Rankings / Muscle & Strength

HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat)

Muscle & Strength · HIF activating agent

Tier C

High-risk evidence profile

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High-risk evidence profile
4.9 / 10
Tier C
Ev 6 Bn 5 Sf 3.5

Bottom line

Read Off Label grades HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat) as C (4.9/10) based on moderate evidence, med benefit magnitude, and a med-high-risk safety profile.

Its high-risk evidence profile reflects a Safety score of 3.5/10; reported benefits and harms can differ by indication, dose, route, duration, and population.

WADA coverage: cobalt, daprodustat/GSK1278863, IOX2, molidustat/BAY 85-3934, roxadustat/FG-4592, vadadustat/AKB-6548, xenon and K-11706.

Studied, labeled, or reported-use context: Clinical anemia dosing varies by agent and kidney-disease context; no performance dose — Rx/investigational depending country and agent; WADA S2 prohibited at all times; not individualized guidance.

What the evidence says

WADA coverage: cobalt, daprodustat/GSK1278863, IOX2, molidustat/BAY 85-3934, roxadustat/FG-4592, vadadustat/AKB-6548, xenon and K-11706. Cobalt and xenon are included here because WADA classifies them as HIF-activating oxygen-delivery agents.

Mechanism

HIF-prolyl hydroxylase inhibition raises endogenous erythropoietin signaling and iron-mobilization pathways, making anemia drugs attractive but risky endurance-doping candidates.

Studied, labeled, or reported dose & route

Clinical anemia dosing varies by agent and kidney-disease context; no performance dose

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat)'s effects?
Read Off Label rates the evidence for HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat) as Moderate and the benefit magnitude as med, producing an overall grade of C (4.9/10). WADA coverage: cobalt, daprodustat/GSK1278863, IOX2, molidustat/BAY 85-3934, roxadustat/FG-4592, vadadustat/AKB-6548, xenon and K-11706.
What safety findings are reported for HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat)?
HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat) has a med-high risk profile in the database. Med-High (thrombosis/vascular concerns, hypertension, tumor-biology uncertainty, off-label misuse risk) Legal status: Rx/investigational depending country and agent; WADA S2 prohibited at all times.
What does the low Safety score for HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat) represent?
The Safety score is 3.5/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.
What doses or routes are reported for HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat)?
Clinical anemia dosing varies by agent and kidney-disease context; no performance dose This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does HIF stabilizers / prolyl-hydroxylase inhibitors (roxadustat / daprodustat / vadadustat) work?
HIF-prolyl hydroxylase inhibition raises endogenous erythropoietin signaling and iron-mobilization pathways, making anemia drugs attractive but risky endurance-doping candidates.

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.