Androcur

Androcur is an oral antiandrogen. Its only active ingredient is Cyproterone Acetate 50 mg, with no ethinylestradiol added.

The medicine works against male hormones (androgens), so it is used for conditions linked to male hormones, as set out in its package insert.

This page follows Bayer's package insert (South African version) and the UK product information. Indications and doses can differ between countries, so ask a doctor or pharmacist before taking it.

According to Bayer's package insert, the 50 mg tablet is labelled as follows.

• Women — severe signs of male-hormone effects: very severe hirsutism (excess hair growth) and severe androgenic hair loss, often with severe acne or oily skin.
• Men — reducing sex drive in sexual deviations, and anti-androgen treatment in inoperable prostate cancer.

In the UK the approved use of the 50 mg tablet covers only control of sex drive in men, while the EMA states that its new restrictions leave the prostate cancer use unchanged.

Restriction on use: doses of 10 mg a day or more are to be used only after other options, including lower doses, have failed, and at the lowest effective dose (prostate cancer excepted).

The dose depends on the indication. Per Bayer's package insert the tablets are taken after a meal, and the treating doctor sets dose and duration.

• Women of child-bearing age — must also take a combined oral contraceptive throughout treatment. One full pill cycle comes first, and pregnancy must be excluded before starting. Then 2 tablets (100 mg) are taken after a meal on days 5 to 14 of the cycle, every 28 days. Once the condition improves, this is reduced to 1 or half a tablet during those 10 days.
• Women after the menopause or a hysterectomy — half to 1 tablet once daily for 21 days, then 7 days off.
• Men (reducing sex drive) — start with 1 tablet twice daily after meals, then keep the lowest effective dose, often half a tablet twice daily, reducing gradually.
• Men (prostate cancer) — the insert states 100 mg two to three times daily. This dose is set individually by the treating doctor.

Do not change the dose or stop taking it without talking to a doctor.

Common side effects listed in the package insert include weight change, low mood, restlessness, shortness of breath, effects on the liver, tiredness and breast tenderness.

• Men — lower sex drive, erectile dysfunction, reduced sperm production that is reversible, breast enlargement, hot flushes and sweating.
• Women — ovulation is inhibited (when taken with the combined pill).

Blood clots have been reported, but a causal link has not been established, and the risk is higher in people who have had a clot before.

Do not take Androcur in the following cases, according to Bayer's package insert and the UK product information.

• Pregnancy or breastfeeding
• Liver disease, including Dubin-Johnson and Rotor syndromes
• A previous or existing liver tumour
• Other malignant tumours (prostate cancer excepted), per the UK document
• Wasting diseases
• Severe chronic depression
• A previous or existing blood clot (thromboembolism)
• Severe diabetes with vascular changes
• Sickle-cell anaemia
• A current or past meningioma
• Women with jaundice or persistent itching in a past pregnancy
• Women with a history of herpes of pregnancy (herpes gestationis)
• Before the end of puberty (the UK document says under 18)
• Allergy to the active ingredient or any other ingredient

Women taking it with a combined pill must also check that pill's own do-not-use list. If you are unsure whether any of these applies to you, ask a doctor or pharmacist before taking it.

Liver — the medicine can be directly toxic to the liver, causing jaundice, hepatitis and liver failure. This is dose-related and usually appears after several months. Fatal cases were mainly in men with advanced prostate cancer on a high dose. Liver function must be tested before treatment and regularly during it.

Meningioma — seen mainly at 25 mg a day and above, and the risk rises with the cumulative dose. In a French cohort of 253,777 women using 50 to 100 mg tablets, meningiomas treated by surgery or radiotherapy occurred at 4.5 per 100,000 patient-years below a cumulative 3 g, 26 at 12 to 36 g, 54.4 at 36 to 60 g and 129.1 above 60 g. A total of 36 g is about one year at 100 mg a day.

Warning signs — vision changes, hearing loss or ringing in the ears, loss of smell, worsening headaches, memory loss, seizures or weakness in the limbs. See a doctor promptly if any appear. If a meningioma is diagnosed, Androcur must be stopped permanently.

Androcur is a single-ingredient antiandrogen at 50 mg. The products below are combined hormone pills for oral use with only 2 mg of cyproterone, so all three are a different group and cannot replace Androcur.

• Diane-35 (Cyproterone + Ethinylestradiol) — a strip of 21 tablets
• Sucee (Cyproterone + Ethinylestradiol) — available as a strip of 21 or 28 tablets
• Annie 21 (Cyproterone + Ethinylestradiol) — made by JSP

In short: if you need a medicine for Androcur's labelled uses, follow what the doctor has set and do not switch to a combined pill yourself.

Tell a doctor or pharmacist about every medicine you take, including supplements and herbal products, because Androcur is processed in the body by the CYP3A4 enzyme.

• Raise the level of Androcur — ketoconazole, itraconazole, clotrimazole, ritonavir
• Lower the level of Androcur — rifampicin, phenytoin, St John's Wort
• Statin cholesterol medicines — carry a risk of muscle damage (myopathy) at high doses
• Diabetes medicines — the amount needed may change

Do not start or stop any of these on your own, because they can change how much Androcur is in the body.

Where to buy Androcur?

Order online at Intimo Life, with delivery across Thailand in 1-3 working days. Parcels are packed discreetly for privacy, with no product name shown on the outer box.