Editing Antiandrogen (section)

===Available forms===
{{See also|Steroidal antiandrogen|Nonsteroidal antiandrogen}}

There are several different types of antiandrogens, including the following:<ref name="pmid11502457" />

* '''Androgen receptor antagonists:''' Drugs that bind directly to and block the AR.<ref name="pmid10637363">{{cite journal | vauthors = Singh SM, Gauthier S, Labrie F | title = Androgen receptor antagonists (antiandrogens): structure-activity relationships | journal = Current Medicinal Chemistry | volume = 7 | issue = 2 | pages = 211–247 | date = February 2000 | pmid = 10637363 | doi = 10.2174/0929867003375371 }}</ref><ref name="ShenTaplin2010">{{cite book| vauthors = Shen HC, Taplin ME, Balk SP |title=Drug Management of Prostate Cancer |chapter=Androgen Receptor Antagonists |year=2010|pages=71–81|publisher=Springer |doi=10.1007/978-1-60327-829-4_6|isbn=978-1-60327-831-7}}</ref> These drugs include the [[steroidal antiandrogen]]s [[cyproterone acetate]], [[megestrol acetate]], [[chlormadinone acetate]], [[spironolactone]], [[oxendolone]], and [[osaterone acetate]] (veterinary) and the [[nonsteroidal antiandrogen]]s [[flutamide]], [[bicalutamide]], [[nilutamide]], [[topilutamide]], [[enzalutamide]], [[apalutamide]], and [[darolutamide]].<ref name="pmid10637363" /><ref name="ShenTaplin2010" /><ref name="SchröderRadlmaier2009" /><ref name="KolvenbagFurr2009" /> Aside from cyproterone acetate and chlormadinone acetate, a few other [[progestin]]s used in [[oral contraceptive]]s and/or in menopausal HRT including [[dienogest]], [[drospirenone]], [[medrogestone]], [[nomegestrol acetate]], [[promegestone]], and [[trimegestone]] also have varying degrees of AR antagonistic activity.<ref>{{cite journal | vauthors = Šauer P, Bořík A, Golovko O, Grabic R, Staňová AV, Valentová O, Stará A, Šandová M, Kocour Kroupová H | display-authors = 6 | title = Do progestins contribute to (anti-)androgenic activities in aquatic environments? | journal = Environmental Pollution | volume = 242 | issue = Pt A | pages = 417–425 | date = November 2018 | pmid = 29990947 | doi = 10.1016/j.envpol.2018.06.104 | bibcode = 2018EPoll.242..417S | s2cid = 51622914 }}</ref><ref name="pmid12600226">{{cite journal | vauthors = Raudrant D, Rabe T | title = Progestogens with antiandrogenic properties | journal = Drugs | volume = 63 | issue = 5 | pages = 463–492 | year = 2003 | pmid = 12600226 | doi = 10.2165/00003495-200363050-00003 | s2cid = 28436828 }}</ref><ref name="pmid14644837">{{cite journal | vauthors = Schneider HP | title = Androgens and antiandrogens | journal = Annals of the New York Academy of Sciences | volume = 997 | issue = 1 | pages = 292–306 | date = November 2003 | pmid = 14644837 | doi = 10.1196/annals.1290.033 | s2cid = 8400556 | bibcode = 2003NYASA.997..292S }}</ref>
* '''Androgen synthesis inhibitors:''' Drugs that directly inhibit the [[enzyme|enzymatic]] [[biosynthesis]] of androgens like testosterone and/or DHT.<ref name="IIIBarbieri2013">{{cite book| vauthors = Strauss III JF, Barbieri RL |title=Yen and Jaffe's Reproductive Endocrinology|url=https://books.google.com/books?id=KZ95AAAAQBAJ&pg=PA90|date=13 September 2013|publisher=Elsevier Health Sciences|isbn=978-1-4557-2758-2|pages=90–}}</ref><ref name="FiggChau2010">{{cite book| vauthors = Figg W, Chau CH, Small EJ |title=Drug Management of Prostate Cancer|url=https://books.google.com/books?id=4KDrjeWA5-UC&pg=PA93|date=14 September 2010|publisher=Springer Science & Business Media|isbn=978-1-60327-829-4|pages=71–72, 75, 91–96}}</ref> Examples include the [[CYP17A1 inhibitor]]s [[ketoconazole]], [[abiraterone acetate]], and [[seviteronel]],<ref name="IIIBarbieri2013" /> the [[CYP11A1]] (P450scc) inhibitor [[aminoglutethimide]],<ref name="IIIBarbieri2013" /> and the [[5α-reductase inhibitor]]s [[finasteride]], [[dutasteride]], [[epristeride]], [[alfatradiol]], and [[saw palmetto extract]] (''[[Serenoa repens]]'').<ref name="pmid19879888">{{cite journal | vauthors = Aggarwal S, Thareja S, Verma A, Bhardwaj TR, Kumar M | title = An overview on 5alpha-reductase inhibitors | journal = Steroids | volume = 75 | issue = 2 | pages = 109–53 | year = 2010 | pmid = 19879888 | doi = 10.1016/j.steroids.2009.10.005 | s2cid = 44363501 }}</ref> A number of other antiandrogens, including cyproterone acetate, spironolactone, medrogestone, flutamide, nilutamide, and [[bifluranol]], are also known to weakly inhibit androgen synthesis.
* '''Antigonadotropins:''' Drugs that suppress the [[gonadotropin-releasing hormone]] (GnRH)-induced release of [[gonadotropin]]s and consequent activation of [[gonadal]] androgen production.<ref name="Brueggemeier2006" /><ref name="FarmerWalker2012">{{cite book| vauthors = Farmer PB, Walker JM |title= The Molecular Basis of Cancer|url=https://books.google.com/books?id=Bva8BAAAQBAJ&pg=PA232|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-1-4684-7313-1|pages=232–}}</ref> Examples include [[GnRH modulator]]s like [[leuprorelin]] (a [[GnRH agonist]]) and [[cetrorelix]] (a [[GnRH antagonist]]),<ref name="LemkeWilliams2012" /> [[progestogen]]s like [[allylestrenol]], chlormadinone acetate, cyproterone acetate, [[gestonorone caproate]], [[hydroxyprogesterone caproate]], [[medroxyprogesterone acetate]], megestrol acetate, osaterone acetate (veterinary), and oxendolone,<ref name="pmid10997774" /><ref name="LedgerSchlaff2014">{{cite book| vauthors = Ledger W, Schlaff WD, Vancaillie TG |title=Chronic Pelvic Pain|url=https://books.google.com/books?id=ON-VBQAAQBAJ&pg=PA55|date=11 December 2014|publisher=Cambridge University Press|isbn=978-1-316-21414-5|pages=55–}}</ref> and [[estrogen (medication)|estrogen]]s like [[estradiol (medication)|estradiol]], [[estradiol ester]]s, [[ethinylestradiol]], [[conjugated estrogens]], and [[diethylstilbestrol]].<ref name="Brueggemeier2006" /><ref name="pmid10997774" />
* '''Miscellaneous:''' Drugs that oppose the effects of androgens by means other than the above. Examples include estrogens, especially [[oral administration|oral]] and [[synthetic compound|synthetic]] (e.g., [[ethinylestradiol]], [[diethylstilbestrol]]), which stimulate [[sex hormone-binding globulin]] (SHBG) [[biosynthesis|production]] in the [[liver]] and thereby decrease free and hence [[biological activity|bioactive]] levels of testosterone and DHT; [[anticorticotropin]]s such as [[glucocorticoid]]s, which suppress the [[adrenocorticotropic hormone]] (ACTH)-induced production of [[adrenal androgen]]s; and [[immunogen]]s and [[vaccine]]s against [[androstenedione]] like [[ovandrotone albumin]] and [[androstenedione albumin]], which decrease levels of androgens via the generation of [[antibody|antibodies]] against the androgen and androgen [[precursor (biochemistry)|precursor]] androstenedione (used only in [[veterinary medicine]]).

