📋 Indications & Clinical Dosage
*Dysmenorrhoea:*
Adults (female): 10 mg twice daily from day 5 to day 25 of the cycle.
*Threatened Miscarriage:*
Adult (female): 40 mg at once then 10 mg every 8 hours untill symtoms remit.
*Habitual Miscarriage:*
Adult (female): 10 mg twice daily until the 20th week of pregnancy.
*Endometriosis:*
Adult (female): 10 mg two or three times daily from day 5 to day 25 of the cycle or continuously.
*Dysfunctional bleeding:*
Adult (female): To arrest bleeding: 10 mg twice daily adjunct to oestrogen for 5-7 days. To prevent bleeding: 10 mg twice daily adjunct to oestrogen from day 11 to 25 of the cycle.
*Infertility due to luteal insufficiency:*
Adult (female): 10 mg daily from day 14 to 25 of the cycle, continue treatment during the first month of pregnancy.
*Premenstrual syndrome:*
Adult (female): 10 mg twice daily from day 12 to day 26 of the cycle.
*Hormone replacement therapy:*
Adult (female): 20 mg daily for 12 days each month.
⛔ Contraindications
History of liver tumours or genital or breast cancer (unless progestogen are being used in the management of these conditions), severe arterial disease, undiagnosed vaginal bleeding and acute porphyria, history during pregnancy of idiopathic jaundice, severe pruritus, or pemphigoid gesta-tions, incomplete miscarriage, missed miscarriage. Avoid in hepatic impairment. Avoid in active liver disease including disorders of hepaticexcretion (e.g. Dublin-Johnson or Rotor Syndromes), infective hepatitis (until liver function returns to normal) and liver tumours and lactation
⚠️ Precautions & Warnings
Renal impairment, conditions that may worsen with fluid retention, epilepsy, hypertension, migraine, asthma, or cardiac dysfunction,susceptible to thromboembolism (particular caution with high dose, history of depression. Progestogens can decrease glucose tolerance and patients with diabetes should be monitored closely.
🔄 Drug Interactions
Rifamycin, anticoagulants, antidepressants, antidiabetics, anti-epileptics, antifungals, antivirals, aprepitant, barbiturates, bosentan, cyclosporin, diuretics, dopaminer-gics, lipid-regulating drugs, muscle relaxants.
⚠️ Adverse Reactions / Side Effects
Menstrual disturbances, premenstrual-like syndrome (including bloating, fluid retention, breast tenderness), weight change, nausea, headache, dizziness, insomnia, drowsiness, depression, change in libido; also skin re-actions (including urticaria, pruritus, rash, and acne), hirsutism and alopecia, jaundice and anaphylactoid reac-tions