Norethisterone 5 mg tablets – patient leaflet, side effects, dosage

1. What Norethisterone tablets is and what it is used for

Norethisterone tablets contains Norethisterone, which belongs to a group of medicines called progestogens, which are female hormones.

Norethisterone tablets can be used in several different circumstances:

• to treat irregular, painful or heavy periods
• to treat endometriosis (where tissue from the lining of the womb is present in places where it is not normally found)
• to treat premenstrual syndrome (also known as premenstrual tension, PMS or PMT)
• to delay periods

You must talk to a doctor if you do not feel better or if you feel worse.

2. What you need to know before you take Norethisterone tablets

• Your doctor will discuss your medical and family history with you. Your doctor will also need to check your blood pressure and make sure you are not pregnant. You may also need additional checks, such as a breast examination, that will be specific to your medical needs and/or concerns.

Do not take Norethisterone tablets:

• if you are allergic to norethisterone or any of the other ingredients of this medicine (listed in section 6).
• if you are pregnant or if you think you might be pregnant
• if you are breast-feeding or
• if you have ever had a problem with your blood circulation. This includes a blood clot (thrombosis) in the legs (deep vein thrombosis), lungs (pulmonary embolism), heart (heart attack), brain (stroke) or any other parts of the body
• if you have any symptoms of a blood clot, such as chest pain, unexplained and often sudden shortness of breath and/or cough
• if you have any condition which makes you more at risk of a blood clot (thrombosis)
• if you have ever suffered migraine with visual disturbance
• if you have (or are recovering from) a liver disease and the blood tests show that your liver is not yet working normally
• if you have (or have ever had) liver tumours
• if you have diabetes with damaged blood vessels
• if you have any type of cancer which might be made worse by exposure to female sex hormones (including breast cancer)
• if you have problems with genital bleeding for which the cause is not yet known
• if you have a condition called endometrial hyperplasia which has not been treated.

Do not use Norethisterone tablets if you have hepatitis C and are taking the medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir (see also in section “Other medicines and Norethisterone tablets”). In addition, do not take Norethisterone tablets if you have had any of the following conditions when you were pregnant:

• yellowing of the skin (idiopathic jaundice of pregnancy)
• itching of the whole body (pruritus of pregnancy) ►Tell your doctor if any of these apply to you and do not take Norethisterone tablets.

Warnings and precautions

Talk to your doctor or pharmacist before taking Norethisterone tablets:

• if you smoke
• if you have diabetes (metabolic disease with elevated blood sugar levels). Norethisterone tablets can produce changes in blood sugar levels. If you are diabetic, your doctor will check your blood sugar before starting treatment and regularly during treatment
• if you are overweight (BMI ≥ 30 kg/m²)
• if you have high blood pressure
• if you have a heart valve disorder or a certain heart rhythm disorder (heart problems)
• if you have had a thrombosis/embolism or anyone in your close family has had a thrombosis, a heart attack or a stroke at a young age
• if you suffer from migraine, asthma, or kidney problems
• if you suffer from epilepsy (see “Other medicines and Norethisterone tablets”)
• if you have an inflammation of your veins (superficial phlebitis)
• if you have varicose veins
• if anyone in your immediate family has had breast cancer

• if you have previously had a condition called chloasma where the skin on your face may develop brownish blotches. You may be advised to avoid exposure to the sun and to ultraviolet light while you are taking Norethisterone tablets

  • if you have previously suffered from depression
  • if you or someone in your close family has ever had high blood levels of cholesterol or triglycerides (fatty substances). High blood levels of fatty substances have been associated with an increased risk of developing pancreatitis (inflammation of pancreas)
  • if you have a disease of the liver or gall bladder
  • if you have certain rare medical conditions such as systemic lupus erythematosus (SLE), sickle cell disease, Crohn’s disease or ulcerative colitis
  • if you have haemolytic uremic syndrome (HUS)
  • if you have a condition that occurred for the first time or worsened during pregnancy or previous use of sex hormones (e.g. hearing loss, porphyria, or Sydenham's chorea)
  • if you have hereditary angioedema. Consult your doctor immediately if you experience symptoms of angioedema such as swollen face, tongue or throat, and/or difficulty swallowing, or hives, together with difficulty breathing. Products containing oestrogens may induce or worsen symptoms of angioedema
  • if you have an intolerance to some types of sugar (galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption)
  • if you are using other medications as mentioned in “Other Medicines and Norethisterone tablets”. ►Tell your doctor before you take Norethisterone tablets if any of these applies to you. Also tell your doctor if any of these conditions develop or worsen while you are taking Norethisterone tablets, because you may need to stop taking it.

