Danol (Danazol) is made by Sanofi Winthrop Limited. It is now a second line treatment for endometriosis and is generally prescribed when other treatments have been tried and proved unsuccessful.

What is Danol?

Danol is a synthetic (artificial) hormone called an androgen, which means that it is a male type hormone, and is similar to progestin.
Danol can also be used for the treatment of:

  • Heavy, painful periods
  • Recurrent breast cysts
  • Breast pain at period times

It can also be used to thin the uterus lining before surgery where the lining of the uterus is ablated (surgically removed using laser).

How Danol works

Danol works directly on the ovaries by suppressing (damping down) the production of oestrogen and progesterone by the ovaries.
Danol also has an indirect action on the hypothalamus (an area of the brain that controls body temperature, thirst and hunger) as well as inhibiting (preventing) the production of gonadotrophin (sex hormone) by the pituitary gland (gland situated at the base of the brain). The treatment will therefore trick the body into a pseudo (false) state of menopause causing the deposits of endometriosis to shrink.

Administration and dosage of Danol

Danol comes in capsule form in strengths of 100mgs and 200mgs per capsule and is taken orally (by mouth). The usual range of dosage is 200mgs to 800mgs daily in up to four divided doses. The dosage will depend on the individual patient as well as the preferences of the medical practitioner. Danol should be started on the first day of the monthly cycle to avoid exposing a pregnancy to the side effects of Danol. The most common dosage of Danol for endometriosis is 400mgs daily for six to nine months. Dosage may need to be increased if bleeding continues after two months treatment or in severe cases of disease.

Danol is not suitable for the treatment of children or the elderly.

When Danol should not be used (contra-indications)

  • Pregnancy
  • Lactating women (breast feeding)
  • Liver disease
  • Undiagnosed abnormal vaginal bleeding
  • Heart disease
  • Women with thrombosis
  • Androgen dependent tumours
  • Kidney disease

Precautions in the use of Danol

Diabetic patients should be regularly checked as Danol can cause insulin resistance.
Patients on anticoagulation treatment must be closely checked. Danol can potentiate (increase) the action of Warfarin.
Patients with high blood pressure need regular blood pressure checks as Danol can cause fluid retention, and can oppose the action of some anti-hypertensive drugs (drugs for lowering blood pressure).
Make the medical practitioner aware in cases of:

  • Epilepsy
  • Cancer
  • Migraine
  • Porphyria
  • Polycythaemia

Reaction of Danol with food/alcohol/drugs

Danol has not been reported to have any interactions with food. There are some reports that Danol may interact with alcohol causing nausea and shortness of breath.
Danol may interact with the following drugs:

  • Gonadal steroid therapy
  • Anti-diabetic therapies
  • Anti-coagulant therapy
  • Anti-hypertensive therapy
  • Cyclosporin (used in cancer)
  • Migraine treatments
  • Ethyl alcohol
  • Alfacalcidol (vitamin D)

Side effects of Danol

As with all drugs, Danol may cause side effects. The main effects experienced are those associated with the menopause as the body has been tricked into a pseudo (false) menopause.
Commonly reported side effects:

  • Acne
  • Hot flushes
  • Visual disturbance
  • Cramp
  • Back pain
  • Bloating
  • Jaundice
  • Weight gain
  • Reduction of breast size
  • Spotting
  • Joint pain
  • Changes to sex drive
  • Headache
  • Voice changes
  • Dysuria (painful urination)
  • Constipation
  • Gastric upsets
  • Greasy skin
  • Breast tenderness
  • Pelvic pain
  • Uterine pain
  • Dyspareunia (painful intercourse)
  • Oedema (fluid retention)
  • Hirsutism (hairiness on face and body)

Other reported side effects include:

  • Vaginal dryness
  • Skin rashes
  • Sun sensitivity
  • Tremors
  • Palpitations
  • Changes in skin pigmentation

As with all treatments, you may have no side effects at all, or you may have a few but it is rare to experience multiple side effects.

Do remember to report any side effects to your medical practitioner and ask for advice.

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