Anti-androgen (steroidal)

Cyproterone acetate

Brand names: Cyprostat, Androcur

Adult dose

Dose: Prostate cancer: 100mg PO BD–TDS; Hirsutism: 50–100mg/day cycle days 5–14 with COC

Route: Oral

Frequency: OD–TDS

Clinical pearls

NICE NG131 prostate cancer; flare prevention with LHRH agonists
MHRA Drug Safety Update 2020: meningioma risk with cumulative dose ≥10g — restrict to lowest effective dose, shortest duration, contraindicated with meningioma history
BAD/RCOG hirsutism guidance — typically as Dianette (with ethinylestradiol) for severe acne / androgenic disorders

Contraindications

Severe hepatic disease
Active VTE
Meningioma history
Severe depression
Pregnancy
Hypersensitivity

Side effects

Hepatotoxicity (severe — fulminant hepatitis)
VTE
Meningioma (dose- and duration-related — MHRA)
Gynaecomastia
Loss of libido / erectile dysfunction
Mood change
Adrenal suppression

Interactions

CYP3A4 inducers
Statins (myopathy)
Antihypertensives

Monitoring

LFTs
BP
Mood
Bone density (long-term)
Meningioma surveillance (long-term high-dose)

Reference: BNF; NICE NG131; MHRA Drug Safety Update; BAD; https://bnf.nice.org.uk/drugs/cyproterone-acetate/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways