Vaniqa (eflornithine) alternatives: What can I take instead of Vaniqa?

Compare Vaniqa alternatives | Ethinyl Estradiol/Norethindrone | Ethinyl Estradiol/Norgestimate | Ethinyl Estradiol/Drospirenone | Aldactone | Proscar | Natural alternatives | How to switch meds

Vaniqa (eflornithine cream) is a prescription medication that is applied as a topical cream to help reduce facial hair. This cream is typically used in females on areas of the body with unwanted hair, like the face, and under the chin. Medications like Vaniqa can be used as a treatment for hirsutism. This condition can happen in females who experience excessive facial hair in unexpected areas like the face, chest, and back. Hirsutism can be associated with emotional distress and depression and usually indicates an endocrine disorder like polycystic ovary syndrome (PCOS).

Vaniqa works by stopping an enzyme, ornithine decarboxylase (ODC), that affects the rate of hair growth. This cream is applied as a thin layer directly onto the affected areas of the skin. After starting the medication, Vaniqa cream takes about four to eight weeks to notice decreased hair growth and may cause skin irritation in the treated area. Unfortunately, a drug shortage of Vaniqa led to an announcement by the drug manufacturer, Allergen, that they discontinued production of Vaniqa.

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What can I take in place of Vaniqa?

While Vaniqa was an effective treatment for some people, they may need to find an alternative treatment for reducing unwanted facial hair as Vaniqa is no longer available. There are other options available for the treatment of facial hair reduction. These alternative prescription medications include combined estrogen-progestin oral contraceptives (COCs) and anti-androgens. There are various kinds of COCs, as they can differ in the estrogen and progestin components. According to the recommendations by the Endocrine Society, all oral contraceptive alternatives appear to be equally effective for hirsutism, and the risk of side effects is low. These guidelines also state that the anti-androgen alternatives are equally effective. These options may be more suitable for certain individuals due to their different uses, side effect profiles, and cost.

Other alternatives to Vaniqa

There are a variety of other generic and brand name estrogen-progestin oral contraceptives (COCs) that are not included in the table above that may be suitable alternatives to Vaniqa. For people unable to take COCs and other oral medications or those who want to try several treatment options, hair removal treatments can directly remove unwanted hair. Hair removal methods include shaving, plucking, waxing, threading, electrolysis, and photoepilation, which uses intense pulsed light to destroy the hair follicles. Some other COCs include the following:

• Afirmelle
• Amethyst
• Aubra EQ
• Aurovela Fe
• Blisovi Fe
• Delyla
• Dolishale
• Falmina
• Finzala
• Gemmily
• Hailey Fe
• Jasmiel
• Joyeaux
• Larin Fe
• Lo-Zumandimine
• Lutera
• Merzee Fe
• Mibelas Fe
• Nikki
• Sronyx
• Tarina Fe
• Taysofy
• Taytulla
• Vestura
• Vienva

Top 5 Vaniqa alternatives

The following are some of the most common alternatives to Vaniqa.

1. Ethinyl Estradiol/Norethindrone Oral Contraceptives

Ethinyl estradiol and norethindrone oral contraceptives are available in a variety of generic and brand name medications, including Charlotte Fe, Junel Fe, and Microgestin Fe. Estrogen-progestin COCs are recommended as a first-line treatment for most females with hirsutism, even though these medications are used off-label for this condition. Hirsutism is associated with hyperandrogenism (high levels of the hormone androgen), and COC therapy reduces hyperandrogenism. Ethinyl estradiol and norethindrone oral contraceptives can also provide additional benefits such as contraception, cycle management, and acne reduction. However, some females cannot take oral contraceptives due to cardiovascular disease, venous thromboembolism (VTE), history of stroke, and women 35 years old who smoke. Ethinyl estradiol and norethindrone oral contraceptives are a well-suited alternative for people treating hirsutism who can safely take oral contraceptives. This alternative is taken once daily in the order presented in the blister pack.

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2. Ethinyl Estradiol/Norgestimate Oral Contraceptives

Ethinyl estradiol and norgestimate oral contraceptives are available in several generic and brand-name medications, including Estarylla, Mili, and Sprintec. Like other formulations of estrogen-progestin COCs, this alternative is recommended as a first-line treatment for most females with hirsutism as an off-label treatment for this condition. This alternative can also help manage contraception, cycle management, and acne. Like other oral contraceptives, ethinyl estradiol and norgestimate should not be used in females with certain conditions such as cardiovascular disease, venous thromboembolism (VTE), history of stroke, and women 35 years old who smoke. Ethinyl estradiol and norgestimate oral contraceptives are a great alternative for people treating hirsutism who can safely take oral contraceptives. This alternative is taken once daily in the order presented in the blister pack.

