Last update: Feb. 15, 2016

Norethindrone

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Progestin contraceptive used as a single product or linked to ethinyl estradiol (see Etinilestradiol + Norethindrone).

Norethindrone is a progestin derivative of 19-nortestosterone. It is excreted in breast milk in clinically significant amount and no problems have been observed in infants whose mothers took it. Plasma levels of these infants were undetectable or very low.

Progestin is generally considered contraceptive drugs of choice during lactation since it neither alter the quantity and composition of milk nor cause side effects on both growth of infants and the duration of breastfeeding.
Published study results have shown protection against breast bone mass loss with the use of progestin-only contraceptives.

For the first 6 weeks postpartum, non-hormonal methods are of choise. There is a debate on the role of progestin-related drugs in decreasing milk production when used before lactation has been fully established.

The American Academy of Pediatrics states that this medication is usually compatible with breastfeeding.
WHO List of Essential Medicines 2002: rates it as compatible with breastfeeding after the 6th postnatal week.

Alternatives

We do not have alternatives for Norethindrone since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Norethindrone is also known as


Norethindrone in other languages or writings:

Group

Norethindrone belongs to this group or family:

Tradenames

Main tradenames from several countries containing Norethindrone in its composition:

  • Activella ™. Contains other elements than Norethindrone in its composition
  • Activelle™. Contains other elements than Norethindrone in its composition
  • Amabelz™. Contains other elements than Norethindrone in its composition
  • Aygestin
  • Cliane™. Contains other elements than Norethindrone in its composition
  • Climagest™. Contains other elements than Norethindrone in its composition
  • Clinorette™. Contains other elements than Norethindrone in its composition
  • Cliovelle™. Contains other elements than Norethindrone in its composition
  • CombiPatch™. Contains other elements than Norethindrone in its composition
  • Estalis™. Contains other elements than Norethindrone in its composition
  • Estragest™. Contains other elements than Norethindrone in its composition
  • Eviana™. Contains other elements than Norethindrone in its composition
  • Evorel Conti™. Contains other elements than Norethindrone in its composition
  • Ginediol™. Contains other elements than Norethindrone in its composition
  • Jolivette
  • Kliofem™. Contains other elements than Norethindrone in its composition
  • Kliogest™. Contains other elements than Norethindrone in its composition
  • Kliovance™. Contains other elements than Norethindrone in its composition
  • Merigest™. Contains other elements than Norethindrone in its composition
  • Mesigyna™. Contains other elements than Norethindrone in its composition
  • Micronor
  • Nor-QD
  • Norcolut (Норколут)
  • Noret
  • Noriday
  • Noristerat
  • Nostidyn™. Contains other elements than Norethindrone in its composition
  • Ortho Micronor
  • Primolut N
  • Primolut-Nor
  • Primolut-Nor (Примолют-Нор)
  • Selectan
  • Sequidot™. Contains other elements than Norethindrone in its composition
  • Systen Conti™. Contains other elements than Norethindrone in its composition
  • Systen Sequi™. Contains other elements than Norethindrone in its composition
  • Trisekvens™. Contains other elements than Norethindrone in its composition

Pharmacokinetics

Variable Value Unit
Bioavailability 70 %
Molecular weight 298 daltons
Protein Binding 97 %
VD 4 l/Kg
Tmax 1,8 hours
T1/2 8,5 hours
M/P ratio 0,3 -
Theoretical Dose 0,0001 mg/Kg/d
Relative Dose 2,2 %

