📋 Indications & Clinical Dosage
*Moderate to severe acne in Females of child-bearing age refractory to topical therapy or oral antibacterials, Moderate to severe hirsutism:*
Females of childbearing potential:1 tablet daily for 21 days, started on day 1 of menstrual cycle; subsequent courses repeated after a 7 day interval(during which withdrawal bleeding occurs), time tosymptom remission, at least 3 months; review need fortreatment regularly.
⛔ Contraindications
Pregnancy, lactation, acute porphyria, gallstones, heartdisease associated with pulmonary hypertension or risk ofembolus, history during pregnancy of cholestatic jaundice, chorea, pemphigoid gestationis or pruritus,history of breast cancer (can be used after 5 years) history of haemolytic uraemic syndrome, migraine with aura, historyof venous or arterial thrombosis, sclerosing treatment for varicose veins, risk factors for arterial disease or for venous thromboembolism, systemic lupus erythematosus, transient cerebral ischaemic attacks, undiagnosed vaginal bleeding, avoid in active liver disease including disorders of hepatic excretion, infective hepatitis and liver tumours
⚠️ Precautions & Warnings
Active trophoblastic disease, arterial disease, gene mutations associated with breast cancer, depression induced by hormonal contraceptive, hyperprolactinaemia, inflammatory bowel disease including Crohns disease,migraine, history of hypertriglyceridaemia, sickle-cell disease, undiagnosed breast mass
⚠️ Adverse Reactions / Side Effects
Abdominal cramps, absence of withdrawal bleeding, amenorrhoea, breast enlargement, secretion and tenderness, cervical erosion, changes in lipidmetabolism, vaginal discharge, chloasma, chorea, hypertension, leg cramps, liver impairment, nausea, nervousness, skin reactions, thrombosis, visual disturbances, vomiting. Rare: gallstones, systemic lupus erythematosus
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.