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3. Ethinyl Estradiol/Drospirenone Oral Contraceptives

Ethinyl estradiol and drospirenone oral contraceptives are available in various generic and brand-name medications, including Beyaz, Loryna, and Yaz. As with other formulations of estrogen-progestin COCs, this alternative is recommended as a first-line treatment used off-label for most females with hirsutism. Drospirenone is an anti-androgenic progestin structurally related to another alternative called spironolactone. Ethinyl estradiol and drospirenone have the same medical conditions contraindicated with other COCs. Ethinyl estradiol and drospirenone oral contraceptives are suitable alternatives for people treating hirsutism who can safely take oral contraceptives. This alternative is taken once daily in the order presented in the blister pack.

4. Aldactone (spironolactone)

Aldactone is a brand name medication that is available as a generic called spironolactone. Aldactone is an anti-androgen that is often the first choice of anti-androgen therapy for hirsutism. This alternative works to stop the enzymes involved in androgen production that can contribute to excessive hair growth. For treatment of hirsutism, spironolactone can either be taken alongside a COC or used alone. Clinical trials for hirsutism have shown consistent benefits with excessive hair growth and are considered a safe treatment option. Some side effects of spironolactone include hyperkalemia (increased potassium levels), gastrointestinal discomfort, and irregular menstrual bleeding. Spironolactone should be avoided in pregnant females due to potential risks to a male fetus. Spironolactone is a well-suited alternative for females who cannot take COCs or need additional treatment for excessive hair growth. The daily dose of spironolactone can vary depending on the treated condition and ranges from 25 to 400 mg by mouth daily in divided doses.

RELATED: Spironolactone side effects and how to avoid them

5. Proscar (finasteride)

Proscar is a brand name medication available as a generic called finasteride. Proscar is another type of anti-androgen that works as a 5 alpha-reductase inhibitor to prevent excess hair growth. Finasteride can be taken alongside a COC or used alone to treat hirsutism. The available clinical trials showed that finasteride reduced hirsutism scores by 30% to 60% and reduced hair shaft diameters. Finasteride should not be used in pregnant females as it is a potential hazard to a male fetus. Side effects include decreased libido, irregular menstruation, and dizziness. Finasteride is a suitable alternative for females who cannot take COCs or tolerate spironolactone. This alternative is usually dosed at 2.5 to 5 mg once daily.

Related: Does finasteride work for women?

Natural alternatives to Vaniqa

Natural alternatives to Vaniqa for hirsutism include lifestyle changes and supplements to help reduce unwanted hair growth.

Endocrine disorders like PCOS and obesity often go hand in hand. For females with hirsutism who are obese, lifestyle changes can be an effective intervention. Lifestyle changes that promote weight loss and reduce the risk of Type 2 diabetes include eating a healthy diet and getting enough exercise. Weight loss can lead to improved insulin sensitivity, decreased androgen levels, and potentially a return of ovulatory cycles. Lifestyle changes that work to lower androgens could potentially improve unwanted hair growth.

Some supplements have anti-androgen effects that may be useful in conditions like hirsutism or PCOS. Some natural remedies that reduce the levels or activity of androgen hormones within the body include spearmint, licorice root, and black cohosh. Commonly used in tea form, spearmint tea used daily may lessen unwanted hair growth associated with hirsutism. While supplements are not prescribed by a doctor, it is important always to discuss the use of supplements with a healthcare team, as some supplements need to be avoided with certain medical conditions or in combination with medications.

How to switch to a Vaniqa alternative

1. Discuss all health conditions with a healthcare provider

Before switching from Vaniqa to an alternative, it’s important that the prescribing doctor is aware of all medical conditions. Some alternatives should be used with caution or avoided with certain medical conditions.

2. Make a treatment plan when discontinuing Vaniqa

When stopping Vaniqa, it is important to know what to expect. While Vaniqa can effectively decrease hair growth, once the medication is stopped, it decreases hair growth for only about 8 weeks. Vaniqa must be used indefinitely to prevent regrowth. Making a new treatment plan with healthcare professionals to continue treating unwanted hair growth is important.

3. Discuss all prescription and over-the-counter medications with a healthcare provider

Before switching from Vaniqa to an alternative, the prescribing doctor must review a patient’s medication list, including prescription drugs and over-the-counter (OTC) meds. Some alternatives have dangerous drug interactions that must be avoided.

4. Continue lifestyle changes if overweight or obese

It’s important for people treating hirsutism and endocrine disorders like polycystic ovary syndrome (PCOS) to manage weight if overweight or obese. Lifestyle changes to manage weight include diet, exercise, and behavioral changes.