Drug reference
Moderate to severe acne in females of child-bearing age refractory to topical therapy or oral antibacterials | Moderately severe hirsutism ▶BY MOUTH ▶Females of childbearing potential: 1 tablet daily for 21 days, to be started on day 1 of menstrual cycle; subsequent courses repeated after a 7-day interval (during which withdrawal bleeding occurs), time to symptom remission, at least 3 months; review need for treatment regularly
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Acute porphyrias p. 1120. gallstones. heart disease associated with pulmonary hypertension or risk of embolus. history during pregnancy of cholestatic jaundice. history during pregnancy of chorea. history during pregnancy of pemphigoid gestationis. history during pregnancy of pruritus. history of breast cancer but can be used after 5 years if no evidence of disease and non-hormonal methods unacceptable. history of haemolytic uraemic syndrome. migraine with aura. personal history of venous or arterial thrombosis. presence or history of liver tumours. sclerosing treatment for varicose veins. severe or multiple risk factors for arterial disease or for venous thromboembolism. systemic lupus erythematosus with (or unknown) antiphospholipid antibodies. transient cerebral ischaemic attacks without headaches. undiagnosed vaginal bleeding
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Active trophoblastic disease (until return to normal of urine- and plasma-gonadotrophin concentration)—seek specialist advice. arterial disease. gene mutations associated with breast cancer (e.g. BRCA 1). history of severe depression especially if induced by hormonal contraceptive. hyperprolactinaemia—seek specialist advice. inflammatory bowel disease including Crohn’s disease. migraine. personal or family history of hypertriglyceridaemia (increased risk of pancreatitis). risk factors for venous thromboembolism. sickle-cell disease. undiagnosed breast mass CAUTIONS, FURTHER INFORMATION ▶Venous thromboembolism There is an increased risk of venous thromboembolism in women taking co-cyprindiol, particularly during the first year of use. The incidence of venous thromboembolism is 1.5–2 times higher in women using co-cyprindiol than in women using combined oral contraceptives containing levonorgestrel, but the risk may be similar to that associated with use of combined oral contraceptives containing third generation progestogens (desogestrel and gestodene) or drospirenone. Women requiring co-cyprindiol may have an inherently increased risk of cardiovascular disease.
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A mixture of cyproterone acetate and ethinylestradiol in the mass proportions 2000 parts to 35 parts, respectively. Skin
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→Appendix 1: combined hormonal contraceptives
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▶Common or very common Abdominal pain. breast abnormalities. depression. headaches. mood altered. nausea. weight changes ▶Uncommon Diarrhoea. fluid retention. sexual dysfunction . skin reactions. vomiting ▶Rare or very rare Contact lens intolerance. erythema nodosum. thromboembolism. vaginal discharge ▶Frequency not known Amenorrhoea (on discontinuation). angioedema aggravated. chorea exacerbated. hepatic function abnormal. hepatic neoplasm. hypertension. hypertriglyceridaemia. inflammatory bowel disease. menstrual cycle irregularities. suicidal tendencies
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Avoid—risk of feminisation of male fetus with cyproterone.
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Manufacturer advises avoid; possibility of anti-androgen effects in neonate with cyproterone.
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Manufacturer advises caution; avoid in severe or active disease
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Co-cyprindiol (Non-proprietary) Ethinylestradiol 35 microgram, Cyproterone acetate 2 mg Co- cyprindiol 2000microgram/35microgram tablets | 63 tablet P £16.65 DT = £10.78 ▶Clairette (Stragen UK Ltd) Ethinylestradiol 35 microgram, Cyproterone acetate 2 mg Clairette 2000/35 tablets | 63 tablet P £5.90 DT = £10.78 ▶Dianette (Bayer Plc) Ethinylestradiol 35 microgram, Cyproterone acetate 2 mg Dianette tablets | 63 tablet P £7.71 DT = £10.78 ▶Teragezza (Morningside Healthcare Ltd) Ethinylestradiol 35 microgram, Cyproterone acetate 2 mg Teragezza 2000microgram/35microgram tablets | 63 tablet P £11.10 DT = £10.78 ANTIBACTERIALS › LINCOSAMIDES
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