Menoral 5mg Tablet 10pcs

✔️ Uses of Menoral

• Pain during menstruation
• Endometriosis
• Heavy menstrual bleeding

✔️ How to use Menoral 5mg Tablet

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. Menoral may be taken with or without food, but it is better to take it at a fixed time.

✔️ How does Menoral work?

Menoral is a synthetic progestin. It works by mimicking the effects of natural progesterone (female hormone). It helps in regulating the growth and shedding of the womb lining, thereby treating menstrual irregularities.

✔️ Side Effects of Menoral 5mg Tablet

• Dizziness
• Nausea
• Uterine bleeding
• Heavy periods
• Painful periods
• Irregular periods
• Increased frequency of periods
• Premenstrual tension
• Vaginal bleeding
• Hypersensitivity reaction
• To delay the next periods
• Weight gain, Skin disorder
• Breast tenderness
• Vomiting
• Injection site reaction

✔️ Over dosage of Menoral 5mg Tablet

If you or anyone else accidentally took more of Menoral, contact your doctor immediately or visit a nearby hospital immediately if the symptoms worsen. The symptoms may include nausea, vomiting, breast enlargement, and vaginal bleeding.

✔️ Quick Suggestions:

• Menoral controls menstrual cycles and is used to treat a variety of menstrual problems, including heavy, painful periods and endometriosis.
• Menoral may induce spotting or bleeding between menstrual cycles. Inform your doctor if this happens regularly.
• Stop using Menoral immediately and notify your doctor if you get severe headaches, stabbing pains or swelling in one leg, discomfort when breathing, skin yellowing, or abrupt changes in your eyesight or hearing.
• If you are pregnant, do not use Menoral. Because Menoral drug is not a contraceptive, use a non-hormonal method of contraception such as condoms to avoid pregnancy while using Menoral.

✔️ Indications of Menoral

Menoral is used to stop pregnancies. Menoral is frequently referred to as the "mini-pill" since it is estrogen-free. A progestin hormone called norethindrone thickens the vaginal fluid to help prevent sperm from fertilizing the egg and alters the uterine lining to stop the fertilization of the egg. These actions together work to prevent pregnancy. The fertilized egg leaves the body if it is not connected to the uterus. Additionally, Menoral prevents ovulation, or the release of an egg, in around 50% of women's menstrual cycles.

✔️ Pharmacology

• Norethisterone is an effective progestogen with negligible androgenic properties. With orally administered doses of 100-150 mg of norethisterone per cycle, estrogen-primed women can achieve a complete transformation of the endometrium from a proliferative to a secretory state. Menoral is used to treat dysfunctional bleeding, primary and secondary amenorrhea, and endometriosis due to the progestogenic effects of norethisterone on the endometrium. A daily dose of 0.5 mg of norethisterone can inhibit gonadotropin secretion and induce ovulation. The suppression of ovarian function is responsible for Menoralbeneficial effects on premenstrual symptoms. Menoral can be used to shift the timing of menstruation due to the endometrium-stabilizing effects of norethisterone. Norethisterone's thermogenic action, like that of progesterone, alters the basal body temperature.
• Norethisterone is rapidly and completely absorbed when taken orally over a wide dose range. Peak serum concentrations of approximately 16 ng/ml are achieved approximately 1.5 hours after administration of one tablet Menoral. The bioavailability of norethisterone after an oral dose is approximately 64% due to a strong first-pass effect.
• Norethisterone binds to serum albumin as well as sex hormone-binding globulin (SHBG). Only about 3-4% of total serum drug concentrations are free steroids, with the remaining 35% and 61% bound to SHBG and albumin, respectively. Norethisterone is transferred into milk, and drug levels in breast milk were found to be approximately 10% of those found in maternal plasma, regardless of the administration route. A maximum of about 1mcg (0.02% of the maternal dose) could reach the infant based on a mean maximum drug level in maternal serum of about 16 ng/ml and an estimated daily intake of 600ml of milk by the nursed infant.
• Norethisterone is primarily metabolized through saturation of the double bond in ring A and reduction of the 3-keto group to a hydroxyl group, followed by conjugation to the corresponding sulfates and glucuronides. Some of these metabolites are eliminated from plasma slowly, with half-lives of around 67 hours. As a result, during long-term treatment with daily oral norethisterone administration, some of these metabolites accumulate in the plasma. The in vivo conversion of norethisterone to ethinylestradiol has been reported for many years but has never been quantified. Recent research has shown that norethisterone is partially metabolized to ethinylestradiol. In humans, one milligram of orally administered norethisterone produces ethinylestradiol equivalent to an oral dose of approximately 4 mcg. Because norethisterone's estrogenicity has always been assumed and experienced in clinical practice, the recent discovery of its metabolic properties does not change the existing recommendations for use.
• Norethisterone is not excreted unchanged in significant amounts. Predominantly A-ring-reduced and hydroxylated metabolites, as well as their conjugates (glucuronides and sulfates), are excreted in a 7:3 ratio via urine and feces. The majority of metabolites excreted by the kidney were eliminated within 24 hours, with a half-life of about 19 hours. Conditions in a steady state: Because of the relatively short half-life of norethisterone, accumulation is unlikely during multiple-dose daily administration. When SHBG-inducing agents, such as ethinylestradiol, are combined, norethisterone serum levels can rise due to the binding of norethisterone to SHBG.