Norethisterone tablets and blood clots:

The main ingredient in Norethisterone tablets (progestogen) is partly converted into oestrogen so you should also consider the general warnings given for combined oral contraceptive pills (“the Pill”). Do not take Norethisterone tablets if you have a blood clot or have any medical condition which makes you more at risk of developing clots.

The risk of blood clots occurring in the veins and arteries is slightly greater in women who take the combined oral contraceptive pill than in women who don’t. People do not always fully recover from such blood clots, which can cause strokes, heart attacks and bleeding into the brain (subarachnoid haemorrhage). In very rare cases these blood clots can be fatal.

You are more at risk of having a blood clot:

• as you get older
• if you’re off your feet for a long time because of major surgery, injury or illness.
• if you smoke
• if you or any of your close family have had blood clots
• if you are overweight (BMI ≥ 30 kg/m²)
• if you have a disorder of blood fat (lipid) metabolism
• if you have a blood disorder
• if you have high blood pressure
• if you suffer from migraines
• if you have a heart valve disorder or a particular type of irregular heartbeat (atrial fibrillation)
• if you have recently had a baby
• if you have diabetes
• if you have certain medical conditions such as systemic lupus erythematosus (SLE), sickle cell disease, Crohn’s disease or ulcerative colitis
• Tell your doctor if any of these apply to you. Taking Norethisterone tablets may add to this risk so it may not be suitable for you.

To reduce the risk of blood clots, treatment with Norethisterone tablets must be stopped:

• six weeks before any planned major operation
• before any surgery to the legs
• before medical treatment for varicose veins
• if you are going to be immobilised for a long time (e.g. if you need bed-rest after an accident or operation, or if you have a plaster cast on a broken leg)

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, speech, sense of smell, taste or touch
• pain or swelling in your leg
• stabbing pain when you breathe
• coughing for no apparent reason
• breathlessness
• pain and tightness in the chest
• sudden weakness or numbness in one side or part of your body
• dizziness or fainting.
• See a doctor as soon as possible if you notice any possible signs of blood clot. Do not take any more Norethisterone tablets until your doctor says you can. Norethisterone tablets and cancer

If you have breast cancer, or have had it in the past, you should not take combined oral contraceptives (the Pill). The Pill slightly increases your risk of breast cancer. This risk goes up the longer you’re on it, but returns to normal within about 10 years of stopping it. Because breast cancer is rare in women under the age of 40, the extra cases of breast cancer in current and recent Pill users is small. For example:

• Of 10,000 women who have never taken the Pill, about 16 will have breast cancer by the time they are 35 years old.
• Of 10,000 women who take the Pill for 5 years in their early twenties, about 17–18 will have breast cancer by the time they are 35 years old.
• Of 10,000 women who have never taken the Pill, about 100 will have breast cancer by the time they are 45 years old.
• Of 10,000 women who take the Pill for 5 years in their early thirties, about 110 will have breast cancer by the time they are 45 years old.

Your risk of breast cancer is higher if:

• you have a close relative (mother, sister or grandmother) who has had breast cancer
• you are overweight (BMI ≥ 30 kg/m²)
• See a doctor as soon as possible if you notice any changes in your breasts, such as dimpling of the skin, changes in the nipple or any lumps you can see or feel. Package leaflet: Information for the patient

Norethisterone 5mg Tablets

170 x 460

Very rarely, the Pill has been linked with some forms of liver cancer in women who take it for a long time. These may lead to bleeding in the abdomen.

Taking the Pill has also been linked to liver diseases, such as jaundice and non-cancerous liver tumours, but this is rare.

• See a doctor as soon as possible if you get severe pain in your stomach that does not go away, or yellow skin or eyes (jaundice). You may need to stop taking Norethisterone tablets.

Other medicines and Norethisterone tablets Tell your doctor if you are taking, have recently taken or might take any other medicines.

Some medicines

• can have an influence on the blood levels of Norethisterone tablets.
• can make it less effective.
• can cause unexpected bleeding.

These include:

• medicines used for the treatment of:
• epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbamazepine, topiramate, felbamate)
• tuberculosis (e.g. rifampicin)
• HIV and Hepatitis C Virus infections (so-called protease inhibitors and non-nucleoside reverse transcriptase inhibitors, e.g. ritonavir, nevirapine, efavirenz)
• fungal infections (griseofulvin, azole antifungals, e.g. itraconazole, voriconazole, fluconazole)
• bacterial infections (macrolide antibiotics, e.g. clarithromycin, erythromycin)
• certain heart diseases, high blood pressure (calcium channel blockers, e.g. verapamil, diltiazem)
• arthritis, arthrosis (etoricoxib)
• high blood pressure in the blood vessels in the lung (bosentan)
• the herbal remedy St. John’s wort (primarily used for the treatment of depressive moods)

