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Norethindrone Brand Names
Aygestin | Camila | Deblitane 28-Day | Errin | Heather | Jencycla | Jolivette | Lyza | Nora-BE | Norlyroc | Nor-QD | Ortho Micronor | Sharobel 28-Day
What is Norethindrone
Norethindrone is a synthetic oral progestin.
Norethindrone acetate is a prodrug that is rapidly converted to norethindrone in the body; on a weight basis, norethindrone acetate is twice as potent as norethindrone.
Norethindrone is a first generation oral progestin with moderate androgenic and slight estrogenic activity relative to newer progestins.
Norethindrone is known as norethisterone outside of the United States.
Norethindrone is used for routine contraception and is available as either a progestin-only contraceptive or in combination hormonal contraceptive products with an estrogen.
Progestin-only formulations or “mini-pills” of norethindrone are not widely used due to the higher risk of contraceptive failure and certain side effects such as spotting and breakthrough bleeding compared to combination hormonal contraceptives.
However, progesin-only oral contraceptives may be appropriate choices when women have relative or absolute contraindications to the use of estrogen-based hormonal contraception.
The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.
The Centers for Disease Control’s U.S. Medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.
Norethindrone acetate is found in some combination oral contraceptives. Single-agent norethindrone acetate products are primarily used to treat such conditions as secondary amenorrhea, endometriosis, and abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as submucous fibroids or uterine cancer.
For endometriosis, norethindrone acetate is commonly used in combination with leuprolide.
While norethindrone acetate is effective at preventing endometrial hyperplasia due to unopposed estrogen therapy in postmenopausal women, single-agent norethindrone products are not available for this indication in the U.S.
Norethindrone was initially approved by the FDA in 1961.
Indications
- amenorrhea
- contraception
- dysfunctional uterine bleeding
- endometriosis
- estrogen replacement therapy
For the treatment of secondary amenorrhea or dysfunctional uterine bleeding due to hormonal imbalance in the absence of organic pathology such as submucous fibroids or uterine cancer
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- anaphylactic shock
- anaphylactoid reactions
- anorexia
- anxiety
- appetite stimulation
- biliary obstruction
- breakthrough bleeding
- cervicitis
- depression
- dizziness
- edema
- elevated hepatic enzymes
- emotional lability
- fatigue
- fluid retention
- galactorrhea
- headache
- hepatitis
- hepatoma
- hirsutism
- hypercholesterolemia
- hyperglycemia
- hypertension
- insomnia
- jaundice
- lactation suppression
- leukorrhea
- libido decrease
- libido increase
- mastalgia
- melasma
- menorrhagia
- menstrual irregularity
- musculoskeletal pain
- nausea
- optic neuritis
- pruritus
- pulmonary embolism
- rash
- retinal thrombosis
- thromboembolism
- thrombosis
- urticaria
- vaginitis
- vomiting
- weight gain
- weight loss
Monitoring Parameters
- pap smear
Contraindications
- asthma
- breast cancer
- breast-feeding
- cerebrovascular disease
- children
- depression
- diabetes mellitus
- ectopic pregnancy
- hepatic disease
- human immunodeficiency virus (HIV) infection
- hyperlipidemia
- incomplete abortion
- migraine
- myocardial infarction
- ovarian cyst
- pregnancy
- renal disease
- seizure disorder
- stroke
- thromboembolic disease
- thrombophlebitis
- tobacco smoking
- vaginal bleeding
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetohexamide
- Acitretin
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amikacin
- Aminoglycosides
- Amobarbital
- Amoxicillin
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amoxicillin; Clavulanic Acid
- Ampicillin
- Ampicillin; Sulbactam
- Amprenavir
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azithromycin
- Aztreonam
- Bacitracin
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bexarotene
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bosentan
- Bromocriptine
- Butabarbital
- Calaspargase pegol
- Canagliflozin; Metformin
- Carbamazepine
- Carbapenems
- Carbenicillin
- Cefaclor
- Cefadroxil
- Cefazolin
- Cefdinir
- Cefditoren
- Cefepime
- Cefiderocol
- Cefixime
- Cefotaxime
- Cefotetan
- Cefoxitin
- Cefpodoxime
- Cefprozil
- Ceftaroline
- Ceftazidime
- Ceftazidime; Avibactam
- Ceftibuten
- Ceftizoxime
- Ceftolozane; Tazobactam
- Ceftriaxone
- Cefuroxime
- Cenobamate
- Cephalexin
- Charcoal
- Chenodiol
- Chloramphenicol
- Chlorpropamide
- Ciprofloxacin
- Clarithromycin
- Clindamycin
- Clobazam
- Cobicistat
- Colistimethate, Colistin, Polymyxin E
- Dabrafenib
- Dalbavancin
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Daptomycin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delafloxacin
- Demeclocycline
- Dicloxacillin
- Doripenem
- Doxycycline
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enasidenib
- Encorafenib
- Enzalutamide
- Eravacycline
- Ertapenem
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Felbamate
- Fidaxomicin
- Flibanserin
- Fosamprenavir
- Gemifloxacin
- Gentamicin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycylcyclines
- Griseofulvin
- Hydantoins
- Idelalisib
- Imipenem; Cilastatin
- Imipenem; Cilastatin; Relebactam
- Incretin Mimetics
- Indinavir
- Insulins
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isotretinoin
- Ivosidenib
- Kanamycin
- Lamotrigine
- Lefamulin
- Leflunomide
- Lesinurad
- Lesinurad; Allopurinol
- Levofloxacin
- Linagliptin
- Linagliptin; Metformin
- Lincomycin
- Lincosamides
- Linezolid
- Lomitapide
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Meglitinides
- Mephobarbital
- Meropenem
- Meropenem; Vaborbactam
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Metronidazole
- Mifepristone
- Miltefosine
- Minocycline
- Mivacurium
- Modafinil
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nafcillin
- Nelfinavir
- Neomycin
- Nevirapine
- Nitrofurantoin
- Norfloxacin
- Ofloxacin
- Omadacycline
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Oxacillin
- Oxcarbazepine
- Paromomycin
- Pegaspargase
- Penicillin G
- Penicillin G Benzathine
- Penicillin G Benzathine; Penicillin G Procaine
- Penicillin G Procaine
- Penicillin V
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Phentermine; Topiramate
- Piperacillin
- Piperacillin; Tazobactam
- Pitolisant
- Plazomicin
- Polymyxin B
- Polymyxins
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Primidone
- Pyrimethamine; Sulfadoxine
- Rifabutin
- Rifampin
- Rifamycins
- Rifapentine
- Riluzole
- Ritonavir
- Roflumilast
- Rufinamide
- Sarilumab
- Saxagliptin
- Secobarbital
- Siltuximab
- Simvastatin; Sitagliptin
- Sitagliptin
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Streptomycin
- Succinylcholine
- Sugammadex
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Sulfonylureas
- Tazemetostat
- Tedizolid
- Telaprevir
- Telavancin
- Telithromycin
- Teriflunomide
- Tetracycline
- Thalidomide
- Thiopental
- Ticarcillin
- Ticarcillin; Clavulanic Acid
- Tigecycline
- Tinidazole
- Tipranavir
- Tizanidine
- Tobramycin
- Tocilizumab
- Tolazamide
- Tolbutamide
- Topiramate
- Trimethoprim
- Ulipristal
- Vancomycin
- Voriconazole
