|Type of medicine||Hormone treatment|
|Used for||Severe acne or hirsutism in women|
|Also called||Cicafem®, Clairette®, Dianette®|
Co-cyprindiol is for severe acne or hirsutism. Acne is a common skin condition which is often treated by skin creams or antibiotic tablets. You may have been prescribed co-cyprindiol because other treatments such as these may not have been sufficiently effective for you. Hirsutism is a condition where dark, thick hair grows in places where it doesn't usually grow in women, such as on the face or chest.
Co-cyprindiol contains two ingredients, ethinylestradiol and cyproterone. Ethinylestradiol is an oestrogen, which is a female sex hormone. Cyproterone is an anti-androgen. Androgens are responsible for stimulating the glands on your skin which produce sebum (grease) and they also encourage hair growth. Too much androgen can cause the glands in your skin to become blocked and inflamed, causing acne spots to develop. Co-cyprindiol works by reducing the amount of androgen you produce, which helps to clear acne and reduces excess hair growth.
Co-cyprindiol is also an oral contraceptive pill. Although it is not prescribed solely for this purpose, it can be helpful if you have one of the skin conditions mentioned above and also wish to take oral contraception.
Before taking co-cyprindiol
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking co-cyprindiol it is important that your doctor or pharmacist knows:
- If you are breast-feeding, or think you may be pregnant.
- If you or a close member of your family have ever had a blood clot, or circulation problems.
- If you have ever had a problem with your veins (such as superficial thrombophlebitis).
- If you smoke.
- If you have high blood pressure.
- If you have a breast lump or have had breast cancer.
- If you have liver problems or gallstones.
- If you have heart problems, migraine, or diabetes.
- If you have any vaginal bleeding other than your normal monthly period.
- If you are not fully mobile for any reason.
- If you have ever had depression.
- If you have had a transient ischaemic attack (TIA), sometimes called a 'mini-stroke'.
- If you or a close relative have ever had high blood levels of lipids (fats).
- If during a pregnancy you have had problems such as severe itching and blistering of your skin, jaundice, or any involuntary jerky movements.
- If you have been told you have high levels of prolactin.
- If you have an inflammatory bowel condition.
- If you have systemic lupus erythematosus (an inflammatory condition also called lupus or SLE).
- If you have sickle cell disease, porphyria, or if you have had haemolytic uraemic syndrome (these are blood disorders).
- If you have ever had an allergic reaction to this or to any other medicine.
- If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is important because some medicines may stop combined hormonal contraceptives from working properly.
How to take co-cyprindiol
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of tablet you have been given, and a full list of possible side-effects from taking it.
- Starting on the first day of your period, take one tablet daily for 21 days and then have 7 days without taking a tablet. Continue to take one tablet daily for 21 days and then have 7 pill-free days until your doctor tells you otherwise.
- You should take your tablets at the same time of day each day. If you forget to take a tablet on time, take it as soon as you remember, and then take the next dose at your usual time (even if this means taking two tablets on the same day).
- If you miss one dose (this means you are more than 24 hours late taking a dose), take a pill as soon as you remember and then take the next dose at your usual time.
- If you miss two or more doses, you may not be protected from becoming pregnant. As soon as you remember, take a tablet and then continue taking your doses as normal. In addition, for the following 7 days you must either not have sex, or you must use another method of contraception, such as a condom. If these 7 days run beyond the end of your packet, start the next packet straightaway without any tablet-free days. This means you may not have a period until the end of the two packets. If you miss two or more pills from the first seven tablets in the pack and you have had unprotected sex recently, ask your doctor or pharmacist for advice on what to do.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor or clinic. This is so your doctor can check on your progress. You will need to have your blood pressure checked every six months.
- If you suspect at any time that you may be pregnant, stop taking co-cyprindiol and see your doctor or pharmacist for a pregnancy test straightaway.
- Important: if you have sickness or diarrhoea, it can reduce the effectiveness of these tablets if you are relying on them for contraception. If you are sick within two hours of taking a pill, take another pill as soon as possible. If the sickness continues or if you have severe diarrhoea lasting for more than 24 hours, you must use additional contraceptive precautions such as a condom during and for seven days after your recovery. If the sickness and diarrhoea occur during the last week of your tablets, miss out the 7 pill-free days and start a new pack straightaway.
- There is a slightly increased risk of thromboembolism (blood clot) with hormonal contraceptives like co-cyprindiol. Travelling that involves long periods of sitting still (for example, flying for more than five hours) can increase the risk of this. It is a good idea to wear flight socks and remember to exercise your feet and ankles regularly to reduce this risk.
- Once your skin condition has been eased, it is likely that your doctor will recommend that you stop taking these tablets after 3 or 4 months. An alternative contraceptive pill can be prescribed for you after this.
- Before having any kind of surgery, you must tell your doctor or surgeon that you are taking these tablets. This is because your doctor may decide that you need to stop them for a period of time to reduce your risk of unwanted blood clots.
Can co-cyprindiol cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common co-cyprindiol side-effects||What can I do if I experience this?|
|Feeling sick, stomach cramps||Eat simple meals - avoid rich and spicy food. If you are sick within 2 hours of taking a tablet, take another as soon as possible (see also the information above)|
|Headache||Ask your pharmacist to recommend a suitable painkiller. If the headache continues or is sudden and severe, contact your doctor for advice|
Breast tenderness, increased weight, mood changes, breakthrough bleeding
|If any of these become troublesome, speak with your doctor|
Important: if you experience any of the following serious symptoms, contact your doctor for advice straightaway:
- Any sudden or severe chest pain.
- Any sudden breathlessness, or if you cough up any blood.
- Any swelling or pain in a leg.
- Severe stomach pain.
- An unusually painful or severe headache, or any loss of your sight or hearing, or any difficulty swallowing.
- A bad fainting attack, a fit, or any numbness on one side of your body,
- Any jaundice (yellowing of your skin or the whites of your eyes).
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store co-cyprindiol
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- Manufacturer's PIL, Dianette®; Bayer plc, The electronic Medicines Compendium. Dated March 2012
- British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Helen Huins