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Hair Loss/increasing Androcure dose

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Dear Dr Panagotacos,

I wrote you this week,that my dermatologist,wanted to increase my dose of Androcure 100,with 10 mg.

And that my endocrinologist,did not agree with this at all,because he thinks,that my current regime of,1 tablet Diane 35,and 2 tablets Androcure 50(taken every day all year round),is already the best treatment worldwide,for female hairloss.

My dermatologist,still wants to increase my dose of Androcure 100,but now,with 5 mg.

He thinks this increase will help with my seborrheic dermatitis.

I still can not tolerate any dandruff shampoo,because of my very sensitive scalp,and oral ketoconozole,is not possible,because of inter actions,with Diane 35 and Androcure 100.

Because I have never had,any seborrheic dermatitis in my life,he says that this temporary increase,could be sufficient,to end the seborrheic dermatitis.

Please give me your opinion about this.

Thanks a lot in advance for your advice!.

Yours Faithfully,

Conny van Rijswijk

Answer
There seems to be a lot of controversy between your two doctors and I really do not want to come between them. There is a relatively minor contraindication in taking both ketoconizole to kill the yeast while you are on Androcur.
This is the warning you will find regarding taking both:
Cyproterone acetate is metabolized by various pathways, including by the cytochrome P450 isoenzyme CYP3A4. Although clinical interaction studies have not been performed, the manufacturer warns that its metabolism may be:
Reduced by drugs which inhibit CYP3A4 for example certain antifungals (itraconazole, ketoconazole)

So the metabolism of Androcur may be reduced while you take ketoconizole. The prescription for 200mg ketoconizole daily by mouth for ten days and perhaps pulsed at 400 mg ketoconizole once a week for a month or two should not change your hormone levels by much if at all. I do not see a reason to have this argument and would take the oral ketoconizole to cure the seborrheic dermatitis. Your dermatologist may be doubly happy because you will get a slightly greater effect of Androcur without having to take more of it if you take ketoconizole at the same time.  

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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