Introduction
Giane 35 is a combination of two hormonal medicines used to treat symptoms of polycystic ovary syndrome (PCOS) such as excessive hair growth (hirsutism), acne and irregular periods. It also work as a contraceptive, hence avoid using any other contraceptive pill.
Giane 35 can be taken with or without food. Take it at the same time every day as it will help you remember to take it. The dose and duration will depend on what you are being treated for, but you should always complete a full course of this medicine as prescribed by your doctor.
The most common side effects of this medicine include nausea, stomach pain, headache, weight gain, and breast pain. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. Consult your doctor if you frequently experience spotting or brown discharge in the middle of the cycle. You must also consult your doctor if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain or changes in vision.
Do not continue with the medicine and consult with the doctor if your periods do not start within a week of the treatment. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. Avoid the use of medicine if you are pregnant or breastfeeding.
Uses of Giane 35
- Polycystic ovarian syndrome (PCOS)
Side effects of Giane 35
Common
- Nausea
- Stomach pain
- Headache
- Weight gain
- Breast pain
- Mood changes
How to use Giane 35
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. Giane 35 may be taken with or without food, but it is better to take it at a fixed time.
How Giane 35 works
Giane 35 is a combination of two hormonal medicines: Cyproterone and Ethinyl Estradiol which treats PCOS symptoms such as acne, excessive hair growth (hirsutism) and irregular periods. Cyproterone works by blocking the overproduction of androgens (male hormones) in the ovaries, thereby reducing unwanted hair growth and acne. Ethinyl Estradiol enhances the effect of Cyproterone by reducing the amount of androgens in the blood. Together, they also regularize the menstrual cycle in PCOS.
Indication
Acne, Contraception, Hirsutism, Prostatic carcinoma, Libido, Hot flushes
Administration
Should be taken with food. Take after meals.
Adult Dose
Oral
Contraception; Hirsutism; Acne
Adult: 2 mg daily (with 35 mcg of ethinylestradiol daily) for 21 days of the menstrual cycle. Start 1st treatment course on the 1st day of menstrual cycle; subsequent courses are started after 7 medication-free days following the preceding course. Withdraw treatment 3 or 4 cycles after condition has resolved.
Contraindication
Markedly impaired liver function or cholestasis; Dubin-Johnson or Rotor syndrome, hepatic adenoma; malignant or wasting diseases; severe chronic depression; severe diabetes with vascular changes; sickle-cell anaemia; history of thromboembolic disorders; renal impairment. Youths <18 yr.
Mode of Action
Cyproterone is a progestogen with anti-androgenic properties.Oestradiol is the major oestrogen in pre-menopausal women. Ethinylestradiol has similar actions as oestradiol. It is responsible for the development and maintenance of female reproductive system and secondary sexual characteristics. It also inhibits anterior pituitary by negative feedback effect and causes capillary dilation, fluid retention and protein anabolism.
Precaution
Prostate cancer, hepatic impairment, DM, history of depression, familial defects in lipoprotein metabolism, CV diseases. Monitor LFT, adrenocortical function, LDL and HDL levels, and RBC count during treatment. In women: Interrupt treatment if persistent or recurrent bleeding occurs to exclude the possibility of organic diseases. May increase risk of thrombo-embolic diseases. Ineffective for male hypersexuality in chronic alcoholism. May impair ability to drive or operate machinery. Pregnancy, lactation.
Side Effect
Inhibits spermatogenesis, reduces volume of ejaculate, causes infertility, produces abnormal spermatozoa, gynecomastia and enlargement of mammary glands; galactorrhoea and benign nodules. Depressive mood changes. Alterations in hair pattern, skin reactions. Fatigue and lassitude, breathlessness, wt changes.
Interaction
Metabolism may be reduced by inhibitors of CYP3A4 e.g. ketoconazole, itraconazole, clotrimazole, ritonavir. Inducers of CYP3A4 e.g. rifampicin, phenytoin may reduce the levels of cyproterone.
CYP1A2 and CYP3A4 inducers such as aminoglutethimide, carbamazepine, phenobarbital, and rifampin may decrease the effects of estradiol. May enhance the effects of hydrocortisone and prednisolone when used together. Altered anticoagulant effect when used with dicoumarol.
Potentially Fatal: Antibiotics (ampicillin, tetracycline, sulphonamides and chloramphenicol) can cause intermenstrual bleeding or failure of contraception. Reduced efficacy of antihypertensives or hypoglycaemic drugs.