The oral bioavailability of oxandrolone is 97%.  Its plasma protein binding is 94 to 97%.  The drug is metabolized primarily by the kidneys and to a lesser extent by the liver .   Oxandrolone is the only AAS that is not primarily or extensively metabolized by the liver, and this is thought to be related to its diminished hepatotoxicity relative to other AAS.   Its elimination half-life is reported as to hours but is extended to hours in the elderly.   Approximately 28% of an oral dose of oxandrolone is eliminated unchanged in the urine and 3% is excreted in the feces . 
Alcohol consumption may exacerbate liver injury caused by other pathogenic factors, including hepatitis viruses. Approximately 20% of patients presenting with alcoholic hepatitis have concomitant hepatitis C virus infection. [ 7 ] Extensive epidemiologic studies suggest that the risk of cirrhosis in patients with chronic hepatitis C infection is greatly exacerbated by heavy alcohol ingestion. Possible mechanisms include the impairment of immune-mediated viral killing or enhanced virus gene expression due to the interaction of alcohol and hepatitis C virus.