Stanozolol (abbrev. Stz), sold under many brand names, is a synthetic androgen and anabolic steroid (AAS) medication derived from dihydrotestosterone (DHT). It is used to treat hereditary angioedema. It was developed by American pharmaceutical company Sterling-Winthrop in 1962, and has been approved by the U.S. Food and Drug Administration for human use, though it is no longer marketed in the United States. It is also used in veterinary medicine. Stanozolol has mostly been discontinued, and remains available in only a few countries. It is given by mouth in humans or by injection into muscle in animals. Unlike most AAS, stanozolol is not esterified and is sold as an aqueous suspension, or in oral tablet form. The drug has a high oral bioavailability, due to a C17α alkylation which allows the hormone to survive first-pass liver metabolism when ingested. It is because of this that stanozolol is also sold in tablet form. Stanozolol is one of the AAS commonly used as performance-enhancing drugs and is banned from use in sports competition under the auspices of the World Anti-Doping Agency (WADA). It is an anabolic steroid that is known to have a diuretic effect. Additionally, stanozolol has been highly restricted in US horse racing.
Medical uses Stanozolol has been used with some success to treat venous insufficiency. It stimulates blood fibrinolysis and has been evaluated for the treatment of the more advanced skin changes in venous disease such as lipodermatosclerosis. Several randomized trials noted improvement in the area of lipodermatosclerosis, reduced skin thickness, and possibly faster ulcer healing rates with stanozolol. It is also being studied to treat hereditary angioedema, osteoporosis, and skeletal muscle injury.
Non-medical uses Stanozolol is used for physique- and performance-enhancing purposes by competitive athletes, bodybuilders, and powerlifters.
Side effects
Side effects of stanozolol include virilization (masculinization), hepatotoxicity, cardiovascular disease, and hypertension.
Pharmacology
Pharmacodynamics
As an AAS, stanozolol is an agonist of the androgen receptor (AR), similarly to androgens like testosterone and DHT. Its affinity for the androgen receptor is about 22% of that of dihydrotestosterone. Stanozolol is not a substrate for 5α-reductase as it is already 5α-reduced, and so is not potentiated in so-called "androgenic" tissues like the skin, hair follicles, and prostate gland. This results in a greater ratio of anabolic to androgenic activity compared to testosterone. In addition, due to its 5α-reduced nature, stanozolol is non-aromatizable, and hence has no propensity for producing estrogenic effects such as gynecomastia or fluid retention. Stanozolol also does not possess any progestogenic activity of significance. Because of the presence of its 17α-methyl group, the metabolism of stanozolol is sterically hindered, resulting in it being orally active, although also hepatotoxic.
Multi-receptor activity and stem-cell differentiation In addition to classical AR signaling, in-vitro work with mesenchymal stem-cell micromass cultures shows that stanozolol:
Binds to the progesterone receptor (PR) and to an unidentified membrane receptor that drives Prostaglandin E2 (PGE₂) synthesis via COX-2 induction. Induces a feed-forward loop in which PGE₂ amplifies BMP2 expression, accelerating osteogenic and chondrogenic differentiation. Causes sustained phosphorylation of PKCε, an isoform linked to suppression of the hypertrophic cartilage marker MATN1 and to formation of articular-cartilage (interzone) phenotypes. Pharmacological blockade of either PR (mifepristone) or COX-2 (indomethacin) abolishes these effects, confirming that stanozolol’s osteochondral activity requires simultaneous PR signaling and PGE₂-driven crosstalk with the BMP2 pathway. Additionally, stanozolol has been shown to exert activity via estrogen receptor alpha (ERα) in vivo. In a rat model of GnRH agonist-induced growth plate suppression, stanozolol restored chondrocyte proliferation via ERα activation, indicating selective estrogen receptor-mediated effects in growth plate cartilage.
Pharmacokinetics Stanozolol has high oral bioavailability, due to the presence of its C17α alkyl group and the resistance to gastrointestinal and liver metabolism that it results in. The medication has very low affinity for human serum sex hormone-binding globulin (SHBG), about 5% of that of testosterone and 1% of that of DHT. Stanozolol is metabolized in the liver, ultimately becoming glucuronide and sulfate conjugates. Its biological half-life is reported to be 9 hours when taken by mouth and 24 hours when given by intramuscular injection in the form of an aqueous suspension. It is said to have a duration of action of one week or more via intramuscular injection.
Chemistry
Stanozolol, also known as 17α-methyl-2'H-androst-2-eno[3,2-c]pyrazol-17β-ol, is a synthetic 17α-alkylated androstane steroid and a derivative of 5α-dihydrotestosterone (DHT) with a methyl group at the C17α position and a pyrazole ring attached to the A ring of the steroid nucleus.
Synthesis Various chemical syntheses of stanozolol have been published.
Detection in body fluids Stanozolol is subject to extensive hepatic biotransformation by a variety of enzymatic pathways. The primary metabolites are unique to stanozolol and are detectable in the urine for up to 10 days after a single 5–10 mg oral dose. Methods for detection in urine specimens usually involve gas chromatography-mass spectrometry or liquid chromatography-mass spectrometry.
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