Drugs and the Third World: Stanozolol Toxicity and Unethical Marketing in Malaysia and the Third World
Item
- Title
-
Drugs and the Third World:
Stanozolol
Toxicity and Unethical
Marketing in Malaysia
and the Third World - extracted text
-
CAP
REPORT
NUMBER 13
Drugs and the Third World:
Stanozolol
Toxicity and Unethical
Marketing in Malaysia
and the Third World
VtMWIMEMy/
CONSUMERS' ASSOCIATION OF PENANG
Drugs and the Third World:
Stanozolol
Toxicity and Unethical
Marketing in Malaysia
and the Third World
CONSUMERS' ASSOCIATION OF PENANG
Published by
Consumers’ Association of Penang
87 Cantonment Road,
Penang, Malaysia.
The Consumers’ Association of Penang is a voluntary
non-profit organisation which fights for the rights
and interests of all consumers through research,
educational and representational activities.
Printed by
Jutaprint
54, Kajang Road
Penang, Malaysia.
Copyright
(c)
Consumers’ Association of Penang 1986
ISBN 967-995O-28-X
CONTENTS
Preface
3
Chapter
1
Introduction
5
Chapter
2
Stanozolol: INN (International
7
Nonproprietary Name Selected by WHO)
(1)
Adverse Effects of Androgen
Therapy
Chapter
3
(2)
Caution and Warnings
(3)
Adverse Reactions
(4)
Dosage
(5)
Studies
Drug Promotion and Marketing in
14
Third World Countries
Chapter
4
Drug Information and Brands Sold
17
in Malaysia
(1)
DIMS Information
(2)
Warnings and Contraindications:
Inadequate Information
Chapter
5
(3)
Indications Given
(4)
Dosages
Drug Information Insert for
Winstrol
21
Chapter
6
Conclusion
25
References
Appendix
23
Drug Information Insert for
Winstrol
27
PREFACE
Stanozolol, an anabolic steroid drug, is generally used
medically in androgen therapy in males as well as females.
However, it can lead to serious disturbances in growth
and sexual development when given to children.
A notable
side effect of stanozolol use is weight gain.
In Malaysia, stanozolol is promoted as an appetite stimu
lant for children.
This is in direct contradiction with
the warning by the American Medical Association that
anabolic steroids should not be used to stimulate growth
in children who are small but otherwise normal and
healthy.
In the US, the stanozolol product Winstrol is
found to be very toxic and prescribed for only the
narrowest indications.
It is obvious that drug companies
are employing double standards in marketing their drugs
in Malaysia and other Third World countries as compared
to developed countries.
This report hopes to throw more light on the dangers of
stanozolol, as well as to alert consumers to the un
ethical marketing practices of the pharmaceutical
companies.
3
CAP urges the Ministry of Health to ban the use of stanozolol in order to safeguard the health of all Malaysian
consumers, particularly the children.
S M Mohd Idris, JP
President
Consumers’ Association of Penang
July 1986
Update
This report was presented to the Ministry of Health,
Malaysia, in July 1986.
On 5 October 1986, the Director
of Health, Tan Sri Abdul Khalid, announced that stanozolol,
together with six other drugs, has been banned in Malaysia.
Manufacturers and distributors would be given three
months’ grace to withdraw all products containing sta
nozolol from the market.
4
CHAPTER 1
INTRODUCTION
Many unnecessary pharmaceutical drugs which are banned or
severely restricted in developed countries are still
being widely marketed and used in developing countries.
From a study conducted by CAP on the anabolic steroid
drug, stanozolol, it has been found that this drug is
being marketed widely in Malaysia as an appetite sti
mulant for children.
Stanozolol should be used only for
treating aplastic anaemia, senile and post-menopausal
osteoporosis and in pituitary dwarfism.
The Drug Index for Malaysia and Singapore (DIMS) shows
one brand of stanozolol, Winstrol, which CAP managed to
purchase over the counter although it is supposed to be
a Group C Poison.
