No documented drug–drug interactions for this medicine.
Alcohol adds hepatotoxicity to that of cyproterone (benign liver tumours and idiosyncratic hepatotoxicity reported with steroidal antiandrogens).
Moderate or avoid alcohol during prolonged treatments.
Site monograph (cyproterone — monitor liver function); EMC-UK Co-cyprindiol SmPC 4.4.
Cyproterone is contraindicated in liver disease — hepatic metabolism and hepatotoxicity (benign liver tumours reported with steroidal antiandrogens).
Exclude liver disease before starting; monitor liver function with prolonged use.
EMC-UK (MHRA) — Co-cyprindiol SmPC (product/9760) § 4.3 (liver disease): https://www.medicines.org.uk/emc/product/9760/smpc
Cyproterone (with oestrogen, as in Co-cyprindiol) is contraindicated in active/past thromboembolic disease — VTE risk (cyproterone acetate raises VTE risk even alone).
Exclude history of DVT/PE before starting; discontinue if VTE signs develop.
EMC-UK (MHRA) — Co-cyprindiol SmPC (product/9760) § 4.3 (VTE): https://www.medicines.org.uk/emc/product/9760/smpc
Contraindicated in pregnancy: cyproterone is a steroidal antiandrogen which, if given to a pregnant woman, would cause antiandrogenic effects on a male fetus (hypospadias, underdeveloped genitalia); it is also contraindicated near delivery. The Prontuário records: "The manufacturer recommends avoiding in confirmed pregnancy" (factor CM) and "Contraindicated during pregnancy, labour and the expulsive period".
Contraindicated in all trimesters; discontinue and confirm absence of pregnancy before starting treatment (dermatological indications/hirsutism) and after each cycle if using the ethinylestradiol combination.
Avoidance is recommended (Prontuário, Annex 2); antiandrogens may suppress lactation and excretion into milk is unknown — do not breastfeed during treatment.
Effective contraception mandatory during treatment (and 1 cycle after); the co-cyprindiol combination already contains ethinylestradiol for contraception — confirm adherence.
Prontuário Terapêutico INFARMED — Annex 1: "Cyproterone — The manufacturer recommends avoiding in confirmed pregnancy (CM)"; "Contraindicated during pregnancy, labour and the expulsive period"; Annex 2: "Cyproterone — Avoidance is recommended" (l. 42369). EMC-UK (MHRA) — Co-cyprindiol/Diane-35 SmPC: https://www.medicines.org.uk/emc/product/1804/smpc (section 4.6).
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
↓ effective androgens: peripheral antiandrogen + central progestogen; ↓ sebum, progressive ↓ hirsutism, ↓ prostate growth.
Competitive antagonist of the androgen receptor (AR) in target tissues; additionally central progestogenic effect (↓ GnRH → ↓ LH → ↓ testicular/ovarian testosterone).
Oral: rapid absorption (> 70%); peak 3–4 h; protein binding > 96%; food does not significantly affect absorption.
Extensive hepatic: sulfoxidation and hydroxylation to active/inactive metabolites; biliary/renal excretion; enterohepatic circulation.
~ 36–39 h (active sulfoxide; sustained pharmacological action between doses).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
