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Megalis (Generic Tadalafil Tablets) prescription medication which is FDA-approved to treat the following in men: erectile dysfunction (ED), a condition in which you can’t get or keep an erection, symptoms of benign prostatic hyperplasia (BPH), a prostate condition that may cause problems with urination and ED and symptoms of BPH together. Megalis comes as a tablet that you swallow. It’s available in two strengths: 10 mg and 20 mg.
Tadalafil tablets are also indicated for the treatment of pulmonary arterial hypertension (PAH).
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Buy Susten Capsules 100 mg (Progesterone), Recurrent miscarriage, amenorrhoea, abnormal uterine bleeding, palliative treatment of advanced, inoperable endometrial carcinoma, Progesterone stimulates luteal actions, changes in uterus and vagina as seen in early pregnancy.
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Premarin is a estrogen medication that consists of conjugated estrogens which is used by women to help reduce symptoms of menopause (such as hot flashes, vaginal dryness). These symptoms are caused by the body making less estrogen.
Biopril AM Tablet is a medicine that is used for the treatment of Hypertension, Severe Pain In Chest, High Blood Pressure, Heart Attack, Heart Failure, Patients Of Diabetes With Kidney Failure and other conditions.
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Megalis (Generic Tadalafil Tablets) prescription medication which is FDA-approved to treat the following in men: erectile dysfunction (ED), a condition in which you can’t get or keep an erection, symptoms of benign prostatic hyperplasia (BPH), a prostate condition that may cause problems with urination and ED and symptoms of BPH together. Megalis comes as a tablet that you swallow. It’s available in two strengths: 10 mg and 20 mg.
Tadalafil tablets are also indicated for the treatment of pulmonary arterial hypertension (PAH).
Buy Femilon Tablet (Drospirenone 0.15 Mg & Ethinylestradiol 0.02 Mg), Ethinyl estradiol and Drospirenone also sold under the brand name Yaz is a birth control pill. It works by preventing ovulation or the release of a female egg from the ovaries.
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Buy Susten Capsules 100 mg (Progesterone), Recurrent miscarriage, amenorrhoea, abnormal uterine bleeding, palliative treatment of advanced, inoperable endometrial carcinoma, Progesterone stimulates luteal actions, changes in uterus and vagina as seen in early pregnancy.
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Premarin is a estrogen medication that consists of conjugated estrogens which is used by women to help reduce symptoms of menopause (such as hot flashes, vaginal dryness). These symptoms are caused by the body making less estrogen.
Biopril AM Tablet is a medicine that is used for the treatment of Hypertension, Severe Pain In Chest, High Blood Pressure, Heart Attack, Heart Failure, Patients Of Diabetes With Kidney Failure and other conditions.
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Buy Loette Pills disappears with constant use and may rarely need medical consultation for disturbing heavier bleeds. Amenorrhoea is the absence of the withdrawal bleed which can occur with prolonged usage as a result of blood levels being maintained continuously above the threshold for withdrawal even in pill free periods. It is not permanent and is totally reversible on pill discontinuation.
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Attentrol (Atomoxetine Hydrochloride Capsules) is a medicine that is prescribed for treating children, adolescents and adults with attention deficit hyperactivity disorder (ADHD).
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Cetrizet Tablet is used for Running Nose, Cold, Allergy Symptoms, Sneezing, Itching, Watery Eyes and other conditions.
Cetrizet Tablet contains Cetirizine as an active ingredient.
Cetrizet Tablet works by blocking histamine that is produced during an allergic rejection.
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Femilon Birth Control Pills (Generic Ethinyl Estradiol and Desogestrel Tablets)All Contraceptives
Femilon Birth Control Pills (Generic Ethinyl Estradiol and Desogestrel Tablets) are a highly effective method for the prevention of pregnancy in women who elect to use this product as a method of contraception. It is a birth control pill that contains two types of hormones, desogestrel and ethinyl estradiol, and when taken properly, prevents pregnancy. It works by stopping a woman's egg from fully developing each month. Femilon Tablets are manufactured by Mylan Laboratories Limited, India and marketed by Organon (India) Private Limited.