Our study found that there are double
standards in the marketing of this drug preparation in
Malaysia and other developing countries as compared to
the USA and UK.
According to The Medical Letter, an independent non
profit publication on drugs and therapeutics in the US,
Winstrol (the only stanozolol preparation marketed in
5
the US) is considered too toxic for all but the narrowest
indications.
Besides this, in 1973, the American Medical
Association warned that anabolic steroids (like Winstrol)
should not be used to stimulate growth in children who
are small but otherwise normal and healthy.
However in
Malaysia, this drug is still being promoted as an appetite
stimulant for children.
Clearly some drug companies are taking advantage of the
fact that local monitoring and surveillance of drugs are
inadequate and hardly existent.
The double standards
practised by drug companies in marketing their drugs in
Malaysia and other Third World countries can lead to
wrong drug prescription and drug use.
Developing countries like Malaysia which already have
limited funds available for the provision of adequate
primary health care should not be spending money on un
necessary drugs.
CAP therefore calls upon the Ministry
of Health to ban the use of stanozolol, for the safety
and health of Malaysian consumers.
6
CHAPTER 2
STANOZOLOL: INN (International Nonproprietary Name
Selected By WO)
Stanozolol is an anabolic steroid which is a derivative
of testosterone
.
*
Testosterone and its derivatives are
used medically in androgen therapy in males and females
and as anabolic agents (agents that aid in the building
and repairing of body tissues).
In the male, androgen therapy may be employed as substi
tution therapy for testosterone deficiency.
Deficiency
states such as the male climacteric impotence (due to
androgen deficiency), delayed puberty, hypogonadism and
any other condition in which testosterone is deficient
or absent may respond to androgen therapy.
*
Testosterone is a natural male steroid hormone
produced by the testes.
Steroid hormones are
chemicals which control the development and
maintenance of reproductive organs in the body.
There is now a synthetic preparation available.
(Parish 1976: 206).
7
In the female, androgen therapy may be used as part of
the chemotherapeutic management of inoperable carcinoma
of the breast in those who are more than one year but
less than five years past menopause.
Postpartum breast
engorgement and pain in the non-nursing mother may also
be relieved with androgens.
Anabolic hormones, which
are closely related to or derived from testosterone, may
be useful in creating a positive nitrogen balance.
Patients in a debilitated state may benefit from androgen
therapy; however, diet and general health measures should
also be considered and should accompany androgen therapy.
Anabolic hormones may also be used in the treatment of
osteoporosis, certain types of anaemia, metastatic breast
cancer, and the reversal of nitrogen loss that may occur
during corticosteroid therapy.
(1)
Adverse Effects of Androgen Therapy
In the adult male, adverse effects are minimal when the
optimum dose is administered.
may occur.
Sodium and water retention
In the prepubertal male, precocious sexual
development may occur and require the discontinuation of
therapy.
In the female, masculinizing effects (deepening of voice,
facial hair, male-pattern baldness, etc) frequently occur
when androgens are administered for long periods of time.
These effects are usually irreversible, even when the
drug is promtply discontinued after the development of
masculinizing features.
These adverse drug effects do
8
not usually occur when androgens are used briefly to treat
post-parturn breast engorgement.
Oedema (water retention) and jaundice may be seen in both
sexes during androgen administration.
There may also be
an elevation of serum electrolytes (calcium, sodium,
potassium and chlorides) as well as changes in other
laboratory tests and studies (Scherer 1982: 154).
In failure of growth in children, especially if hypogonadal, androgens may occasionally be useful, but may
promote premature epiphyseal fusion.
Although they can
cause jaundice, they may relieve the itching associated
with jaundice.
In combination with oestrogens, they
may help in the treatment of post-menopausal disorders
(Girdwood 1979: 430).
