NYNA Tablet 10's

Introduction About NYNA TABLET

NYNA TABLET contains Norethisterone, which belongs to a group of medicines
called Progestogens. It is used to manage heavy menstrual bleeding or abnormal
uterine bleeding (that occurs due to hormonal imbalance), painful periods,
irregular periods or periods that are more frequent than normal
(polymenorrhoea), premenstrual tension, endometriosis (abnormal growth of
endometrial tissue of the uterus that causes pain and menstrual irregularities),
metriopatheias haemorrhagia (intermenstrual bleeding) and breast cancer. It is
also used to delay the menstrual cycle.

NYNA TABLET is not recommended for use in patients with pulmonary embolism
(blood clots in the lung), liver disease, heart attack (myocardial infarction)
or angina and deep vein thrombosis. NYNA TABLET should be used with caution in
patients with asthma, kidney disease, fits, and migraine headaches.

NYNA TABLET is not recommended for use during pregnancy as it may affect the
developing baby. Inform your doctor if you have had repeated miscarriages. NYNA
TABLET should be used with caution in breastfeeding women as it may pass through
the breast milk. If you experience mood changes and depressive symptoms, contact
your doctor as soon as possible.

The most common side effects of taking NYNA TABLET are irregular bleeding, heavy
menstruation, spotting between menstrual cycles, delayed or not having a
menstrual cycle, stomach discomfort, nausea, vomiting, breast tenderness,
headache, and dizziness. Contact your physician if the symptoms worsen

Uses Of NYNA TABLET

NYNA TABLET manages and manages:

• heavy periods
• painful periods
• irregular periods
• increased frequency of periods
• premenstrual tension
• endometriosis (a disease where the tissue lining the uterus, grows outside the uterus)
• breast cancer
• metropathia
• haemorrhagia (intermenstrual bleeding)
• abnormal uterine bleeding
• breast cancer
• to delay the next periods

How NYNA TABLET Works

NYNA TABLET inhibits the release of pituitary hormones that are responsible for
the release of female hormones (such as oestrogen and progesterone) and thereby
suppressing ovulation. This action modifies the lining of the endometrium and
thus ceases bleeding in menstrual abnormalities in cancer NYNA TABLET may act by
pituitary inhibition or by direct action on tumour deposits.

How to use NYNA TABLET

Follow the instructions given by your doctor. Take NYNA TABLET as advised
according to your symptoms and disease severity. Swallow the whole tablet with a
glass of water.

Side Effects Of NYNA TABLET

Common

• irregular bleeding, heavy menstruation
• spotting between menstrual cycles
• delayed or not having a menstrual cycle
• stomach discomfort, nausea, vomiting
• breast tenderness
• headache and dizziness

Rare

Stop taking NYNA TABLET and contact your doctor immediately if you experience
any of the following side effects:

• yellowing of the skin or white area of the eyes (jaundice)
• migraine headache for the very first time (a headache that usually restricts itself to one side of your head)
• high blood pressure
• symptoms of severe allergic reaction such as itchy skin rash, swelling of the face or tongue, hands or feet causing wheezing, difficulty breathing or feeling faint
• symptoms of a blood clot in the lungs include a sudden, severe, sharp pain in the chest, coughing up blood, shortness of breath, rapid heartbeats
• symptoms of a blood clot in the brain (stroke) include unusually severe or long headache, change in sight, difficulty speaking, collapsing, or fainting, and weakness or paralysis of any part of your body
• symptoms of a deep-vein thrombosis such as severe pain, tenderness or swelling in your calf, ankle or foot, purplish discolouration of the skin of the leg and red or warmth skin

How To Manage Side Effects

Nausea, vomiting:

Take the medicine with or just after a meal. Stick to simple meals. Avoid eating
oily or spicy foods. Contact your doctor if nausea and vomiting get worse.

Headache:

Rest and relax. Apply a pain-relieving balm to your forehead if needed. Do not
consume alcohol. Contact your doctor if your headache does not improve.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating machinery if
you feel dizzy. Avoid alcohol consum
your doctor if the dizziness worsens.

Stomach pain:

Try to rest and relax. Eat small meals but take them frequently. Keep a heating
pad on your stomach. Contact your doctor if the stomach pain does not improve.

Warning & Precautions

!### Pregnancy

NYNA TABLET is not recommended for use during pregnancy and if you have a
history of Idiopathic jaundice during pregnancy or an itchy rash or blisters on
the abdomen known as pemphigoid gestationis (rare autoimmune skin disorder in
pregnancy) and NYNA TABLET should be used with caution in patients with a
history of repeated miscarriages. Contact your doctor before taking NYNA TABLET.

