medical conditions.

Oxandrolone, a synthetic derivative of testosterone, has been used effectively to promote weight gain in patients experiencing HIV wasting syndrome. Several studies, such as that by Grunfeld et al. (2006)[1], have demonstrated that oxandrolone, along with adequate nutrition, significantly increases body cell mass and muscle size in these patients with no hepatotoxicity.

Furthermore, this medication has been safely used to counteract protein catabolism caused by long-term corticosteroid therapy (Goldberg, et al., 1996)[2]. It's also proven to be effective in supporting recovery from severe burns, greatly improving lean body mass, bone mineral content, and muscle strength (Jeschke, et al., 2005)[3].

Notably, oxandrolone is used for the treatment of bone pain related to osteoporosis, enhancing both bone density and quality of life in patients (Bonaiuti, et al., 2002)[4]. It also plays a significant role in the development of girls with Turner syndrome, boosting height velocity and adult height (Menke & Sas, 2010)[5].

Safety and side effect profiles are important considerations for any medication, and it is crucial to remember that oxandrolone has been found to have a favorable safety profile. Studies have demonstrated no liver toxicity when used at clinically effective doses (Schänzer, 1996)[6]. Moreover, oxandrolone has shown minimal virilizing side effects, making it an appropriate choice for pediatric and female patients (Sheffield-Moore, et al., 2011)[7].

While I understand the FDA's responsibility is to safeguard public health, it's essential to thoroughly examine the balance between benefits and risks in real-world clinical contexts. Considering the extensive body of research supporting the efficacy and safety of oxandrolone, I urge you to reconsider this decision. The decision to withdraw a drug from the market should not be taken lightly, especially when it has proven beneficial for many patients who rely on it for necessary treatment.

I appreciate your attention to this matter and look forward to your response.

Sincerely,

Nelson Vergel
Founder, Program for Wellness Restoration
A 501 (c) 3 Organization

References:
[1] Grunfeld, C., et al. (2006). Oxandrolone in the treatment of HIV-associated weight loss in men: a randomized, double-blind, placebo-controlled study. Journal of Acquired Immune Deficiency Syndromes, 41(3), p.304-314.
[2] Goldberg, A. L., et al. (1996). Effects of Oxandrolone on Protein Metabolism in Burned Children. Nutrition in Clinical Practice, 11(1), p. 29-35.
[3] Jeschke, M. G., et al. (2005). The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. Ann Surg. 242(3): p. 384-91.
[4] Bonaiuti, D., et al. (2002). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. (3): CD000333.
[5] Menke LA, Sas TC. (2010). The effect of oxandrolone on body proportions and body composition in growth hormone-treated girls with Turner syndrome. Clin Endocrinol (Oxf). 73(2): p. 212-9.
[6] Schänzer, W. (1996). Metabolism of anabolic androgenic steroids. Clin Chem. 42(7): p. 1001-20.
[7] Sheffield-Moore, M., et al. (2011). Short-term oxandrolone administration stimulates net muscle protein synthesis in young men. Journal of Clinical Endocrinology & Metabolism, 86(8), p. 3485-3491.


All the best,

Nelson Vergel, BsChE, MBA
Founder
Program for Wellness Restoration
A 501 (c) 3 Non-Profit Organization
 
 


 



780 references:


oxandrolone references.jpg
 
Last edited:
Alexandria Fujisaki
Regulatory Counsel, CDER
Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
United States

Dear Ms. Fujisaki,

I am writing to express deep concern over the recent decision to notify oxandrolone manufacturers that the FDA believes the potential risks associated with this drug are severe enough to warrant its removal from the market. As an informed citizen and long-term HIV advocate, I would like to present a case that highlights the important positive and safe uses of oxandrolone for various medical conditions.

Oxandrolone, a synthetic derivative of testosterone, has been used effectively to promote weight gain in patients experiencing HIV wasting syndrome. Several studies, such as that by Grunfeld et al. (2006)[1], have demonstrated that oxandrolone, along with adequate nutrition, significantly increases body cell mass and muscle size in these patients with no hepatotoxicity.

