Cyproterone (Siterone) Cessation

[lindsey69 (imported)]

All the documentation says that if you are stopping a chemical castration session using Cyproterone (Siterone or Androcur) you should come off it in stages.

My reading of the documentation is to drop no more than 50mg per day at a time over some period. So 50mg to zero is OK, but not 200mg to nothing.

Am I reading this right?

I did a 7 week trial at 3 weeks at 100mg/day and then 4 at 50mg/day and then to nothing.

As I mentioned in another post reply, it didn't seem to cause any immediate physical issues in my case.

What are the symptoms that one could expect if it were to cause a problem?

Thanks.

[fhunter]

I found this in wikipedia:

Abrupt withdrawal of cyproterone acetate can be harmful, and the package insert from Schering AG recommends that the daily dose be reduced by no more than 50 mg, at intervals of several weeks. The primary concern is the manner in which cyproterone acetate affects the adrenal gland. Due to its glucocorticoid activity, high levels of cyproterone acetate may reduce ACTH, resulting in adrenal insufficiency if discontinued suddenly. In addition, although cyproterone acetate reduces androgen production in the gonads, it can increase adrenal androgen production, in some cases resulting in an overall rise in testosterone levels.[20] Thus the sudden withdrawal of cyproterone acetate may result in undesirable androgenic effects. This is a particular concern because androgens, especially DHT, suppress adrenal function, further reducing cortisol production.[21] In theory, 5-alpha-reductase inhibitors such as finasteride and dutasteride may be able to mitigate this effect somewhat by preventing the conversion of testosterone to the more potent DHT.

The article is here (http://en.wikipedia.org/wiki/Cyproterone).

[lindsey69 (imported)]

Thanks for that, I saw that info as well.

However, what does this mean?

"....

reduced by no more than 50 mg, at intervals of several weeks.

"

Is this covered by 50mg/day to nothing as the final step in the coming off process.

That's the way I read it at first....or is this 50mg via lower dosages to nothing?

Confused of Reading, UK........

[fhunter]

Thanks for that, I saw that info as well.

However, what does this mean?

"....

reduced by no more than 50

mg, at intervals of several weeks.

"

Is this covered by 50mg/day to nothing as the final step in the coming off process.

That's the way I read it at first....or is this 50mg via lower dosages

to nothing?

Confused of Reading, UK........

Looks like it is safe to drop from 50mg to nothing. To be safe you can drop to 25mg/day for a week or two, before stopping completely.

I stopped from 50mg/day without any serious problems, if depression, mood changes and some other things for about two months afterwards can be considered not serious problems .

[lindsey69 (imported)]

Thanks fhunter, our findings compare quite well on this (real life clinical trial methinks).

Regards.

[bobbie (imported)]

It is recommended to reduce the dose. Seems like most have gone from 100mg to nothing in one step. From a much higher dose of <100mg may be wise to back off a little. I am thinking that two weeks should be enough at one step.

The symptom you may experience is most likely the reverse of what you experienced in the start. If you did not have much changes to start with you, can expect little change. You may have never really shut down your hormones.

[transward (imported)]

A common effect of any too sudden change of hormones is wild and unpredictable emotional swings as your hormone systems swings wildly trying to find a new equilibrium. Think of a male version of PMS on steroids. Hence the advice to rush slowly and taper off gently.

Transward

[clysmaniac (imported)]

I was on a daily dose of 150 mg of Siterone to get my testosterone level down because my doctor said if my T level was at or below the level of the previous test that he would remove my testicles. The Siterone decreased my T level to under 50 and he said he would castrate me. I immediately stopped the Siterone at that point because it had served its purpose (and would have needed a refill anyway). I had no noticable unwanted side-effects in the three weeks period it took before the surgery. I'm only a sample of one but there was no problem for me.

[Riven (imported)]

A common effect of any too sudden change of hormones is wild and unpredictable emotional swings as your hormone systems swings wildly trying to find a new equilibrium. Think of a male version of PMS on steroids. Hence the advice to rush slowly and taper off gently.

Transward

I know what that feels like. When I abruptly stopped taking cyproterone acetate after only a week or so on 50mg per day, I had some very bad temper flashes a couple of days later. I literally flew into a rage over not very much. I screamed and shouted and threw things around. My temper is usually under much better control so it was a bit of a shock to me as well as to my son who was on the receiving end of my blast. Pretty much the same thing happened when I quit cyproterone after my subsequent trial. This time I had only been taking 1/4 tab (12.5mg) daily for a week, but stopping still caused me to become extremely irritable and I lost my temper quite badly again before I settled down.

I seem to be hyper sensitive to cyproterone. ie. it only takes a tiny amount of the drug to cause my hormones to crash. It could be an advantage, in that if I can learn to tolerate the side effects, I'll only need a tiny maintenance dose, which will mean I don't have to worry much about the drug's toxicity (liver damage). But it seems that after any length of time on the drug even at teeny weenie doses I'm liable to be badly upset when I come off it.

[lindsey69 (imported)]

Thanks for all the feedback folks!

Does anyone know of any physiological manifestations as well?

Regards.