DRUGS & SUPPLEMENTS
When are you taking this medicine?
Kliane (Estradiol Hemihydrate) is a female sex hormone that regulates many functions in the female organism. This medicine is currently available under the form of tablets in two concentrations - 1 mg and 2 mg, respectively.
Kliane (Estradiol Hemihydrate) is used for the treatment of menopausal symptoms such as vaginal dryness, irritation or burning, or hot flushes - other symptoms that are not listed here may be treated with this medicine as well. Also, this pharmaceutical preparation can be used as a prophylactic agent for the prevention of a medical condition known as osteoporosis in both female and male patients. In some cases, this medicine may also be employed in conjunction with other drugs as part of the treatment for certain types of cancer, both in the case of women and men.
There may be other uses for Kliane (Estradiol Hemihydrate), which are not covered in this leaflet. If you are interested to find out more about the possible uses of this product, it is recommended that you consult with a pharmacist or a specialized physician.
Kliane (Estradiol Hemihydrate) should not be administered to patients that are suffering from any type of disorder involving blood clots, or from circulatory / cardiac disorders. Patients who present an undiagnosed, abnormal vaginal bleeding may not start taking this medicine until they undergo medical examination and receive their physician's approval. Also, patients that have uterine cancer, breast cancer or any type of hormone-dependant cancer may not start a treatment with Kliane (Estradiol Hemihydrate).
Before you start a therapy course with this drug, it is strongly advised to inform your personal physician of any health problems you may be suffering from. In particular, affections such as hypertension, heart disease, angina, high triglyceride / cholesterol levels, renal or hepatic disease, asthma, migraines, epilepsy (or any other disorder involving seizures), diabetes or gallbladder disease should be mentioned, as well as past surgical procedures such as a hysterectomy. Patients suffering from these conditions may require special dosage adjustments or monitoring during the treatment.
Kliane (Estradiol Hemihydrate) may not be administered during pregnancy. Also, for the duration of the therapy you will need to employ an effective, non-hormonal contraceptive method.
Pharmaceutical products based on Estradiol (including Kliane (Estradiol Hemihydrate)) increase the patients' risk of developing an affection known as endometrial hyperplasia. This can be countered by administration of progestin medication. It is recommended that you consult with your doctor for more information.
You need to take Kliane (Estradiol Hemihydrate) exactly as directed by your health care specialist. You may take the tablets with a glass of water or with food to reduce stomach upset; however you may not chew, crush or break the tablets.
While following a treatment course with Kliane (Estradiol Hemihydrate) you will need to undergo regular medical examination, typically on a monthly basis. Also, you will need to regularly self-examine your breasts for the presence of lumps.
Your health care specialist will determine the Kliane (Estradiol Hemihydrate) dosage appropriate for your case by taking into consideration a number of factors, most of which are characteristic to you; as such, your medication dosage is very likely to be different from that of other patients'. Because of that, you should never use the Kliane (Estradiol Hemihydrate) dosage that has been prescribed to another patient - you may not obtain the desired results unless you employ the medication dosage best suited for your situation.
At the same time, your physician will inform you regarding the duration of the Kliane (Estradiol Hemihydrate) therapy and the number of daily intakes. Make sure that you understand all of his or her indications. If you have trouble understanding or remembering any of the dosage directions, you should ask your physician to assist you by providing additional information.
If an overdose with Kliane (Estradiol Hemihydrate) is suspected, immediately contact the nearest hospital as the patient may need emergency medical assistance. The most common signs of an overdose are vaginal bleeding, nausea and vomiting.
In the event that you miss taking one of your Kliane (Estradiol Hemihydrate) doses, take it when you remember before returning to your normal dosing schedule. However, you should skip taking the missed dose if it is almost time for another dose of the medicine. Consult with your physician if you have missed two or more intakes.
Side effects of a treatment with Kliane (Estradiol Hemihydrate) include nausea and vomiting, loss of appetite, swelling of the breasts, sex drive changes, impotence (in the case of men), abnormal vaginal bleeding, vaginal dryness, discomfort or pain, break-through bleeding, menstrual period changes, jaundice, sudden weakness or numbness, breast lumps. These are not all the signs and symptoms that may appear. It is best that you check with your doctor at any point during the course of your therapy if anything unusual occurs.
