Selectan

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Selectan uses


DESCRIPTION

Selectan® (norethindrone acetate tablets USP) - 5 mg oral tablets.

Selectan® (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

Selectan® (norethindrone acetate tablets USP) contain the following inactive ingredients: anhydrous lactose, magnesium stearate, and microcrystalline cellulose.

Selectan structural formula

CLINICAL PHARMACOLOGY

Selectan induces secretory changes in an estrogen-primed endometrium. On a weight basis, it is twice as potent as norethindrone.

Pharmacokinetics

Absorption

Selectan is completely and rapidly deacetylated to norethindrone after oral administration, and the disposition of Selectan is indistinguishable from that of orally administered norethindrone. Selectan is rapidly absorbed from Selectan 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 Selectan in 29 healthy female volunteers are summarized in Table 1.


Table 1

Pharmacokinetic Parameters after a Single Dose of

Selectan® in Healthy Women


Selectan® (n = 29) Arithmetic Mean ± SD


Norethindrone (NET)


AUC (0-inf)(ng/ml*h)


166.90 ± 56.28


Cmax (ng/ml)


26.19 ± 6.19


tmax (h)


1.83 ± 0.58


t1/2 (h)


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

Figure 1

Effect of Food

The effect of food administration on the pharmacokinetics of Selectan has not been studied.

Distribution

Norethindrone is 36% bound to sex hormone-binding globulin and 61% bound to albumin. Volume of distribution of norethindrone is about 4 L/kg.

Metabolism

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.

Excretion

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 Selectan is approximately 9 hours.

Special Populations

Geriatrics

The effect of age on the pharmacokinetics of norethindrone after Selectan administration has not been evaluated.

Race

The effect of race on the disposition of norethindrone after Selectan administration has not been evaluated.

Renal Insufficiency

The effect of renal disease on the disposition of norethindrone after Selectan 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.

Hepatic Insufficiency

The effect of hepatic disease on the disposition of norethindrone after Selectan administration has not been evaluated. However, Selectan is contraindicated in markedly impaired liver function or liver disease.

Drug Interactions

No pharmacokinetic drug interaction studies investigating any drug-drug interactions with Selectan have been conducted.

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INDICATIONS AND USAGE

Selectan (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. Selectan (norethindrone acetate tablets USP) is not intended, recommended or approved to be used with concomitant estrogen therapy in postmenopausal women for endometrial protection.

CONTRAINDICATIONS

WARNINGS

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PRECAUTIONS

General

Information for the Patient

Healthcare providers are advised to discuss the PATIENT INFORMATION leaflet with patients for whom they prescribe Selectan.

Drug/Laboratory Tests Interactions

The following laboratory test results may be altered by the use of estrogen/progestin combination drugs:

Carcinogenesis, Mutagenesis, and Impairment of Fertility

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.

Pregnancy

Category X

Selectan 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.

Nursing Mothers

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.

Pediatric Use

Selectan tablets are not indicated in children.

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ADVERSE REACTIONS

See WARNINGS and PRECAUTIONS .

The following adverse reactions have been observed in women taking progestins:

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DOSAGE AND ADMINISTRATION

Therapy with Selectan must be adapted to the specific indications and therapeutic response of the individual patient.

Secondary amenorrhea, abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology

2.5 to 10 mg Selectan 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 Selectan therapy. Patients with a past history of recurrent episodes of abnormal uterine bleeding may benefit from planned menstrual cycling with Selectan.

Endometriosis

Initial daily dosage of 5 mg Selectan for two weeks. Dosage should be increased by 2.5 mg per day every two weeks until 15 mg per day of Selectan is reached. Therapy may be held at this level for six to nine months or until annoying breakthrough bleeding demands temporary termination.

HOW SUPPLIED

Selectan® (norethindrone acetate tablets USP) is available as:


5 mg:


White, oval, flat-faced, beveled edge, tablet scored on one side. Debossed with 5 Selectan 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

PATIENT INFORMATION

Selectan®

(norethindrone acetate tablets USP)

Read this PATIENT INFORMATION before you start taking Selectan and read what you get each time you refill Selectan. 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 Selectan (A Progestin Hormone)?


What is Selectan?

Selectan is similar to the progesterone hormones naturally produced by the body. Your healthcare provider may provide Selectan as individual tablets.

What are Selectan used for?

Selectan 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 Selectan?

You should not take Selectan if you are postmenopausal, pregnant or breastfeeding.

You should not take Selectan if you have the following conditions:


What are the risks associated with Selectan?


Selectan should not be used if you are pregnant. Selectan 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 Selectan during pregnancy. If you take Selectan 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 Selectan, 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 Selectan 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 Selectan?


General information about the safe and effective use of Selectan

Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not take Selectan for conditions for which it was not prescribed. Do not give Selectan tablets to other people, even if they have the same symptoms you have. It may harm them.

Keep Selectan 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 Selectan that is written for health professionals.

What are the ingredients in Selectan?

Selectan 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

NDC 51285-424-10

Aygestin®

(norethindrone acetate

tablets USP)

ORALLY ACTIVE PROGESTIN

5 mg

PHARMACIST: PLEASE DISPENSE WITH

ATTACHED PATIENT INFORMATION LEAFLET.

Rx only

50 TABLETS

TEVA

TEVA WOMEN’S HEALTH

Selectan pharmaceutical active ingredients containing related brand and generic drugs:

Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Selectan available forms, composition, doses:

Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Selectan destination | category:

Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Selectan Anatomical Therapeutic Chemical codes:

A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Selectan pharmaceutical companies:

Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. Dailymed."AYGESTIN (NORETHINDRONE ACETATE) TABLET [TEVA WOMEN'S HEALTH, INC.]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  2. Dailymed."NORETHINDRONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  3. "norethindrone". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Selectan?

Depending on the reaction of the Selectan after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Selectan 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 Selectan 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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Review

sdrugs.com conducted a study on Selectan, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Selectan consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Rachana Salvi, MD Pharmacology

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