Cyproterone Acetate and Ethinyloestradiol

Anti-acne Preps · Anti-androgen/Oestrogen

Indications

Female acne.

Dosage

Adults: Females, 1 daily for 21 days starting on first day of menstrual cycle i.e. 1st day of the menstrual bleeding, then 7 tab free days. Children: Not recommended.

Adverse Effects

Abnormal biochemistry or haematology results, thromboembolism, GI upset, wt gain, headache, depression, mood changes, breast pain/tenderness, menstrual changes, breakthrough bleeding, chloasma, contact lens irritation. Reasons for immediate discontinuation of treatment: First signs of thrombophlebitis or thromboembolism or appearance of risk factors, pain or tightness in the chest, unexplained severe calf pain or swelling, occurrence of migraine for first time, unusually severe, frequent or prolonged headache, acute visual or auditory disturbance, increase in epileptic seizures, significant increase in BP, hepatitis, jaundice, liver enlargement, generalised itching, severe upper abdominal pain, onset of severe depression. Prolonged immobility, leg injury. Discontinue 6 weeks before major elective surgery. Pregnancy.

Risk Factor (Pregnancy/Lactation)

Contraindications: Multiple risk factors or severe single risk factor for venous or arterial thrombosis incl family history in 1st degree relative <45 years, severe hypertension, diabetes mellitus with vascular changes, disorders of lipid metabolism. History of severe hepatic disease, Dubin-Johnson or Rotor syndromes, liver tumours. VTE or arterial thrombosis, stroke, angina or TIA, Major surgery with prolonged immobilisation, history of migraine with focal aura. Sickle-cell anaemia, breast or endometrial cancer. History in pregnancy of pruritus, cholestatic jaundice, deteriorating otosclerosis, herpes gestationis. Undiagnosed abnormal vaginal bleeding. Precautions: There is a small increased risk of breast and cervical cancer being diagnosed in women taking combined oral contraceptives. Check BP before and regularly during treatment. Family history of VTE or arterial disease, family…

Interactions

Tizanidine, theophylline, etoricoxib, dasabuvir, other hormonal contraceptives, enzyme inducers ( incl rifampicin, St John's wort, anticonvulsants, barbiturates, griseofulvin, protease inhibitors, NNRTIs), lamotrigine, cyclosporin, ombitasvir/paritaprevir/ritonavir.

Advice to Patient

Swallow whole tablet with a drink, can be taken with or without meals. Take at the same time every day. Once the condition becomes better, discontinue medication 3 or 4 menstrual cycles later.

Pharmacokinetics

CYPROTERONE ACETATE: Absorption: Completely absorbed. Metabolism: Hepatic. Bioavailability: 88% of dose. Half-life elimination: Oral: 38 hrs. Time to peak, plasma: Oral: 3-4 hrs. Excretion: Bile (60%). Renal (33%). ETHINYLOESTRADIOL: Absorption: Rapidly and well absorbed from the GI tract. Metabolism: Hepatic. Excretion: Urine (59.2%). Faeces (2-3%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.