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.
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.
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. 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.
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 ordinary 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.
En ratas macho, no se clasificaron efectos como neoplásicos en respuesta a dosis de hasta 150 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.
Anapolon Tablets está indicado en el tratamiento de las anemias causadas por la producción deficiente de glóbulos rojos. La anemia aplásica adquirida, la anemia aplásica congénita, la mielofibrosis y las anemias hipoplásicas debidas a la administración de medicamentos mielotóxicos a menudo responden. Sin embargo, como se indica a continuación en REACCIONES ADVERSAS, oligospermia en varones y amenorrhea en mujeres son efectos adversos potenciales del tratamiento con Anapolon tabletas. Por lo tanto, el deterioro de la fertilidad es un posible resultado del tratamiento con Anapolon Tablets. 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.
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