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Oxymetholone, an anabolic-androgenic steroid, is currently used to treat wasting related to HIV and other diseases. The drug was originally intended to treat anemia, hence its use in an HIV regimen is an off-label use, not directly approved by the Food and Drug Administration (FDA), and therefore is not always covered by health insurance. Oxymetholone is not always the first choice of treatment for HIV-associated wasting because of its potential for abuse. Children taking oxymetholone should be monitored regularly to ensure that it is not interfering with normal growth. The goal of this treatment is to maintain lean body mass, which is connected with increased chances of survival. Adverse side effects are discussed. Drug interactions exist with cimetidine, paroxetine, and haloperidol, but are not expected with indinavir, ritonavir, clarithromycin, or itraconazole. Information is provided on how to get assistance with the drug cost if coverage is denied by an insurance carrier.