Cyprostat 50 mg tablet

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

1. What Cyprostat is and what it is used for
2. What you need to know before you take Cyprostat
3. How to take Cyprostat
4. Possible side effects
5. How to store Cyprostat
6. Contents of the pack and other information

Cyprostat is a medicine containing cyproterone acetate. It is an anti-androgen therapy. It blocks the actions of male sex hormones (androgens) and reduces the amount of male sex hormones produced by the body.

Cyprostat is used in men to treat prostate cancer.

This medicine is used:

1. to reduce the possible worsening of the disease which may occur when you start other treatments used for prostate cancer
2. for long term treatment of prostate cancer when surgery or other medicines are not suitable
3. to treat hot flushes which may occur during treatments with other medicines used for prostate cancer or following surgery.

• If you have liver diseases (including previous or existing liver tumours (unless these are due to secondary cancers caused by prostate cancer), Dubin-Johnson Syndrome or Rotor Syndrome)
• If you have any type of cancer (except for cancer of the prostate gland)
• If you have ever been diagnosed with a meningioma (a generally benign tumour of the tissue layer between the brain and the skull). You should ask your doctor if you are in doubt
• If you have wasting diseases (diseases involving an unintended loss of weight or muscle) except for prostate cancer that cannot be operated on
• If you have blood clots (thrombosis or embolism)

or:

• If you are allergic to cyproterone acetate or any of the other ingredients of this medicine (listed in section 6)
• If you are under 18 years old or if your testes or bones are not yet fully formed.

Talk to your doctor before taking Cyprostat

Several blood tests or checks may be required while you are taking this medicine:

• liver problems, some of them severe or even fatal, have been reported with cyproterone acetate treatment. Your doctor may arrange for you to have regular liver tests before and during treatment to monitor this and may stop your treatment if necessary. See also section 4.
• using medicines such as Cyprostat has very rarely been linked to the development of benign (non-malignant) liver tumours and with some forms of liver cancer (malignant liver tumours). Liver tumours may lead to bleeding in the abdomen, which can be life-threatening. If you have any new stomach discomfort or pain that does not go away quickly, you must tell your doctor straight away
• Use of cyproterone acetate has been linked to the development of a generally benign brain tumour (meningioma). The risk increases especially when you use it for longer duration (several years) or for a shorter duration with high doses (25 mg per day and above). If you are diagnosed with meningioma, your doctor will stop your treatment with cyproterone acetate (see section ‘Do not take Cyprostat’). If you notice any symptoms such as changes in vision (e.g. seeing double or blurriness), hearing loss or ringing in the ears, loss of smell, headaches that worsen with time, memory loss, seizures, weakness in your arms or legs, you must tell your doctor straightaway.
• blood clots have been reported in patients taking this medicine which may also be linked to the reason you are taking Cyprostat. Tell your doctor if any of the following apply to you, as you may be at an increased risk of getting a blood clot. If you have:
  • a history of blood clots, strokes or heart attacks
  • abnormal red blood cells (sickle–cell anaemia)
  • severe diabetes that affects your blood circulation
• if you suffer from severe depression, this may get worse whilst you are taking Cyprostat. (See your doctor if you are affected by this)
• effects on the blood (anaemia) have been reported rarely during long term treatment with this medicine. See also section 4.
• shortness of breath has been reported in patients taking this medicine at high doses (300 mg daily),
• Cyprostat can alter the sugar levels in your blood. If you are diabetic, check your blood sugar levels regularly. Your doctor may alter the dose of medicine used to treat your diabetes
• Your doctor will check the function of your adrenal glands, as they may become suppressed during treatment with Cyprostat. Symptoms may include tiredness, fatigue, loss of appetite, weight loss, low blood sugar, low blood pressure, dehydration, headache, irritability and depression, aching muscles, abdominal pain, a craving for salty foods, feeling or being sick and diarrhoea.

Tell your doctor if you are taking, have recently taken or might take any other medicines.

Some medicines may stop Cyprostat from working properly. Also Cyprostat may change the way other medicines you are taking are broken down in your body.

Tell your doctor if you take any other medicines regularly, especially:

• medicines such as rifampicin for the treatment of tuberculosis
• medicines such as phenytoin used to treat epilepsy or other illnesses
• products containing the herbal remedy commonly known as St John’s wort (Hypericum perforatum)
• medicines such as ketoconazole, itraconazole, clotrimazole for the treatment of fungal conditions
• medicines such as ritonavir used to treat HIV infections
• cholesterol-lowering drugs such as statins. Cyprostat may make the side effects of statins worse, for example the breakdown of muscle
• medicines such as glitazones used to treat diabetes.

If you are diabetic your doctor may need to alter the dose of medicine required to treat your diabetes. See also section 2 ‘Warnings and precautions’.

You may feel tired and weak during treatment. If affected, do not drive, operate machinery or do anything where these symptoms may put either yourself or others at risk.

Cyprostat contains Lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

As soon as you can, talk to your doctor who will tell you what you need to do. There have been no reports of serious illness from taking too much Cyprostat in a single dose.

If you forget to take a dose, take it as soon as you remember and take the next dose when it is due. Do not take a double dose to make up for a forgotten dose.

Do not reduce the dose or stop taking your tablets unless your doctor tells you to.

After you have been taking this medicine for some months, you may not have any sperm in your ejaculate. You will probably be unable to make anyone pregnant, but note that this does not happen at once. Do not rely on this medicine for contraception at any time. While the overall number of sperm that you produce will be reduced, more of your sperm than usual will be abnormal in shape. Some people think these abnormal sperm might possibly produce abnormal babies. Your doctor will be able to advise you further if you are thinking of having children.

• blood clots have been reported in patients taking this medicine but they have not definitely been linked to Cyprostat. See also section 2 ‘Warnings and precautions’
• the occurrence of meningiomas (a generally benign tumour of the tissue layer between the brain and the skull) has been reported in association with longer term use (years) of Cyprostat at doses of 25 mg per day and above
• dry skin and improvement in acne
• temporary patchy loss of body hair, a reduction in hair growth on the body, an increased growth of hair on the head, lightening of hair colour, a female type of pubic hair growth
• effects on the blood (anaemia) have been reported rarely during long term treatment with this medicine. Your doctor may arrange for you to have regular blood tests during treatment to monitor this
• thinning of the bones (osteoporosis)
• tiredness, fatigue, loss of appetite, weight loss, low blood sugar, low blood pressure, dehydration, headache, irritability and depression, aching muscles (often muscle weakness), abdominal pain, a craving for salty foods, feeling or being sick and diarrhoea (suppressed adrenal glands).

After stopping treatment, the decrease in sex drive, reduction in sperm count and breast swelling will generally go back to normal.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

By reporting side effects you can help provide more information on the safety of this medicine.

• the active ingredient is cyproterone acetate. Each tablet contains 50 mg of cyproterone acetate
• the other ingredients are: maize starch, povidone 25000, magnesium stearate (E572), lactose, colloidal anhydrous silica.

Each pack of Cyprostat 50 mg contains 160 tablets as 16 blister strips of 10 tablets.

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