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Dianette

The Dianette contraceptive pill 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, and then get infected and become inflamed, which leads to acne spots. Dianette works to prevent androgens from acting on the skin and reduces the number of androgens produced, which has a positive effect on the 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. Acne and hirsutism (excessive hairiness) can both be very hard to live with. As with any skin condition, they are very visible and can seriously affect a 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 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 others. Both can be treated with the Dianette contraceptive pill also known as Diane, but only when the benefits of such a treatment are deemed to outweigh the risks.

What is Dianette?

The Dianette contraceptive pill 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, and then get infected and become inflamed, which leads to acne spots. Dianette works to prevent androgens from acting on the skin and reduces the number of androgens produced, which has a positive effect on the 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 and excessive hair growth. Dianette is only used in the following circumstances:

  • If you are of reproductive age;
  • If other treatments such as 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.

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

How do you use Dianette?

As it is a combined oral contraceptive, Dianette is taken on a monthly cycle. Start taking the Dianette pill on the first day of your period when you are taking it for the first time. Take one Dianette pill every day for 21 days, 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, and 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 Dianette 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 seven-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 seven-day break until you finish your first strip of Dianette).

What dosages are there?

The dose for Dianette is always the same: one Dianette tablet a day for 21 days followed by a seven-day break. If you forget to take your Dianette 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 Dianette 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 (do not take any others that you missed – simply leave them in the pack). Then 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, and always use extra contraception for seven days if you miss a pill. If you miss one or more Dianette 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 tablets come with a warning of some side effects, although not everyone who takes Dianette will 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, slurred speech, fainting or dizziness, weakness or numbness, severe stomach or leg pain, leg swelling, sudden changes to your senses, and unusual or severe migraines;
  • Severe allergic reaction – look out for difficulty breathing, swelling around the face, nose, mouth, throat and tongue, and rashes or hives;
  • Breast cancer – look out for unusual lumps, changes to the nipples and dimpling of the skin;
  • Cervical cancer – look out for discharge from the vagina that smells or contains blood, unusual vaginal bleeding, and pain in the pelvis or when having sex;
  • Liver problems – look out for yellowing skin or whites of the eyes, severe stomach pain, itching over the whole body and 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 the Dianette pill but this should calm down after the first few months of taking it and is not normally cause for concern.

When should you not 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;
  • Being 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 medicines, including lamotrigine (anti-epileptic), theophylline (for breathing problems), ciclosporin and tizanidine (for muscle pain/cramps).

Where can you buy Dianette?

You can buy Dianette or Diane from any reputable pharmacy. Choose 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 obtain the Dianette pill without a prescription. You will need a consultation with a doctor to get a prescription and they will need to check your own and 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. 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 discuss it with your doctor.

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

Sources:

Bayer Plc, 2019. Medicines.org.uk. Retrieved 3 April 2020.

British Skin Foundation, n.d. Acne. 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.

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