Flutamide

Flutamide is a potent anti-androgen that is used to treat prostate cancer, and can also be useful for acne (82). It is administered at 250 mg twice daily in combination with an oral contraceptive. Liver function tests must be monitored in patients on flutamide as it can cause fatal hepatitis (83). Patients with adrenal hyperandrogenism may benefit from a combination of low dose glucocorticoidsteroid with an oral contraceptive. The glucocorticoid works byblocking adrenal androgen production. Prednisone 2.5-5 mg can be given daily at bedtime. Alternatively, dexamethasone 0.25-0.75 mg can be given nightly. Chronic glucocorticoid use may cause adrenal suppression (especially dexamethasone), and should be used with caution (84).