Flutamide is a potent nonsteroidal antagonist of the androgen receptor. Although most commonly used to treat prostate cancer, flutamide has been reported to be efficacious in the treatment of acne, hirsutism, and androgenic alopecia (39). It can be given in doses of 250 mg twice daily in combination with an oral contraceptive. Fatal hepatitis has been reported with this drug. Liver function tests should be monitored and serious consideration should be given to the risk/benefit ratio of its use in acne (40). Additionally, because it is an antiandrogen, pregnancy issues are a concern.
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