Although uncommon, allergic reactions to Kliane (Estradiol Hemihydrate) are possible. It is strongly recommended that you cease taking the medicine and contact your personal health care provider if you begin experiencing any of the characteristic symptoms - breathing difficulties, swelling of the throat, lips, tongue or face, rashes and hives.
Kliane (Estradiol Hemihydrate) may interact with Phenobarbital, Phenytoin, Ritonavir, Cimetidine, Carbamazepine, Rifampin, blood thinning agents such as Warfarin or with antibiotics (Clarithromycin, Erythromycin, Ketoconazole or Itraconazole). Also, this product may interact with the herbal remedy St. John's wort. These are not all the possible drug reactions; it is best that you tell your prescriber about any other drugs you are currently taking prior to starting your treatment. In most cases, an adjustment to the medication dosage will ensure the safety of the treatment, reducing the risk of accidental interactions.
Kliane (Norethindrone Acetate)® (norethindrone acetate tablets USP) - 5 mg oral tablets.
Kliane (Norethindrone Acetate)® (norethindrone acetate tablets USP), (17-hydroxy-19-nor-17α-pregn-4-en-20-yn-3-one acetate), a synthetic, orally active progestin, is the acetic acid ester of norethindrone. It is a white, or creamy white, crystalline powder. The structural formula is as follows:
C22H28O3 M.W. 340.46
Kliane (Norethindrone Acetate)® (norethindrone acetate tablets USP) contain the following inactive ingredients: anhydrous lactose, magnesium stearate, and microcrystalline cellulose.
Kliane induces secretory changes in an estrogen-primed endometrium. On a weight basis, it is twice as potent as norethindrone.
Kliane is completely and rapidly deacetylated to norethindrone (NET) after oral administration, and the disposition of Kliane (Norethindrone Acetate) is indistinguishable from that of orally administered norethindrone. Kliane (Norethindrone Acetate) is rapidly absorbed from Kliane (Norethindrone Acetate) tablets, with maximum plasma concentration of norethindrone generally occurring at about 2 hours post-dose. The pharmacokinetic parameters of norethindrone following single oral administration of Kliane (Norethindrone Acetate) in 29 healthy female volunteers are summarized in Table 1.
Pharmacokinetic Parameters after a Single Dose of
Kliane (Norethindrone Acetate)® in Healthy Women
Kliane (Norethindrone Acetate)® (n = 29) Arithmetic Mean ± SD
166.90 ± 56.28
26.19 ± 6.19
1.83 ± 0.58
8.51 ± 2.19
AUC = area under the curve,
Cmax = maximum plasma concentration,
tmax = time at maximum plasma concentration,
t1/2 = half-life,
SD = standard deviation
Figure 1. Mean Plasma Concentration Profile after a Single Dose of 5 mg Administered to 29 Healthy Female Volunteers under Fasting Conditions
The effect of food administration on the pharmacokinetics of Kliane (Norethindrone Acetate) has not been studied.
Norethindrone is 36% bound to sex hormone-binding globulin and 61% bound to albumin. Volume of distribution of norethindrone is about 4 L/kg.
Norethindrone undergoes extensive biotransformation, primarily via reduction, followed by sulfate and glucuronide conjugation. The majority of metabolites in the circulation are sulfates, with glucuronides accounting for most of the urinary metabolites.
Plasma clearance value for norethindrone is approximately 0.4 L/hr/kg. Norethindrone is excreted in both urine and feces, primarily as metabolites. The mean terminal elimination half-life of norethindrone following a single dose administration of Kliane is approximately 9 hours.
The effect of age on the pharmacokinetics of norethindrone after Kliane administration has not been evaluated.
The effect of race on the disposition of norethindrone after Kliane (Norethindrone Acetate) administration has not been evaluated.
The effect of renal disease on the disposition of norethindrone after Kliane administration has not been evaluated. In premenopausal women with chronic renal failure undergoing peritoneal dialysis who received multiple doses of an oral contraceptive containing ethinyl estradiol and norethindrone, plasma norethindrone concentration was unchanged compared to concentrations in premenopausal women with normal renal function.