Muscular development is enhanced by anabolic agents and
they have been used to promote the performance of athletes,
especially females: this use is contrary to the inter
national and most national rules of sports (Bowman, et
al, 1980: 206).
Stanozolol has been effective for increasing haemoglobin
levels in some patients with aplastic (congenital and
idiopathic) anaemia (Physicians' Desk Reference 1983: 2140).
It is probably effective as adjunctive but not primary
therapy in senile and post-menopausal osteoporosis (Ibid).
In pituitary dwarfism it may be used with care (Ibid).
9
(2)
Caution and Warnings
Stanozolol is contraindicated in men with cancer of the
prostate or breast (Martindale 28th ed: 1436).
It should
be avoided in pregnancy since virilisation of the female
foetus has been reported.
Its use should also be avoided
in patients with nephrosis (Ibid).
It should be used
cautiously in patients with circulatory failure, renal or
hepatic dysfunction, epilepsy, or migraine, which would
be aggravated by fluid retention (Ibid).
Given for prolonged periods, it can cause jaundice (Ibid:
1426).
Stanozolol lowers total testosterone by actions
at both pituitary and hepatic levels (Small, et al, 1984:
21, 49-55).
Anabolic steroids are known to cause a variety of changes
in plasma protein levels (Barbosa, et al, 1971: 388-398;
Laurel1, et al, 1979: 719-725).
Stanozolol can lower the
level of three important hormone-binding plasma proteins -
TBG, DBG (Globulins) and SHBG (fl Globulins).
(3)
Adverse Reactions
These include increase in nitrogen retention and skeletal
weight, sodium and water retention oedema, increased
vascularity of the skin, hypercalcaemia (excess of calcium
in the blood), and increased bone growth (Martindale 28th
ed: 1436).
Large and repeated doses in early puberty may
cause closure of the epiphysis (a piece of bone separated
from a long bone on early life by cartilage but later
10
becoming a part of the larger bone.
It is at this carti
laginous joint that growth in length of the bone occurs)
and stop linear growth (Ibid).
Elderly males may become
overstimulated (Ibid).
In women stanozolol leads to suppression of ovarian activity
and menstruation, produces male pattern hirsutism (abnormal
hairiness), causes deepening of the voice, atrophy of the
breasts (wasting away or diminution in size of the breasts)
and endometrial tissue, acne and hypertrophy (morbid en
largement or overgrowth) of the clitoris, increases libido
(sexual drive) and suppresses lactation (Ibid).
In men large doses suppress spermatogenesis and cause
degenerative changes in the seminiferous tubules (small
tubes producing or carrying semen) (Ibid).
Hepatic car
cinomas have developed in some patients given the drug for
prolonged periods (Ibid).
(4)
Dosage
The recommended dosage is 6 mg (three tablets) daily in
divided doses (Physicians * Desk Reference 1983: 2140).
The recommended daily dosage for children is:
Children under 6 years - | tablet (1 mg) twice daily.
Children 6-12 years - 1 tablet (2 mg) thrice daily (Ibid).
(5)
Studies
The effects of orally-administered stanozolol, 5 mg twice
11
daily, on fibrinolysis, coagulation and on various haema
tological and biochemical parameters were studied in 16
healthy adults, eight males and eight females.
There is
good evidence that stanozolol produces some degree of
fibrinolytic enhancement in both healthy adults- and patients
with various forms of vascular disease associated with
fibrinolytic impairment (Kluft, et al, 1984: 157-164).
More specific effects of stanozolol are a reduction of
plasma fibrinogen and an increase of plasma plasminogen,
Ci-inactivator and antithrombin III (Ibid).
The only stanozolol preparation marketed in the US is
Winstrol by Winthrop.
According to The Medical Letter
(Vol 15 No 6, 16/3/73) an independent non-profit publi
cation on drugs and therapeutics in the US, Winstrol is
considered too toxic for all but the narrowest indications
( cf Ledogar 1975: 27).
