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Diethylstilbestrol
⚠️ Warning: High doses of diethylstilbestrol (DES) in early pregnancy have caused clear cell vaginal carcinoma in female offspring 16–20 years later. 👉 It must never be used in pre-menopausal women.
💊 About
- A synthetic oestrogen, historically prescribed for pregnancy-related issues.
- Withdrawn for most uses due to carcinogenic potential.
- Now only used in the treatment of malignant disease.
- Check BNF here for the latest details.
⚙️ Mode of Action
- Acts as an oestrogen analogue.
- Suppresses testosterone production → useful in androgen-dependent cancers (e.g., prostate carcinoma).
- Also used in certain post-menopausal breast cancers.
🎯 Indications / Dose
- Prostate carcinoma: 1–3 mg daily.
- Post-menopausal breast carcinoma: 10–20 mg daily.
🤝 Interactions
- See BNF for detailed interactions (multiple CYP- and oestrogen-related drug effects).
⚠️ Cautions
- As per BNF – monitor cardiovascular, hepatic, and thrombotic risks carefully.
- Long-term exposure increases malignancy risk.
🚫 Contraindications
- Pregnancy, children.
- Oestrogen-dependent tumours (breast, endometrium).
- Undiagnosed vaginal bleeding, porphyria.
- Moderate–severe hypertension.
- Severe or active liver disease.
- Dyslipidaemia, history of MI, stroke, VTE.
- Sickle cell anaemia, untreated polycythaemia, pulmonary hypertension.
❗ Side Effects
- Gynaecomastia.
- Thromboembolic risk (DVT, PE, stroke).
- Fluid retention, hypertension.
- Nausea, weight gain, reduced libido.
- ⚠️ Clear cell vaginal / cervical carcinoma in offspring exposed in utero.
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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