Danazol

INTRODUCTION

Indications

Treatment of moderate endometriosis that is unresponsive to conventional therapy. Palliative therapy of fibrocystic breast disease. Prophylaxis of hereditary angioedema.

Action

Inhibits pituitary output of gonadotropins, resulting in suppression of ovarian function. Has weak androgenicanabolic activity. Therapeutic Effects: Atrophy of ectopic endometrial tissue in endometriosis. Decreased pain and nodularity in fibrocystic breast disease. Correction of biochemical abnormalities in hereditary angioedema.

Adverse Reactions/Side Effects

CNS: emotional lability. EENT: deepening of voice. CV: edema. GI: hepatitis (cholestatic jaundice). GU: amenorrhea, clitoral enlargement, testicular atrophy. Derm: acne, hirsutism, oiliness. Endo: amenorrhea, anovulation, decreased breast size (women), decreased libido. Metab: weight gain.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor symptoms of endometriosis (painful periods, pain during sexual intercourse, excessive menstrual bleeding, GI problems), or breast pain and tenderness associated with benign fibrocystic breast disease. Report any changes in these symptoms to help document the effects of drug therapy.

• For patients with hereditary angioedema, monitor symptoms such as laryngeal edema, swelling in the face and extremities, and GI problems (diarrhea, vomiting, abdominal cramping). Document any changes in these symptoms to help assess the effects of drug therapy.

• Be alert for signs of drug-induced hepatitis, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, skin rashes, flu-like symptoms, and muscle/joint pain. Report these signs to the physician immediately.

• Assess peripheral edema using girth measurements, volume displacement, and measurement of pitting edema (See Appendix N). Report increased swelling in feet and ankles or a sudden increase in body weight due to fluid retention.

• Monitor and report emotional lability or other changes in mood and behavior.

• Periodically assess body weight and report a sustained or substantial weight gain.

Patient/Client-related Instruction

• Instruct patient to report signs of drug-induced hepatitis, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, skin rashes, flu-like symptoms, and muscle/joint pain.

• Instruct patient to report severe or troublesome changes in sexual function or characteristics, including decreased libido, testicular atrophy in men, and clitoral enlargement and decreased breast size in women.

• Instruct women to notify health care professional about decreased or absent menstruation.

• Instruct patient to report other troublesome side effects such as severe or prolonged skin reactions (acne, oiliness, increased hair growth) or deepening of the voice.

Pharmacokinetics

Absorption: Absorbed from the GI tract.

Distribution: Unknown.

Metabolism and Excretion: Metabolized by the liver.

Half-life: 4.5 hr.