✔️ Dosage & Administration of Menoral 5mg Tablet

Before beginning Menoral, a thorough general medical and gynecological examination (including the breasts and a cytological smear of the cervix) should be performed, guided by the contraindications and warnings, and pregnancy should be ruled out. Control examinations should be performed every 6 months as a precaution during long-term Menoral® treatment. The tablets should be taken whole with some liquid. If a user forgets to take a tablet as directed, the efficacy of Menoral may be reduced. The woman should only take the last missed tablet as soon as she remembers, and then resume tablet intake at her regular time the following day. If additional non-hormonal contraceptive methods are required, they should be used.

The following dosages are recommended:

• Uterine dysfunctional bleeding (DUB): The administration of one tablet of Menoral three times per day for ten days usually results in the cessation of uterine bleeding not associated with organic lesions within one to three days. Nonetheless, Menoral® must be taken for the full 10 days to ensure treatment success. Withdrawal bleeding will occur 2 to 4 days after treatment completion, with the intensity and duration of normal menstruation. After the initial stoppage of bleeding, there may be some minor bleeding. Tablet use must not be interrupted or stopped in these circumstances. The absence of hemorrhage arrest, as well as heavy break-through bleeding If the vaginal bleeding does not stop despite taking the prescribed medication, an organic cause or an extra-genital factor (e.g. polyps, high-situated carcinoma of the cervix uteri or endometrium, myoma, residual of abortion, extra-uterine pregnancy, or coagulation disorders) must be considered, and other measures are usually required. This is also true when, after the initial stoppage of bleeding, fairly heavy bleeding continues during tablet administration. Preventing the recurrence of dysfunctional bleeding Prophylactic administration of Menoral is recommended to prevent the recurrence of dysfunctional bleeding in patients with anovulatory cycles. From the 16th to the 25th day of the cycle (1st day of the cycle = 1st day of the last bleeding), take 1 tablet 1 to 2 times daily. Withdrawal bleeding occurs a few days after the last tablet is administered.
• Mastopathy, premenstrual syndrome: One tablet of Menoral 1 - 3 times daily during the luteal phase of the cycle may relieve or alleviate premenstrual symptoms such as headaches, depressive moods, water retention, and a feeling of tension in the breasts.
• Menstruation cycle timing Menoral can be used to postpone menstrual bleeding on a monthly basis. This method, however, should be limited to users who are not at risk of pregnancy during the treatment cycle. Dosage: 1 tablet Menoral 2 to 3 times daily for 10 - 14 days, starting about 3 days before the expected menstruation. Bleeding will occur 2 to 3 days after stopping the medication.
• Endometriosis Treatment should begin between the first and fifth day of the cycle with 1 Menoral tablet twice daily, increasing to 2 tablets twice daily if spotting occurs. If the bleeding stops, the first dose can be restarted. The treatment will last at least 4 - 6 months. Ovulation and menstruation do not usually occur with continuous daily intake. Withdrawal bleeding will occur following the discontinuation of hormone treatment. Menorrhagia (hypermenorrhea) treatment with Menoral 1 tablet 3 times daily from day 5 to day 25 of the cycle has been shown to reduce menstrual blood loss.