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Femilon (Desogestrel and Ethinyl Estradiol tablets) Clearsky Pharmacy
Femilon (Desogestrel and Ethinyl Estradiol Tablets) is a highly effective oral contraceptive therapy of 21 white round tablets each containing 0.15 mg Desogestrel and 0.03 mg Ethinyl Estradiol.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
How to Give Better Lectures: Some Tips for Doctors
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CYPROTERONE ACETATE
AND ETHINYL ESTRADIOL
TABLETS
2 MG/ 0.03MG
Package leaflet: Information for the
patient
Cyproterone Acetate and Ethinyl Estradiol
2mg/0.03mg Tablets.
Read all of this leaflet carefully before you
start taking this medicine because it
contains important information for you.
- Keep this leaflet. You may need to read it
again.
- If you have any further questions, ask your
doctor or pharmacist.
- This medicine has been prescribed for you
only. Do not pass it on to others. It may
harm them, even if their signs of illness are
the same as yours.
- If any of the side effects gets serious, or if
you notice any side effects not listed in this
leaflet, please tell your doctor.
The name of the product is Cyproterone
Acetate and Ethinyl Estradiol Tablets which
will be referred as Cyproterone Acetate EE in
this leaflet.
What is in this leaflet
1. What Cyproterone Acetate EE is and what
it is used for
2. Before you are given Cyproterone Acetate
EE
3. How you will be given Cyproterone
Acetate EE
4. Possible side effects
5. How Cyproterone Acetate EE is stored
6. Further Information
1. What Cyproterone Acetate EE is
and what it is used for
Cyproterone Acetate EE is used to treat skin
conditions such as acne, very oily skin and
excessive hair growth in women of
reproductive age. Due to its contraceptive
properties it should only be prescribed for
you if your doctor considers that treatment
with a hormonal contraceptive is
appropriate.
You should only take Cyproterone Acetate
EE if your skin condition has not improved
after use of other anti-acne treatments,
including topical treatments and antibiotics.
2. Before you are given Cyproterone
Acetate EE
Before you take Cyproterone Acetate EE
It’s important that you understand the
benefits and risks of taking Cyproterone
Acetate EE before you start taking it, or
when deciding whether to carry on taking it.
Although Cyproterone Acetate EE is suitable
for most healthy women it isn’t suitable for
everyone.
Warnings and precautions
→ Talk to your doctor or pharmacist
before taking Cyproterone Acetate EE or if
you have any of the illnesses or risk factors
mentioned in this leaflet.
Before you start taking Cyproterone
Acetate EE
--Your doctor will ask about you and your
family’s medical problems and check your
blood pressure and exclude the likelihood
of you being pregnant. You may also need
other checks, such as a breast examination,
but only if these examinations are necessary
for you or if you have any special concerns.
--Cyproterone Acetate EE also works as an
oral contraceptive. You and your doctor
will have to consider all the things that
would normally apply to the safe use of oral
hormonal contraceptives.
When should you contact your doctor?
Stop taking the tablets and contact your
doctor immediately if you notice possible
signs of a blood clot.
While you’re on Cyproterone Acetate EE
--You will need regular check-ups with your
doctor, usually when you need another
prescription of Cyproterone Acetate EE.
You should go for regular cervical smear
tests.
Check your breasts and nipples every
month for changes
– tell your doctor if you can see or feel
anything odd, such as lumps or dimpling of
the skin.
-- If you need a blood test tell your doctor
that you are taking Cyproterone Acetate EE,
because this type of medicine can affect the
results of some tests.
--If you’re going to have an operation,
make sure your doctor knows about it. You
may need to stop taking Cyproterone
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Acetate EE about 4–6 weeks before the
operation. This is to reduce the risk of a
blood clot (see section below). Your doctor
will tell you when you can start taking
Cyproterone Acetate EE again.
--If you need to stop taking Cyproterone
Acetate EE, remember to use another
contraceptive (e.g. condoms) if you are
relying on Cyproterone Acetate EE for
contraception.
Cyproterone Acetate EE and blood clots
Taking Cyproterone Acetate EE may
slightly increase your risk of having a
blood clot (called a thrombosis), especially
in the first year of taking it.
A clot in a leg vein a deep vein thrombosis
(or DVT) is not always serious. However, if it
moves up the veins and blocks an artery in
the lungs, it can cause chest pain,
breathlessness or collapse. A full recovery is
not always made and in 1-2% of cases, can
be fatal. This is called a pulmonary
embolism and is very rare.
Your chances of having a blood clot are
only increased slightly by taking
Cyproterone Acetate EE compared with
women who do not take Cyproterone
Acetate EE or any contraceptive pill.
