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Co-cyprindiol: Indications, Dosing, Side Effects and Interactions
Co-cyprindiol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Co-cyprindiol: Indications, Dosing, Side Effects and Interactions
Co-cyprindiol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Moderate to severe acne vulgaris related to hyperandrogenism caused by polycystic ovary syndrome [adjunct in refractory acne], Moderately severe hirsutism for co-cyprindiol**
- **Females of childbearing potential** (By mouth): 1 tablet daily for 21 days, to be started on day 1 of menstrual cycle; subsequent courses repeated after a 7-day interval (during which withdrawal bleeding occurs), time to symptom remission, at least 3 months; review need for treatment regularly.
Cautions
For co-cyprindiol Cervical intraepithelial neoplasia or cancer; cholestasis with previous use of combined oral contraception-seek specialist advice before use; gallbladder disease-if medically treated or current, seek specialist advice before use; gene mutations associated with breast cancer (e.g. BRCA 1)-seek specialist advice before use; history of breast cancer-seek specialist advice before use; history of cholestasis during pregnancy; history of depression; inflammatory bowel disease; migraine; organ transplantation-when complicated, seek specialist advice before use; personal or family history of hypertriglyceridaemia (increased risk of pancreatitis); prolactinoma-seek specialist advice before use; risk factors for arterial thromboembolism; risk factors for cardiovascular disease; risk factors for venous thromboembolism; sickle-cell disease; systemic lupus erythematosus; undiagnosed breast mass-seek specialist advice before use; undiagnosed vaginal bleeding Cautions, further information Venous thromboembolism There is an increased risk of venous thromboembolism in females taking co-cyprindiol, particularly during the first year of use. The incidence of venous thromboembolism is 1.5-2 times higher in females using co-cyprindiol than in females using oral combined hormonal contraceptives containing levonorgestrel, but the risk may be similar to that associated with use of oral combined hormonal contraceptives containing third generation progestogens (desogestrel and gestodene) or drospirenone. For more information about the risk factors for venous thromboembolism, see cautions for combined hormonal contraceptive preparations (e.g. ethinylestradiol with gestodene ). Cardiovascular disease Co-cyprindiol also slightly increases the risk of cardiovascular disease, such as myocardial infarction and ischaemic stroke. Females requiring co-cyprindiol may have an inherently increased risk of cardiovascular disease such as that associated with polycystic ovary syndrome. For more information about the risk factors for cardiovascular disease, see cautions for combined hormonal contraceptive preparations (e.g. ethinylestradiol with gestodene ).
Contraindications
For co-cyprindiol Acute porphyrias ; atrial fibrillation; Budd-Chiari syndrome; cardiomyopathy with impaired cardiac function; complicated congenital heart disease; complicated valvular heart disease; current breast cancer; history of stroke (including transient ischaemic attack); hypertension (blood pressure systolic 160 mmHg or diastolic 100 mmHg or higher); hypertensive retinopathy; ischaemic heart disease; known thrombogenic mutations (e.g. factor V Leiden, prothrombin mutation, protein S, protein C and antithrombin deficiencies); less than 3 weeks postpartum in non-breastfeeding women with other risk factors for venous thromboembolism; major surgery with prolonged immobilisation; migraine with aura; peripheral vascular disease with intermittent claudication; positive antiphospholipid antibodies; presence or history of liver tumours (benign or malignant); previous or current venous or arterial thrombosis; severe or multiple risk factors for arterial or venous thromboembolism; smoking in patients aged 35 years and over (15 or more cigarettes daily); systemic lupus erythematosus with antiphospholipid antibodies
Side effects
For co-cyprindiol Common or very common Abdominal pain; breast abnormalities; depression; headaches; mood altered; nausea; weight changes Uncommon Diarrhoea; fluid retention; sexual dysfunction; skin reactions; vomiting Rare or very rare Contact lens intolerance; erythema nodosum; thromboembolism; vaginal discharge Frequency not known Amenorrhoea (on discontinuation); angioedema aggravated; chorea exacerbated; hepatic function abnormal; hepatic neoplasm; hypertension; hypertriglyceridaemia; inflammatory bowel disease; menstrual cycle irregularities; suicidal behaviours
Pregnancy
For co-cyprindiol Avoid-risk of feminisation of male fetus with cyproterone.
Breast feeding
For co-cyprindiol Manufacturer advises avoid; possibility of anti-androgen effects in neonate with cyproterone.
Hepatic impairment
For co-cyprindiol Manufacturer advises caution; avoid in severe or active disease
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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