This is a progestogen

Indications: endometriosis, habitual abortion, failure of nidation, menstrual disorders, amenorrhoea, dysfunctional uterine bleeding.

Cautions: conditions that may worsen with fluid retention e.g. epilepsy, hypertension, migraine, asthma, cardiac or renal dysfunction, and in those susceptible to thromboembolism. breakthrough bleeding may rarely occur (increase dose). Liver function disturbance and jaundice; hepatic impairment; pregnancy.

Contra-indications: history of liver tumours; severe liver impairment; genital or breast cancer; severe arterial disease; undiagnosed vaginal bleeding & porphyria; history of idiopathic jaundice, severe pruritis, pemphinoid gestations.

Side Effects: menstrual disturbances; premenstrual like syndrome (including bloating, fluid retention, breast tenderness); weight gain, nausea, headache, dizziness, insomnia, drowsiness, depression, skin reactions (including urticaria, pruritus, rash, acne) hirsutism, alopecia, jaundice and anaphylactoid reactions.

Dose: endometriosis, 10 mg 2-3 times daily from day 5 to day 25th of cycle or continuously.

Failure of nidation, irregular cycles, 10 mg twice daily from 11th to 25th day for at least 6 cycles.

Habitual abortion, 10 mg twice daily from day 11th to 25th day of cycle until conception, then continuously until 20th week of pregnancy and gradually reduced.

Dysfunctional uterine bleeding, 10 mg twice daily for 5-7 days to arrest bleeding; 10 mg twice daily from 11th to 25th day of cycle to prevent bleeding. Dysmenorrhoea, 10 mg twice daily from 5th to 25th day of cycle.

Amenorrhoea, 10 mg twice daily from 11th to 25th day of cycle following estrogen therapy from 1st to 25th day of cycle. Premenstrual syndrome, 10 mg twice daily from 12th to 26th day of cycle. Hormone replacement therapy, with continuous estrogen therapy, 10 mg daily on days 15-28 of each 28-day estrogen HRT cycle increased to 10 mg twice daily if withdrawal bleed is early or endometrial biopsy shows inadequate progestational response.