Uses of Ethinor: - Pain during menstruation - Endometriosis - Heavy menstrual bleeding Breast cancer, Metropathia haemorrhagica (dysfunctional uterine bleeding), Premenstrual syndrome, Contraception, Endometriosis, Menorrhagia, Menopausal HRT Severe hepatic dysfunction; undiagnosed vaginal bleeding; porphyria; pregnancy; previous idiopathic or current thromboembolism; thromboembolic disease; DVT.

Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones, Oral Contraceptive preparations

Norethisterone is a synthetic oral progestin used for contraception or to treat other hormone-related conditions such as menopausal symptoms and endometriosis. As a synthetic progestin, norethisterone acts similarly to endogenous progesterone but with a much higher potency- it acts at the pelvic level to alter cervical and endometrial function, as well as via the inhibition of pituitary hormones that play a role in follicular maturation and ovulation. A small increase in the risk of developing breast cancer has been observed in patients using combined oral contraceptives, with some evidence also implicating progestin-only pills - patients starting hormonal contraception should be advised of this risk and should employ routine breast self-examinations to check for evidence of any developing masses.

How to use Norethisterone: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Norethisterone may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Adult Abnormal bleeding – 1 tablet three times a day for 10 days. Bleeding usually stops within 1-3 days. A period usually starts 2-4 days after stopping treatment. Prevention of abnormal bleeding – 1 tablet twice a day from the 19th - 26th day of the cycle. Premenstrual Syndrome - 2 to 3 tablets a day from the 19th - 26th day of the cycle. You will normally be treated for several months. Delaying a period - 1 tablet three times a day starting three days before the expected beginning of the period. Your period should occur 2-3 days after you have stopped taking the medicine. Dysmenorrhea (Painful periods) - 1 tablet three times a day for 20 days starting on the 5th day of the cycle. You will usually be treated for 3-4 cycles. Menorrhagia (Heavy periods) - 1 tablet two to three times a day from the 19th - 26th day of the cycle. Endometriosis - 2 tablets a day starting on the 5th day of your cycle. If you continue having small bleeds (“spotting”), the dosage may be increased to 4 to 5 tablets a day. Once bleeding has stopped the dosage may be reduced. You will usually be treated continuously for 4-6 months or longer. (Counting the first day of menstruation as day 1).

Concentration may be reduced by CYP450 inducers (e.g. phenobarbital, phenytoin, carbamazepine, rifampicin, rifabutin, nevirapine, efavirenz, tetracyclines, ampicillin, oxacillin, co-trimoxazole) and ritonavir, nelfinavir (usually inhibitors of CYP450 but have inducing properties when used with steroid hormones). May cause additive fluid retention with NSAIDs, vasodilators. Adjustment in antidiabetic, thyroid hormone and anticoagulant therapy may be required. Potentially Fatal: May increase ciclosporin concentration.

Severe hepatic dysfunction; undiagnosed vaginal bleeding; porphyria; pregnancy; previous idiopathic or current thromboembolism; thromboembolic disease; DVT.

Common - Headache - Dizziness - Breast tenderness - Nausea - Vaginal spotting - Vomiting - Abdominal cramp Mental depression, cholestatic jaundice, porphyria, epilepsy, migraine, headache, breast discomfort, dizziness, nausea and vomiting, changes in libido, appetite and weight, breakthrough bleeding, changes in menstrual flow, amenorrhoea, oedema, rash, melasma or cholasma, acne, urticaria, abnormal LFTs, moodswings, insomnia, thrombotic and thromoembolic events, optic neuritis, altered lipid profile.

Norethisterone has been assigned to pregnancy category X by the FDA. Norethisterone is considered contraindicated during pregnancy. Norethisterone is excreted into human milk in small amount. It should be avoided during lactation.

Precaution: Hypertension; CVS disease; hepatic impairment; epilepsy; lactation; new onset of migraine-type headache; asthma; renal impairment; history of clinical depression.

Signs of an overdose include feeling or being sick, breast enlargement or vaginal bleeding. In case of overdose contact your doctor immediately.

Keep in a cool and dry place. Protect from light. Keep out of the reach of children.

Norethisterone has typical effects of a progestogen and converts the endometrium from the proliferative to the secretory phase. It may also have some oestrogenic, anabolic and androgenic activities, but these may not be significant. Norethisterone delays onset of periods and controls abnormal uterine bleeding. It also has contraceptive effects due to negative feedback inhibition of pituitary gonadotropin thus preventing ovulation.