Dear Ian,
The cyproterone acetate (CPA) data sheet expands slightly on BNF by
stating, "During treatment, adrenocortical function should be supervised,
since suppression has been observed."
The manufacturer says this relates to reports of adrenal suppression
in children taking CPA for the treatment of precocious puberty.
In rats, high doses of CPA bring about a decrease in adrenal weight and
atrophy of the adrenal cortex (Girard 1978; Panesar 1979). Findings
suggest that inhibition of ACTH secretion is the reason for the
adrenocortical atrophy seen.
In adults, adrenal suppression has rarely been reported and studies
confirm that CPA does not usually suppress ACTH secretion (Van Wayjen,
1980).
They have no formal recommendations regarding adrenocortical
supervision, and suggest monitoring should be performed using local
procedures.
I hope this information is of some use.
Best wishes, Michael Petchey
Panesar et al J Endocrinol (1979) 80; 222
Girard et al J Clin Endocrinol Metab (1978) 47; 581
van Wayjen et al Excerpta Medica (1980) 246-258
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