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Synthetic non-steroidal oestrogen (legacy)

Diethylstilbestrol

Brand names: DES (special import)

Diethylstilbestrol is a synthetic non-steroidal oestrogen now used rarely, principally as a hormonal treatment for advanced prostate cancer.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

As an oestrogen-receptor agonist it suppresses the hypothalamic-pituitary-gonadal axis, lowering luteinising hormone and consequently testosterone, depriving androgen-dependent prostate tumour cells of stimulation.

Prescribing in practice

  • It carries a substantial risk of thromboembolic and cardiovascular events, so cardiovascular risk must be assessed and it is generally avoided where this risk is significant.
  • Fluid retention, gynaecomastia and hepatic effects are recognised and may limit use.
  • It is reserved for selected cases under specialist oncology or urology supervision when other options are unsuitable.

Monitoring

Monitor for thromboembolic and cardiovascular events, fluid retention and liver function during treatment.

Counselling the patient

  • Seek urgent help for chest pain, leg swelling or pain, or sudden breathlessness, which may signal a clot.
  • Breast tenderness or enlargement can occur with this medicine.

Evidence & guidelines

Diethylstilbestrol's androgen-suppressing effect in prostate cancer is long established, though thromboembolic toxicity has limited its modern role.

Reference: ESMO prostate cancer; NICE NG131; specialist hospital protocols; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.