Winthrop’s entry on Winstrol in
the 1983 edition of the Physicians' Desk Reference states
that it can lead to serious disturbances of growth and
sexual development when given to children.
Premature
stunting of growth can occur, as can premature enlargement
of the penis and increased frequency of erections in boys.
In girls, increase in body hair, male pattern baldness,
deepening of the voice and clitoral enlargement can occur.
In girls,
’These changes are usually irreversible even
after prompt discontinuance of therapy’ (Physicians' Desk
Reference 1983: 2140).
According to The Medical Letter
’every child who takes the drug in the recommended dosage
for a long enough period of time will demonstrate these
12
effects’ (cf
Ledogar 1975: 28).
Stanozolol is not listed in the generic index in the
Monthly Index of Medical Specialities (MIMS) Australia
(Oct-Nov 1979 Vol 16 No 6).
In MIMS UK (January 1980 Vol 22 No 1), there is one
preparation containing stanozolol, namely Stromba (Izal),
which is used in ’Debilitating diseases, post-menopausal,
senile or corticosteroid-induced osteoporosis; acute renal
failure’ with Contraindications in ’prostatic carcinoma
and pregnancy’.
in
Special Precautions warn against its use
’impaired cardiac and renal function’.
In bold
lettering is stated that Stromba is ’Not recommended for
children *
.
13
CHAPTER 3
DRUG PROMOTION AND MARKETING IN THIRD WORLD COUNTRIES
In 1973, the American Medical Association warned that
anabolic steroids (like Winstrol)
’should not be used to
stimulate growth in children who are small but otherwise
normal and healthy
*
(Ledogar 1975: 28).
According to Robert Ledogar, in Latin America, Winthrop
was promoting Winstrol ’widely as (among other things) an
appetite stimulant for underweight children
*
(Ibid).
In Mexico, he came across a drug compendium based on
company-supplied information which was distributed to
doctors, recommending Winstrol ’in states in which weight
gain in children and adults is necessary, for loss of
appetite no matter what the cause, for beneficial action
to increase strength, interest, and general well-being
(Ibid).
In Brazil, he found boxes of Winstrol tablets which
carried the statement that ’in states of appetite loss
and malnutrition (Winstrol) stimulates appetite and improves
protein anabolism (protein build up)’ (Ibid: 28-29).
the drug inserts,
In
’thinness’ and ’alterations in nutrition
14
and growth in children’ were added, as well as many other
indications (Ibid).
There was also a Winstrol paediatric preparation for
children marketed in Brazil which was recommended for,
among other things, appetite loss, malnutrition, and thin
ness, specifying ’alterations in nutrition and growth in
children of pre-school age’ (Ibid).
In the Dominican Republic he found that Winstrol was
recommended for use in eight wide ranging conditions.
One
of them is ’non-malignant chronic diseases (renal, cardio
vascular, gastrointestinal, arthritic or chronic infections)
Another is ’retardation of growth in children’
(Ibid).
In 1975, Dr Milton Silverman also found wide discrepancies
of information on Winstrol by Winthrop in the countries in
Central and South America (Silverman 1976: 53, 59).
In
Mexico, Central America, Ecuador, Columbia and Brazil it
was promoted for the treatment of cirrhosis and chronic
hepatitis; as supportive therapy in both chronic and acute
illness in Mexico, Central America, Ecuador and Columbia;
and for convalescent, pre-operative and post-operative
care in Mexico, Central America, Ecuador, Columbia, Brazil
and Argentina (Ibid).
He also found that adverse reactions
like growth stunting in children, increase in body hair,
deepening of the voice and menstrual irregularities in
females were mentioned in Mexico and Brazil.
In Brazil
there was also premature sexual development in young males.
In Central America and Argentina, increase in body hair,
15
deepening of the voice and menstrual irregularities in
females were disclosed.
In Ecuador and Columbia none of
the adverse reactions listed above were listed (Ibid:
53, 60).
