Ginet (Cyproterone/Ethinylestradiol)

Ginet tablets contain a combination of ethinyloestradiol, a synthetic oestrogen and cyproterone acetate, an antiandrogen, which work together to reverse the effects of too much androgen in women, like acne and hirsutism, while acting as a contraceptive.  

Ginet general information

What is Ginet used for?

Ginet tablets are used to treat women with severe signs of androgenisation (overproduction of androgen), that can result in conditions like hirsutism (unwanted hair) and androgenic alopecia (hair loss) both caused by excess androgen production.  These conditions are often accompanied by acne, inflammation and seborrhoea (greasy skin from too much sebum).  Ginet tablets reduce the symptoms of androgen-dependent conditions where oral antibiotic or local treatment alone has not been successful.  Ginet tablets can also be used for oral contraception at the same time as they are being used to treat androgen-dependent conditions, however, they should not be used for contraception alone.  Ginet tablets can also be used for the treatment of Polycystic Ovary Syndrome (PCOS), which is also caused by excess androgen and is usually accompanied by acne and hirsutism; also irregular or absent periods, infertility, recurrent miscarriage and obesity. 

How does Ginet work?

Ginet tablets contain a combination of ethinyloestradiol, a synthetic oestrogen, and cyproterone acetate, which is a derivative of progestagen and is also an antiandrogen.  These two hormones work together to reverse the effects of too much androgen, while at the same time protecting against pregnancy.  Although androgens, one of which is testosterone, are considered primarily male hormones, women also produce androgens, although in much lower amounts, in the ovaries, adrenal glands and fat cells.  Androgens have several functions in the female body, including puberty related changes like pubic hair growth, preventing bone loss, libido, and for the production of oestrogen.  However, some women produce too much androgen and this can cause hirsutism (unwanted hair) and other unwanted symptoms of androgen overproduction like acne and/or seborrhoea (greasy skin from too much sebum) and androgen-dependent alopecia (hair loss).  Polycystic Ovary Syndrome (PCOS) is also caused by over production of androgens in women.  Cyproterone in Ginet tablets blocks the production of androgens by the ovaries and binds to the androgen receptors on specific cells in the pilosebaceous unit in the skin, containing sebum glands and hair follicles, blocking the action of androgens like over stimulation of sebum and over production of hair.  The ethinyloestradiol component enhances the effect of cyproterone by reducing the amount of androgens in the circulation, relieving symptoms like acne and hirsutism.  The combination of a progestagen (cyproterone) and an oestrogen (ethinyloestradiol) in Ginet tablets, provides effective contraception, by blocking ovulation, preventing development of the endometrium so that a fertilised egg would not be able to implant and grow, and preventing the thinning of cervical secretions so that sperm cannot get through.  However, Ginet tablets should not be used solely as a contraceptive in women who are not being treated for over production of androgens and also should not be combined with use of another oral contraceptive.

What does Ginet contain?

Ginet tablets contains the active ingredients ethinyloestradiol (35mcg), a synthetic oestrogen, and cyproterone acetate (2mg), a progestagen and antiandrogen, which work together to reverse the effects of too much androgen, while at the same time protecting against pregnancy.  Each pack contains 21 yellow (active) tablets and 7 white (inactive) tablets.  The white inactive tablets also contain lactose, starch, microcrystalline cellulose, talc, magnesium stearate, colloidal anhydrous silica, hypromellose, titanium dioxide and propylene glycol.  The yellow active tablets also contain lactose, povidone, starch, talc, magnesium stearate, hypromellose, titanium dioxide, quinoline yellow, propylene glycol.

Treating overproduction of androgen with Ginet

Ginet tablets contain a combination of ethinyloestradiol, a synthetic oestrogen, and cyproterone acetate, which is a derivative of progestagen and is also an antiandrogen.  These two hormones work together to reverse the effects of too much androgen.  Although androgens, are primarily male hormones (like testosterone) women also produce androgens, although in much lower amounts, which are needed for puberty related changes like pubic hair growth, preventing bone loss, libido, and for the production of oestrogen.  However, some women produce too much androgen and this can cause over production of sebum (oil produced by sebum glands in the skin) which blocks hair follicles causing acne and/or seborrhoea (greasy skin from too much sebum).  Cyproterone in Ginet tablets blocks the production of androgens by the ovaries and binds to the androgen receptors on specific cells in the pilosebaceous units in the skin, containing sebum glands and hair follicles, blocking the over stimulation of sebum and over production of hair by the action of androgens.  The ethinyloestradiol component enhances the effect of cyproterone by reducing the amount of androgens in the circulation, relieving symptoms like acne. Polycystic Ovary Syndrome (PCOS) is also caused by excess androgen and is usually accompanied by acne and hirsutism; also irregular or absent periods, infertility, recurrent miscarriage and obesity.  Ginet tablets are also used to treat PCOS to relieve symptoms.

