Generic Aygestin (Norethisterone Bp)

General information

Generic Aygestin (Norethisteron) is a progestin. It causes the transformation of the uterine mucosa from the proliferation phase to the secretory one, and after conception, the necessary conditions are created for the implantation of the impregnated ovum. The drug deminishes the excitability and the number of muscles of the uterus, induces the development of the terminal elements of the mammary gland. Suppresses the secretion of gonadotropins by the pituitary gland, averting the maturation of follicles and ovulation.

On admission, Norethisteron binds to progesterone receptors in end-organs, including myometrium. Norethisteron in the cytoplasm of cells forms a complex with specific receptors that binds to the chromatin of target cells and alters the synthesis processes in them. Norethisteron blocks the secretion of gonadotropin in the pituitary gland, thus hindering the onset of ovulation and the maturation of follicles, transforms the uterine mucosa from the proliferation phase to the secretory phase. Norethisteron slows down proliferous activity in the hyperplastic endometrium. Norethisteron contrib utes to the secretory transformation, the development of atrophic changes in the stroma and epithelium of the glands and the decidual reaction of the stroma. After fertilization, Norethisteron promotes the transition of the tunica mucosa of the uterus to a state that is favorable for the growth of a fertilized egg.

After 2 to 4 days after discontinuation of Norethisteron, menstrual-like bleeding occurs. Due to the effects on the endometrium, Norethisteron leads to the cessation of dysfunctional bleeding. Norethisteron stimulates the development of the terminal elements of the breast. Norethisteron has mild androgenic and estrogenic properties.

Precautions

Hypersensitivity, breast cancer (including suspect), pregnancy (including suspect, except cases of miscarriage), cholesteric jaundice in pregnant women, jaundice (including in anamnesis), acute hepatic diseases (including benign and malignant neoplasms), acute thrombophleitis, bleeding from the urine excretory ways of unknown etiology, metrorrhia of not clear genesis, bleeding from genitals of not clear genesis, the period of puberty.

The drug must be taken with caution: CHF, epilepsy, bronchial asthma, arterial hypertension, migraine, convulsions or other disorders of the CNS function (including history), renal failure, saccharine disease, liver disease (history), hyperlipidemia, thrombophlebitis in history, thromboembolism in anamnesis.

Before prescribing Norethisteron, it is necessary to carefully review the woman’s medical history and conduct a pelvic examination. Before Norethisteron is prescribed, it is necessary to restore the cause of menstrual disorders, for example, amenorrhea and oligomenorrhea. The interval between the control medical examinations is set individually, but at least once every 6 months.

If Norethisteron can affect a hidden or existing disease, then an appropriate schedule of follow-up medical examinations should be made. When Norethisteron is used, irregular bleeding may occur. If the bleeding is very frequent and irregular, then it is necessary to consider the possibility of using another treatment. If the indicated bleedings are persistent, then it is necessary to exclude their organic cause.

With prolonged therapy with Norethisteron, systematic medical examinations, monitoring of carbohydrate and lipid metabolism, levels of bilirubin, aspartate aminotransferase, alanine aminotransferase, blood coagulation system are shown.

In short, the main contraindications are:

• Young age under 18;
• oncopathology of the glandula mammaria and genitals;
• pregnancy — except for the threat of miscarriage and miscarriage;
• hepatitis of any aetiology, including in the past;
• liver diseases, including oncopathology and benign tumors;
• impaired renal function;
• a tendency to thrombosis, including thrombophlebitis or thromboembolism;
• uterine bleeding;
• overweight;
• herpes;
• allergic to the main active ingredient.

Aygestin Dosage

The attending physician sets the dosage individually; the daily dose is 300 mg-350 mg.

How to take Aygestin?