In 1979, Bill Breckon of The Listener found Winthrop
selling Winstrol suspension in Colombo, Sri Lanka (The
Listener 6/9/79: 290-292).
He also found that under
’demonstrated beneficial effects’ in the Winstrol leaflet
it concentrated solely on the trial use of Winstrol in
promoting the growth of convalescing children between
1J and 6J years of age.
(Ibid).
No other trial use was quoted
Winstrol suspension is not marketed in the US
and according to Wilfred Lionel, Associate Professor of
Pharmacology at Colombo University and Secretary of Sri
Lanka’s drug control committee, this was certainly a
paediatric preparation (Ibid).
16
CHAPTER 4
DRUG INFORMATION AND BRANDS SOLD IN MALAYSIA
In Malaysia, doctors obtain information on stanozolol from
three major sources.
a)
They are:
The Drug Index for Malaysia and Singapore (DIMS) .
DIMS is a quarterly publication on ethical medicines
available in Malaysia and Singapore.
It is prepared
by the pharmaceutical companies and distributed free
to doctors in both countries.
b)
Drug advertisements and brochures which are distri
buted free to doctors by drug company detailmen.
c)
Drug inserts which come together with the drugs
when they are purchased.
The insert gives infor
mation on the use of the drug, the dangers and the
precautions to be taken when the drug is used.
The
instructions and information on the drug insert are
provided by the company which markets its particular
brand product.
(1)
DIMS Information
DIMS (January 1982 Vol 11 No 1) lists only one preparation
for stanozolol: Winstrol tablet, manufactured by Winthrop/
17
Sterling.
The contents consist solely of stanozolol.
It
is a Group C Poison, which means that according to the law,
it can be dispensed by a pharmacist with entry in the
Prescription Book. Apart from this there are no restrict
ions on the use of this drug. However, CAP staff were
able to buy it over the counter without even so much as
an entry in the Prescription Book!
(2)
Warnings and Contraindications: Inadequate Information
Under Contraindications is listed:
’Cancer of the breast or prostate in males.
Cancer of breast in some females.
Pregnancy, nephrosis,
nephrotic phase of nephritis.’
It must be noted that the information provided is extremely
skimpy.
Although it is contraindicated in pregnancy, no
mention
is made of the fact that it should be avoided by
nursing mothers.
(3)
Indications Given
Besides the lack of information on adverse effects and
contraindications, the information given on indications
is also insufficient.
The drug is indicated for ’patients
with reduced protein synthesis or excessive breakdown of
proteins’.
18
Winstrol tablets, containing stanozolol, which were bought over the counter
without entry in the Prescription Book.
(4)
Dosages
The dosages for adults and children are listed as follows:
'Adults:
1 tablet three times daily
Children:
2-6 years : J tablet twice daily
6-12 years: 1 tablet twice daily'
The amount of stanozolol in each tablet is not listed.
20
CHAPTER 5
DRUG INFORMATION INSERT FOR WINSTROL
In the drug insert given with the drug in Malaysia,
Winthrop describes the action of Winstrol in the following
terms:
’Winstrol therapy leads to improvement in appetite,
increased vigor and sense of well-being and notable gains
in weight.
In children it has been observed that Winstrol
also produces a rapid increase in linear height without
accelerating bone maturation.’
It is recommended for use ’in all conditions with reduced
protein synthesis or excessive breakdown of proteins;
children and adolescents with retarded growth or under
weight; patients convalescing from acute illnesses;
patients with gastrointestinal disorders that interfere
with normal metabolism; to reduce catabolic breakdown of
the tissue in patients with kidney disease; for patients
with arthritis or osteoporosis to counteract catabolic
effects of prolonged steroid therapy; for patients with
decubitus ulcers; for pre- and post-operative care’.
all, there are eight wide ranging conditions for which
Winstrol is recommended.
