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Norethisterone is a synthetic progesterone hormone. In plain English, it’s a man-made version of a naturally occurring female chemical produced by your body. Norethisterone has many uses but primarily it is used for delaying periods or lightening heavy periods.
Norethisterone can be used by women who have started regular periods. It should be used infrequently, for delaying periods that may be inconvenient. A classic example where Norethisterone could be used would be a holiday.
If more frequent treatment is required or period delay of more than 17 days is needed, a doctor should be consulted face-to-face.
There are several different brands of drug Norethisterone available in the UK. There is unbranded (generic) norethisterone and the brands Utovlan and Primolut-N. All these brands and generics are the same, just produced by different manufacturers. At Travelpharm we supply the brand that is available at the time. Norethisterone is often difficult to source so we will supply what is available at the time whether it is branded or unbranded.
Women taking the combined oral contraceptive pill should not use Norethisterone to delay their periods. The reason for this is because you never have a “true period” whilst using this tablet. What you experience as a period is actually a withdrawal bleed due to stopping the tablets. If you want to avoid your withdrawal bleed simply miss the 7-day break and start your next pack straight away. Got concerns or a question about this? Give us a call and we can help.
Norethisterone is NOT a contraceptive and will not prevent pregnancy.
This product is only suitable for women. Norethisterone 5mg is taken THREE times daily, starting THREE days before your expected period and whilst you need your period postponing. Your period should usually start again within a week of taking your last tablet. If your period does not restart it is important you take a pregnancy test to exclude pregnancy. The tablets do not need to be taken with food but should be swallowed with a glass of water. This tablet is NOT a contraceptive.
Travelpharm will supply a maximum of 60 tablets of Norethisterone, which should be sufficient to delay your period for up to 17 days. Norethisterone should only be used occasionally and so we are happy to issue this product (if suitable) once every 3-4 months.
When using Norethisterone it’s important to realise that we are altering the balance of your menstrual cycle. When you stop taking Norethisterone this is the signal for your body to start afresh cycle and you will start your period. This is usually about 2 or 3 days after stopping.
Norethisterone can be used to manage heavy periods but this should only be prescribed by a GP face to face. Travelpharm will prescribe Norethisterone for the period delay on an occasional basis only.
• Anti-Convulsants for treatment of epilepsy eg Phenobarbital, Phenytoin, Carbamazepine
• Antibiotics eg Ampicillin, Tetracyclines, rifampicin, rifabutin, co-trimoxazole, oxacillin
• Antiviral drugs used for HIV - Nevirapine and Efavirenz
• St Johns Wort
• Medicines that have the potential to cause fluid retention NSAIDS, and vasodilators
Most people will use Norethisterone without any side effects but some people may see the following side effects occur:
• Breast tenderness
• Mood disturbances
• Upset digestive system (Nausea, Vomiting, diarrhoea etc)
• Increased blood pressure
• Fluid retention
This list is not exhaustive and only highlights the most common adverse events (which are usually minor). The full list of side effects can be found in the Patient Information Leaflet which is available on the product page, in the dropdown "Product Downloads". The Patient Information leaflet should be read before purchasing and taking this medicine.
Norethisterone is a progesterone hormone that has weak oestrogen (estrogen) activity which means that it is unsuitable in patients where estrogens are not recommended. The following patients should not use Norethisterone:
• Women who are allergic to any active or inactive ingredient contained in the tablet
• Who are Pregnant
• Have a history of miscarriage and jaundice
• Have a history of Blood Clots, especially in the leg (Venous Thromboembolism) or lungs (Pulmonary Embolism)
• Ongoing Cardiovascular problems, eg Angina, recent Heart Attack (Myocardial infarction)
• Liver problems
• Undiagnosed irregular vaginal bleeding
• Migraine sufferers
If the following occur whilst using Norethisterone, please discontinue immediately:
• Increase in blood pressure
• New onset of migraine-type headaches
• Significant mood changes
It is well documented that hormonal medicines containing estrogens are associated with increased risk of VTE, but that increased risk is less than the risk during pregnancy but higher than not using estrogens. Therefore it is vitally important that anyone who uses estrogens or hormonal contraception beware of this very serious risk. A VTE is a blood clot that usually starts in veins in the extremities of the body, for example, the lower leg. Typical symptoms will include swelling of the area, redness and discomfort. The blood clot represents a risk because it can travel very quickly to the heart or lungs which can ultimately and very quickly prove fatal. Whilst the absolute risk is very low for an event like this it is very important that the user is aware of the possibility of a VTE. Should you experience symptoms like this, immediately seek emergency medical attention. A quick blood test is all that is required to diagnose this potentially fatal condition.
The risk of VTE is greater for those who suffer the following conditions:
• Migraines especially those with visual disturbances
• Obesity - doubles the risk
• Cardiovascular Health issues, like recent heart attack, high blood pressure or high cholesterol
• Recent major surgery
• Poor mobility
• Age: Over 40 risk doubles each decade A family.org)
• A family history of VTE
The evidence for norethisterone and VTE is relatively limited as most studies observed the effect of combined oral contraceptives pills which combine norethisterone with ethinylestradiol. Because 1mg of orally administered Norethisterone is metabolised into 4-6mcg of Ethinyl Estradiol is should be noted that there is a potential risk of VTE caused by estrogens and the advice above should still be considered despite Norethisterone being classed as progesterone. (Mansour D Safer prescribing of therapeutic norethisterone for women at risk of venous thromboembolism J Fam Plann Reprod Health Care 2012;38:148-149.)
The article was written by Andrew Walton MPharm (April 2019)
Reviewed (Aug 2020)