Prostate cancer: anti-androgens (Formulary)

Bicalutamide should be considered first choice in preference to cyproterone.

ABIRATERONE

Important: Therapy notes

Abiraterone is included in the Highland Formulary for use with prednisolone for the treatment of metastatic castration-resistant prostate cancer in adult men whose disease has progressed on or after a docetaxel-based chemotherapy regimen:

  • in accordance with the SMC 764/12 restriction for use in patients who have received only one prior chemotherapy regimen
  • the small cohort of patients in NHS Highland who have received second-line chemotherapy since abiraterone received its UK marketing authorisation
  • in patients who have received only one prior chemotherapy regimen in the castrate refractory period but have received chemotherapy in the castrate sensitive phase within a clinical trial.

Important: Formulation and dosage details

Formulation:

Tablets 500mg (specialist use only)

Dosage:

1 gram once daily. 

As per SMC 764/12: with prednisone or prednisolone for the treatment of metastatic castration resistant prostate cancer (mCRPC) in adult men whose disease has progressed on or after a docetaxel-based chemotherapy regimen.
SMC restriction: abiraterone is restricted to use in patients who have received only one prior chemotherapy regimen.

873/13: abiraterone acetate is indicated with prednisone or prednisolone for the treatment of metastatic castration resistant prostate cancer (mCRPC) in adult men who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated. 

2215: abiraterone acetate with prednisone or prednisolone for the treatment of newly diagnosed high risk metastatic hormone sensitive prostate cancer in adult men in combination with androgen deprivation therapy.

BICALUTAMIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 50mg, 150mg (specialist use only)

Dosage:

50mg daily in combination with gonadorelin analogue, 150mg once daily as monotherapy.

CYPROTERONE

Important: Therapy notes

MHRA advice: Cyproterone acetate: new advice to minimise risk of meningioma (June 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 50mg, 100mg (specialist use only)

Dosage:

Anti-androgen, 100mg twice daily. Progestogen, 50mg daily.

ENZALUTAMIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 40mg (hospital use only)

Dosage:

See SMC advice 1066/15 and 2400.

MEDROXYPROGESTERONE ACETATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets (Provera®) 10mg (specialist use only)

Editorial Information

Document Id: F299