Norethisterone Acetate

Norethisterone acetate is a synthetic progestin, a type of female hormone (progestogen), that is structurally similar to the natural hormone progesterone. It is used in various forms to regulate menstrual cycles and treat different gynecological disorders. It has anti-estrogenic, anti-androgenic, and some weak androgenic activity.

Indications

Norethisterone acetate is commonly prescribed for the following conditions: Menstrual irregularities such as amenorrhea (absence of periods) and oligomenorrhea (irregular periods). Dysfunctional uterine bleeding (abnormal bleeding not caused by a structural issue). Endometriosis, a condition where the lining of the uterus grows outside the uterine cavity, causing pain and irregular bleeding. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). As a contraceptive in certain formulations.

Dosage

In cyclic treatment with oestradiol, norethisterone acetate should be given during last 12 days of each 3 -week period of oestradiol administration, so that the 4th week of each cycle remains without any treatment. In patients receiving continuous oestradiol therapy, norethisterone acetate should be taken for 10-14 days (preferably first 12 claendar days)of each month.

Contra-Indications

Norethisterone acetate is contraindicated in the following situations: Pregnancy or suspected pregnancy. Active thrombophlebitis, thromboembolic disorders, or history of such disorders. Significant liver disease or liver tumors. Known or suspected hormone-dependent malignancy (e.g., breast cancer). Undiagnosed abnormal genital bleeding. Hypersensitivity to norethisterone acetate or any other component of the medication.

Special Precautions

Close monitoring is required in patients with a history of thromboembolic disorders, heart disease, diabetes, or hypertension. Patients with a history of depression should be carefully monitored, as norethisterone acetate may exacerbate depressive symptoms.

Side Effects

Nausea and vomiting. Headache or migraine. Breast tenderness or enlargement. Weight gain or changes in appetite. Mood changes such as depression or irritability. Irregular bleeding or spotting between periods.

Drug Interactions

Enzyme inducers (e.g., rifampicin, certain anti-epileptic drugs) may decrease the effectiveness of norethisterone acetate. Other hormonal contraceptives should be avoided. Care should be taken when used alongside other medications that affect liver function.