Dianette

Dianette

Dianette contains both an oestrogen and an anti-androgen.  Androgens are the hormones that stimulate hair growth and the grease glands in your skin. Sometimes these grease glands can get blocked as they produce too much sebum, the blocked glands can then get infected and become inflamed which leads to acne spots. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

Acne and Hirsutism (excessive hairiness) can both be really hard to live with. Like any skin condition, they are very visible and can really affect the person’s self-confidence. Acne is very common, often appearing in teenagers and affecting the face back and chest. Hirsutism affects around 10% of western women and is more common in those of the Mediterranean or Middle-Eastern origin. These skin conditions can be completely unrelated to one another and both have several treatment options, from lifestyle changes to topical treatments and beyond. In fact, both can be treated with Dianette an oral contraceptive pill also known as Diane, but only when the benefits of such a treatment are deemed to outweigh the risks. 

What is Dianette? 

Dianette contains both an oestrogen and an anti-androgen. 

Androgens are the hormones that stimulate hair growth and the grease glands in your skin. Sometimes these grease glands can get blocked as they produce too much sebum, the blocked glands can then get infected and become inflamed which leads to acne spots. 

Dianette works to prevent androgens from acting on your skin and reduces the number of androgens produced which has a positive effect on your skin. 

Dianette comes in the form of a daily pill which you take in line with your menstrual cycle. Each tablet contains 2 milligrams of the anti-androgen, cyproterone acetate, and 35 micrograms of the oestrogen, ethinylestradiol. 

When is Dianette used? 

Dianette is a contraceptive pill that is used to treat a variety of skin conditions including: 

  • acne 
  • very oily skin 
  • excessive hair growth 

Dianette is only used in the following circumstances: 

  • if you are of reproductive age; 
  • if other treatments like topical creams and antibiotics have not improved your condition; 
  • if your doctor considers treatment with a hormonal contraceptive appropriate; 
  • if the benefits are deemed to outweigh the risks. 

Dianette is also a combined oral contraceptive pill however it is only used to treat skin conditions, you cannot take another contraceptive pill while taking Dianette but once your skin condition has cleared up then you should switch to a different oral contraceptive if you want to remain protected from unwanted pregnancy. 

How do you use Dianette? 

As it’s a combined oral contraceptive Dianette is taken on a monthly cycle: 

  • Start taking Dianette on the first day of your period when you are taking it for the first time; 
  • Take one pill every day for 21 days; 
  • Take your pill at the same time every day; 
  • Swallow the pill whole, with or without water; 
  • Follow the arrows on the strip to ensure you take one pill a day; 
  • When you have finished the pack (21 tablets) you will have a seven-day break, during which you will have a breakthrough bleed like a period; 
  • You are still protected from pregnancy on the seven-day break as long as you have taken the tablets correctly every day; 
  • On day eight of the break start a new packet and a new 21-day cycle of pills; 
  • Your doctor will tell you how long to keep taking his medication; 
  • If you are switching from a different 21-day pill start Dianette the day after you finish the previous contraceptive (you will not have a 7-day break until you finish the first strip of Dianette); 
  • If you are switching from a 28-day pill, start taking Dianette on the 29th day. (you will not have a 7-day break until you finish your first strip of Dianette). 

What dosages are there? 

The dose for Dianette is always the same: 

  • One pill a day for 21 days followed by a 7-day break; 

If you forget to take your pill, take it as soon as you remember and then carry on with the remaining pills as normal. 

If you are more than 12 hours late taking your pill or you have missed more than one day: 

  • Take the pill you missed most recently as soon as you remember, even if this means you take two pills at once (don’t take any others that you missed, leave them in the pack); 
  • Continue taking your pills as normal; 
  • If it is less than seven days before you are due a break, do not take a break and start the new packet straight away; 
  • Always use extra contraception for seven days of you miss a pill; 
  • If you miss 1 or more pills from days 1-7 of the cycle you could become pregnant if you do not use an additional method of contraception when having sex. 

What are the side effects of Dianette? 

As with all medicines, Dianette comes with a warning of some side effects, although not everyone who takes Dianette with experience them. 

The most serious side effects are: 

  • Severe depression and sometimes thoughts of ending your life 
  • Blood clots – look out for: 
    • Pain in the chest and/or left arm; 
    • Breathing difficulties; 
    • Sudden cough; 
    • Slurring speech; 
    • Fainting or dizziness; 
    • Weakness or numbness; 
    • Severe stomach pain; 
    • Severe leg pain; 
    • Leg swelling; 
    • Sudden changes to your senses; 
    • Unusual or server migraine. 
  • Severe allergic reaction – look out for: 
    • Difficulty breathing; 
    • Swelling around the face, nose, mouth, throat and tongue; 
    • Rashes or hives. 
  • Breast cancer – look out for: 
    • Unusual lumps; 
    • Changes to the nipple; 
    • Dimpling of the skin. 
  • Cervical cancer – look out for: 
    • Discharge from your vagina that smells or contains blood; 
    • Unusual vaginal bleeding; 
    • Pain in the pelvis; 
    • Pain when having sex. 
  • Liver problems – look out for: 
    • Yellowing skin or whites of the eyes; 
    • Severe stomach pain; 
    • Itching over the whole body; 
    • Inflammation of the liver. 

