9 Contraceptive Patch Hormones embedded in adhesive layer of the patch Composition: EE/norelgestrominApplied: abdomen, buttocks, armUse 3wks plus 1 patch free wkEfficacy: 5 preg/5,240 cyclesMech, indications & side effects: similar to OCPsNot effective women >180 lbsThis is one of the newer contraceptive delivery systems. Instead of taking a pill orally, the hormones are delivered transdermally via a patch. The contraceptive patch is very effective. The mechanism, indications for use and side effect profiles are similar to oral contraceptive pill. Contains ethinlyl estradiol and norelgestromin. Not an effective method of contraception for women > 180 lbs.• Launched: June 2002OB/GYN News, 20026-
12 Combination Oral Contraceptive Pills Treatment Regimen21 hormone days7 hormone free daysThis is an example of a monophasic combined oral contraceptive pill. Each pill contains both an estrogen and progestin and it is administered for 21 days. The amount of estrogen and progestin in each pill does not vary from pill to pill. The last seven days are “hormone free.” Because of the sharp drop in hormone at the end of 21 days, the woman will experience withdrawal bleeding or menstrual period. Oral contraceptive pills were designed to mimic a woman’s 28 day menstrual cycle. In fact contraceptive pills could have been designed in such a way that a woman would have a period every three or four months without experiencing any ill effects. This could be accomplished by skipping the pill free day. In some cases women having significant problems with their menstrual periods can be placed on “continuous” oral contraceptive pills, skip the hormone free day and never have a menstrual period without any ill effects. By tradition, most contraceptive pills, are designed so that the woman has a period every month.6-
18 Diphereline 3.75mg S.R. 1. NAME OF THE MEDICINAL PRODUCT Diphereline 3,75mg S.R. powder and solvent for suspension for injection, sustained release form.INN: triptorelin2. QUALITATIVE AND QUANTITATIVE COMPOSITION. PHARMACEUTICAL FORM.Powder (triptorelin, D,L lactide-coglycolide polymer, mannitol, Carmellose sodium, Polysorbate ) andsolvent (water, mannitol) for suspension for injection (i.m.), sustained release form.
19 3. CLINICAL PARTICULARS3.1. Therapeutic indicationsProstate cancer.Treatment of the prostate cancer with metastases. Patients who have not previously received hormonetherapy respond better to Diphereline.Precocious puberty ( before 8 years in girls and 10 years in boys ).Genital and extra genital endometriosis (stage I to IV )Female infertilitySupplementary treatment in combination with gonadotrophin to induce ovulation with a view to in vitrofertilisation and embryo transfer (I.V.F.E.T.).Myoma
20 - from the outset , one i. m. injection of Diphereline 3. 75 mg S. R - from the outset , one i.m. injection of Diphereline 3.75 mg S.R., repeated every 28 days.Precocious puberty:Children weighing more than 20 kgEndometriosisThe treatment must be started in the first five days of menstrual cycle.
21 One i. m. injection of Diphereline 3. 75 mg S. R One i.m. injection of Diphereline 3.75 mg S.R. on the second day of the cycle. Gonadotropins should be started after the pituitary desensitisation ( plasma estrogens less than 50 pg/ml ), generally 15 days after injection of Diphereline.3.3. Contraindications :Should never be used during pregnancy.
22 Female infertilityWarnings and precautions: the follicular retrieval may increase markedly in some predisposed patients and particularly in those with polycystic ovarian disease.4. PHARMACOLOGICAL PROPERTIES Triptorelin is a synthetic decapeptide analogue of natural GnRH