Androcur vs Gale: Are These Cyproterone Acetate 50 mg Tablets the Same?
Both brands contain the same active ingredient at the same strength. They differ in manufacturer, registration and price. What matters more than the brand is using the lowest effective dose with medical follow-up.
Androcur and Gale both contain cyproterone acetate 50 mg, and both are registered with the Thai FDA.
They differ in manufacturer and price. We found no published bioequivalence study comparing Gale with Androcur, so they should not be called “identical”.
The dose matters more than the brand. Meningioma risk rises with cumulative dose, so current practice uses the lowest dose that works.
“Doctor, are Androcur and Gale different? Can I switch?” is a question I hear often from the trans women I care for. This article compares the two side by side and explains what matters more than the brand name.
Androcur and Gale: the same active ingredient, different brands
In short, the active ingredient and strength match. Androcur is the originator brand and Gale is a lower-priced alternative; both are registered in Thailand. Matching ingredients do not by themselves prove the two are absorbed identically (bioequivalence), and we found no published bioequivalence study of Gale against Androcur, so we do not call them “100% identical”.
How cyproterone acetate works
Where it acts
What it does
Result
Androgen receptor
Competes with testosterone and DHT for the receptor
Less androgen effect on target cells
Brain (pituitary)
Progestogen-like effect lowers LH and FSH release
The testes make less testosterone
In practice this means less body hair, less acne and oily skin, and a better response to estradiol in trans women. It also has other medical uses, such as some prostate cancers, which need specialist supervision.
The dose matters more than the brand
Cyproterone used to be given at 50 mg a day or more. In 2020 the European Medicines Agency warned that meningioma risk rises with cumulative dose, and the ENIGI study in trans women found that around 10 mg a day suppressed testosterone about as well as higher doses when combined with estradiol.
Current practice therefore uses the lowest effective dose and reviews regularly whether it is still needed. People who have had an orchiectomy or gender-affirming surgery no longer need an antiandrogen and use estradiol alone. Compare regimens in Trans women's hormone regimens.
Side effects and risks
Risk
What to know
Meningioma
Linked to dose and duration. Do not use if you have had a meningioma. See a doctor for persistent headache or vision changes.
Liver
Can affect liver tests; have blood tests as scheduled. Stop and seek care for jaundice or dark urine.
Blood clots
Risk rises with estrogen, smoking, obesity or immobility.
Mood
Low mood or mood swings can occur; talk to your doctor if daily life is affected.
Common side effects
Breast tenderness, tiredness, nausea, weight change, lower libido; usually mild.
Can I switch from Androcur to Gale?
Often yes, because the ingredient and strength match. Tell your doctor before switching and repeat blood tests afterwards to confirm testosterone stays suppressed. If you have taken 50 mg daily for a long time, that visit is a good chance to review your dose too.
When to seek urgent care
Severe unusual headache, seizures, vision changes, limb weakness, yellow skin or eyes, a swollen painful leg, sudden chest pain or breathlessness: go to hospital immediately or call 1669.
Antiandrogen care at Dr. Kris Clinic
At Dr. Kris Clinic I assess whether you need an antiandrogen at all, choose a suitable dose, run blood tests before and during treatment, and help people on long-term high-dose cyproterone move to a safer regimen. See Androcur 50 mg, Gale 50 mg or start with pre-hormone blood tests.
Summary & ordering
A feminising regimen has two parts: estradiol (the female hormone) and an antiandrogen. Whether you need both depends on whether you have had surgery.
Your situation
Regimen doctors usually recommend
No gender-affirming surgery yet, testes present
Estradiol + an antiandrogen (Gale or Androcur) at the lowest effective dose
Orchiectomy or gender-affirming surgery done
Estradiol alone, no antiandrogen needed
Estradiol comes in two forms: tablets (Estrofem) and transdermal gel, which carries a lower blood-clot risk and suits people who are older, smoke or have vascular risk. If you have not started hormones yet, begin with pre-hormone blood tests.
1. Estradiol (choose one form)
Estrofem estradiol tablets (28 tablets)THB 350once daily at the same timeDetails & order
Estradiol gel (80 g)THB 590once daily, bypasses first-pass liver effectDetails & order
2. Antiandrogen (if testes are present, choose one brand)
Gale 50 mg (10 tablets)THB 590about THB 59 per 50 mg tabletDetails & order
Androcur 50 mg (10 tablets)THB 990about THB 99 per 50 mg tabletDetails & order
Self-checks are a guide only and do not replace a doctor's assessment. Outcomes vary from person to person, depending on the severity of symptoms, the complexity of the problem and other factors.
Consult Dr. Kris
Start hormones safely
Assessment, blood tests and follow-up with a judgement-free doctor, in line with WPATH SOC-8.
Every medicine and service requires a doctor's assessment first.
Frequently asked questions
Can Androcur and Gale be used interchangeably?
The active ingredient and strength match, so switching is often possible, but tell your doctor first and repeat blood tests afterwards, as no published bioequivalence study is available.
Why is Gale cheaper than Androcur?
Androcur is the originator brand and Gale comes from a different manufacturer. At our clinic Androcur is THB 990 and Gale THB 590 per 10 tablets.
Do I need 50 mg of cyproterone a day?
Not necessarily. Newer evidence shows around 10 mg a day suppresses testosterone about as well when combined with estradiol. Your doctor sets the dose from your blood results.
Is long-term cyproterone dangerous?
Meningioma risk rises with cumulative dose, so use the lowest effective dose, keep up with blood tests and review the need regularly with your doctor.
European Medicines Agency (PRAC). Restrictions in use of cyproterone due to meningioma risk. February 2020.
Kuijpers SME, Wiepjes CM, Conemans EB, et al. Toward a Lowest Effective Dose of Cyproterone Acetate in Trans Women: Results From the ENIGI Study. J Clin Endocrinol Metab. 2021;106(10):e3936–e3945.
Coleman E, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022;23(Suppl 1):S1–S259.
Hembree WC, et al. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102(11):3869–3903.
สำนักงานคณะกรรมการอาหารและยา (อย.). ฐานข้อมูลทะเบียนตำรับยา: Androcur 1C 19/59(N), Gale 1A 18/68(NG).
This article is for education and does not replace diagnosis or treatment by a doctor. If you have symptoms or concerns, please see a doctor.
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