Antiandrogens Use in Clinical Practice

Antiandrogens are a class of medications that inhibit the effects of androgens, the primary male sex hormones, by blocking androgen receptors or reducing androgen production. These medications are vital in the treatment of various conditions, including prostate cancer, androgenic alopecia, and conditions causing excess androgen levels such as polycystic ovary syndrome (PCOS) and severe acne. In clinical pharmacology, understanding the mechanisms of action, therapeutic applications, and potential side effects of antiandrogens is essential for optimizing patient care.
A list of common antiandrogen drugs used in clinical pharmacology:
-Flutamide
Mechanism: Non-steroidal antiandrogen that competes with androgens at the androgen receptor.
Clinical Use: Prostate cancer.
-Bicalutamide
Mechanism: Non-steroidal antiandrogen with a similar mechanism to flutamide but with a better safety profile.
Clinical Use: Prostate cancer.
-Enzalutamide
Mechanism: Non-steroidal antiandrogen that inhibits androgen receptor signaling more effectively than older drugs.
Clinical Use: Metastatic castration-resistant prostate cancer.
-Nilutamide
Mechanism: Non-steroidal antiandrogen that inhibits androgen receptors.
Clinical Use: Prostate cancer.
-Cyproterone Acetate
Mechanism: Steroidal antiandrogen that also has progestational effects.
Clinical Use: Prostate cancer, severe acne, hirsutism, and as part of hormone therapy for transgender women.
-Spironolactone
Mechanism: Steroidal antiandrogen that also acts as a potassium-sparing diuretic.
Clinical Use: Hirsutism, acne, and as part of hormone therapy for transgender women.
Abiraterone Acetate
Mechanism: Inhibits CYP17A1, an enzyme crucial for androgen production.
Clinical Use: Metastatic castration-resistant prostate cancer.
-Finasteride
Mechanism: 5-alpha-reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone (DHT).
Clinical Use: Benign prostatic hyperplasia, androgenic alopecia.
-Dutasteride
Mechanism: 5-alpha-reductase inhibitor with a broader inhibition profile compared to finasteride.
Clinical Use: Benign prostatic hyperplasia.
-Ketoconazole
Mechanism: Antifungal that also inhibits steroid synthesis.
Clinical Use: Advanced prostate cancer (off-label use).