Stopping cyproterone acetate.

Hi Gentlemen, just a question..... I have had orchedectomy and been taking cyproterone for 4 years or so. I understand it stops adrenal gland production of potential testosterone. I have been in remission since the nuts left....is it safe to stop using the drug. I stopped a couple of months ago and the hot flashes are very low and I can deal with that....cheers

[pjoshea13]

Hi Dave,

It is described as an antiandrogen [1] which would make it a cousin of the 'lutamides' - rather than Abiraterone (which does stop adrenal profuction of hormones.)

So you are castrate & wondering whether it is safe to stop the antiandrogen. What was the reasoning for adding the drug after the orchiectomy?

"Prostate cancer [1]

"CPA is used as an antiandrogen monotherapy and means of androgen deprivation therapy in the palliative treatment of prostate cancer in men.[9][87][88][89][90][91] It is used at very high doses by mouth or by intramuscular injection to treat this disease. Antiandrogens do not cure prostate cancer, but can significantly extend life in men with the disease.[92][93][87] CPA has similar effectiveness to GnRH modulators and surgical castration, high-dose estrogen therapy (e.g., with diethylstilbestrol), and high-dose nonsteroidal antiandrogen monotherapy (e.g., with bicalutamide), but has significantly inferior effectiveness to combined androgen blockade with a GnRH modulator and a nonsteroidal antiandrogen (e.g., with bicalutamide or enzalutamide).[87][93][94][95][96] In addition, the combination of CPA with a GnRH modulator or surgical castration has not been found to improve outcomes relative to a GnRH modulator or surgical castration alone, in contrast to nonsteroidal antiandrogens.[97] Due to its inferior effectiveness, tolerability, and safety, CPA is rarely used in the treatment of prostate cancer today, having largely been superseded by GnRH modulators and nonsteroidal antiandrogens.[98][99] CPA is the only steroidal antiandrogen that continues to be used in the treatment of prostate cancer.[93]

Dose-ranging studies of CPA for prostate cancer were not performed, and the optimal dosage of CPA for the treatment of the condition has not been established.[100][101] A dosage range of oral CPA of 100 to 300 mg/day is used in the treatment of prostate cancer, but generally 150 to 200 mg/day oral CPA is used.[102][103] Schröder (1993, 2009) reviewed the issue of CPA dosage and recommended a dosage of 200 to 300 mg/day for CPA as a monotherapy and a dosage of 100 to 200 mg/day for CPA in combined androgen blockade (that is, CPA in combination with surgical or medical castration).[104][89] However, the combination of CPA with castration for prostate cancer has been found to significantly decrease overall survival compared to castration alone.[105] Hence, the use CPA as the antiandrogen component in combined androgen blockade would appear not to be advisable.[105] When used by intramuscular injection to treat prostate cancer, CPA is used at a dosage of 300 mg once a week.[63]

The combination of CPA with an estrogen such as ethinylestradiol sulfonate or low-dose diethylstilbestrol has been used as a form of combined androgen blockade and as an alternative to the combination of CPA with surgical or medical castration."

-Patrick

[1] en.wikipedia.org/wiki/Cypro...

[Hidden in reply to pjoshea13]

Hi and thanks for helping out..cyproterone was added to stop hot flashes and it did work for that,cheers

[Tall_Allen]

Cyproterone does not prevent the adrenals from producing androgens. It is a weak steroidal anti-androgen. The drugs that stop the adrenals from producing androgens are abiraterone or ketoconazole. You do not need cyproterone after an orchiectomy, In fact, because cyproterone is steroidal, your cancer may adapt to feeding on it.

[Hidden in reply to Tall_Allen]

Thank you mate, very interesting for me to see this information. It was being used to stop hot flashes at 50 mg a day.