Cyclogest

Overdose

There is a wide margin of safety with Cyclogest pessaries, but overdosage may produce euphoria or dysmenorrhoea.

Shelf life

Shelf-life

Three years from the date of manufacture.

Shelf-life after dilution/reconstitution

Not applicable.

Shelf-life after first opening

Not applicable.

Cyclogest price

We have no data on the cost of the drug.
However, we will provide data for each active ingredient

Contraindications

- Undiagnosed vaginal bleeding.

- Known or suspected progesterone sensitive malignant tumours.

- Porphyria.

- Severe hepatic dysfunction or disease- Known missed abortion or ectopic pregnancy.

- Active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events.

Incompatibilities

None known.

List of excipients

Also contains: vegetable fat.

Pharmaceutical form

Off-white pessaries.

Undesirable effects

Very common (> 1/10), Common (> 1/100 to < 1/10), Uncommon (> 1/1,000 to < 1/100), Rare (> 1/10,000 to < 1/1,000), Very rare (< 1/10,000), Not known (cannot be estimated from the available data)

SYSTEM ORGAN CLASS

Common

Uncommon

Not known

Nervous system disorder

Somnolence

Gastrointestinal disorders

Abdominal pain, Abdominal discomfort

Diarrhoea and flatulence may occur with rectal administration.

Skin and subcutaneous tissue disorders

Hypersensitivity reactions (e.g. rash, pruritus)

Reproductive system and breast disorders

Breast pain

Menstruation may occur earlier than expected, or, more rarely, menstruation may be delayed.

General disorders and administration site conditions

Soreness, some leakage of the pessary base

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme; website: www.mhra.gov.uk/yellowcard

Preclinical safety data

There are no preclinical data of relevance to the prescriber which are additional to those already included in other sections of the SmPC.

Therapeutic indications

Cyclogest is indicated for the

1) Treatment of premenstrual syndrome, including premenstrual tension and depression.

2) Treatment of puerperal depression.

Pharmacotherapeutic group

Sex hormones and modulators of the genital system; Progestogens; Pregnen-(4) derivatives. ATC code: G03DA04.

Pharmacodynamic properties

Pharmacotherapeutic group: Sex hormones and modulators of the genital system; Progestogens; Pregnen-(4) derivatives. ATC code: G03DA04.

Progesterone is a naturally occurring steroid that is secreted by the ovary, placenta, and adrenal gland.

Pharmacokinetic properties

Not applicable.

Date of revision of the text

19th April 2016

Marketing authorisation holder

Actavis UK Limited

(Trading style: Actavis)

Whiddon Valley

Barnstaple

North Devon

EX32 8NS

United Kingdom

Special precautions for storage

Store below 25°C in a dry place.

Nature and contents of container

The product may be supplied in strip packs contained in cartons:

Carton: White backed folding box board printed on white.

Strip pack: Aluminium foil lacquer-laminated to 20µm polypropylene foil and coated on the reverse with polythene (20mg/m2). The alternative is thermoplastic film and laminated PVC to 95µm and polyethylene to 27-30µm.

Pack sizes: 5s, 12s, 15s

Marketing authorisation number(s)

PL 00142/0507

Special warnings and precautions for use

Cyclogest is not indicated in threatened miscarriage. Treatment should be discontinued in the event of a missed miscarriage.

Cyclogest should be discontinued if any of the following conditions are suspected:

myocardial infarction, cerebrovascular disorders, arterial or venous thromboembolism (venous thromboembolism or pulmonary embolism), thrombophlebitis or retinal thrombosis.

Although risk of thromboembolism has been associated with estrogens, a link with progestins remains questionable. Therefore, in women with generally recognised risk factors for thromboembolic events, such as personal or family history, treatment with Cyclogest may further increase the risk. In these women, the benefits of Cyclogest administration need to be weighed against the risks. It should be noted however, that pregnancy itself carries an increased risk of thrombo-embolic events.

Patients with a history of depression need to be closely observed. Consider discontinuation if symptoms worsen.

Because progesterone may cause some degree of fluid retention, conditions that might be influenced by this factor (e.g. epilepsy, migraine, asthma, cardiac or renal dysfunction) require careful observation.

A decrease in glucose tolerance has been observed in a small number of patients on estrogen-progestin combination drugs. The mechanism of this decrease is not known. For this reason, diabetic patients should be carefully observed while receiving progestin therapy.

Progesterone is metabolised in the liver and should be used with caution in patients with hepatic dysfunction.

Cyclogest contains the hormone progesterone which is present in significant concentrations in women during the second half of the menstrual cycle and during pregnancy. This should be borne in mind when treating patients with conditions that may be hormone-sensitive.

Abrupt discontinuation of progesterone dosing may cause increased anxiety, moodiness, and increased sensibility to seizures.

Use rectally if barrier methods of contraception are used.

Use rectally if patients suffer from vaginal infection (especially moniliasis) or recurrent cystitis or have recently given birth.

Use vaginally if patients suffer from colitis or faecal incontinence.

Effects on ability to drive and use machines

None known.

Dosage (Posology) and method of administration

200mg daily to 400mg twice a day, by vaginal or rectal insertion. For premenstrual syndrome commence treatment on day 14 of menstrual cycle and continue treatment until onset of menstruation. If symptoms are present at ovulation commence treatment on day 12.

Use in special populations: There is no experience with use of Cyclogest in patients with impaired liver or renal function.

Paediatric population:There is no relevant use of Cyclogest in the paediatric population.

Elderly: No clinical data have been collected in patients over age 65.

Special precautions for disposal and other handling

Not applicable.

Administrative data

Date of first authorisation/renewal of the authorisation

23 August 2000