Certain antiandrogens combine multiple of the above mechanisms.<ref name="pmid11502457" /><ref name="HannaCrosby2015">{{cite book| vauthors = Hanna L, Crosby T, Macbeth F |title=Practical Clinical Oncology|url=https://books.google.com/books?id=wm_OCgAAQBAJ&pg=PA37|date=19 November 2015|publisher=Cambridge University Press|isbn=978-1-107-68362-4|pages=37–}}</ref> An example is the steroidal antiandrogen cyproterone acetate, which is a potent AR antagonist, a potent progestogen and hence antigonadotropin, a weak glucocorticoid and hence anticorticotropin, and a weak androgen synthesis inhibitor.<ref name="pmid11502457" /><ref name="HannaCrosby2015" /><ref name="Weber2015">{{cite book| vauthors = Weber GF |title=Molecular Therapies of Cancer|url=https://books.google.com/books?id=dhs_CgAAQBAJ&pg=PA316|date=22 July 2015|publisher=Springer|isbn=978-3-319-13278-5|pages=314, 316}}</ref><ref name="pmid9592622">{{cite journal | vauthors = Mahler C, Verhelst J, Denis L | title = Clinical pharmacokinetics of the antiandrogens and their efficacy in prostate cancer | journal = Clin Pharmacokinet | volume = 34 | issue = 5 | pages = 405–17 | date = May 1998 | pmid = 9592622 | doi = 10.2165/00003088-199834050-00005 | s2cid = 25200595 }}</ref>

