NORETHISTERONE

Progesterone

Dosage Forms

Tablet

5 mg

Uses

  • Endometriosis
  • Menorrhagia
  • Dysfunctional uterine bleeding
  • Dysmenorrhoea
  • Postponement of menstruation
  • Premenstrual syndrome

Dose and Duration

Endometriosis

Adult (female): by mouth, 10–15 mg daily for 4–6 months or longer, starting on day 5 of cycle (increased to 20–25 mg daily if spotting occurs and reduced once bleeding has stopped)

Menorrhagia and dysfunctional uterine bleeding

Adult (female): by mouth, 5 mg every 8 hours for 10 days to stop bleeding; followed by 5 mg every 12 hours from day 19 to day 26 of cycle to prevent bleeding

Dysmenorrhoea

Adult (female): by mouth, 5 mg every 8 hours from day 5 to day 24 for 3–4 cycles

Postponement of menstruation

Adult (female): by mouth, 5 mg every 8 hours starting 3 days before expected onset of menstruation

Premenstrual syndrome

Adult (female): 5 mg every 8–12 hours from day 19–26 for several cycles

Contraindications

  • Pregnancy
  • Undiagnosed vaginal bleeding
  • Hepatic impairment or active liver disease
  • Severe arterial disease
  • Breast or genital tract cancer
  • Porphyria
  • History of idiopathic jaundice, severe pruritus or pemphigoid infestations in pregnancy

Side Effects

  • Headache
  • Nausea
  • Amenorrhoea, spotting, hypomenorrhoea
  • Uterine or vaginal bleeding
  • Oedema
  • Cholestasis

Interactions

  • Carbamazepine, griseofulvin, nevirapine, phenobarbital, phenytoin, rifampicin (reduced noerthisterone effect)
  • Atazanavir (increased concentration of norethisterone)
  • Ciclosporin (increased plasma ciclosporin concentration)
  • Warfarin (antagonism of anticoagulant effect)

Patient Instructions

  • When taken for postponement of menstruation, menstruation occurs 2–3 days after stopping

Pregnancy

  • Do not use

Breast-feeding

  • Do not use

⚠️ Caution

  • Use with caution in epilepsy, migraine, diabetes mellitus, hypertension or cardiac or renal disease, susceptibility to thromboembolism or depression
  • Norethisterone may suppress lactation
  • Should only be prescribed by a specialist (gynaecologist)