6/10/2023

Janusmed kön och genus

Janusmed kön och genus – Zyrona

Janusmed kön och genus är ett kunskapsstöd som tillhandahåller information om köns- och genusaspekter på läkemedelsbehandling. Kunskapsstödet är avsedd främst för hälso- och sjukvårdspersonal. Texterna är generella och ska inte ses som behandlingsriktlinjer. Det är alltid behandlande läkare som ansvarar för patientens medicinering.

För att komma till startsidan för Janusmed kön och genus och för att göra sökningar klicka här.

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B B
B B

Etinylestradiol

Etinylestradiol

Klass: B

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Produkter

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Abelonelle 28, Amorest 28, Anastrella 28, Cilest, Ciles......

Abelonelle 28, Amorest 28, Anastrella 28, Cilest, Cilest 28, Cleodette, Cleodette 28, Cleonita, Cleosensa, Cleosensa 28, Daylette, Desolett, Desolett 28, Diane, Dienorette, Diza, Dizmine 28, Dizminelle, Eloine, Erlibelle, Estrelen, Estron, Evra, Femistad, Leverette, Leverette 21, Levesia, Levonorgestrel/Etinylestradiol 2care4, Levonorgestrel/Etinylestradiol Ebb, Liofora, Loette 28, Mercilon, Mercilon 28, Midiana, Midiana 28, Ministat, Neovletta, Neovletta 28, Novogyn, NuvaRing, Ornibel, Orthonett Novum, Prionelle, Prionelle 28, Restovar, Rigevidon, Rigevidoncont, Rosal 28, Stefaminelle, Synfase, Synfase 28, Synphase, Triella, Trimiron 28, Trinordiol, Trinordiol 28, Trinovum, Trinovum 28, Trionetta, Trionetta 28, Triregol, Vagiprev, Valette, Yasmin, Yasmin 28, Yasminelle, Yasminelle 28, Yaz, Zelle, Zellmine, Zellmine 28, Zellminelle, Zellminelle 28, Zyrona
ATC-koder

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G02BB01, G03AA03, G03AA05, G03AA07, G03AA09, G03AA11......

G02BB01, G03AA03, G03AA05, G03AA07, G03AA09, G03AA11, G03AA12, G03AA13, G03AA16, G03AB, G03AB02, G03AB03, G03AB04, G03AB05, G03HB01
Substanser

etinylestradiol, etinylestradiol betadex, etinylöstradiol

etinylestradiol, etinylestradiol betadex, etinylöstradiol
Sammanfattning

Eftersom substansen bara används av kvinnor har analys avseende könsskillnader inte bedömts relevant.

Eftersom substansen bara används av kvinnor har analys avseende könsskillnader inte bedömts relevant.
Background

Ethinyl estradiol is a synthetic, steroidal estrogen primarily used in combination products for contraception or hormone replacement therapy [1-2].

Ethinyl estradiol is a synthetic, steroidal estrogen primarily used in combination products for contraception or hormone replacement therapy [1-2].
Försäljning på recept

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Fler kvinnor än män hämtade ut läkemedel innehållande kombinationer med etinylestradiol (ATC-koder G03AA03,05,07,09, G03AA11-13, G03AB02-05, G02BB01) på recept i Sverige år 2016, totalt 314 312 kvinnor och 11 män. Det motsvarar 64 respektive 0 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 20-24 år hos kvinnor [3].
Referenser

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  1. Fass.se [cited 2016-12-20].

  2. Physicians' Desk Reference. http://www.pdr.net. [cited 2016-12-20].

  3. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2016 [cited 2017-06-20.]

  1. Fass.se [cited 2016-12-20].
  2. Physicians' Desk Reference. http://www.pdr.net. [cited 2016-12-20].
  3. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2016 [cited 2017-06-20.]
Uppdaterat

Litteratursökningsdatum 12/20/2016

Litteratursökningsdatum 12/20/2016
B B
B B

Cyproteron

Cyproteron

Klass: B

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Produkter

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Androcur, Androcur Depot, Climen, Cyproteron Mylan, Cyp......

Androcur, Androcur Depot, Climen, Cyproteron Mylan, Cyproteronacetat Ebb, Diane, Zyrona
ATC-koder

G03HA01, G03HB01

G03HA01, G03HB01
Substanser

cyproteron, cyproteronacetat

cyproteron, cyproteronacetat
Sammanfattning

Cyproteron är en antiandrogen med olika indikation hos kvinnor och män vilket gör det svårt att göra jämförelse. De vanligaste biverkningarna, men inte de allvarliga, skiljer sig åt mellan kvinnor och män. Meningiom är en ovanlig biverkan av högdosbehandling av cyproteron och en retrospektiv kohortstudie har visat på högre risk hos kvinnor.

Cyproteron är en antiandrogen med olika indikation hos kvinnor och män vilket gör det svårt att göra jämförelse. De vanligaste biverkningarna, men inte de allvarliga, skiljer sig åt mellan kvinnor och män. Meningiom är en ovanlig biverkan av högdosbehandling av cyproteron och en retrospektiv kohortstudie har visat på högre risk hos kvinnor.
Background

Cyproterone is an antiandrogen with different indications in men and women. In men, it is primarily used to decrease the sex-drive in men with paraphilia or in sex offenders [1-2]. but also in prostate cancer [3]. In fertile women, it is used to treat extensive hirsutism [1-2]. The substance is also one of the main antiandrogen medications used in feminizing hormone therapy in transgender men [4].

In combination with ethinylestradiol cyproterone is used for treatment of moderate to severe acne or hirsutism in women [1-2]. It might also be used as an oral contraceptive drug in women but this is not a primary indication.

