Cyproterone acetate (CPA)

Cyproterone acetate can be taken alone, but when used for acne it is almost always prescribed in the form of a birth control pill (combined oral contraceptive – COC) that contains both CPA and an estrogen. In fact, researchers recommend that CPA by itself be prescribed only for women who no longer have a uterus or ovaries or who cannot tolerate estrogens.3 When taken alone, the recommended dose of CPA is 50 – 100 mg. This is significantly higher than the dose present in COCs, which is 2 mg. When taken alone, it should be started on either the first or fifth day of the menstrual cycle and stopped on the fourteenth day, just before ovulation. In contrast, COCs containing CPA should be taken daily.1