Drug Action
Danazol inhibits pituitary gonadotrophins; it combines androgenic activity with antioestrogenic and antiprogestogenic activity.
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Drug reference
Danazol inhibits pituitary gonadotrophins; it combines androgenic activity with antioestrogenic and antiprogestogenic activity.
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Endometriosis ▶BY MOUTH ▶Adult: 200–800 mg daily in up to 4 divided doses usually for 3–6 months, dose to be adjusted to achieve amenorrhoea, in women of child-bearing potential, treatment should start during menstruation, preferably on day 1 Severe pain and tenderness in benign fibrocystic breast disease not responding to other treatment ▶BY MOUTH ▶Adult: 300 mg daily in divided doses usually for 3–6 months, in women of child-bearing potential, treatment should start during menstruation, preferably on day 1 Hereditary angioedema ▶BY MOUTH ▶Adult: Initially 100–200 mg daily, dose to be reduced according to response, in women of child-bearing potential, treatment should start during menstruation, preferably on day 1 l UNLICENSED USE Not licensed for use in hereditary angioedema.
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Acute porphyrias p. 1120. androgen-dependent tumours. thromboembolic disease. undiagnosed genital bleeding
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Cardiac impairment (avoid if severe). diabetes mellitus. elderly. epilepsy. history of thrombosis or thromboembolic disease. hypertension. lipoprotein disorder. migraine. polycythaemia
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→Appendix 1: danazol
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Alopecia. aminolevulinic acid synthetase induction. anxiety. appetite increased. breast atrophy. carpal tunnel syndrome. clitoris enlarged. contact lens intolerance. cutaneous lupus erythematosus. depressed mood. dizziness. embolism and thrombosis. emotional lability. eosinophilia. epigastric pain. epilepsy exacerbated. face oedema. fatigue. fever. fluid retention. flushing. glucose tolerance impaired. haematuria. headaches. hepatic disorders. hirsutism. hypertension. idiopathic intracranial hypertension. insulin resistance. Endocrine system joint disorders. leucopenia. libido disorder. menstrual cycle irregularities. muscle contractions involuntary. muscle cramps. myocardial infarction. nausea. neoplasms . pain. palpitations. pancreatitis. photosensitivity reaction. polycythaemia. respiratory disorders. seborrhoea. skin reactions. speech pitch disorder. spermatogenesis reduced. splenic peliosis. tachycardia. throat pain. thrombocytopenia. tremor. vertigo. vision disorders. voice alteration. vulvovaginal disorders. weight increased SIDE-EFFECTS, FURTHER INFORMATION Withdraw if virilisation effects occur—may be irreversible on continued use.
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Ensure patients with amenorrhoea are not pregnant. Non-hormonal contraceptive methods should be used, if appropriate.
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Avoid; has weak androgenic effects and virilisation of female fetus reported.
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No data available but avoid because of possible androgenic effects in infant.
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Manufacturer advises caution; avoid in marked impairment.
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Caution in renal impairment (avoid if severe).
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Manufacturer advises periodic monitoring of hepatic function and haematological state (including biannual hepatic ultrasonography for treatment exceeding 6 months or repeated courses of treatment).
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: capsule Capsule ▶Danazol (Non-proprietary) Danazol 100 mg Danazol 100mg capsules | 28 capsule P £18.40 DT = £10.08 e Danazol 200 mg Danazol 200mg capsules | 56 capsule P £36.31–£66.20 DT = £36.32 e ▶Danol (Sanofi) Danazol 100 mg Danol 100mg capsules | 60 capsule P £16.38 e Danazol 200 mg Danol 200mg capsules | 60 capsule P £32.43 e Hypothalamic and anterior pituitary hormone related disorders Hypothalamic and anterior pituitary hormones Anterior pituitary hormones Corticotrophins Tetracosactide p. 784 (tetracosactrin), an analogue of corticotropin (ACTH), is used to test adrenocortical function; failure of the plasma cortisol concentration to rise after administration of tetracosactide indicates adrenocortical insufficiency. Both corticotropin and tetracosactide were formerly used as alternatives to corticosteroids in conditions such as Crohn’s disease; their value was limited by the variable and unpredictable therapeutic response and by the waning of their effect with time. Gonadotrophins Follicle-stimulating hormone (FSH) and luteinising hormone Endocrine system (LH) together, or follicle-stimulating hormone alone (as in follitropin), are used in the treatment of infertility in women with proven hypopituitarism or who have not responded to clomifene citrate p. 809, or in superovulation treatment for assisted conception (such as in vitro fertilisation). The gonadotrophins are also occasionally used in the treatment of hypogonadotrophic hypogonadism and associated oligospermia. There is no justification for their use in primary gonadal failure. Growth hormone Growth hormone is used to treat deficiency of the hormone in children and in adults. In children it is used in Prader- Willi syndrome, Turner syndrome, chronic renal insufficiency, short children considered small for gestational age at birth, and short stature homeobox-containing gene (SHOX) deficiency. Growth hormone of human origin (HGH; somatotrophin) has been replaced by a growth hormone of human sequence, somatropin p. 788, produced using recombinant DNA technology. Mecasermin, a human insulin-like growth factor-I (rhIGF- I), is licensed to treat growth failure in children and adolescents with severe primary insulin-like growth factor-I deficiency. Hypothalamic hormones Gonadorelin p. 785 when injected intravenously in normal subjects leads to a rapid rise in plasma concentrations of both luteinising hormone (LH) and follicle-stimulating hormone (FSH). It has not proved to be very helpful, however, in distinguishing hypothalamic from pituitary lesions. Gonadorelin analogues are indicated in endometriosis and infertility and in breast and prostate cancer. Adrenocortical function 7.1 testing PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES › CORTICOTROPHINS
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200–800 mg daily in up to 4 divided doses
First-line fragment. Read the complete Indications and Dose section above.
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300 mg daily in divided doses usually for
First-line fragment. Read the complete Indications and Dose section above.
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Initially 100–200 mg daily, dose to be reduced
First-line fragment. Read the complete Indications and Dose section above.
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