The effect of hepatic disease on the disposition of norethindrone after Kliane (Norethindrone Acetate) administration has not been evaluated. However, Kliane (Norethindrone Acetate) is contraindicated in markedly impaired liver function or liver disease.
No pharmacokinetic drug interaction studies investigating any drug-drug interactions with Kliane (Norethindrone Acetate) have been conducted.
Kliane (Norethindrone Acetate) (norethindrone acetate tablets USP) is indicated for the treatment of secondary amenorrhea, endometriosis, and abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as submucous fibroids or uterine cancer. Kliane (Norethindrone Acetate) (norethindrone acetate tablets USP) is not intended, recommended or approved to be used with concomitant estrogen therapy in postmenopausal women for endometrial protection.
Patients with risk factors for arterial vascular disease (e.g., hypertension, diabetes mellitus, tobacco use, hypercholesterolemia, and obesity) and/or venous thromboembolism (e.g., personal history or family history of VTE, obesity, and systemic lupus erythematosus) should be managed appropriately.
Discontinue medication pending examination if there is a sudden partial or complete loss of vision or if there is sudden onset of proptosis, diplopia, or migraine. If examination reveals papilledema or retinal vascular lesions, medication should be discontinued.
Healthcare providers are advised to discuss the PATIENT INFORMATION leaflet with patients for whom they prescribe Kliane.
The following laboratory test results may be altered by the use of estrogen/progestin combination drugs:
Some beagle dogs treated with medroxyprogesterone acetate developed mammary nodules. Although nodules occasionally appeared in control animals, they were intermittent in nature, whereas nodules in treated animals were larger and more numerous, and persisted. There is no general agreement as to whether the nodules are benign or malignant. Their significance with respect to humans has not been established.
Kliane is contraindicated during pregnancy as it may cause fetal harm when administered to pregnant women. Several reports suggest an association between intrauterine exposure to progestational drugs in the first trimester of pregnancy and congenital abnormalities in male and female fetuses. Some progestational drugs induce mild virilization of the external genitalia of female fetuses.
Detectable amounts of progestins have been identified in the milk of mothers receiving them. Caution should be exercised when progestins are administered to a nursing woman.
Kliane (Norethindrone Acetate) tablets are not indicated in children.
See WARNINGS and PRECAUTIONS .
The following adverse reactions have been observed in women taking progestins:
Therapy with Kliane must be adapted to the specific indications and therapeutic response of the individual patient.
2.5 to 10 mg Kliane (Norethindrone Acetate) may be given daily for 5 to 10 days to produce secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen.
Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing Kliane (Norethindrone Acetate) therapy. Patients with a past history of recurrent episodes of abnormal uterine bleeding may benefit from planned menstrual cycling with Kliane (Norethindrone Acetate).
Initial daily dosage of 5 mg Kliane (Norethindrone Acetate) for two weeks. Dosage should be increased by 2.5 mg per day every two weeks until 15 mg per day of Kliane (Norethindrone Acetate) is reached. Therapy may be held at this level for six to nine months or until annoying breakthrough bleeding demands temporary termination.
Kliane (Norethindrone Acetate)® (norethindrone acetate tablets USP) is available as:
White, oval, flat-faced, beveled edge, tablet scored on one side. Debossed with 5 Kliane (Norethindrone Acetate) on the unscored side and stylized b / 424 on the scored side. Available in bottles of 50 tablets (NDC 51285-424-10).
Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required).
Store at 20º to 25ºC (68º to 77ºF).
KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.
TEVA WOMEN’S HEALTH, INC.
Subsidiary of TEVA PHARMACEUTICALS USA, INC.
North Wales, PA 19454
Rev. A 10/2015
Kliane (Norethindrone Acetate)®
(norethindrone acetate tablets USP)
Read this PATIENT INFORMATION before you start taking Kliane (Norethindrone Acetate) and read what you get each time you refill Kliane (Norethindrone Acetate). There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition.
What is the most important information I should know about Kliane (Norethindrone Acetate) (A Progestin Hormone)?
What is Kliane (Norethindrone Acetate)?
