📋 Indications & Clinical Dosage
*Contraception for women with a history of normal biphasic cycles:*
BY DEEP IM INJ: Females of childbearing potential: On the first day of a cycle then at intervals of 30 (plus minus 3 days) i.e., minimum 27, max 33 days, regardless of the cycle pattern, If the injection interval is more than 33 days, no adequate contraception cover will be available that time on-wards.
⛔ Contraindications
Pregnancy, severe liver dysfunction, Dubin-Johnson syndrome, Rotor syndrome, liver tumour, thromboembolic processes in arteries or veins, sickle-cell anaemia, cancer of breast, endometrium, diabetes, disturbances of lipometabolism, history of herpes, otosclerosis with deterioration.
⚠️ Precautions & Warnings
Active trophoblastic disease (until return to normal of urine- and plasma gonadotrophin concentration), arterial disease,functional ovarian cysts, history of jaundice in pregnancy, malabsorption syndromes, pastectopic pregnancy, sex-steroid dependent cancer, systemic lupus erythematosus with positive (or unknown) antiphospholipid antibodies, severe hepatic impairment, overdue menstrual bleeding,
Interactions: Barbiturates, phenylbutazone, hydantoins, rifampicin, ampicillin, oral antidiabetics, insulin.
⚠️ Adverse Reactions / Side Effects
Depression, headache, nausea, vomiting, breast discomfort, breast tenderness, changes in libido, disturbances of appetite, dizziness, fatigue, menstrual irregularities, skin disorders. Rare: Break-through bleeding (discontinue if heavy break-through bleeding) and amenorrhoea.
📚 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.