a. Phenytoin has been in clinical use for over 70 years now. It is one of the most commonly used drug.
b. The drug on long term administration can cause hirsutism. This is in line with the fact that majority of anticonvulsants cause a variety of endocrine abnormalities when used on long term basis.
c. Flutamide is an antiandrogen and is used in treatment of hirsutism rather than the cause of it. Danazol is a modified testosterone and is a derivative of ethisterone.
d. Androgenic side effects therefore complicate the treatment in the long run. Its main advantage on long term is that it does not cause osteoporosis like GnRH analogues do. Due to this, its role in treatment of endometriosis has been replaced by GnRH analogues.
e. It is used for breast pain (mastalgia), fibrocystic disease of breast and hereditary angioneurotic edema.
f. Norethindrone (norethisterone), is a progestogen with high degree of testosterone like activity. The drug is used for irregular bleeding, menorrhagia and in combination with estrogens; it is used for as a part of hormone replacement therapy (BG Katzung’ 10th Edition, 2010).
Table: drugs causing hirsutism
f. Oral contraceptives - containing progesterone
h. Heavy metals
(Remember: Drugs have antiandrogen effect causes gynecomastia; these can be used for treatment of hirsutism. Best example is Sipronolactone (A/E: gynecomastia ) can be used for hirsutism