✔️ Interactions

CYP450 inducers, such as phenobarbital, phenytoin, carbamazepine, rifampicin, rifabutin, nevirapine, efavirenz, tetracyclines, ampicillin, oxacillin, and co-trimoxazole, as well as ritonavir and nelfinavir, may lower concentration. (usually inhibitors of CYP450 but have inducing properties when used with steroid hormones). With NSAIDs and vasodilators, fluid retention may be exacerbated. Anticoagulant, thyroid hormone, and anti-diabetic treatment adjustments may be necessary. Increased ciclosporin concentration might be fatal.

✔️ Contraindications

Norethisterone should not be used if any of the following conditions exist, which are derived from information on other progestogen-only products. If any of these conditions appear while using Norethisterone, the medication must be stopped immediately.

• Pregnancy, whether known or suspected
• Lactation Thromboembolic events
• Diabetes with vascular complications
• As long as liver function values have returned to normal, the presence or
• history of severe hepatic disease is permissible.
• The presence of or a history of liver tumors (benign or malignant)
• Sex-hormone-dependent cancers that are known or suspected
• Hypersensitivity to any of the active ingredients or excipients

✔️ Pregnancy & Lactation

• Use During Pregnancy: Norethisterone should not be used during pregnancy. Pregnancy category X according to the US Food and Drug Administration.
• Menoral should not be used during pregnancy or lactation.

✔️ Precautions & Warnings

If any of the conditions/risk factors mentioned below is present or deteriorate, an individual risk-benefit analysis should be done before Norethisterone is started or continued.

• Circulatory disorders: Epidemiological studies have concluded that the use of oral estrogen/progestogen-containing ovulation inhibitors is associated with an increased incidence of thromboembolic diseases. As a result, the possibility of an increased thromboembolic risk should be considered, especially if there is a history of thromboembolic disease. A positive personal or family history (VTE in a sibling or parent at a young age), age, obesity, prolonged immobilization, major surgery, or major trauma are all known risk factors for venous thromboembolism (VTE). In the puerperium, there is an increased risk of thromboembolism. If there are any symptoms or suspicions of an arterial or venous thrombotic event, treatment should be discontinued immediately.
• Circulatory disorders: Epidemiological studies have concluded that the use of oral estrogen/progestogen-containing ovulation inhibitors is associated with an increased incidence of thromboembolic diseases. As a result, the possibility of an increased thromboembolic risk should be considered, especially if there is a history of thromboembolic disease. A positive personal or family history (VTE in a sibling or parent at a young age), age, obesity, prolonged immobilization, major surgery, or major trauma are all known risk factors for venous thromboembolism (VTE). In the puerperium, there is an increased risk of thromboembolism. If there are any symptoms or suspicions of an arterial or venous thrombotic event, treatment should be discontinued immediately.
• Other: If the patient has diabetes, strict medical supervision is required. Chloasma can occur on occasion, particularly in women with a history of chloasma gravid arum. When taking Norethisterone, women who are prone to chloasma should avoid exposure to the sun or ultraviolet radiation. Patients with a history of depression should be closely monitored, and the medication should be discontinued if the depression worsens. Because of its partial conversion to estrogen estradiol, norethisterone also has estrogenic properties. There are no comparable estrogen-related safety findings available. Reasons for the tablets' immediate discontinuation: Occurrence of migrainous headaches for the first time or more frequent occurrence of unusually severe headaches, sudden perceptual disorders (e.g., disturbances in vision or hearing), first signs of thrombophlebitis or thromboembolic symptoms (for example, unusual pains in or swelling of the legs, stabbing pains on breathing or coughing for no apparent reason), a feeling of pain and tightness in the chest, pending operations (six weeks beforehand

✔️ Storage Conditions

Store in a cool and dry place, protected from light and moisture. Keep out of reach of children.