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6 Hair Removal Prescription Oral Medications - 3
1. Spironolactone (Aldactone)
2. Finasteride (marketed as Propecia and Proscar)
3. Flutamide
4. Cyproterone acetate (not available in the US)
5. Ketoconazole
6. Gonadotrophin releasing hormone agonists
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Ketoconazole
Ketoconazole is a relatively new and particularly potent anti androgen drug. Since 1985 there have been various studies suggesting that ketoconazole could be used to treat hirsutism. Ketoconazole works by blocking the production of hormones by the ovaries and the adrenal glands.
As with other antiandrogen drugs, there are several different research reports that claim a reduction in hirsutism with different drug use protocols. The intake of ketoconazole may range from 200mg to 400mg a day.
Although the list of references below might seem to suggest that ketoconazole is a popular treatment for hirsutism, most dermatologists are wary of using it on a regular basis. Because it is such a powerful anti androgen, some dermatologists believe the risk of side effects is greater than with other antiandrogen drugs.
Dermatologists are particularly concerned with the risk of hepatotoxicity when using ketoconazole. Most dermatologists only use ketoconazole when the hirsutism is particularly pronounced and even then the drug is only prescribed for a brief period of time before switching to other antiandrogen drugs.
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Gonadotrophin releasing hormone agonists
Gonadotrophin releasing hormone agonists (GnRH) have been suggested as potential treatments for hirsutism. The most common GnRH agonists used are leuprolide acetate, buserelin and decapeptyl. GnRH agonists are drugs that decrease ovarian steroid production and some studies show that GnRH agonists could be very effective for treating hirsutism where ovarian hyperandrogenism (too much androgen production by the ovaries) is the problem. However, the effect of GnRH agonists is on ovarian production so they are not very effective for hirsutism where the root cause is over activity of the adrenal glands.
GnRH agonists are still primarily an experimental treatment. Some studies suggest that addition of GnRH agonists to treatment using antiandrogen drugs prolongs remission of hirsutism. GnRH agonists have to be taken along with hormone replacement therapy (often called "add back treatment") as the GnRH agonist shuts down ovarian hormone production almost completely so while androgens are no longer produced, neither are estrogens and progesterones. Hormone replacement is particularly important as using GnRH agonists without estrogen and progesterone supplements bone density decreases significantly.
The greatest barrier to wide spread use of GnRH agonists is that the drugs are quite expensive compared to cyproterone acetate or spironolactone.
1. Spironolactone (Aldactone);
2. Finasteride (marketed as Propecia and Proscar)
3. Flutamide;
4. Cyproterone acetate (not available in the US)
