Dienogest

Dienogest is a synthetic progestogen medication primarily used in hormonal contraceptives and in the treatment of gynecological conditions. It works by modulating the hormonal balance in the body, suppressing ovulation, and thinning the uterine lining, which helps in reducing menstrual bleeding and treating endometriosis.

Indications

-Hormonal Contraception: Dienogest is used in combination with an estrogen (such as ethinylestradiol) in oral contraceptive pills to prevent pregnancy. -Endometriosis: Dienogest is used to treat endometriosis by reducing the size and activity of endometriotic lesions and alleviating associated pain. -Abnormal Uterine Bleeding: Dienogest may be used to manage abnormal uterine bleeding in some cases.

Dosage

-For Contraception: Dienogest is typically used in combination with an estrogen in oral contraceptive pills, taken once daily. -For Endometriosis: The recommended dose of dienogest is typically 2 mg once daily, taken continuously without interruption.

Contra-Indications

-Hypersensitivity to dienogest or any of its components. -Pregnancy and lactation. -Active or recent history of arterial or venous thromboembolic events. -Severe hepatic impairment. -Certain hormone-sensitive cancers (e.g., breast cancer). -Undiagnosed abnormal vaginal bleeding.

Special Precautions

-Monitor for signs of venous thromboembolism or arterial thromboembolism, especially in patients with risk factors. -Use caution in patients with a history of depression; if mood changes occur, discontinuation may be considered. -May affect glucose tolerance; patients with diabetes should be monitored. -Regular monitoring of liver function may be recommended, especially in patients with a history of hepatic disease.

Side Effects

Common side effects include: -Headache -Nausea -Breast tenderness -Mood changes Less common side effects may include: -Weight gain or loss -Acne -Irregular bleeding -Abdominal pain

Drug Interactions

-Enzyme-inducing drugs (e.g., rifampicin, carbamazepine) may decrease the effectiveness of dienogest by increasing its metabolism. -Caution when using with other medications affecting liver enzymes. -May affect the efficacy of other drugs (e.g., lamotrigine).