--Of 100,000 women who are not taking
Cyproterone Acetate EE, not on the Pill and
not pregnant, about 5 to 10 will have a
blood clot in a year.
--Of 100,000 women who take Cyproterone
Acetate EE or the Pill, up to 40 will have a
blood clot in a year.
--Of 100,000 women who are pregnant,
around 60 will have a blood clot in a year.
Very rarely, blood clots can also form in
the blood vessels of the heart (causing a
heart attack) or the brain (causing a
stroke). In healthy young women the
chance of having a heart attack or stroke is
extremely small.
Blood clots in a vein
A blood clot in a vein (known as a ‘venous
thrombosis’) can block the vein. This can
happen in veins of the leg, the lung (a lung
embolus), or any other organ.
Using a combined pill increases a woman’s
risk of developing such clots compared with
a woman not taking any combined pill. The
risk of developing a blood clot in a vein is
highest during the first year a woman uses
the pill. The risk is not as high as the risk of
developing a blood clot during pregnancy.
The risk of blood clots in a vein in users of
a combined pill increases further:
--If you have polycystic ovary syndrome
as you get older
if you smoke
o When using a hormonal contraceptive
like Cyproterone Acetate EE you are
strongly advised to stop smoking,
especially if you are older than 35 years
--if you or any of your close family have had
blood clots in the leg, lung or other organ at
a
young age if you are overweight
if you have very rare blood disorders
if you have recently had a baby
if you have diabetes
if you have certain rare medical
conditions such as systemic lupus
erythematosus, Crohn’s
disease or ulcerative colitis
--if you have sickle cell disease
Symptoms of blood clots
Stop taking the tablets and see your
doctor immediately if you notice possible
signs of a blood clot such as:
--a migraine for the first time, a migraine
that is worse than normal, unusual, or are
frequent, or
severe or long-lasting headaches
any sudden changes to your eyesight
(such as partial or complete loss of vision,
double vision, or blurred vision)
any sudden changes to your hearing,
speech (such as slurring or speech
disability), sense of smell, taste or touch
severe pain in your abdomen
severe pain or swelling in either of your
legs
breathlessness or stabbing pain when
you breathe
unusual sudden coughing for no apparent
reason
severe pain and tightness in the chest
which may reach the left arm
sudden weakness or numbness in one
side or any part of your body
dizziness or fainting.
→ See a doctor as soon as possible. Do not
take any more Cyproterone Acetate EE until
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your doctor says you can. If needed, use
another method of contraception, such as
condoms, in the meantime.
Following a blood clot, recovery is not
always complete. Rarely serious permanent
disabilities may occur or the blood clot may
even be fatal.
Directly after giving birth, women are at an
increased risk of blood clots so you should
ask your doctor how soon after delivery you
can start taking Cyproterone Acetate EE.
Cyproterone Acetate EE and cancer
While high dose COCs reduce your risk of
cancer of the ovary and womb if used in the
long term, it is not clear whether lower dose
oestrogen-progestogen containing Pills like
Cyproterone Acetate EE also provide the
same protective effects. However, it also
seems that taking Cyproterone Acetate EE
slightly increases your risk of cancer of the
cervix – although this may be due to having
sex without a condom, rather than
Cyproterone Acetate EE. All women should
have regular smear tests.
If you have breast cancer, or have had it in
the past, you should not take Cyproterone
Acetate EE or other oral contraceptives, as
they slightly increase your risk of breast
cancer. This risk goes up the longer you’re
on Cyproterone Acetate EE, but returns to
normal within about 10 years of stopping it.
Because breast cancer is rare in women
under the age of 40, the extra cases of
breast cancer in current and recent
Cyproterone Acetate EE users is small. For
example:
--Of 10,000 women who have never taken
Cyproterone Acetate EE or the Pill, about
16 may have breast cancer by the time they
are 35 years old.
--Of 10,000 women who take Cyproterone
Acetate EE or the Pill for 5 years in their
early twenties, about 17–18 may have breast
cancer by the time they are 35 years old.
-- Of 10,000 women who have never taken
Cyproterone Acetate EE or the Pill, about
100 may have breast cancer by the time
they are 45 years old.
--Of 10,000 women who take Cyproterone
Acetate EE or the Pill for 5 years in their
early thirties, about 110 may have breast
cancer by the time they are 45 years old.
