Co-Cyprindiol

Co-cyprindiol is a combined hormonal preparation containing cyproterone acetate and ethinylestradiol.

It is the generic equivalent of Dianette and is prescribed for the treatment of moderate to severe acne in women of reproductive age who have not responded adequately to topical therapy and oral antibiotics, and for moderately severe hirsutism.

Cyproterone acetate is a potent anti-androgen that blocks testosterone and other androgens from binding to receptors in the skin.

Excessive androgen activity stimulates the sebaceous glands, increasing sebum production and contributing to acne. In women with hirsutism, it drives unwanted facial and body hair growth.

By opposing androgen action and reducing gonadotrophin secretion, cyproterone acetate lowers sebum output and gradually decreases unwanted hair growth.

The ethinylestradiol component provides reliable cycle control, suppresses ovulation, and stimulates hepatic production of sex hormone-binding globulin (SHBG).

Higher SHBG levels bind more free testosterone in the circulation, further reducing the androgenic drive on the skin.

Co-cyprindiol provides effective contraception as a secondary benefit but is not licensed solely for this purpose.

Take one tablet daily for 21 consecutive days, followed by a seven-day tablet-free interval during which a withdrawal bleed normally occurs.

Start the first tablet on the first day of your menstrual period. Swallow the tablet at approximately the same time each day with water.

Follow the missed-pill rules in the patient information leaflet if you forget a dose.

Once acne or hirsutism has resolved, co-cyprindiol should be discontinued.

Treatment for acne is typically three to four cycles, though your prescriber may extend it if the condition has not fully responded.

After stopping, switch to an alternative contraceptive if ongoing contraception is needed.

One tablet daily for 21 days, followed by a seven-day break. Each tablet contains cyproterone acetate 2 mg and ethinylestradiol 35 micrograms. Acne treatment usually lasts three to four cycles.

Hirsutism may require six to twelve months of treatment before full benefit is apparent. Co-cyprindiol should not be combined with other hormonal contraceptives. No dose titration is available.

Common side effects (more than 1 in 100 women) include headache, nausea, breast tenderness, mood changes, fluid retention, and altered menstrual bleeding patterns including breakthrough bleeding.

Uncommon effects include migraine, decreased libido, weight change, and skin reactions. Chloasma (patchy facial pigmentation) may occur and is worsened by sun exposure.

Serious risks include venous thromboembolism (VTE), which is higher with co-cyprindiol than with standard combined oral contraceptives containing levonorgestrel.

Arterial thromboembolism (stroke, myocardial infarction) is a rare risk, increased by smoking, hypertension, and other cardiovascular risk factors.

Hepatic tumours and meningioma have been associated with cyproterone acetate, though meningioma risk is primarily linked to higher doses and prolonged use.

Co-cyprindiol should not be used solely for contraception due to the higher VTE risk compared with standard combined pills. Discontinue once the skin condition has resolved.

Seek urgent medical attention if you develop sudden severe headache, chest pain, breathlessness, leg swelling or pain, or visual disturbance.

Women who smoke, particularly those over 35, should not use co-cyprindiol. It must not be combined with another hormonal contraceptive.

Have your blood pressure checked before starting and at follow-up visits.

Co-cyprindiol is contraindicated in women with current or past venous or arterial thromboembolism, known thrombophilic disorders, migraine with aura, uncontrolled hypertension, severe hepatic disease or liver tumours, diabetes with vascular involvement, known or suspected oestrogen-dependent malignancy, undiagnosed vaginal bleeding, known or suspected pregnancy, and known or existing meningioma.

Concurrent use with other hormonal contraceptives is not permitted.