Primolut N

Primolut N Tablet Uses

Primolut N tablets contain norethisterone, which belongs to a group of hormone medicines known as progestogens. It can be prescribed for:

• Treating irregular, painful, or heavy periods
• Treating premenstrual syndrome (PMS), also known as premenstrual tension (PMT)
• Treating endometriosis, where tissue like the womb lining grows outside the womb
• Delaying periods

How Does Primolut N Work for Heavy and Painful Periods?

Primolut N contains norethisterone, a man-made version of progesterone. Progesterone is one of the hormones that controls your menstrual cycle. Norethisterone acts similarly to progesterone, but it is better at stopping ovulation (the monthly release of an egg).

This affects heavy and painful periods in different ways:

• Heavy periods: your womb lining builds up during each cycle, and a drop in progesterone near the end of the cycle causes it to shed as a period. Norethisterone keeps hormone levels up, so the lining stays in place, and bleeding is controlled. When you stop taking the tablets, hormone levels fall, and you usually have a bleed similar to a normal period.
• Painful periods: period pain that has no underlying cause is almost always eased by stopping ovulation. Taking Primolut N for a set number of days each cycle prevents ovulation.

How Long Does Primolut N Take to Work?

How quickly Primolut N works depends on why it has been prescribed:

• Heavy or irregular bleeding: if you've been prescribed a 10-day course to stop bleeding, it usually stops within 1 to 3 days. Keep taking the tablets for the full 10 days, even if the bleeding stops sooner or some light bleeding returns. You should then have a bleed similar to a normal period 2 to 4 days after your last tablet.
• Painful periods: treatment usually runs for three to four cycles, followed by a break from treatment. There is no set timeframe for when the pain starts to ease.
• Endometriosis and PMS: these are treated over several cycles or months, rather than as a short course.

If heavy bleeding doesn't stop while you are taking Primolut N as prescribed, or comes back heavily during the course, contact your doctor. Something else may be causing the bleeding, and it will need to be checked.

How Effective is Primolut N for Heavy Bleeding?

Primolut N has been shown to reduce heavy bleeding, with results varying depending on how it is taken.

In a UK trial, women with heavy, regular periods that had no identified cause took norethisterone 5mg three times a day, from day 5 to day 26 of their cycle, for three cycles. On average, their menstrual blood loss fell by 87%, to within normal limits. However, only 22% of the women taking norethisterone wanted to continue after three cycles, compared with 76% of those given a hormonal coil.

A 2019 review of 15 trials looked at both shorter courses (taken only in the second half of the cycle) and longer courses of progestogen tablets like Primolut N. It found that both reduced blood loss less than tranexamic acid or the hormonal coil, though much of the evidence in that review was of low or very low quality.

Your prescriber will consider this when deciding whether Primolut N is the right treatment for you.

How to Take Primolut N Tablets

Swallow the tablets whole with a drink of water. The number of tablets you will need to take and when to take them will depend on why you have been prescribed them. A common dose is about 2-3 tablets per day.

For some conditions, you need to take Primolut N every day, though this isn't always the case. Always take the medication exactly as prescribed and check with your clinician or doctor if you are ever unsure.

If You Take Too Many Primolut N Tablets

Taking too many tablets is unlikely to cause serious problems; however, contact your doctor for advice.

If You Forget a Dose of Primolut N

If you forget to take Primolut N when you should, wait until it's time to take the next prescribed dose. Do not take the missed dose or try to double up. If you are worried, contact your clinician or doctor.

Side Effects of Primolut N

Primolut N can cause side effects, though not everyone will experience them. Some can be quite common, while others will result in you having to stop treatment altogether. It's important to understand what to expect when using the treatment so you can make an informed decision about whether it is suitable for you.

General Side Effects

The table below outlines some common side effects of Primolut N tablets:

Primolut N can also result in rare and very rare side effects, including:

• Allergic reactions, including skin rash or hives
• Visual disturbances
• Difficulty breathing

Please note that the above is not a complete list of possible adverse reactions from Primolut N tablets. More details are in the Patient Information Leaflet that comes with the medication. If you experience side effects, you can report them to your clinician or via the MHRA's Yellow Card scheme.

Serious Side Effects

You should stop taking Primolut N tablets immediately and contact your doctor if:

• You become pregnant
• You develop jaundice or other liver problems
• You develop itching
• Your doctor finds your blood pressure is too high

You should also see a doctor as soon as possible if you get severe stomach pain that does not go away.