Ginet for contraception

Ginet tablets contain a combination of ethinyloestradiol, a synthetic oestrogen, and cyproterone acetate, which is a derivative of progestagen and is also an antiandrogen.  These two hormones work together to reverse the effects of too much androgen, while at the same time protecting against unwanted pregnancy.  The combination of a progestagen (cyproterone) and an oestrogen (ethinyloestradiol) in Ginet tablets, provides effective contraception, by blocking ovulation, preventing development of the endometrium so that a fertilised egg would not be able to implant and grow, and preventing the thinning of cervical secretions so that sperm cannot get through.  However Ginet tablets should not be used solely as a contraceptive in women who are not being treated for over production of androgens and should not be combined with use of another oral contraceptive.

What are the side effects of Ginet?

The most commonly reported side effects when taking Ginet tablets include breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, skin rash and itching, insomnia and depression.  Less common side effects include: migraine, fluid retention, changes in body weight, changes in libido.

When should Ginet not be used?

You should not use Ginet tablets if you:

• are allergic to ethinyloestradiol or cyproterone or any ingredients in Ginet
• are pregnant or are breastfeeding
• have a past or family history of carcinoma of the breast, endometrial carcinoma or liver disease
• have high blood pressure, lipid disorders or migraine
• have had deep venous thrombosis, thromboembolic disorders, heart attack or stroke
• have diabetes with changes to the blood vessels
• are a diabetic taking antidiabetics or insulin, without discussion with your doctor, as the cyproterone in Ginet 36 tablets may affect your glucose tolerance
• abnormal genital bleeding of unknown cause
• are taking other medications that may interact with Ginet, such as anticonvulsants like phenytoin and carbamazepin, barbiturates, anti-infectives like rifampicin, rifabutin, nevirapine, the antifungal griseofulvin, antibiotics like penicillin, preparations containing St John's Wort

What are the health risks of Ginet?

Combination contraceptive pills like Ginet tablets can increase risk of thrombosis (blood clots), which can have serious consequence depending on where the clot forms.  There is also an increased risk of breast cancer. 

How should Ginet be taken?

Each pack of Ginet tablets contains 21 yellow (active) tablets and 7 white (inactive) tablets.  You should take one tablet a day continually in the order directed.  During the last 7 days, when you will be taking the inactive tablets, you should have a menstrual bleed.  As soon as one pack is finished you start a new pack on the next day.  If you have gastrointestinal problems like vomiting or diarrhoea within 3-4 hours of taking a tablet, this is the same as missing a pill and you should take other contraceptive precautions for the next 7 days.  You should take your Ginet tablets continually for as long as your doctor recommends to ensure effective contraception.  It may take several months for your condition to clear up completely and longer for symptomatic relief of PCOS.  

Note: While you are taking Ginet tablets you should not use an additional hormonal contraceptive, as this will expose you to an excessive dose of hormones and is not necessary for effective contraception. 

How long should you take Ginet?

You should take your Ginet tablets continually for as long as your doctor recommends to ensure effective contraception.  It may take several months for your condition to clear up completely and longer for symptomatic relief of PCOS.  

Missed dose of Ginet

If you forget to take your Ginet tablets follow the instructions below.  The more tablets you have missed, the greater the risk that you are protected from pregnancy, particularly high risk if you miss yellow active tablets in the first 21 days.

White inactive tablets (last 7 days)

If you have forgotten to take one or more of the White inactive tablets (last 7 days) then skip the missed dose and take your next tablet on the next day as usual.

Yellow active tablets (first 21 days)

• If you are less than 12 hours late, take your tablet as soon as you remember and take the next one at your usual time, you are still protected against pregnancy. 
• If you are more than 12 hours late, you will not be protected from pregnancy.  Take the last tablet as soon as you remember and take the next one at your normal time.  This may mean taking 2 tablets in one day. You must take extra contraceptive precautions for the next 7 days.

How should Ginet be stored?

You should store your Ginet below 25°C in a cool dry place.