Your risk of breast cancer is higher:
--if you have a close relative (mother, sister
or grandmother) who has had breast cancer
if you are seriously overweight
→ See a doctor as soon as possible if you
notice any changes in your breasts, such
as dimpling of the skin, changes in the
nipple or any lumps you can see or feel.
-Taking Cyproterone Acetate EE has also
been linked to liver diseases, such as
jaundice and noncancer liver tumours, but
this is rare. Very rarely, Cyproterone Acetate
EE has also been linked with some forms of
liver cancer in women who have taken it for
a long time.
→ See a doctor as soon as possible if you
get severe pain in your stomach, or yellow
skin or eyes (jaundice). You may need to
stop taking Cyproterone Acetate EE.
Make sure Cyproterone Acetate EE is OK
for you
Cyproterone Acetate EE should not be
taken by some women
→ Tell your doctor if you have any medical
problems or illnesses.
Do not take Cyproterone Acetate EE
Tell your doctor if any of the following
conditions applies to you before starting to
use Cyproterone Acetate EE. Taking
Cyproterone Acetate EE would put your
health at risk. Your doctor may then advise
you to use a different treatment:
--If you are using another hormonal
contraceptive
If you are pregnant or might be pregnant
If you are breast-feeding
If you have or have ever had breast
cancer
If you have (or have ever had) a problem
with your blood circulation. This includes a
blood clot in the legs (deep vein
thrombosis) or the lungs (pulmonary
embolism) or any other part of the body
-- If you have (or have ever had), or your
close family have ever had, a heart attack or
stroke.
If you have any condition which makes
you more at risk of a blood clot (thrombosis
– see section above, Cyproterone Acetate
EE and blood clots) or a blood clot in your
arteries. This applies to the following
conditions:
o diabetes affecting your blood vessels
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o very high blood pressure
o a very high level of fat in your blood
(cholesterol or triglycerides)
-- If you have (or have ever had) any
symptoms of a blood clot or of a disease
that may be an indicator of a heart attack
in the future, such as severe chest pain
(angina pectoris) or ‘mini-stroke’ (transient
ischaemic attack)
--If you have problems with blood clotting
(e.g. protein C deficiency)
If you have uncontrolled blood pressure
If you have (or have ever) suffered from
migraine, with visual disturbances
If you have ever had a severe liver
disease, and you have been told by your
doctor that your liver test results are not
yet back to normal
-- If you have hepatitis C and are taking the
medicinal products containing
ombitasvir/paritaprevir/ritonavir and
dasabuvir (see also in section Other
medicines and Cyproterone
Acetate/Ethinylestradiol).
-- If you have ever had liver tumours
If you are allergic to cyproterone acetate,
ethinylestradiol or any of the other
ingredients of this medicine .
→ If you suffer from any of these, or get
them for the first time while taking
Cyproterone Acetate EE, contact your
doctor as soon as possible. Do not take
Cyproterone Acetate EE. If needed, use
another form of contraception.
Cyproterone Acetate EE can make some
illnesses worse
Some of the conditions listed below can be
made worse by taking Cyproterone Acetate
EE. Or they may mean it is less suitable for
you. You may still be able to take
Cyproterone Acetate EE but you need to
take special care and have check-ups more
often.
-- If you or your close family have ever had
problems with your heart or circulation,
such as high blood pressure If you or your
close family have ever had problems with
blood clotting
If you have had migraines
If you are currently suffering from
depression or have done so in the past
If you are overweight (obese)
If you have the inherited disease called
porphyria
If you have diabetes with blood disorders
or disorder of the eye, kidneys or nerves
If you have inflammation of the pancreas
(pancreatitis), or a history or family history
of high levels of fat in your blood
(hypertriglyceridemia),as you may be at risk
of developing pancreatitis
--If you have brown patches on your face or
body (chloasma) (see below ‘Cyproterone
Acetate / Ethinylestradiol and sun-beds or
sun-lamps’)
-- If you have any illness that worsened
during pregnancy or previous use of the Pill
or Cyproterone Acetate EE .
--If you have hereditary angioedema.
Consult your doctor immediately if you
experience symptoms of angioedema
such as swollen face, tongue or throat,
and/or difficulty swallowing, or hives,
together with difficulty breathing. Products
containing oestrogens may induce or
worsen symptoms of angioedema.
