Can Danazol (Danzen) or Myoflex cause pus from the nipple?

Danazol (Danzen) or Myoflex and Nipple Discharge with Pus

Neither Danazol nor Myoflex is known to directly cause purulent nipple discharge as a reported side effect, but any unusual nipple discharge warrants immediate medical evaluation as it could indicate infection or other serious conditions.

Understanding Danazol and Its Side Effects

Danazol (also marketed as Danzen) is a synthetic steroid with multiple biologic effects used primarily for:

• Treatment of endometriosis 1
• Management of hereditary angioedema 1
• Treatment of immune thrombocytopenia 1

While Danazol has numerous documented side effects, purulent nipple discharge is not among them. According to the FDA drug label, the breast-related side effects of Danazol include:

• Reduction in breast size
• Nipple discharge (non-purulent) 2

The most common side effects of Danazol include:

• Androgen-like effects: weight gain, acne, seborrhea, mild hirsutism
• Menstrual disturbances: spotting, cycle alterations, amenorrhea
• Hepatic dysfunction with elevated liver enzymes 2
• Voice changes, hair loss, edema 1

Myoflex and Side Effects

Myoflex (typically containing trolamine salicylate) is a topical analgesic. There is no evidence in the provided literature linking Myoflex to purulent nipple discharge.

Clinical Significance of Purulent Nipple Discharge

Purulent (pus-containing) nipple discharge is a concerning clinical finding that requires prompt evaluation as it typically indicates:

1. Infection: Most commonly bacterial mastitis or abscess
2. Ductal ectasia: Inflammation of the mammary ducts
3. Malignancy: Though less common, can be a sign of breast cancer

Diagnostic Approach for Purulent Nipple Discharge

If a patient presents with purulent nipple discharge while taking Danazol or Myoflex:

1. Immediate evaluation: Physical examination of the breast to check for:

   • Erythema, warmth, tenderness (signs of infection)
   • Masses or lumps
   • Skin changes

2. Laboratory tests:

   • Culture of the discharge
   • Complete blood count to assess for infection
   • Inflammatory markers (ESR, CRP)

3. Imaging:

   • Mammography
   • Ultrasound
   • MRI if necessary

Management Recommendations

1. Do not assume the medication is the cause: Purulent nipple discharge is more likely due to an underlying infection or other breast pathology rather than medication side effect.

2. Do not delay evaluation: Regardless of medication use, purulent nipple discharge requires prompt medical assessment.

3. Consider discontinuing Danazol: If the patient is on Danazol and develops any breast abnormalities, discuss the risk-benefit of continuing therapy with their healthcare provider.

Key Points to Remember

• Purulent nipple discharge is not a known direct side effect of either Danazol or Myoflex
• Non-purulent nipple discharge can occur with Danazol use
• Any nipple discharge with pus requires immediate medical evaluation to rule out infection or other serious conditions
• Do not attribute purulent discharge to medication effects without proper diagnostic workup

If a patient on these medications develops purulent nipple discharge, they should seek immediate medical attention rather than assuming it is a medication side effect.