21
In
Under ’Side Effects and Precautions ’ Winthrop states that
’prolonged administration of Winstrol has produced mild
hirsutism or voice change.
In occasional patients, the
menstrual periods have become milder and shorter.
All
these side effects are reversible with reducing or sus
pending medication’ (See Appendix).
Winthrop does not state in its drug insert that the ’mild
hirsutism or voice change’ refers to young girls, and the
side effects which are ’reversible’ is in direct contra
indication to its information in the Physicians’ Desk
Reference where it states:
’In females, hirsutism, male
pattern baldness, deepening of the voice, and clitoral
enlargement have occurred.
These changes are usually
irreversible even after prompt discontinuance of therapy.’
There is no mention that the drug given for prolonged
periods can cause jaundice.
Nowhere under this section
in the drug insert is it stated that Winstrol can lead
to premature stunting of growth in children, premature
enlargement of the penis and increased frequency of
erections in boys, male pattern baldness and clitoral
enlargement in girls over a prolonged period.
Winstrol in its information to doctors in Malaysia not
only deliberately leaves out important information and
plays down the dangers of the drug, it has been shown to
deliberately misinform users as well.
In promoting its
Winstrol product, Winthrop has also included a wide range
of conditions for which the drug can be used, unlike in
the US, where it is only used for aplastic anaemia, pituitary
dwarfism and as supplementary treatment in senile and
post-menopausal osteoporosis.
22
CHAPTER 6
CONCLUSION
This report has attempted to make a case for the need to
remove all stanozolol preparations from the market.
Stanozolol is a drug which has been found to have many
undesirable side effects.
Its promotion as an appetite
stimulant for children should not be continued as the
many side effects resulting from its use show.
It would
be worthwhile to quote once more the opinion voiced by
the American Medical Association when it said that anabolic
steroids (like Winstrol) should not be used to stimulate
growth in children who are small but otherwise normal and
healthy.
It has been found that the drug company promoting this drug
preparation has been practising double standards in its
marketing of Winstrol in Third World countries as compared
to developed countries.
For instance in Latin America in
1974, Winthrop was promoting Winstrol as an appetite
stimulant for underweight children.
This was also the
case in countries like Brazil, the Dominican Republic and
Sri Lanka.
The drug company is also irresponsibly promoting its
23
product in Malaysia.
Whereas in the Physicians' Desk
Reference Winthrop’s entry on Winstrol states that it
can lead to serious disturbances of growth and sexual
development when given to children, in Malaysia the
drug insert for Winstrol states that Winstrol therapy
leads to improvement in appetite, increased vigour and
sense of well-being and notable gains in weight.
Drug companies cannot be allowed to promote such a
dangerous drug for unnecessary conditions like appetite
stimulation.’
This kind of promotion can lead to irrational
drug prescription and drug use and to needless injury.
From the above it can be seen that drug companies have
been indulging in most unethical aggressive double
standard marketing of their drugs.
CAP strongly urges the Ministry of Health to recall this
drug preparation from the market for the safety and
health of Malaysian consumers.
The Ministry of Health
should immediately withold the sale of the drug until
proper labelling is carried out by Winthrop.
It should
also warn all doctors as soon as possible of the dangers
of the drug, and the limited conditions of its use.
24
REFERENCES
1.
Barbosa, J, et al, ’Effects of anabolic steroids
on haptoglobin, orosomucoid, plasminogen, fibri
nogen, transferrin, ceruloplasmin c/--antitrypsin,
-glucuronidase and total serum proteins’,
Journal of Clinical Endocrinology, Vol 33, 1971.
2.
Bowman, W C and Rand M J, Textbook of Pharmacology
2nd edition, Oxford: Blackwell Scientific 1980.
3.
Drug Index for Malaysia and Singapore Vol 11 No 1
January 1982.
4.
FDA classification of WINSTROL based on National
Academy of Sciences (NAC) and National Research
Council Review of Winstrol as cf Physicians'
Desk Reference.