If you think you have any of the above, then seek immediate medical assistance as these conditions are extremely serious. 

Common side effects (may affect up to 1 in 10 women) include: 

  • Nausea; 
  • Weight gain; 
  • Stomach ache; 
  • Headaches; 
  • Painful breasts; 
  • Mood swings; 
  • Feeling depressed. 

Uncommon side effects (may affect up to 1 in 100 women) include: 

  • Migraine; 
  • Low libido; 
  • Increase in breast size; 
  • Vomiting; 
  • Rashes on the skin. 

Rare side effects (may affect up to 1 in 1000 women) include: 

  • Weight loss; 
  • Higher libido; 
  • Problems using contact lenses; 
  • Discharge from vagina or breasts; 
  • Blood clots in a vein. 

You may also experience unexpected bleeding or spotting when taking Dianette but this should calm down after the first few months of taking it and is not normally cause for concern. 

When shouldn’t you use Dianette? 

Do not take Dianette if any of the following apply: 

  • You are allergic to any of the ingredients of Dianette listed on the packet; 
  • You are already taking a type of contraceptive medicine; 
  • You are pregnant or breastfeeding, or think you may be pregnant; 
  • You have or have ever had a blood clot; 
  • You have or have ever had a heart attack or stroke; 
  • You have a condition that increases your chance of a stroke or heart attack; 
  • You have hepatitis C and are taking medicines containing paritaprevir, ritonavir, dasabuvir or ombitasvir; 
  • You have ever had problems with blood clotting; 
  • You have or have ever had migraine with vision issues; 
  • You have ever had a liver tumour; 
  • You have ever had severe liver disease. 

You should also take special care with Dianette if you have ever had any of the following: 

  • Migraines; 
  • Depression; 
  • High blood pressure; 
  • Porphyria; 
  • Diabetes; 
  • High levels of fat in the blood; 
  • Brown patches on your face and body (chloasma); 
  • Inflammation of the pancreas; 
  • Any illness that worsened during pregnancy or whilst taking the pill; 
  • You are overweight. 

Does Dianette interact with other medications? 

Always tell your doctor about any other medication you are taking, including herbal remedies and supplements as some medicines can cause others to be less effective or cause problems when taken together. 

With Dianette you should take particular care with medicines that treat: 

  • Tuberculosis; 
  • Epilepsy; 
  • HIV; 
  • Hepatitis C; 
  • Arthritis; 
  • Arthrosis; 
  • Fungal infections; 
  • High blood pressure in the blood vessels in the lungs. 

You should also avoid St John’s Wort 

Dianette interacts badly with several medicine, some of these are: 

  • Lamotrigine (an anti-epileptic); 
  • Theophylline (for breathing problems); 
  • Ciclosporin; 
  • Tizanidine (for muscle pain/cramps). 

Where can you buy Dianette? 

You can buy Dianette or Diane from any reputable pharmacy, pick the pharmacy that is easiest for you to access, as Dianette is a type of medication that you will need to take over a long period of time, so you will likely need to purchase Dianette or Diane more than once. 

Making it easy to get hold of will ensure you have your medication when you need it. 

Can I get Dianette without a prescription? 

No, you cannot get Dianette without a prescription. You will need a consultation with a doctor to get a prescription and they will need to check your medical history, your family medical history and include a general check-up to ensure Diane or Dianette is the right medication to treat you with. 

Dianette can only be prescribed for skin conditions when other avenues have been exhausted and the benefits are deemed to outweigh the risks. Likewise, as a contraceptive, it is not usually prescribed at all, as other options are considered to be lower risk. If you think Diane or Dianette is the right medicine for you then you can always open a discussion with your doctor. 

You will need to have regular check-ups   while you are taking Dianette, including a cervical smear, blood pressure and you should also check your breasts regularly. 

Sources 

Bayer Plc, 2019. Medicines.org.uk. Retrieved 3 April 2020 from <https://www.medicines.org.uk/emc/files/pil.1122.pdf

British Skin Foundation, n.d. Acne. British Skin Foundation. Retrieved 3 April 2020 from <https://www.britishskinfoundation.org.uk/acne?gclid=EAIaIQobChMIlsGlm-mo6AIVGLLtCh2eeQHcEAAYAiAAEgLEQPD_BwE

British Skin Foundation, n.d. Hirsutism. British Skin Foundation. Retrieved 3 April 2020 from https://www.britishskinfoundation.org.uk/hirsutism?gclid=EAIaIQobChMI37Dq7vfM6AIVGeDtCh221A-DEAAYASAAEgJnFPD_BwE>  

 GOV.UK. 2014. Cyproterone Acetate With Ethinylestradiol (Co-Cyprindiol): Balance Of Benefits And Risks Remains Positive. Retrieved 3 April 2020 from <https://www.gov.uk/drug-safety-update/cyproterone-acetate-with-ethinylestradiol-co-cyprindiol-balance-of-benefits-and-risks-remains-positive>. 

Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.