• grapefruit juice

Norethisterone tablets may influence the effect of other medicines, e.g.:

• medicines containing ciclosporine
• the anti-epileptic lamotrigine (this could lead to an increased frequency of seizures)
• theophylline (used to treat breathing problems)
• tizanidine (used to treat muscle pain and/or muscle cramps)

Do not use Norethisterone tablets if you have Hepatitis C and are taking the medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir as this may cause increases in liver function blood test results (increase in ALT liver enzyme). Norethisterone tablets can be restarted approximately 2 weeks after completion of this treatment. See section “Do not use Norethisterone tablets”. Taking Norethisterone tablets can affect the results of some blood and urine tests. Tell your doctor that you are taking Norethisterone tablets if you are asked to provide a blood or urine sample.

Other things you should know:

Once you have finished taking a course of Norethisterone tablets, you will usually have a menstrual bleed (period) 2-3 days after taking your last tablet. If you do not have a period, you must make sure that you are not pregnant before taking any more tablets.

Pregnancy and breast-feeding

Do not take Norethisterone tablets if you are pregnant or breast-feeding. If you think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Driving and using machines

Norethisterone tablets is unlikely to affect your ability to drive or use machines.

3. How to take Norethisterone tablets

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is:

The number of tablets that you need to take and the number of days per month when you need to take them will depend on why the doctor has prescribed Norethisterone tablets. A common dosage would be 2-3 tablets each day. For some conditions Norethisterone tablets has to be taken every day, but this is not always the case.

Ask your doctor or pharmacist, if you are not sure about the number of tablets that you need to take, when they should be taken or how long you should take them for. Swallow the tablets whole with a drink of water. If you take more Norethisterone tablets than you should

Taking too many tablets is unlikely to cause serious problems. If you take too many, contact your doctor who will tell you what to do.

If you forget to take Norethisterone tablets

If you forget a dose, wait until it is time to take the next prescribed dose. Do not take a double dose to make up for a forgotten dose. If you are worried, contact your doctor or pharmacist.

If you stop taking Norethisterone tablets

Do not stop the treatment unless your doctor tells you so. Contact your doctor or pharmacist before stopping. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Reasons for stopping Norethisterone tablets immediately:

Stop taking Norethisterone tablets and speak to your doctor immediately if you experience any of the following:

• migraine for the first time
• unusually bad headaches, occurring more often than before
• sudden changes to your eyesight, hearing or speech
• sudden changes to your senses of smell, taste or touch
• symptoms of blood clot formation or symptoms of inflammation of the veins combined with the formation of blood clots (thrombophlebitis):

o unusual pains in your leg(s)

o unusual swelling of your arms or legs

o sharp pains in your chest or sudden shortness of breath

o crushing pains or feelings of heaviness or tightness in your chest

o coughing for no apparent reason

o one side of your body suddenly becoming very weak or numb

Norethisterone tablets must also be stopped immediately if:

• you become pregnant
• you develop jaundice or other liver problems
• you develop itching (pruritus)
• your doctor finds that your blood pressure is too high General side effects:

Side effects that have been reported with Norethisterone tablets are listed below according to the frequency with which they occur.

Very common side effects

(These may affect more than 1 in 10 people)

• Vaginal bleeding, including spotting.
• Periods that are much shorter than normal and where blood flow is reduced.

Common side effects

(These may affect up to 1 in 10 people)

• Headache
• Feeling sick (nausea)
• Absence of a period
• Swelling

Uncommon side effects

(These may affect up to 1 in 100 people)

• Migraine

Rare side effects

(These may affect up to 1 in 1,000 people)

• Allergic reactions including skin rash or “hives” Very rare side effects

(These may affect up to 1 in 10,000 people)

• Visual disturbances
• Difficulty in breathing

Other side effects

(Frequency not known: frequency cannot be estimated from the available data)

• Worsening of depression
• Dizziness
• Abdominal pain
• Jaundice
• Cholestasis

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Norethisterone tablets

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the label and carton. The expiry date refers to the last day of that month.
• This medicinal product does not require any special storage conditions.
• Do not use this medicine if you notice any visible signs of deterioration.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Norethisterone tablets contains

• The active ingredient is Norethisterone: Each tablet contains 5mg of Norethisterone.
• The other ingredients are cellulose microcrystalline, maize starch, ethyl cellulose and magnesium stearate. What Norethisterone tablets looks like and contents of the pack

White to off white, round shaped, flat tablets, beveled edge debossed ‘L’ on one side and ‘12’on another side. Norethisterone tablets are available in packs of 30, 72, 90 or 180 tablets.

Not all pack sizes may be marketed.

This leaflet was last revised in March 2026.