→ Tell your doctor if any apply to you.
Also tell them if you get any of these for the
first time while taking Cyproterone Acetate
EE, or if any get worse or come back,
because you may need to stop taking it.
Cyproterone Acetate EE will not protect you
against sexually transmitted infections, such
as Chlamydia or HIV. Only condoms can help
to do this.
Other medicines and Cyproterone Acetate
EE
Also check the leaflets that come with all
your medicines to see if they can be taken
with hormonal contraceptives. Tell your
doctor or pharmacist if you are taking, have
recently taken or might take any other
medicines.
If you are taking Cyproterone Acetate EE for
skin treatment, you must not take any other
hormonal contraceptive at the same time.
Some medicines can stop Cyproterone
Acetate EE from working properly – for
example:
-- some medicines used to treat epilepsy
(such as primidone, phenytoin,
carbamazepine, oxcarbazepine,
topiramate, felbamate) some medicines
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used to treat HIV and Hepatitis C Virus
infection (so-called protease inhibitors and
non-nucleoside reverse transcriptase
inhibitors such as ritonavir, nelfinavir and
nevirapine)
--griseofulvin and rifampicin (anti-fungal
medicines)
certain sedatives (called barbiturates)
St. John’s wort (a herbal remedy).
If you do need to take one of these
medicines, Cyproterone Acetate EE may not
be suitable for you or you may need to use
extra contraception for a while. Your doctor,
pharmacist or dentist can tell you if this is
necessary and for how long.
Do not use Cyproterone
Acetate/Ethinylestradiol if you have
Hepatitis C and are taking the medicinal
products containing
ombitasvir/paritaprevir/ritonavir and
dasabuvir as this may cause increases in liver
function blood test results (increase in ALT
liver enzyme).
Your doctor will prescribe another type of
contraceptive prior to start of the treatment
with these medicinal products.
Cyproterome Acetate/Ethinylestradiol can
be restarted approximately 2 weeks after
completion of this treatment.
Cyproterone Acetate EE can also affect
how well other medicines work.
Cyproterone Acetate EE may increase or
decrease the amount of certain medicines
(such as ciclosporin and lamotrigine) in your
blood. Your doctor may need to adjust the
dose of your other medicine.
In addition, Cyproterone Acetate EE can
also interfere with the results of some blood
tests, so always tell your doctor that you are
taking Cyproterone Acetate EE if you have a
blood test.
Pregnancy and breast-feeding
Do not use Cyproterone Acetate EE if you are
pregnant or are breast-feeding.
If you think you might be pregnant, do a
pregnancy test to confirm that you are
before you stop taking Cyproterone Acetate
EE.
If you are pregnant or breast-feeding, think
you may be pregnant or are planning to
have a baby, ask your doctor or pharmacist
for advice before taking this medicine.
Driving and using machines
Cyproterone Acetate EE has no known
effect on the ability to drive or use
machines.
Cyproterone Acetate EE and sun-beds or
sun-lamps
Sun-lamps are used by some women for
acne as well as to tan the skin. This is not a
very useful treatment for acne. Do not use
sun-beds or sun-lamps and avoid
prolonged sunbathing if you are taking
Cyproterone Acetate EE. Their use increases
the chance of chloasma, a patchy
discolouration of the skin (as it does with
ordinary oral contraceptives). Cyproterone
Acetate EE contains lactose and sucrose
If you have been told by your doctor that
you have an intolerance to some sugars,
contact your doctor before taking this
medicinal product.
3. How you will be given Cyproterone
Acetate EE
Always take this medicine exactly as your
doctor or pharmacist has told you. Check
with your doctor or pharmacist if you are
not sure.
Your doctor has chosen Cyproterone
Acetate EE as a treatment for your severe
acne or excessive hair growth on your face
and body. However, Cyproterone Acetate EE
also has a contraceptive effect, so it is
important to follow the advice below if you
are relying on Cyproterone Acetate EE for
contraception.
If you are only using Cyproterone Acetate EE
for your acne or excessive hair growth, you
can still follow this advice, but ask your
doctor if you are unsure.
Duration of use
Your doctor will tell you how long you need
to keep taking Cyproterone Acetate EE.
How to take it
Take Cyproterone Acetate EE every day
for 21 days
Cyproterone Acetate EE comes in strips of
21 pills, each marked with a day of the week.
Take your pill at the same time every day.
