12 Common medicines treatment hair loss in women - 5
11. Systemic flutamide for female
Systemic flutamide is an antiandrogen treatment for female pattern baldness.
Flutamide is a non-steroidal antiandrogen that is devoid of other hormonal activity. It most likely acts after converting to 2-hydroxyflutamide, which is a potent competitive inhibitor of dihydrotestosterone (DHT) binding to the androgen receptor. Flutamide is currently approved for the treatment of prostate cancer in combination with luteinizing hormone-releasing hormone (LHRH), wherein Flutamide is thought to inhibit the action of testosterone on cancer cells by blocking the receptor sites that testosterone uses in the cells.
Side Effects of flutamide
Side effects of oral Flutamide are primarily gastrointestinal, mainly diarrhea. A high incidence of dry skin (58 percent) has also been reported. An important side effect to be cautious about in oral administration is hepatotoxicity, including progressive liver failure, which limits the usefulness of the drug in androgenetic alopecia. Evidence of hepatic injury includes elevated serum transaminase (liver enzyme) levels, jaundice, hepatic encephalopathy, and death related to acute hepatic failure. Serum transaminase levels should be measured prior to starting treatment with Flutamide. Liver function tests also should be obtained at the first signs and symptoms suggestive of liver dysfunction, like nausea, vomiting, abdominal pain, fatigue, anorexia, "flu-like" symptoms or jaundice.
Flutamide should not be given to pregnant women or women desiring to become pregnant. If the drug crosses the placenta, it would be expected to produce male pseudohermaphroditism, similar to cyproterone acetate. Therefore Flutamide should be combined with an oral contraceptive pill in women of child-bearing potential to avoid the risk of pregnancy.
12. Systemic cyproterone acetate for female
Systemic cyproterone acetate is a popular treatment for female pattern baldness in Europe.
Cyproterone acetate belongs to the class of hormone inhibitors and has been prescribed to treat severe hirsutism in woman of childbearing age and also androgenetic alopecia in women. Every woman normally produces a certain amount of androgen, which is necessary for axillary and pubic hair formation and maintenance.
Cyproterone acetate is an anti-androgen and blocks the normal activity of androgen by suppressing the actions of testosterone (and its metabolite dihydrotestosterone) on tissues. The term antiandrogen, as defined by Dorfman, implies prevention of expression of androgen activity at target sites and does not include other mechanisms of decreasing androgen action, such as a decrease in production of androgens, interference with androgen metabolism, or change in androgen plasma protein binding. However, Cyproterone acetate exerts its effects by blocking the binding of dihydrotestosterone (DHT) to its receptors.
Cyproterone acetate is available in Europe, Asia and Canada, but not in the US. Oral cyproterone acetate is poorly absorbed (5 to 30 percent), with maximum plasma levels achieved in a few hours. 58 percent of the drug is excreted via bile and 30 percent via urine.
Side effects of cyclical antiandrogen therapy
Cyproterone acetate is potentially damaging to the liver (hepatotoxic) and liver function tests should be performed periodically. Women of childbearing potential must never get pregnant while taking Cyproterone. Fetal malformations (damage) can occur in patients on cyproterone; therefore the drug must be prescribed in conjunction with the contraceptive pill. Potential side effects of CAT are somewhat similar to those seen with intake of oral contraceptive pills and include :
- Nausea
- Headache
- Asthenia (lack of bodily strength
- Increased weight
- Decreased libido
- Breast discomfort and depression have been reported in more than 5 percent of cases treated with CAT
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