5.
Girdwood, R H, Clinical Pharmacology 24th ed,
1979: 430.
6.
Kluft, C, et al, ’Stanozolol-induced Changes in
Fibrinolysis and Coagulation in Healthy Adults’,
Thrombosis & Haemostasis (Stuttgart) Vol 51 No 2
1984.
7.
Laurell, C B and Rannevik, G, ’A comparison of
plasma protein changes induced by danazol, preg
nancy and estrogens’, Journal of Clinical Endo
crinology and Metabolism, Vol 49, 1979.
8.
Ledogar, Robert J, Hungry for Profits, New York:
lODOC/North America 1975.
9.
Martindale: The Extra Pharmacopoeia, TwentyEighth Edition, 1982.
10.
Parish, Peter, Medicines: A Guide For Everybody,
Harmondsworth, Middlesex: Penguin 1976.
11.
Physicians' Desk Reference, 37th Edition, New
Jersey: Medical Economics Company 1983.
25
12.
Scherer, J C, Introductory Clinical Pharmacology,
2nd Edition, Philadelphia, Pa: Lippincott 1982.
13.
Silverman, Milton, The Drugging of The Americas,
Berkeley: University of California Press 1976.
14.
Small, M, et al, ’Stanozolol and hormone levels’,
Clinical Endocrinology 1984.
15.
The Listener, ’In Sickness or in Wealth’, Vol 102
No 26, 27, 6 September 1979, London: BBC.
16.
The Medical Letter: A Non-Profit Publication on
Drugs and Therapeutics Vol 15 No 6, 16 March 1973:
28.
26
APPENDIX
DRUG INFORMATION INSERT FOR WINSTROL
WINSTROL
• HAND Of STANOZOLOL
Stimulates protein synthesis in
anorexia, weight loss and inanition
DESCRIPTION: It has long been recognized that hormones, par
ticularly androgens, exert a positive influence on anabolic ac
tivity and play a major role in stimulating growth and positive
nitrogen balance, especially in adolescents. However, the use of
androgens as an aid to stimulating protein synthesis has been
limited in women because of the undesirable masculinizing
effects.
Winstrol is 17/J-hydroxy-17«-methylandrostano (3,2-c) pyrazole, a new heterocyclic steroid with marked anabolic but weak
androgenic activity. When administered orally in animals.
Winstrol was found to have about thirty times the anabolic activity
and one-fourth the androgenic activity of methyltestosterone.
ACTION: Winstrol increases the retention of nitrogen and min
erals, reverses tissue depleting processes and promotes better
utilization of dietary protein. Winstrol therapy leads to improve
ment in appetite increased vigor and sense of well-being and
notable gains in weight. In Children it has been observed that
Winstrol also produces a rapid increase in linear height without
accelerating bone maturation.
$
INDICATIONS: Winstrol stimulates the appetite and promotes
protein synthesis in all conditions characterized by negative
nitrogen balance whether due to insufficient absorption or inade
quate protein synthesis or to excessive breakdown of proteins.
Winstrol is indicated in all conditions with reduced protein
synthesis or excessive breakdown of proteins: children and
adolescents with retarded growth or underweight; patients con
valescing from acute illnesses; patients with gastrointestinal
disorders that interfere with normal metabolism; to reduce cata
bolic breakdown of the tissue in patients with kidney disease;
for patients with arthritis or osteoporosis to counteract catabolic
effects of prolonged steroid therapy; for patients with decubitus
ulcers; for pre- and post-operative care.
DOSAGE: The suggested initial dose for adults is 1 tablet (2 mg.)
three times daily just before or with meals. Although smaller
doses produce a response in some patients, consistently better
continued next page
results have been obtained with a daily dose of 6 mg. Higher
doses have been employed but. as a rule, have not improved
the results significantly.