Primolut N and Blood Clots

The main ingredient in Primolut N tablets (norethisterone) is partially converted into oestrogen, so it's important to consider general warnings given for combined oral contraceptive pills. The risk of blood clots in veins and arteries is slightly higher in women who take these medications than in those who don't, so you should not use Primolut N if you have a blood clot or any medical condition that makes you more susceptible to developing one.

Signs of a blood clot include:

• A migraine for the first time or one that is worse than normal
• Unusually frequent or severe headaches
• Any sudden changes to your eyesight, such as loss of vision or blurred vision
• Any sudden changes to your hearing or speech, or sense of smell, taste or touch
• Pain or swelling in your leg
• Stabbing pain when you breathe
• Coughing for no clear reason
• Breathlessness
• Pain or tightness in your chest
• Sudden weakness or numbness on one side or part of your body
• Dizziness or fainting

If you notice any of these signs, stop taking Primolut N and see a doctor as soon as possible. Do not start taking it again until your doctor says it is safe.

You are more at risk of developing a blood clot:

• As you get older
• If you or a close family member have had a blood clot
• If you are overweight (BMI of 30 or more)
• If you smoke
• If you have recently had a baby
• If you're off your feet for a long time because of surgery, injury, or illness

If you have a major operation, leg surgery or treatment for varicose veins planned, you will need to stop taking Primolut N six weeks beforehand.

Some medical conditions, including high blood pressure, diabetes and migraines, can also increase your risk. You can find the full list in the Primolut N Patient Information Leaflet. Taking Primolut N may add to this risk, so tell your prescriber if any of these apply to you.

Primolut N Tablets Interactions and Warnings

Primolut N is not suitable for everyone. Before starting treatment, it's important to know which medical conditions and other medicines could make it unsafe for you.

You should not take Primolut N if you:

• Are allergic to norethisterone or any other ingredient in this medication
• Are pregnant or think you may be pregnant
• Are breastfeeding
• Have ever had a problem with blood circulation
• Have any symptoms of a blood clot
• Have any condition that makes you more at risk of a blood clot
• Have ever suffered migraines with visual disturbance
• Have (or are recovering from) a liver disease and liver function blood tests show it is not yet working normally
• Have or have ever had liver tumours
• Have any type of cancer that might be worsened by exposure to female sex hormones
• Have problems with undiagnosed genital bleeding
• Have a condition called endometrial hyperplasia that has not yet been treated
• Have diabetes with damaged blood vessels
• Have hepatitis C and are taking medicines containing ombitasvir/paritaprevir/ritonavir and dasabuvir
• Had severe pruritus or idiopathic jaundice (yellowing of the skin or itching all over your body) during pregnancy

Precautions Before Taking Primolut N

There are several circumstances where you should speak to your clinician or doctor before starting Primolut N. These include if you:

• Are a smoker
• Have diabetes
• Have high blood pressure
• Have previously suffered from depression
• Are overweight (BMI of 30+)
• Have high levels of cholesterol or triglycerides (fats) in your blood, or a close family member does
• Have had a blood clot, or a close family member has had a blood clot, heart attack or stroke at a young age
• Suffer from migraine, asthma, or kidney problems
• Have an intolerance to some types of sugar

Please note that this is not an exhaustive list. More details can be found within the Patient Information Leaflet that comes with the medication.

Primolut N and Other Medicines

Some medicines can make Primolut N less effective, influence blood levels, or cause unexpected bleeding when taken together. Therefore, tell your clinician or doctor about any other medications you're using before starting treatment. This includes over-the-counter and herbal medicines.

You should especially inform your clinician if you are using medicines used to treat:

• Epilepsy
• Tuberculosis
• HIV and Hepatitis C Virus infections
• Fungal infections
• Bacterial infections
• Certain heart diseases
• High blood pressure
• Arthritis or arthrosis
• High blood pressure in blood vessels in the lung

You should also tell them if you're using St John's wort or are drinking grapefruit juice.

Primolut N can also affect how some other medicines work, including:

• Lamotrigine, used for epilepsy, which could lead to more frequent seizures
• Ciclosporin
• Theophylline, used for breathing problems
• Tizanidine, used for muscle pain or cramps

More details about potential interactions between Primolut N and other medicines can be found in the Patient Information Leaflet.

Pregnancy and Breastfeeding

Do not take Primolut N tablets if you are pregnant or breastfeeding. If you think you might be pregnant or are planning to have a baby, speak to your clinician or doctor before starting treatment. If you do not have a period after finishing a course of Primolut N, make sure you are not pregnant before taking any more tablets.

Frequently Asked Questions About Primolut N Tablets