Start by taking a pill marked with the
correct day of the week.
Follow the direction of the arrows on the
strip. Take one pill each day, until you have
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finished all 21 pills.
Swallow each pill whole, with water if
necessary. Do not chew the pill.
Then have seven pill-free days
After you have taken all 21 pills in the strip,
you have seven days when you take no pills.
Within a few days of taking the last pill from
the strip, you should have a withdrawal
bleed like a period. This bleed may not have
finished when it is time to start your next
strip of pills. If you are relying on this
medicine to prevent pregnancy, always take
Cyproterone Acetate EE as described here.
You don’t need to use extra contraception
during the seven pill- free days – as long as
you have taken your pills correctly and start
the next strip of pills on time. Check with
your doctor if you are not sure.
Start your next strip on day eight
Start taking your next strip of Cyproterone
Acetate EE after the seven pill-free days (on
day eight) – even if you are still bleeding. So
if you take the last pill of one pack on a
Friday, you willtake the first pill of your next
pack on the Saturday of the following week.
Always start the new strip on time.
As long as you take Cyproterone Acetate EE
correctly, you will always start each new
strip on the same day of the week. Starting
Cyproterone Acetate EE
New users or starting Cyproterone
Acetate EE after a break
It is best to take your first Cyproterone
Acetate EE pill on the first day of your next
period. By starting in this way, you will have
contraceptive protection with your first pill.
Changing to Cyproterone Acetate EE from
another contraceptive Pill
If you are currently taking a 21-day Pill:
start Cyproterone Acetate EE the next day
after the end of the previous strip. You will
have contraceptive protection with your
first pill. You will not have a bleed until after
your first strip of Cyproterone Acetate EE.
If you are taking a 28-day Pill: start taking
Cyproterone Acetate EE the day after your
last active pill. You will have contraceptive
protection with your first pill. You will not
have a bleed until after your first strip of
Cyproterone Acetate EE.
If you are taking a progestogen-only Pill
(POP or ‘mini Pill’): start Cyproterone
Acetate / Ethinylestradiol on the first day
of bleeding, even if you have already taken
the progestogen- only Pill for that day. You
will have contraceptive protection straight
away.
Starting Cyproterone Acetate EE after a
miscarriage or abortion
If you have had a miscarriage or an abortion
during the first three months of
pregnancy, your doctor may tell you to start
taking Cyproterone Acetate EE straight
away. This means that you will have
contraceptive protection with your first pill.
If you have had a miscarriage or an abortion
after the third month of pregnancy, ask
your doctor for advice. You may need to use
extra contraception, such as condoms, for a
short time.
Contraception after having a baby
If you have just had a baby, your doctor may
advise you that Cyproterone Acetate EE
should be started 21 days after delivery
provided that you are fully mobile. You do
not have to wait for a period. You will need
to use another method of contraception,
such as a condom, until you start
Cyproterone Acetate EE and for the first 7
days of pill taking.
A missed pill
If you are less than 12 hours late with a
pill, take it straight away. Keep taking your
pills at the usual time. This may mean taking
two pills in one day. Don’t worry – your
contraceptive protection should not be
reduced.
If you are more than 12 hours late with a
pill, or you have missed more than one pill,
your contraceptive protection may be
reduced.
Take the most recently missed pill as soon
as you remember, even if it means taking
two
at once. Leave any earlier missed pills in the
pack.
Continue to take a pill every day for the
next seven days at your usual time.
If you come to the end of a strip of pills
during these seven days, start the next
strip without taking the usual seven day
break. You probably won’t have a bleed
until after you finish the second strip of pills,
but don’t worry. If you finish the second
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strip of pills and don’t have a bleed, do a
pregnancy test before starting another strip.
Use extra contraception for seven days
after missing a pill, such as condoms.
If you have missed one or more pills from
the first week of your strip (days 1 to 7)
andyou 9 had sex in that week, you could
become pregnant. Contact your doctor or
pharmacist for advice as soon as possible.
They may recommend you use emergency
contraception. If you have missed any of
the pills in a strip, and you do not bleed in
the first pill free break, you may be
pregnant. Contact your doctor or do a
pregnancy test yourself.
If you start a new strip of pills late, or
make your ‘week off’ longer than seven
days, you may not be protected from
pregnancy. If you had sex in the last seven
days, ask your doctor or pharmacist for
advice. You may need to consider
emergency contraception. You should also
use extra contraception, such as a condom,
for seven days.