Furthermore, this medication has been safely used to counteract protein catabolism caused by long-term corticosteroid therapy (Goldberg, et al., 1996)[2]. It's also proven to be effective in supporting recovery from severe burns, greatly improving lean body mass, bone mineral content, and muscle strength (Jeschke, et al., 2005)[3].

Notably, oxandrolone is used for the treatment of bone pain related to osteoporosis, enhancing both bone density and quality of life in patients (Bonaiuti, et al., 2002)[4]. It also plays a significant role in the development of girls with Turner syndrome, boosting height velocity and adult height (Menke & Sas, 2010)[5].

Safety and side effect profiles are important considerations for any medication, and it is crucial to remember that oxandrolone has been found to have a favorable safety profile. Studies have demonstrated no liver toxicity when used at clinically effective doses (Schänzer, 1996)[6]. Moreover, oxandrolone has shown minimal virilizing side effects, making it an appropriate choice for pediatric and female patients (Sheffield-Moore, et al., 2011)[7].

While I understand the FDA's responsibility is to safeguard public health, it's essential to thoroughly examine the balance between benefits and risks in real-world clinical contexts. Considering the extensive body of research supporting the efficacy and safety of oxandrolone, I urge you to reconsider this decision. The decision to withdraw a drug from the market should not be taken lightly, especially when it has proven beneficial for many patients who rely on it for necessary treatment.

I appreciate your attention to this matter and look forward to your response.

Sincerely,

Nelson Vergel
Founder, Program for Wellness Restoration
A 501 (c) 3 Organization

References:
[1] Grunfeld, C., et al. (2006). Oxandrolone in the treatment of HIV-associated weight loss in men: a randomized, double-blind, placebo-controlled study. Journal of Acquired Immune Deficiency Syndromes, 41(3), p.304-314.
[2] Goldberg, A. L., et al. (1996). Effects of Oxandrolone on Protein Metabolism in Burned Children. Nutrition in Clinical Practice, 11(1), p. 29-35.
[3] Jeschke, M. G., et al. (2005). The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. Ann Surg. 242(3): p. 384-91.
[4] Bonaiuti, D., et al. (2002). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. (3): CD000333.
[5] Menke LA, Sas TC. (2010). The effect of oxandrolone on body proportions and body composition in growth hormone-treated girls with Turner syndrome. Clin Endocrinol (Oxf). 73(2): p. 212-9.
[6] Schänzer, W. (1996). Metabolism of anabolic androgenic steroids. Clin Chem. 42(7): p. 1001-20.
[7] Sheffield-Moore, M., et al. (2011). Short-term oxandrolone administration stimulates net muscle protein synthesis in young men. Journal of Clinical Endocrinology & Metabolism, 86(8), p. 3485-3491.


All the best,

Nelson Vergel, BsChE, MBA
Founder
Program for Wellness Restoration
A 501 (c) 3 Non-Profit Organization
GOOD LETTER @Nelson Vergel Its too bad the IDIOTS at the FDA don't have enough common sense to understand. I guess UG sales oxandrolone will crease. This has been one of the most popular drugs going for many years. Yet Tylenol is still on the market.



Assessment of safety showed that there were no long-lasting deleterious effects associated with oxandrolone use in our patients.
 
Last edited:
GOOD LETTER @Nelson Vergel Its too bad the IDIOTS at the FDA don't have enough common sense to understand. I guess UG sales oxandrolone will crease. This has been one of the most popular drugs going for many years. Yet Tylenol is still on the market.
They never replied to my July 2023 letter but now I am proceeding with a Citizen's Petition that they HAVE to address.
 
Good for you Nelson. This is the biggest bunch of BS I have ever seen. This drug has a tremendous value to the medical industry and it's safety has been shown many times. Its certainly not hard to find. Keep us up on the results and please let me know if I can ever help with fighting non-sense directives like this.
 
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