Diane 35

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What is this medication used for?

Diane-35 contains two types of sex hormones, a progestogen called Cyproterone acetate and an estrogen called Ethinylestradiol. It is used in women of reproductive age who suffer from conditions due to an increased sensitivity to androgens in the body. Androgens are hormones in the body that make one display more male characteristics. Women who are more sensitive to androgen may have conditions such as acne, very oily skin or excessive hair growth in certain areas of the face or body. The medication also provides effective oral contraception in women being treated for the above conditions. 

If you are taking Diane-35 for any of the conditions above, you must not take any other hormonal contraceptive at the same time.  

Dosage and How to Use

  • Do not stop taking your medication without checking with your healthcare professional.
  • You should take this medication after food.
  • You may start taking this medication on the first or second day of your menses (if this is your first time taking hormonal contraceptives).
  • If you are also using it for contraceptive purposes, a barrier method of contraception e.g. condoms, is recommended for the first 7 days of taking Diane-35 for the first time.
  • You should take one tablet daily for 21 consecutive days, preferably at the same time every day. Each subsequent pack is started after a 7-day tablet-free interval, during which a withdrawal bleeding usually occurs. This usually starts on day 2-3 after the last tablet is taken and may not have finished before the next pack is started.

What to do if I missed a tablet?

​​If you missed a tablet for less than 12 hours from your usual time​

  • The protection against pregnancy is not reduced.
  • Take the tablet as soon as you remember and then take the following tablets again at the usual time.

If you missed a tablet for more than 12 hours from your usual time​

If the missed tablet is within week 1 of the pack: 

  • Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. 
  • Continue to take your tablets at your usual time on the next day. 
  • Use a barrier method such as a condom for the next 7 days.

If the missed tablet is within week 2 of the pack: 

  • Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. 
  • Continue to take your tablets at your usual time. 
  • If you have taken your tablets correctly in the 7 days before the first missed tablet, there is no need to use extra contraceptive precautions. However if this is not the case, or you have missed more than 1 tablet, use a barrier method such as a condom for the next 7 days.

If the missed tablet is within week 3 of the pack:  

If you took your tablets correctly in the previous 7 days, follow any of the following 2 methods. You do not need extra contraception. If this was not the case, follow the first method and you would need additional contraception, such as condoms, for the next 7 days.

  • First method: Take the last missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. Continue to take your tablets at your usual time and start the next pack right away without the 7-day tablet free period, i.e. no gap should be left between packs. Your menses may not come until the next pack is finished, but there is no need to worry. However, if your menses does not occur after the next pack is finished, you should take a pregnancy test to rule out pregnancy. 
  • Second method: Stop the current pack and have a tablet-free period of up to 4 days (including the day you missed the tablet) – during which time a withdrawal bleed (menses) usually occurs and then continue with the next pack.
What to do if you missed a tablet?

If you vomit or suffer from diarrhea within 3 to 4 hours of taking this medication, the tablet may not be absorbed. This is considered a missed dose. You should then follow the instructions above.

What are the possible side effects of the medicines?​

  • Spotting or bleeding may occur between your periods during the first 1-2 months of taking oral contraceptives. However, if this continues after the second month, check with your doctor
  • Nausea, vomiting, bloating and stomach cramps. Take the medication after food to reduce these side effects. 
  • Breast tenderness
  • Headache or migraine. You may take Paracetamol to manage headaches.
  • Intolerance to contact lenses
  • Weight changes, mood swings. Take medication at the same time every day to avoid huge changes in the hormone levels in your body. 
  • Pigmentation (changes in colour) of the skin. Apply sunblock when you are outdoors and avoid long hours of sun exposure. 

Check with your doctor about any symptoms that becomes bothersome.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Using a combined hormonal medication increases a woman’s risk of developing blood clots compared to a woman not taking any combined hormonal contraception. The risk of developing a blood clot in a vein is highest during the first year a woman uses the medication. Other risk factors for developing blood clots include smoking and obesity. However, the formation of a blood clot is rare and the doctor would have considered the risks against the benefits before making the recommendation. 

The symptoms of a blood clot include one or more of the following:

  • Any unusual sudden cough, breathlessness or difficulty in breathing 
  • Severe pain in the chest which may reach the left arm
  • Severe pain in legs or swelling in either of your legs
  • Weakness or numbness in any part of your body
  • Change in your speech, including slurring of words
  • Change in your senses of hearing, smell or taste
  • Vision changes such as loss of vision/blurred vision 

Other rare but serious effects that you may or may not experience: 

  • Unusual, severe or long-lasting headache or worsening of migraine 
  • Dizziness or fainting
  • Severe pain in your abdomen
  • Dark urine or light coloured stools
  • Nausea and vomiting
  • Loss of appetite
  • Yellowing of eyes or skin

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What precautions should I take?

Inform your healthcare professional if: 

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding 
  • You are taking any other medications, including supplements, traditional medications and herbal remedies.
  • You have a history of or current medical conditions such as liver problems, stroke, heart disease, migraine headaches, epilepsy (fits), diabetes or cancer
  • You are a smoker

If you are seeing other healthcare professionals for any other medical conditions, inform them that you are taking this medication.

What other medications and foods should I avoid when taking Diane-35?

Some medications including antibiotics and antifungals may affect how Diane-35 works or be affected by Diane-35. Please inform other healthcare professionals about this medication you are taking if you are seeing them for other medical conditions.

Handling and storage

  • Store in a cool, dry place away from moisture, heat and direct sunlight.
  • Keep the medicine out of reach of children.
  • Throw away all expired medicines.

The above information answers some common questions about this medicine. It does not contain all the available information. It also does not take the place of talking to your doctor or pharmacist.

References

https://www.healthhub.sg/a-z/medications/310/Cyproterone-acetate-Ethinylestradiol


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