{| class="wikitable sortable mw-collapsible <!--mw-collapsed-->" style="margin-left: auto; margin-right: auto; border: none;"
|+ class="nowrap" | Antiandrogens marketed for clinical or veterinary use
! Generic name !! Class !! Type !! Brand name(s) !! Route(s) !! Launch !! Status !! {{abbr|Hits|Google Search hits (February 2018)}}<sup>a</sup>
|-
| {{No selflink|Abiraterone acetate}} || Steroidal || Androgen synthesis inhibitor || Zytiga || Oral || 2011 || Available || 523,000
|-
| {{No selflink|Allylestrenol}} || Steroidal || Progestin || Gestanin, Perselin || Oral || 1961 || Available<sup>b</sup> || 61,800
|-
| {{No selflink|Aminoglutethimide}} || Nonsteroidal || Androgen synthesis inhibitor || Cytadren, Orimeten || Oral || 1960 || Available<sup>b</sup> || 222,000
|-
| {{No selflink|Apalutamide}} || Nonsteroidal || AR antagonist || Erleada || Oral || 2018 || Available || 50,400
|-
| {{No selflink|Bicalutamide}} || Nonsteroidal || AR antagonist || Casodex || Oral || 1995 || Available || 754,000
|-
| {{No selflink|Chlormadinone acetate}} || Steroidal || Progestin; AR antagonist || Belara, Prostal || Oral || 1965 || Available || 220,000
|-
| {{No selflink|Cyproterone acetate}} || Steroidal || Progestin; AR antagonist || Androcur, Diane || Oral, {{abbr|IM|Intramuscular injection}} || 1973 || Available || 461,000
|-
| {{No selflink|Darolutamide}} || Nonsteroidal || AR antagonist || Nubeqa || Oral || 2019 || Available || ?
|-
| {{No selflink|Delmadinone acetate}} || Steroidal || Progestin; AR antagonist || Tardak || Veterinary || 1972 || Veterinary || 42,600
|-
| {{No selflink|Enzalutamide}} || Nonsteroidal || AR antagonist || Xtandi || Oral || 2012 || Available || 328,000
|-
| {{No selflink|Flutamide}} || Nonsteroidal || AR antagonist || Eulexin || Oral || 1983 || Available || 712,000
|-
| {{No selflink|Gestonorone caproate}} || Steroidal || Progestin || Depostat, Primostat || {{abbr|IM|Intramuscular injection}} || 1973 || Available<sup>b</sup> || 119,000
|-
| {{No selflink|Hydroxyprogesterone caproate}} || Steroidal || Progestin || Delalutin, Proluton || {{abbr|IM|Intramuscular injection}} || 1954 || Available || 108,000
|-
| {{No selflink|Ketoconazole}} || Nonsteroidal || Androgen synthesis inhibitor || Nizoral, others || Oral, topical || 1981 || Available || 3,650,000
|-
| {{No selflink|Medroxyprogesterone acetate}} || Steroidal || Progestin || Provera, Depo-Provera || Oral, {{abbr|IM|Intramuscular injection}}, {{abbr|SC|Subcutaneous injection}} || 1958 || Available || 1,250,000
|-
| {{No selflink|Megestrol acetate}} || Steroidal || Progestin; AR antagonist || Megace || Oral || 1963 || Available || 253,000
|-
| {{No selflink|Nilutamide}} || Nonsteroidal || AR antagonist || Anandron, Nilandron || Oral || 1987 || Available || 132,000
|-
| {{No selflink|Osaterone acetate}} || Steroidal || Progestin; AR antagonist || Ypozane || Veterinary || 2007 || Veterinary || 87,600
|-
| {{No selflink|Oxendolone}} || Steroidal || Progestin; AR antagonist || Prostetin, Roxenone || {{abbr|IM|Intramuscular injection}} || 1981 || Available<sup>b</sup> || 36,100
|-
| {{No selflink|Spironolactone}} || Steroidal || AR antagonist || Aldactone || Oral, topical || 1959 || Available || 3,010,000
|-
| {{No selflink|Topilutamide}} || Nonsteroidal || AR antagonist || Eucapil || Topical || 2003 || Available<sup>b</sup> || 36,300
|- class="sortbottom"
| colspan="8" style="width: 1px; background-color:#eaecf0; text-align: center;" | '''Footnotes:''' <sup>a</sup> = Hits = Google Search hits (as of February 2018). <sup>b</sup> = Availability limited / mostly discontinued. '''Class:''' Steroidal = {{No selflink|Steroidal antiandrogen}}. Nonsteroidal = {{No selflink|Nonsteroidal antiandrogen}}. '''Note:''' For other antiandrogens not included in the table like [[5α-reductase inhibitor]]s, [[GnRH modulator]]s, and [[estrogen (medication)|estrogen]]s, see elsewhere. '''Sources:''' See individual articles.
|}