Dinogest 2 - Tablet Dienogest - 2mg 10 Tablet(s) / Strip Nuvista Pharma Ltd Introduction: Dinogest 2 is used for the treatment of pelvic pain associated with endometriosis. It consists of progestin, which is similar to the female hormone and works by suppressing the production of hormone causing endometrium. Dinogest 2 can be taken with or without food, but take it at the same time to get the most benefit. It should be taken as your doctor's advice. The dose and how often you take it depends on what you are taking it for. Your doctor will decide how much you need to improve your symptoms. Swallow the tablets whole with a drink of water.... Uses of Dinogest 2: Endometriosis Side effects of Dinogest 2: AcneHeadacheDepressionBreast discomfort How to use Dinogest 2: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Dinogest 2 may be taken with or without food, but it is better to take it at a fixed time. How Dinogest 2 works: Dinogest 2 is a progestin (female hormone). It works by suppressing the production of estradiol, a hormone that causes excessive growth of the endometrium. Indication: Treatment of endometriosis. Administration: May be taken with or without food. Adult Dose: 1 tab daily w/o interruption, taken preferably at the same time each day. Contraindication: Hypersensitivity. Active venous thromboembolic disorder. Presence or history of arterial & CV disease (eg MI, CVA, ischemic heart disease); severe hepatic disease as long as liver function values have not returned to normal; benign or malignant liver tumors. DM w/ vascular involvement; known or suspected sex hormone-dependent malignancies; undiagnosed vag bleeding. Pregnancy. Childn prior to menarche. Mode of Action: Dienogest is a nortestosterone derivative with no androgenic but rather an antiandrogenic activity of approximately 1/3 of that of cyproterone acetate. Dienogest binds to the progesterone receptor of the human uterus with only 10% of the relative affinity of progesterone. Despite its low affinity to the progesterone receptor, dienogest has a strong progestogenic effect in vivo. Dienogest has no significant androgenic, mineralocorticoid or glucocorticoid activity in vivo. Dienogest acts on endometriosis by reducing the endogenous production of estradiol and thereby suppressing the trophic effects of estradiol on both the eutopic and ectopic endometrium. When given continuously, dienogest leads to a... Precaution: Obtain a complete medical history & perform physical & gynecological exam prior to initiation or reinstitution of therapy. Patients w/ history of extrauterine pregnancy or impairment of tube function, depression, chloasma gravidarum, gestational DM. Increased risk of MI or cerebral thromboembolism, DVT, pulmonary embolism; breast cancer, hepatic tumor. Adenomyosis uteri or uterine leiomyomata; recurrence of cholestatic jaundice &/or pruritus; persistent ovarian follicles. Rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Lactation. Adolescents (menarche to 18 yr). Side Effect: Increased wt; depressed mood, sleep disorder, nervousness, loss of libido, altered mood; headache, migraine; nausea, abdominal pain or distension, flatulence, vomiting; acne; alopecia; back pain; breast discomfort, ovarian cyst, hot flush, uterine/vag bleeding including spotting; asthenic conditions, irritability. Interaction: Increased clearance w/ enzyme inducers eg phenytoin, barbiturates, primidone, carbamazepine, rifampicin; oxcarbazepine, topiramate, felbamate, griseofulvin, nevirapine, St. John's wort-containing products. Increased plasma levels w/ enzyme inhibitors eg ketoconazole, itraconazole, fluconazole; cimetidine, verapamil; erythromycin, clarithromycin, roxithromycin; diltiazem; ritonavir, saquinavir, indinavir, nelfinavir; nefazodone, fluvoxamine, fluoxetine; grapefruit juice.