• Norethisteron is taken orally.
• Uterine fibroids: 5 to 10 mg, from 5 to 25 day of the menstrual cycle, not more than 6 months.
• Mastodynia, premenstrual syndrome, dysmenorrhea: 5 to 10 mg per day in the period from 16 to 25 day of the menstrual cycle. It can be taken together with estrogen. With lack of effectiveness and severe decompensated form — 5 mg, starting from the fifth day of the cycle for 21 days.
• Endometriosis: 5 mg per day in the period from 5 to 25 day cycle, for 6 months; further continuation of therapy is determined by the doctor.
• Adenomyosis: 5 mg per day from the fifth to the 25th day of the cycle for 6 months, or, starting from 2.5 mg per day on the fifth day of the cycle, gradually increase the dose by 2.5 mg every 2 to 3 weeks for 4 – 6 months.
• Termination of dysfunctional uterine bleeding: 5–10 mg for 6–12 days, prevention of relapse — 5–10 mg per day from the 16th to the 25th day of the cycle.
• Endometrial hyperplasia, anovulatory metrorrhagia: no more than 6 months before treatment, the dysfunctional nature of the bleeding must be confirmed by histological analysis; 5 to 10 mg per day for 6 to 12 days; upon reaching the desired effect, between 16 and 25 days of the cycle, 5 to 10 mg per day, usually together with estrogen, to prevent relapse.
• Diagnostic progesterone test: 10 mg for 10 days; if after 3–7 days after the end of the application of Norethisteron, moderate bleeding appeared and persisted for 3–4 days, and then the reaction is regarded as regular.
• Termination of lactation: in the first three days prescribed in a daily dose of 20 mg, from the fourth to the seventh day, take 15 mg per day, from the eighth to the tenth day, take 10 mg per day.
• Lactation warning: if pregnancy is interrupted between 16 and 28 weeks, take the pill on the first day- 15 mg per day, take 10 mg per day on the second and third day, and take 5 mg per day from the fourth to the seventh day; if pregnancy is interrupted between 28 and 36 weeks, take 15 mg per day on the first day, take 10 mg per day on the second and third day, and take 10 mg per day from the fourth to the seventh day.
• Transfer of the period of occurrence of the next menstruation: once a day, 10 mg, starting 8 days before the expected period, for no more than 12 days; This scheme allows to achieve a delay of menstruation for about 7 – 8 days.
• Contraception: only with estrogen, 1.25 – 2.5 mg from 1 to 5 days of the cycle for 21 days, then a break of 7 days.

Aygestin Side-effects

• On the part of the endocrine system: engorgement of the mammary glands, uterine bleeding, and weight gain.
• On the part of the nervous system: exhaustion, paresthesia.
• On the part of the digestive system: vomiting, nausea.
• Metabolism: oedema peripheral.
• Others: skin irritation, rash, melasma, chloasma.

Overdose

If taken more than prescribed, such side effects as nausea, vomiting and vaginal bleeding may occur. In this case symptomatic treatment is recommended.

Interactions

• Norethisteron must be taken with caution with antihyperglycemic drugs, oral anticoagulants, GCS.
• It is not recommended combining Norethisteron with barbiturates, phenytoin, rifampicin, cimetidine and other drugs that affect microsomal oxidation in the liver.
• The drug may influence the ability to drive motor transport and control mechanisms.

Alcohol interaction

To answer the question about the compatibility of hormonal drugs and alcoholic beverages, you need to know why this or that medication is used.

Norethisteron is prescribed in the treatment of infertility. That is, the woman is trying to get pregnant, so drinking alcohol during the preparation for conception, at least, is unwise.

Although Norethisteron itself does not interact with ethyl alcohol, it can negate all medical appointments. And alcohol is not needed for a woman who is trying to have a baby.
Norethisteron tablets are used for the growth of the inner layer of the uterus — endometriosis. The disease is accompanied by pain and bleeding. Alcohol dilates blood vessels and can provoke an unpleasant relapse.

What is the danger of Norethisteron? The drug has a negative effect on the liver, so it is not prescribed to patients with hepatitis, even if the disease is completely cured. The liver works to wear for the processing of alcohol.

Aygestin Reviews

Tanya (28): After giving birth to my baby, I was disturbed by extremely heavy menstruation. The examination (ultrasound intravaginal) showed the presence of a polyp in the uterus and endometrial change in the type of endometriosis. It is necessary to do hysteroscopy and remove all these defects. But before the invasive treatment, my doctor decided to try the pills. The gynecologist prescribed Generic Aygestin, a course on certain days of the cycle, for three months. I took 2 pills a day regardless of food intake, also I tried to take them at a fixed time (for example, the first pill in the morning at 10 o'clock, the second in the evening at 22 o'clock). I have been taking them for 2 months already, now there is a third course. The impressions from the reception are great! Menstruation became less profuse after the first month of admission and painless. Moreover, there is no fluid retention before menstruation.

Susanna (33): The drug causes a wild appetite. As an average woman in the last days of the cycle, I always want a chocolate with herring, and a salty cucumber. When I am taking Norethisteron, the appetite increases significantly. I always want to eat.

Bojana (35): I am a balanced and calm woman. 5-7 days before the onset of menstruation, I get a little more emotional, I can cry. If I’m taking Generic Aygestin, I am annoyed, I am not happy about the surrounding people, they get angry. Maybe I exaggerate a little, but only a little. The storm calms down the day after the end of the last pill.