!### Breastfeeding

NYNA TABLET should be used with caution in breastfeeding women as it may pass
through the breast milk. Contact your doctor before taking NYNA TABLET.

!### Driving and Using Machines

NYNA TABLET does not affect the ability to drive or operate machinery.

!### Kidney

NYNA TABLET should be used with caution in patients with kidney disease. Contact
your doctor before taking NYNA TABLET.

!### Liver

NYNA TABLET should be used with caution in patients with liver disease. Contact
your doctor before taking NYNA TABLET.

!### Allergy

Do not use NYNA TABLET if you are allergic to norethisterone, similar other
hormone medicines, or any other ingredients in the medicine.

!### Lungs

NYNA TABLET is not recommended for use in patients who have or had a pulmonary
embolism (blood clots in the lung) and should be used with caution in patients
with asthma. Contact your doctor before taking NYNA TABLET.

!### Heart Disease

NYNA TABLET is not recommended for use in patients with active or recent angina
(chest pain) or heart attack. Contact your doctor before takingNYNA TABLET.

Others

NYNA TABLET is not recommended for use if you have:

• blood disorders like porphyria
• clotting disorders like deep vein thrombosis or a family history of the same
• pruritis (a condition with severe generalised itching of the body)
• undiagnosed vaginal bleeding (not a period)

Before taking NYNA TABLET tell your doctor if you have:

• epilepsy
• migraine headache
• are very overweight
• systemic lupus erythematosus.
• a blood clot in the veins
• are unable to move for long periods (Ex. after an operation)
• serious injury
• have major surgery or are going to have an operation (particularly abdominal or orthopaedic surgery to the lower limbs)
• blood tests (for liver function, thyroid function, and coagulation).
• vision impairment, bulging eyes, double vision
• depression

Interactions

A. Drug-Drug Interactions:

• antiepile
• antibiotics ex. tetracyclines, co-trimoxazole, ampicillin, oxacillin (medicines used for bacterial infections)
• medicines used for tuberculosis (rifampicin, rifabutin)
• antiviral medicines for management of HIV (ritonavir, nelfinavir, efavirenz)
• anticancer medicines
• aminoglutethimide (used in Cushing’s syndrome)
• ciclosporin (immunosuppressants or medicines used to manage rejection of a transplanted organ)
• nonsteroidal anti-inflammatory drugs NSAID’s (medicines used for pain)
• medicines for managing high blood pressure (amlodipine, captopril, atenolol, telmisartan)
• st. john’s wort (medicines used to manage depression)

Overdosage:

If you or anyone else accidentally took more of NYNA TABLET, contact your doctor
immediately or visit a nearby hospital immediately if the symptoms worsen. The
symptoms may include nausea, vomiting, breast enlargement and vaginal bleeding.

Synopsis

Drug	:	Norethisterone
Pharmacological Category	:	Progestogens
Therapeutic Indication	:	Menstrual disorders and breast cancer
Dosage Forms	:	Tablet

More Information

• Keep NYNA TABLET below 25°C
• Keep NYNA TABLET out of sight and reach from children

FAQs About NYNA TABLET

Can NYNA TABLET affect the regular menstrual cycle?

NYNA TABLET is a synthetic form of the hormone progesterone. Rather than
allowing for the natural fall in progesterone during your period, NYNA TABLET
keeps your progesterone levels high. This delays the shedding of your womb
lining and the period.

When will my menstrual cycle start after taking NYNA TABLET?

Your doctor will advise you when to take NYNA TABLET and for how long. You'll
usually be prescribed 3 NYNA TABLET tablets a day, starting 3 to 4 days before
you expect your period to begin. Your period should arrive 2 to 3 days after you
stop taking the NYNA TABLET.

How long will NYNA TABLET take to stop bleeding?

If a period is very heavy or prolonged, your doctor may advise you to take NYNA
TABLET 5mg three times daily for 10 days. Bleeding will usually stop
within 24-48 hours of starting management.

What happens if I take NYNA TABLET too late?

It is important to take NYNA TABLET three days before your menstrual cycle. If
you take NYNA TABLET too late, it may delay your menstrual cycle.

Can NYNA TABLET cause mood depression?

Yes, NYNA TABLET may cause depressed mood, acne, breast tenderness, fluid
retention and loss of libido. Contact your doctor if you get any of the side
effects.

Useful Diagnostic Tests

• Complete blood count
• Thyroid functions
• HCG
• Pap smear