Pharmacokinetics and dosing
No studies comparing pharmacokinetic properties in men and women have been found. One small study in healthy men (n=28, ages 22-74 years) found an age-dependent change in apparent clearance and volume of distribution causing a longer terminal half-life of cyproterone in older men [5].

Effects
Cyproterone is used on different indications in men and women and thus comparison of effects is not relevant.

Adverse effects
The most common re......

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Cyproterone is an antiandrogen with different indications in men and women. In men, it is primarily used to decrease the sex-drive in men with paraphilia or in sex offenders [1-2]. but also in prostate cancer [3]. In fertile women, it is used to treat extensive hirsutism [1-2]. The substance is also one of the main antiandrogen medications used in feminizing hormone therapy in transgender men [4]. In combination with ethinylestradiol cyproterone is used for treatment of moderate to severe acne or hirsutism in women [1-2]. It might also be used as an oral contraceptive drug in women but this is not a primary indication. # Pharmacokinetics and dosing No studies comparing pharmacokinetic properties in men and women have been found. One small study in healthy men (n=28, ages 22-74 years) found an age-dependent change in apparent clearance and volume of distribution causing a longer terminal half-life of cyproterone in older men [5]. # Effects Cyproterone is used on different indications in men and women and thus comparison of effects is not relevant. # Adverse effects The most common reported adverse events in men are decreased libido, erectile dysfunction, and reversible inhibition of the spermatogenesis. In women, the most commonly reported adverse events are spot bleedings, increased weight, and depression [1]. The most severe adverse events in both men and women are hepatotoxicity, benign and malignant hepatic tumors which may lead to intraabdominal bleeding, and thromboembolic events [1]. In rats, considerably higher doses (five-fold) have been needed to induce hepatic tumors [6]. Meningioma is an uncommon adverse effect of cyproterone treatment [7]. An observational retrospective cohort study from Spain (130 men, 326 women with meningiomas identified in 2 137 191 persons of which 2 474 used high dose cyproterone) found an increased risk of meningioma in those with high doses of cyproterone during a period of at least 2 years of 11.4 (95% CI 4.3, 30.8) (8). Women were found to have a risk ratio of 2.0 compared to men [7]. # Reproductive health issues Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).
Försäljning på recept

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Fler män än kvinnor hämtade ut cyproteron (ATC-kod G03HA01) på recept i Sverige år 2016, totalt 700 män och 269 kvinnor. Fler kvinnor än män hämtade ut läkemedel innehållande kombination av cyproteron och etinylestradiol (ATC-kod G03HB01) på recept i Sverige år 2016 totalt 6 124 kvinnor och 4 män [8].
Referenser

Visa referenser

  1. Androcur (cyproteron). Summary of Product Characteristics. Medical Products Agency (MPA); 2017.

  2. Cyproterone. Drugscom [www]. [cited 2017-07-11].

  3. Fung R, Hellstern-Layefsky M, Tastenhoye C, Lega I, Steele L. Differential Effects of Cyproterone Acetate vs Spironolactone on Serum High-Density Lipoprotein and Prolactin Concentrations in the Hormonal Treatment of Transgender Women. J Sex Med. 2016;13:1765-1772.

  4. Ola Bratt. Prostatacancer. Internetmedicin [www]. [cited 2017-07-11].

  5. Kuhnz W, Kulmann H, Fuhrmeister A. Investigation into the age-dependence of the pharmacokinetics of cyproterone acetate in healthy male volunteers. Eur J Clin Pharmacol. 1997;53:75-80.

  6. Ding W, Bishop ME, Pearce MG, Davis KJ, White GA, Lyn-Cook LE et al. Sex-specific dose-response analysis of genotoxicity in cyproterone acetate-treated F344 rats. Mutat Res Genet Toxicol Environ Mutagen. 2014;774:1-7.

  7. Gil M, Oliva B, Timoner J, Maciá MA, Bryant V, de Abajo FJ. Risk of meningioma among users of high doses of cyproterone acetate as compared with the general population: evidence from a population-based cohort study. Br J Clin Pharmacol. 2011;72:965-8.

  8. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2016 [cited 2017-06-20.]

  1. Androcur (cyproteron). Summary of Product Characteristics. Medical Products Agency (MPA); 2017.
  2. Cyproterone. Drugscom [www]. [cited 2017-07-11].
  3. Fung R, Hellstern-Layefsky M, Tastenhoye C, Lega I, Steele L. Differential Effects of Cyproterone Acetate vs Spironolactone on Serum High-Density Lipoprotein and Prolactin Concentrations in the Hormonal Treatment of Transgender Women. J Sex Med. 2016;13:1765-1772.
  4. Ola Bratt. Prostatacancer. Internetmedicin [www]. [cited 2017-07-11].
  5. Kuhnz W, Kulmann H, Fuhrmeister A. Investigation into the age-dependence of the pharmacokinetics of cyproterone acetate in healthy male volunteers. Eur J Clin Pharmacol. 1997;53:75-80.
  6. Ding W, Bishop ME, Pearce MG, Davis KJ, White GA, Lyn-Cook LE et al. Sex-specific dose-response analysis of genotoxicity in cyproterone acetate-treated F344 rats. Mutat Res Genet Toxicol Environ Mutagen. 2014;774:1-7.
  7. Gil M, Oliva B, Timoner J, Maciá MA, Bryant V, de Abajo FJ. Risk of meningioma among users of high doses of cyproterone acetate as compared with the general population: evidence from a population-based cohort study. Br J Clin Pharmacol. 2011;72:965-8.
  8. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2016 [cited 2017-06-20.]
Uppdaterat

Litteratursökningsdatum 7/11/2017

Litteratursökningsdatum 7/11/2017
Se även

Etinylestradiol