Cytadren: Full Drug Profile
Cytadren - General Information
An aromatase inhibitor that produces a state of "medical" adrenalectomy by blocking the production of adrenal steroids. It also blocks the conversion of androgens to estrogens. Cytadren has been used in the treatment of advanced breast and prostate cancer. It was formerly used for its weak anticonvulsant properties. (From Martindale, The Extra Pharmacopoeia, 30th ed, p454)
Pharmacology of Cytadren
Cytadren inhibits the enzymatic conversion of cholesterol to D5-pregnenolone, resulting in a decrease in the production of adrenal glucocorticoids, mineralocorticoids, estrogens, and androgens.
Cytadren for patients
Patients should be warned that drowsiness may occur and that they should not drive, operate potentially dangerous machinery, or engage in other activities that may become hazardous because of decreased alertness.
Patients should also be warned of the possibility of hypotension and its symptoms.
Cytadren Interactions
Cytadren accelerates the metabolism of dexamethasone; therefore, if glucocorticoid replacement is needed, hydrocortisone should be prescribed.
Aminoglutethimide diminishes the effect of coumarin and warfarin.
Cytadren Contraindications
Cytadren is contraindicated in those patients with serious forms, and/or more severe manifestations, of hypersensitivity to glutethimide or aminoglutethimide.
Additional information about Cytadren
- Cytadren Indication
For the suppression of adrenal function in selected patients with Cushing's syndrome, malignant neoplasm of the female breast, and carcinoma in situ of the breast.
- Mechanism Of Action
- Cytadren reduces the production of D5-pregnenolone and blocks several other steps in steroid synthesis, including the C-11, C-18, and C-21 hydroxylations and the hydroxylations required for the aromatization of androgens to estrogens, mediated through the binding of aminoglutethimide to cytochrome P-450 complexes. A decrease in adrenal secretion of cortisol is followed by an increased secretion of pituitary adrenocorticotropic hormone (ACTH), which will overcome the blockade of adrenocortical steroid synthesis by aminoglutethimide. The compensatory increase in ACTH secretion can be suppressed by the simultaneous administration of hydrocortisone. Since aminoglutethimide increases the rate of metabolism of dexamethasone but not that of hydrocortisone, the latter is preferred as the adrenal glucocorticoid replacement. Although aminoglutethimide inhibits the synthesis of thyroxine by the thyroid gland, the compensatory increase in thyroid-stimulating hormone (TSH) is frequently of sufficient magnitude to overcome the inhibition of thyroid synthesis due to aminoglutethimide. In spite of an increase in TSH, aminoglutethimide has not been associated with increased prolactin secretion.
- Drug Interactions
- Anisindione The agent decreases the anticoagulant effect
- Food Interactions
- Take without regard to meals.
- Generic Name
- Aminoglutethimide
- Synonyms
- Dl-Aminoglutethimide; P-Aminoglutethimide
- Drug Category
- Antineoplastic Agents; Adrenergic Agents
- Drug Type
- Small Molecule; Approved
- Other Brand Names containing Aminoglutethimide
- Cytadren; Elipten; Orimeten;
- Absorption
- Rapidly and completely absorbed from gastrointestinal tract. The bioavailability of tablets is equivalent to equal doses given as a solution.
- Toxicity (Overdose)
- Oral LD50s (mg/kg): rats, 1800; dogs, >100. Intravenous LD50s (mg/kg): rats, 156; dogs, >100. Symptoms of overdose include respiratory depression, hypoventilation, hypotension, hypovolemic shock due to dehydration, somnolence, lethargy, coma, ataxia, dizziness, fatigue, nausea, and vomiting.
- Protein Binding
- 21-25%
- Biotransformation
- Hepatic. 34-54% of the administered dose is excreted in the urine as unchanged drug during the first 48 hours, and an additional fraction as an N-acetyl derivative.
- Half Life
- 12.5 ± 1.6 hours
- Dosage Forms of Cytadren
- Tablet Oral
- Chemical IUPAC Name
- 3-(4-aminophenyl)-3-ethylpiperidine-2,6-dione
- Chemical Formula
- C13H16N2O2
- Aminoglutethimide on Wikipedia
- https://en.wikipedia.org/wiki/Aminoglutethimide
- Organisms Affected
- Humans and other mammals
