cyproterone acetate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
cyproterone acetate: clinical details
Prescribing considerations
- For indications other than prostate cancer, reserve treatment for situations where alternative interventions are unavailable or inappropriate.
- Assess cumulative exposure and discuss the rare, exposure-dependent risk of meningioma.
- Consider thromboembolic risk, diabetes control, mood, fertility and long-term effects of androgen deprivation.
- Cyproterone acetate is not a male contraceptive; consider baseline semen assessment when future fertility is relevant.
Contraindications and cautions
- Current or previous meningioma
- Liver disease and specified liver tumours
- Current thrombosis or embolism; Androcur also excludes a history of these events
- Malignancy other than prostate carcinoma, subject to product-specific wording
- Androcur-specific exclusions include severe diabetes with vascular changes, sickle-cell anaemia and severe chronic depression
- Hypersensitivity and use before completion of puberty
Monitoring
- Liver function before and during treatment, and when hepatotoxicity is suspected
- Clinical surveillance for meningioma symptoms or signs; permanently discontinue if diagnosed
- Blood count during long-term treatment
- Adrenocortical function during treatment
- Glucose control in people with diabetes
- Consider bone health during prolonged androgen deprivation
Clinical pharmacology
A steroidal anti-androgen with progestogenic and antigonadotrophic effects. It competitively blocks androgen receptors and suppresses gonadotrophin release, reducing testicular androgen production. Oral absorption is high, metabolism includes CYP3A4 pathways, and it is strongly albumin-bound.
Formulation and product differences
- Both selected products are scored, lactose-containing oral tablets.
- Cyprostat is licensed for specified prostate-cancer roles; Androcur is licensed for restricted control of libido in adult men.
- Contraindications differ slightly by product and indication, so the relevant product SmPC should be checked.
cyproterone acetate preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg
cyproterone acetate interactions
Tell the prescriber or pharmacist about all prescribed, non-prescribed and herbal products.
Rifampicin, phenytoin and St John's wort
These can increase cyproterone metabolism and reduce its concentration and effect.
Strong CYP3A4 inhibitors, including azole antifungals and ritonavir
These may slow cyproterone metabolism and increase exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.