Hormonal Norethisterone

Neven P, Lunde T, Benedetti-Panici P, Tiitinen A, Marinescu B, Villiers T, Hillard T, Cano A, Peer E, Quail D, Nickelsen T (2003) A multicentre randomised trial to compare uterine safety of raloxifene with a continuous combined hormone replacement therapy containing oestradiol and norethisterone acetate. Br J Obstet Gynaecol 110 157-167... 

The synthesis of Lp(a) can be influenced by hormones, as is reported by Albers et al. (A7), who observed a reduction of Lp(a) concentrations in nor-molipidemic postmenopausal women treated during 6 weeks with the anabolic steroid stanazolol. The same effect was reported for norethisterone (FI) and danazol (Cl2). Exogenous estrogens, as used in treatment of postmenopausal complaints and in oral contraceptives, induce a decrease of Lp(a) (D9, H27, K13, KAO, L21, S37). This effect is dose-related and dependent on Lp(a) levels before treatment (F2). Watanabe (W9) investigated the influence of progestogen (alone) and detected a decrease of Lp(a) during treatment. 

Norethisterone Synthetic progestogen Abnormal uterine bleeding. Endometriosis, component of some oral contraceptives and in hormone replacement therapy... 

Conflicting data concerning the effects of oral contraceptives on carbohydrate metabolism have been presented the effects are probably clinically insignificant. However, estrogen hormone replacement therapy with a sequential-type product containing mestranol and norethisterone caused significantly impaired glucose tolerance (30). 

Another approach to the study of the effects of hormone replacement therapy on the breast is to examine breast density, using mammography and the Wolfe classification. In a randomized study of 166 menopausal women, using this technique, there was increased breast density after 6 months of treatment eight times more commonly in those who took estradiol and norethisterone acetate than in those who took tibolone (186). The significance of this increased density is not clear, but it should for the present be regarded as undesirable,... 

In one of the largest international multicenter studies of raloxifene it was found that, compared with combined hormone replacement therapy (with 17-beta-oestradiol 2 mg + norethisterone acetate 1 mg) 12 months of raloxifene treatment at 60 mg/day was not associated with increased endometrial thickness or uterine volume (31). 

Hormones and analogues growth hormone corticotrophin (ACTH) calcitonin desmopressin (DD AVP) lypressin oxytocin buserelin nafarelin progesterone norethisterone 17/1-estradiol testosterone insulin Gonadorelin (Gonadotrophin-releasing hormone GnRH LH-RH)... 

NEVIRAPINE PROGESTOGENS- NORETHISTERONE 1 efficacy of contraceptives, with risk of contraceptive failure Uncertain Avoid co-administration recommend alternative non-hormonal contraceptives - barrier methods are necessary to prevent transmission of infection... 

Estrogens, etidronate, and parathyroid hormone have been used with partial success to prevent gonadorelin-induced bone loss. In a prospective study of 49 women treated with goserelin and randomized to estradiol plus norethisterone or placebo, bone loss persisted 6 years after stopping therapy, and the hormone replacement therapy had only a minor protective effect (44). 

PAPWORTH 255 postmenopausal women with coronary heart disease Transdermal 17 S-estradiol 80 mcg/day alone for women with hysterectomy transdermal 17 S-estradiol, 80 mcg/day plus cyclic transdermal norethisterone 120 mcg/day for 14 days or placebo No reduction in the incidence of acute coronary events (coronary disease death, myocardial infarction, unstable angina) among women in the hormone therapy group During the first 2 years of follow-up, the hormone-therapy group had a higher acute coronary event rate than the control group. 

Preliminary results of a study show that rufinamide 800 mg twice daily for 14 days decreased the AUC of ethinylestradiol 35 micrograms hy 22% and of norethisterone 1 mg by 14% in healthy women taking a combined oral contraceptive. Inhibition of ovulation was not assessed. These reductions in plasma levels of the contraceptive hormones are similar to those seen with topiramate (see Hormonal contraceptives + Antiepileptics Topiramate , below), and their clinical relevance is unknown. However, given these findings, low-dose contraceptives (ethinylestradiol 20 micrograms) may be considered unsuitable for use with rufinamide. Further study is needed. 

St John s wort may affect the pharmacokinetics of desogestrel, ethinylestradiol, and norethisterone. Both breakthrough bleeding and, more rarely, combined oral contraceptive failure have been reported in women taking St John s wort Two cases describe the failure of emergency hormonal contraception, which was attributed to the use of St John s wort... 

There are data showing that rifamycins can reduce the plasma levels of norethisterone when it is used as a component of combined oral contraceptives (see Hormonal contraceptives + Rifamycins , p.lOOl). The manufacturer of Noristerat notes that enzyme inducers may reduce the efficacy of the norethisterone enantate injection. However, guidance from the FFPRHC Clinical Effectiveness Unit is to continue with the normal injection schedule for norethisterone.. ... 

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