References

  1. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Abstract
  2. Tepper NK, Phillips SJ, Kapp N, Gaffield ME, Curtis KM. Combined hormonal contraceptive use among breastfeeding women: an updated systematic review. Contraception. 2015 Abstract
  3. Bhardwaj NR, Espey E. Lactation and contraception. Curr Opin Obstet Gynecol. 2015 Abstract
  4. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  5. WHO. Department of Reproductive Health and Research World Health Organization. Medical Eligibility Criteria for Contraceptive Use. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  6. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Abstract
  7. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  9. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Abstract Full text (link to original source) Full text (in our servers)
  10. Hall KS, Trussell J, Schwarz EB. Progestin-only contraceptive pill use among women in the United States. Contraception. 2012 Abstract
  11. Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Abstract Full text (link to original source) Full text (in our servers)
  12. [No authors listed] Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009 Abstract
  13. Taneepanichskul S, Reinprayoon D, Thaithumyanon P, Praisuwanna P, Tosukhowong P, Dieben T. Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants. Contraception. 2006 Abstract
  14. Díaz S. Contraceptive implants and lactation. Contraception. 2002 Abstract
  15. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  16. Reinprayoon D, Taneepanichskul S, Bunyavejchevin S, Thaithumyanon P, Punnahitananda S, Tosukhowong P, Machielsen C, van Beek A. Effects of the etonogestrel-releasing contraceptive implant (Implanon on parameters of breastfeeding compared to those of an intrauterine device. Contraception. 2000 Abstract
  17. Lawrie TA, Hofmeyr GJ, De Jager M, Berk M, Paiker J, Viljoen E. A double-blind randomised placebo controlled trial of postnatal norethisterone enanthate: the effect on postnatal depression and serum hormones. Br J Obstet Gynaecol. 1998 Abstract
  18. Shaaban MM. Contraception with progestogens and progesterone during lactation. J Steroid Biochem Mol Biol. 1991 Abstract
  19. Betrabet SS, Shikary ZK, Toddywalla VS, Toddywalla SP, Patel D, Saxena BN. ICMR Task Force Study on hormonal contraception. Transfer of norethisterone (NET) and levonorgestrel (LNG) from a single tablet into the infant's circulation through the mother's milk. Contraception. 1987 Abstract
  20. Cooke ID, Back DJ, Shroff NE. Norethisterone concentration in breast milk and infant and maternal plasma during ethynodiol diacetate administration. Contraception. 1985 Abstract
  21. West CP. The acceptability of a progestagen-only contraceptive during breast-feeding. Contraception. 1983 Abstract
  22. Fotherby K, Towobola O, Muggeridge J, Elder MG. Norethisterone levels in maternal serum and milk after intramuscular injection of norethisterone oenanthate as a contraceptive. Contraception. 1983 Abstract
  23. Koetsawang S, Nukulkarn P, Fotherby K, Shrimanker K, Mangalam M, Towobola K. Transfer of contraceptive steroids in milk of women using long-acting gestagens. Contraception. 1982 Abstract
  24. Melis GB, Strigini F, Fruzzetti F, Paoletti AM, Rainer E, Düsterberg B, Fioretti P. Norethisterone enanthate as an injectable contraceptive in puerperal and non-puerperal women. Contraception. 1981 Abstract
  25. Toddywalla VS, Mehta S, Virkar KD, Saxena BN. Release of 19-nor-testosterone type of contraceptive steroids through different drug delivery systems into serum and breast milk of lactating women. Contraception. 1980 Abstract
  26. Seth U, Yadava HS, Agarwal N, Laumas KR, Hingorani V. Effect of a subdermal silastic implant containing norethindrone acetate on human lactation. Contraception. 1977 Abstract
  27. Saxena BN, Shrimanker K, Grudzinskas JG. Levels of contraceptive seroids in breast milk and plasma of lactating women. Contraception. 1977 Abstract
  28. Giner Velázquez J, Cortés Gallegos V, Sotelo López A, Bondani G. [Effect of daily oral administration of 0.350 mg of norethindrone on lactation and on the composition of milk]. Ginecol Obstet Mex. 1976 Abstract
  29. Karim M, Ammar R, el-Mahgoub S, el-Ganzoury B, Fikri F, Abdou I. Injected progestogen and lactation. Br Med J. 1971 Abstract Full text (link to original source) Full text (in our servers)

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