Indications

Menorrhagia, Endometriosis, Contraception, Progestogen component of menopausal hormonal replacement therapy, Premenstrual syndrome, Postponement of menstruation

Contraindication

Severe hepatic dysfunction; undiagnosed vaginal bleeding; porphyria; pregnancy; previous idiopathic or current thromboembolism; thromboembolic disease; DVT.

Special Precautions

Hypertension; CVS disease; hepatic impairment; epilepsy; lactation; new onset of migraine-type headache; asthma; renal impairment; history of clinical depression.

Side Effects

Mental depression, cholestatic jaundice, porphyria, epilepsy, migraine, headache, breast discomfort, dizziness, nausea and vomiting, changes in libido, appetite and weight, breakthrough bleeding, changes in menstrual flow, amenorrhoea, oedema, rash, melasma or cholasma, acne, urticaria, abnormal LFTs, moodswings, insomnia, thrombotic and thromoembolic events, optic neuritis, altered lipid profile.

Drug Interactions

Concentration may be reduced by CYP450 inducers (e.g. phenobarbital, phenytoin, carbamazepine, rifampicin, rifabutin, nevirapine, efavirenz, tetracyclines, ampicillin, oxacillin, co-trimoxazole) and ritonavir, nelfinavir (usually inhibitors of CYP450 but have inducing properties when used with steroid hormones). May cause additive fluid retention with NSAIDs, vasodilators. Adjustment in antidiabetic, thyroid hormone and anticoagulant therapy may be required.

Route of Administration

Oral, IM

Dosage

As directed by the physician