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Aygestin (norethindrone) is a synthetic oral progestin. It is used for contraception or to treat such conditions as secondary amenorrhea, abnormal uterine bleeding, and endometriosis. As an oral contraceptive, norethindrone is available as either a single agent or in combination with an estrogen. Progestin-only formulations or "mini-pills" of norethindrone are not widely used because of increased incidence of certain side effects such as irregular, unpredictable spotting and breakthrough bleeding.

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Uses

To prevent abnormal uterine bleeding due to hormonal imbalance or to restore menstrual periods

How to take

To prevent abnormal uterine bleeding due to hormonal imbalance or to restore menstrual periods
The usual dose is 2.5 to 10 milligrams a day taken for 5 to 10 days during the second half of a 28-day cycle. Your period should start 3 to 7 days after you stop taking norethindrone.

To treat endometriosis
The recommended starting dose is 5 milligrams a day for 2 weeks. The doctor may increase your dose by 2.5 milligrams a day every 2 weeks up to a maximum of 15 milligrams a day. Treatment may continue for 6 to 9 months or until intolerable breakthrough bleeding occurs.

Side effects

All progesterone drugs are associated with certain side effects, none of which can be anticipated. If any side effects develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking norethindrone.

Side effects caused by progesterone drugs may include: acne, allergic reaction, blood clots in the arteries, veins, eyes, or lungs, breakthrough menstrual bleeding, breast enlargement or tenderness, bulging eye, depression, double vision, cervical changes or secretions, change in menstrual flow, headache, hives, inflammation of the optic nerve, insomnia, menstrual spotting, migraine, mood swings, nausea, rash with or without itchy spots, skin discoloration, stopping of menstrual flow, swelling, vision loss, weight increase or decrease, yellowing of the skin or eyes

Side effects caused by estrogen/progesterone combinations may include: appetite changes, backache, blood pressure increase, bull's-eye rash, changes in appetite, changes in sex drive, dizziness, fatigue, hair growth or loss, headache, inflammation of the urinary tract, itching, nervousness, skin bruising, symptoms similar to premenstrual syndrome, red or tender skin nodules.

Precaution

Remember that norethindrone can cause clot-related disorders. Check with your doctor immediately if you experience any of the warning signs listed in "Most important fact about norethindrone."
To rule out cancer and other problems before you start taking norethindrone, your doctor will give you a complete physical exam, including examination of your breasts and pelvic organs. You also should have a Pap test (cervical smear).
Norethindrone may cause some degree of fluid retention. If you have a medical condition that could be made worse by fluid retention--such as epilepsy, migraine, asthma, or a heart or kidney problem--make sure your doctor knows about it.
Be sure to tell your doctor if you experience any irregular or unexplained vaginal bleeding while taking norethindrone.
Norethindrone makes some women depressed. If you've suffered from serious depression in the past, alert your doctor if you think you're having a relapse. You will probably need to stop taking norethindrone.
The long-term effects of drugs such as norethindrone on the function of certain organs--including the pituitary, ovaries, adrenal glands, liver, and uterus--are unknown.
Norethindrone may affect cholesterol and blood-sugar levels. If you have diabetes or high cholesterol, your doctor will want to watch you closely while you are taking norethindrone.
Norethindrone may mask the onset of menopause. However, women who are of menopausal age are still eligible to take the drug.
If you're being screened for cancer, make sure the doctor or lab technician knows you are taking norethindrone.

Drug interactions

If norethindrone is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Make sure your doctor knows about all the prescription and over-the-counter drugs you are taking.
In general, when you are taking a progesterone drug such as norethindrone, it is especially important to check with your doctor before taking the following:

Aminoglutethimide (Cytadren)
Carbamazepine (Tegretol)
Phenobarbital
Phenytoin (Dilantin)
Rifabutin (Mycobutin)
Rifampin (Rifadin, Rimactane)

Missed dose

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.