📋 Indications & Clinical Dosage
*Moderate to severe non-menstrual pelvic pain associated with endometriosis:*
Adult (Female): Initiate treatment with 150 mg once daily, may increase to 200mg daily. Max duration of treatment is 24 months.
*Dysmenorrhea with coexisting Dyspareunia:*
Adult: 200 mg once daily may increase to twice daily if tolerated. Max duration of treatment is 6 months.
⛔ Contraindications
Severe hepatic impairment (Child-Pugh C), women taking inhibitors of organic anion transporting polypeptide (OATP)1B1 (a hepatic uptake transporter), Osteoporosis (risk of further bone loss), Pregnancy, hypersensitivity reaction to the drug which includes anaphylaxis and angioedema.
⚠️ Precautions & Warnings
Moderate hepatic impairment; only 150 mg once daily regimen is recommended for women with moderate hepatic impairment (Child-Pugh B), Cardiac disorder, use effective non-hormonal contraceptives during treatment and for 28 days after discontinuing treatment,
🔄 Drug Interactions
Oral hormonal contraceptives, OATPs
⚠️ Adverse Reactions / Side Effects
Bone loss (irreversible decrease in bone mineral density), hepatic transaminase elevations, change in menstrual bleeding pattern and reduced ability to recognize pregnancy, Suicidal ideation, suicidal behavior, and exacerbation of mood disorders.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated
Lactation / Breastfeeding:
Contraindicated, avoid