Last updated: October 29, 2014
Trade Names: Danocrine
Drug Class: Attenuated androgen, gonadotropin inhibitor
Preparations: 50-, 100-, 200-mg capsules
Dose: Hereditary angioedema, 400 mg/day in two or three divided doses; decrease if favorable response
Indications: Hereditary angioedema prophylaxis, fibrocystic breast disease, endometriosis, idiopathic thrombocytopenic purpura with refractory thrombocytopenia
Mechanism of Action: Prevents attacks of angioedema by increasing concentrations of C1 esterase inhibitor and thus C4; suppresses ovarian production of pituitary gonadotropins and ovarian hormone production; has weak androgenic effects
Contraindications: Hypersensitivity, pregnancy, significant renal or hepatic impairment, undiagnosed vaginal bleeding, androgen-dependent tumors
Precautions: Thromboembolic disease, hepatic or renal dysfunction, seizure disorders, migraines, cardiac disease, exclude pregnancy before starting and ensure adequate contraception
Pregnancy Risk: X
Common: Androgenic effects (hirsutism, irregular menstrual cycles, intercycle menstrual bleeding, weight gain), fluid retention
Less common: Cholestatic jaundice or liver dysfunction, pancreatitis, leukopenia, thrombocytopenia, rashes, benign intracranial hypertension
Drug Interactions: Increased effects of warfarin, carbamazepine, hypoglycemics, cyclosporine, tacrolimus. Increased rhabdomyolysis with statins.
Patient Instructions: Contraception with two reliable nonhormonal methods is recommended. Avoid sunlight because of photosensitivity.
Clinical Pharmacology: Hepatic metabolism and renal excretion; half-life 4–6 hours