A lost pill
If you lose a pill,
Either take the last pill of the strip in place
of the lost pill. Then take all the other pills
on their proper days. Your cycle will be one
day shorter than normal, but your
contraceptive protection won’t be affected.
After your seven pill-free days you will have
a new starting day, one day earlier than
before.
Or if you do not want to change the starting
day of your cycle, take a pill from a spare
strip if you have one. Then take all the other
pills from your current strip as usual. You
can then keep the opened spare strip in case
you lose any more pills.
If you are sick or have diarrhoea
If you are sick (vomit) or have very bad
diarrhoea, your body may not get its usual
dose of hormones from that pill. If you are
better within 12 hours of taking
Cyproterone Acetate EE, follow the
instructions in section above, A lost pill,
which describes how to take another pill.
If you are still sick or have diarrhoea more
than 12 hours after taking Cyproterone
Acetate EE, see section above, A missed pill.
→ Talk to your doctor if your stomach
upset carries on or gets worse. He or she
may recommend another form of
contraception. Missed a period – could you
be pregnant? Occasionally, you may miss a
withdrawal bleed. This could mean that you
are pregnant, but that is very unlikely if you
have taken your pills correctly. Start your
next strip at the normal time. If you think
that you might have put yourself at risk of
pregnancy (for example, by missing pills or
taking other medicines), or if you miss a
second bleed, you should do a pregnancy
test. You can buy these from the chemist or
get a free test at your doctors surgery. If you
are pregnant, stop taking Cyproterone
Acetate EE and see your doctor.
Taking more than one pill should not
cause harm
It is unlikely that taking more than one pill
will do you any harm, but you may feel sick,
vomit or have some vaginal bleeding. Talk
to your doctor if you have any of these
symptoms. When you want to get
pregnant
If you are planning a baby, it’s best to use
another method of contraception after
stopping Cyproterone Acetate EE until you
have had a proper period. Your doctor or
midwife relies on the date of your last
natural period to tell you when your baby is
due. However, it will not cause you or the
baby any harm if you get pregnant straight
away.
4. Possible Side Effects
Like all medicines, this medicine can cause
side effects, although not everybody gets
them.
If any of the following side effects
happen, you may need urgent medical
attention. Stop taking Cyproterone
Acetate EE and contact a doctor or go to
the nearest hospital immediately.
Uncommon (may affect up to 1 in 100
people) --if you get migraines or if you get
more frequent headaches
Rare (may affect up to 1 in 1,000 people)
--Signs of a severe allergic reaction or
worsening of hereditary angioedema: a red
bumpy rash (hives) and itching, swelling of
the hands, face, lips, mouth, tongue or
throat. A swollen tongue/throat may lead to
difficulty swallowing and breathing
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Venous or arterial blood clot which
include signs such as:
--a migraine for the first time, a migraine
that is worse than normal or unusually
frequent or severe headaches
-- any sudden changes to your eyesight
(such as loss of vision or blurred vision)
any sudden changes to your hearing,
speech, sense of smell, taste or touch
pain or swelling in your leg
stabbing pain when you breathe
coughing for no apparent reason
pain and tightness in the chest
sudden weakness or numbness in one
side or part of your body
dizziness or fainting.
Not known (frequency cannot be
estimated from the available data)
Severe depression:
Although, it is not considered a direct side
effect of Cyproterone Acetate EE, some
women have reported feeling depressed
whilst taking Cyproterone Acetate EE. In
very rare cases this has been associated with
thoughts of ending their lives. If you
develop severe depression, you should stop
Cyproterone Acetate EE as a precaution, and
see your doctor straight away.
--inflammation of the colon or other parts of
the intestine (Crohn’s disease or ulcerative
colitis)
--severe increase in blood pressure
breast cancer, which include signs such
as:
--dimpling of the skin
changes in the nipple
any lumps you can see or feel.
cancer of the cervix, which include signs
such as:
-- vaginal discharge that smells and/or
contains blood
unusual vaginal bleeding
pelvic pain
painful sex.
severe liver problems, which include
signs such as:
--severe pain in your stomach
yellow skin or eyes (jaundice)
inflammation of the liver (hepatitis)
your whole body starts itching.
