Drug Index

Mechanism :

Inhibits LH release from pituitary that prevents maturation and release of ovum. It also transforms proliferative endometrium to secretory one int he presence of adequate estrogen.

Indication :

  • Contraception
  • Severe dysfunctional uterine bleeding
  • Dysmenorrhea

Contraindications :

Hypersensitivity, Severe hepatic disease, Breast cancer, Cerebral haemorrhage, Undiagnosed vaginal bleeding, Thromboembolic disorders, Pregnancy.

Dosing :

Available as 28 day pack containing norethindrone/ethinyl estradiol 1 mg/20 mcg tab x 21 days and inert tab x 7 days or 1 mg/20 mcg x 24 tablets and ferrous fumarate 75 mg x 4 tabs or 0.4 mg/35 mcg tab x 21 days and ferrous fumarate tab 75 mg x 7 days.
Contraception, Dysmenorrhea, Endometriosis:
1 tab OD PO. Start on day 1 of menstrual cycle.
Severe dysfunctional uterine bleeding:
1 tab PO twice a day for 5-7 days and then 1 tab OD PO until all active tabs given. Skip the inert tabs/ferrous fumarate tabs. Use 0.15 mg/30 mcg tab.

Adverse Effect :

Common Reactions: Musculoskeletal, pain, abdominal cramps/distension, dyspepsia, nausea/vomiting, constipation, cervical secretion changes, headache, fluid retention, insomnia, mood changes, vulvovaginal candidiasis, glucose intolerance, weight changes, libido changes, contact lens intolerance, vision changes, rash, melasma/chloasma, alopecia, hirsutism, breast development.

Serious Reactions: Thromboembolism, hypertension, breast cancer, ovarian cancer, endometrial cancer, uterine hyperplasia, fibroid enlargement, hypercalcemia, cholestatic jaundice, gall stones, pancreatitis, hepatic hemangioma enlargement, depression, dementia, migraine, chorea exacerbation, seizure disorder exacerbation, asthma exacerbation, porphyria aggravation, SLE exacerbation, hypersensitivity reaction, anaphylaxis/anaphylactoid reaction, erythema multiforme, erythema nodosum, ischemic colitis, intestinal obstruction, vaginal erosion/ulcer.

Interaction :

Rifampin: Decreases pharmacologic effect of norethindrone.

Hepatic Dose :

Use is contraindicated in patients with hepatic tumors or impairment.
09/28/2020 08:28:33 Norethindrone/Ethinyl Estradiol
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