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

Adverse Effects
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

Cost: $$$$


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