The dosage for children should be adjusted according to age.
as follows: 1 tablet daily or ¥2 tablet twice daily for children
under 6 years, and 1 tablet twice daily for children from 6 to 12.
For young women who appear particularly susceptible to the
androgenic effects of the drug, 1 tablet twice daily appears
adequate for long-term administration. If this amount does not
produce the desired results, the dosage may be raised to 1 tablet
three times daily.
To obtain the maximal therapeutic effect, a well balanced
diet should accompany the administration of Winstrol.
SIDE EFFECTS AND PRECAUTIONS: Winstrol is well'tolerated.
particularly when the tablets are taken shortly before or with
meals. As is the case with other anabolic steroids, prolonged
administration of Winstrol has produced mild hirsutism or voice
change. In occasional patients, the menstrual periods have
become milder and shorter. All these side effects are reversible
with reducing or suspending medication. Patients with impaired
cardiac and renal function should be watched closely during
treatment because of the possibility of retention of sodium and
water. A reversible abnormality in the bromsulphalein reaction
has been observed with Winstrol as with all other anabolic
steroids currently available.
Although Winstrol has been employed in patients with cancer
of the prostate, its mild androgenic activity is considered by
some investigators to be a contraindication.
Neither Winstrol nor any other agent with any detectable
androgenic activity should be used in the pregnant patient.
HOW SUPPLIED: Winstrol is available as scored tablets of 2 mg.,
for easy administration of half-tablet doses to children.
WINTHROP PRODUCTS INC.
New York, N.Y.. U.S.A.
89022-503
OTHER REPORTS IN THE 'DRUGS AND THE THIRD WORLD
SERIES PUBLISHED BY CAP INCLUDE:
1)
* Oxyphenbutazone and Phenylbutazone
$5.00
2)
* Aminophenazone and * Dipyrone
$5.00
3)
* Chloroform
$3.00
4)
* Phenacetin
5)
* Pizotifen
6)
* Stanozolol
* Besides stanozolol, these drugs were also banned by the Malaysian
government a few months after the reports were presented to the
Ministry of Health.
OTHER RECENT TITLES FROM CAP ARE:
BUY
A HOUSE
membeli
rumah
WITHOUT GETTING
CHEATED
I tanpa ditipu
*
L*
A CAP GUIDE
1) Your Money and You
$8.00
2) Selling Dreams — How Advertising
Misleads Us
$6.00
3) Malaysian Consumers and Development
$5.00
4)
Buy a House — Without Getting Cheated
(available in English and Bahasa Malaysia)
$5.00
Drugs and the Third World:
Stanozolol
Toxicity and Unethical
Marketing in Malaysia
and the Third World
Stanozolol is an anabolic steroid drug being marketed in the Third
World and in Malaysia as an appetite stimulant for children. In the
US, however, the drug is considered very toxic and is not recom
mended for stimulating growth in children who are small but other
wise normal and healthy.
This report reveals the dangers of stanozolol to children, as well as
the double standards employed by drug companies in promoting
this drug in developing countries. It calls for a ban on the drug in
Malaysia.
In October 1986, a few months after CAP sent this report to the
Malaysian Ministry of Health, the government banned the sale of
stanozolol in Malaysia.
The Consumers’ Association of Penang (CAP) is a non-profit making organisa
tion which fights for the rights and interests of Malaysian consumers through
research, educational and representational activities.
The issues it takes up include the fulfilment of basic needs (food, nutrition,
health, housing, transport, etc.), food and product safety, environmental pollu
tion and problems, the rational use of resources, specific problems of women,
and business malpractices.
This is part of a series of CAP Reports aimed at providing the public with the
results of some of the important areas of CAP’s activities. It is hoped that this
series will generate public interest and awareness, and help to contribute towards
a better life for Malaysians.
Copyright (c)Consumers’ Association of Penang 1986
ISBN: 967 - 9950 - 28 -X
Position: 584 (12 views)