Kliane (Norethindrone Acetate) is similar to the progesterone hormones naturally produced by the body. Your healthcare provider may provide Kliane (Norethindrone Acetate) as individual tablets.
What are Kliane (Norethindrone Acetate) used for?
Kliane (Norethindrone Acetate) are used for the treatment of secondary amenorrhea (absence of menstrual periods in women who have previously had a menstrual period who are not pregnant), the treatment of endometriosis, and the treatment of irregular menstrual periods due to hormone imbalance.
Who should not take Kliane (Norethindrone Acetate)?
You should not take Kliane (Norethindrone Acetate) if you are postmenopausal, pregnant or breastfeeding.
You should not take Kliane (Norethindrone Acetate) if you have the following conditions:
What are the risks associated with Kliane (Norethindrone Acetate)?
Kliane (Norethindrone Acetate) should not be used if you are pregnant. Kliane (Norethindrone Acetate) are contraindicated during pregnancy as it may cause fetal harm when administered to pregnant women. There is an increased risk of minor birth defects in children whose mothers take this drug during the first 4 months of pregnancy. Several reports suggest an association between mothers who take these drugs in the first trimester of pregnancy and congenital abnormalities in male and female babies. Although it is not clear that these events were drug related, you should check with your healthcare provider about the risks to your unborn child of any medication taken during pregnancy.
You should avoid using Kliane (Norethindrone Acetate) during pregnancy. If you take Kliane (Norethindrone Acetate) and later find you were pregnant when you took it, be sure to discuss this with your healthcare provider as soon as possible.
Use of progestational drugs, such as Kliane (Norethindrone Acetate), has been associated with changes in the blood-clotting system. These changes allow the blood to clot more easily, possibly allowing clots to form in the bloodstream. If blood clots do form in your bloodstream, they can cut off the blood supply to vital organs, causing serious problems. These problems may include a stroke (by cutting off blood to part of the brain), a heart attack (by cutting off blood to part of the heart), a pulmonary embolus (by cutting off blood to part of the lungs), visual loss or blindness (by cutting off blood vessels in the eye), or other problems. Any of these conditions may cause death or serious long-term disability. Call your healthcare provider right away if you suspect you have any of these conditions. He or she may advise you to stop using the drug.
Discontinue Kliane (Norethindrone Acetate) tablets and call your healthcare provider right away if you experience sudden partial or complete loss of vision, blurred vision, or sudden onset of bulging eyes, double vision, or migraine.
These are some of the warning signs of serious side effects with progestin therapy
Call your healthcare provider right away if you get any of these warning signs, or any other unusual symptom that concerns you.
Common side effects include
Other side effects include
These are not all the possible side effects of progestin and/or estrogen therapy. For more information, ask your healthcare provider or pharmacist.
What can I do to lower my chances of getting a serious side effect with Kliane (Norethindrone Acetate)?
General information about the safe and effective use of Kliane (Norethindrone Acetate)
Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not take Kliane (Norethindrone Acetate) for conditions for which it was not prescribed. Do not give Kliane (Norethindrone Acetate) tablets to other people, even if they have the same symptoms you have. It may harm them.
Keep Kliane (Norethindrone Acetate) out of the reach of children.
This leaflet provides a summary of the most important information about progestin and/or estrogen therapy. If you would like more information, talk with your healthcare provider or pharmacist. You can ask for information about Kliane (Norethindrone Acetate) that is written for health professionals.
What are the ingredients in Kliane (Norethindrone Acetate)?
Kliane (Norethindrone Acetate) contain the following inactive ingredients: anhydrous lactose, magnesium stearate, and microcrystalline cellulose.
TEVA WOMEN’S HEALTH, INC.
Subsidiary of TEVA PHARMACEUTICALS USA, INC.
North Wales, PA 19454
Rev. A 10/2015
ORALLY ACTIVE PROGESTIN
PHARMACIST: PLEASE DISPENSE WITH
ATTACHED PATIENT INFORMATION LEAFLET.
TEVA WOMEN’S HEALTH
Depending on the reaction of the Kliane after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Kliane not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.Is Kliane addictive or habit forming?
Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
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The information was verified by Dr. Rachana Salvi, MD Pharmacology