Other conditions that may happen or
worsen during pregnancy or use of the
Pill such as:
- yellowing of the skin (jaundice)
- persistent itching (pruritus)
- kidney or liver problems
- gall stones
- certain rare medical conditions such as
systemic lupus erythematosus
- blister-like rash (herpes gestationis) whilst
pregnant
- an inherited form of deafness (otosclerosis)
- a personal or family history or a form of
sickle cell disease
- an inherited disease called porphyria
- cancer of the cervix
- movement disorder chorea
If you have hereditary angioedema
medicines containing certain female sex
hormones (oestrogens) may induce or
worsen the symptoms of angioedema
Other possible side effects:
Common (may affect up to 1 in 10
people) ------feeling sick
stomach ache
putting on weight
headaches
depressive moods or mood swings
sore or tender breasts
Uncommon (may affect up to 1 in 100
people) --being sick, diarrhea
fluid retention
reduced sex drive
breast enlargement
skin rash, which may be itchy
Rare (may affect up to 1 in 1,000 people)
-- poor tolerance of contact lenses
losing weight
increased sex drive
vaginal or breast discharge
painful reddish nodules in the skin (
erythema nodosum ) , skin rash with
irregular red
patches ( erythema multiforme )
Not known (frequency cannot be
estimated from the available data)
--changes in the amount of fat in the blood
or in liver function which may be seen in
blood
tests change in menstrual periods
including absence of menstruation. elevated
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blood glucose( glucose intolerance)
bleeding and spotting between your
periods can sometimes occur for the first
few months
but this usually stops once your body has
adjusted to Cyproterone Acetate EE. If it
continues, becomes heavy or starts again,
contact your doctor chloasma (yellow
brown patches on the skin). This may
happen even if you have been using
Cyproterone Acetate EE for a number of
months. Chloasma may be reduced by
avoiding too much sunlight and/or UV
lamps
--increase in blood pressure
Bleeding between periods should not last
long A few women have a little unexpected
bleeding or spotting while they are taking
Cyproterone Acetate EE, especially during
the first few months. Normally, this bleeding
is nothing to worry about and will stop after
a day or two. Keep taking Cyproterone
Acetate EE as usual. The problem should
disappear after the first few strips.
You may also have unexpected bleeding if
you are not taking your pills regularly, so try
to take your pill at the same time every day.
Also, unexpected bleeding can sometimes
be caused by other medicines.
→ Make an appointment to see your
doctor if you get breakthrough bleeding or
spotting that:
--carries on for more than the first few
months
starts after you’ve been taking
Cyproterone Acetate EE for a while
carries on even after you’ve stopped
taking Cyproterone Acetate EE.
Reporting of side effects
If you get any side effects, talk to your
doctor or pharmacist. This includes any
possible side effects not listed in this leaflet.
By reporting side effects you can help
provide more information on the safety of
this medicine.
5. How Cyproterone Acetate EE is
stored
Keep this medicine out of the sight and
reach of children.
Do not use this medicine after the expiry
date which is stated on the carton/strip after
EXP. The expiry date refers to the last day of
that month.
Keep the blister strips in the outer carton in
order to protect from light. Do not store
above 25degrees.
Do not throw away any medicines via
wastewater or household waste. Ask your
pharmacist how to throw away medicines
you no longer use. These measures will help
protect the environment.
6. Further information
What Cyproterone Acetate EE contains
The active substances are cyproterone
acetate and ethinylestradiol. Each coated
tablet contains cyproterone acetate 2 mg
and ethinylestradiol 35 micrograms.
The tablet also contains: Lactose
monohydrate, Maize starch, Povidone,
Talc, Magnesium stearate, Sucrose,
Macrogol, Calcium carbonate, Glycerol
85%, Titanium dioxide, Iron oxide yellow,
Montanglycol wax
What Cyproterone Acetate EE looks like
and contents of the pack
Cyproterone Acetate EE tablets are round,
beige, coated tablets with no markings.
These tablets are available in blister packs of
21, 42, 63, 84, 105, 126, 147, 168, 189, 210,
231, 252 tablets*. Your pharmacist will
dispense the number of tablets prescribed
by your doctor.
*Not all pack sizes may be marketed.
Manufactured in India by:
TAJ PHARMACEUTICALS LTD.
Mumbai, India
At: 615, GIDC, Kerala, Bavla, Dist.
Ahmedabad 438225, Gujarat, INDIA
This leaflet was last revised in August 2019