Co-cyprindiol Tablets (Clairette, Dianette)
Hormonal treatment for severe acne and hirsutism in women, with contraceptive effects and important safety considerations.
Co-cyprindiol tablets, available as brands like Clairette and Dianette, are a combined hormonal treatment primarily prescribed for women with severe acne or hirsutism when contraception is also needed. This medication contains cyproterone acetate (an anti-androgen) and ethinylestradiol (a synthetic estrogen), which work together to reduce androgen effects on the skin while providing contraceptive protection.
| Type of medicine | A hormone treatment |
|---|---|
| Used for | Severe acne or hirsutism in women |
| Also called | Clairette®; Dianette® |
| Available as | Tablets |
About co-cyprindiol
Co-cyprindiol is specifically indicated as a second-line treatment for women aged 16 and over with severe acne unresponsive to antibiotics or moderately severe hirsutism. It addresses hormone imbalances by blocking androgen production and activity, which reduces excess oil production in the skin leading to acne and decreases unwanted facial or body hair growth associated with hirsutism.
The medication also acts as an effective contraceptive by inhibiting ovulation and thickening cervical mucus, making it suitable only for women who require both skin treatment and pregnancy prevention. However, it is not recommended solely for contraception due to a higher risk of venous thromboembolism (VTE) compared to standard combined oral contraceptives.
Treatment typically requires at least 3-4 months to show visible improvements in skin conditions, as acne and hirsutism are chronic issues influenced by hormonal cycles. Doctors should review progress regularly, and once the skin condition improves, switch to an alternative contraceptive if ongoing birth control is needed.
Before taking co-cyprindiol
Consult your doctor before starting co-cyprindiol, especially if you have risk factors for blood clots, certain medical conditions, or are taking other medications. This treatment carries a slightly elevated risk of thromboembolism, particularly in the first year of use.
Do not take co-cyprindiol if:
- You are allergic to cyproterone acetate, ethinylestradiol, or any ingredients in the tablets.
- You have or have had blood clots (e.g., deep vein thrombosis, pulmonary embolism).
- You have heart disease, severe liver disease, breast cancer, or endometrial cancer.
- You have uncontrolled high blood pressure, migraines with aura, or diabetes with vascular complications.
- You are pregnant or breastfeeding.
- You have systemic lupus erythematosus (SLE), porphyria, sickle cell disease, or inflammatory bowel disease.
Caution is needed in some people:
Inform your doctor if you have any of the following, as they may require monitoring or adjustments:
- History of depression, transient ischaemic attack (TIA), or haemolytic uraemic syndrome.
- Pregnancy-related issues like severe itching, jaundice, or jerky movements.
- Long periods of immobility (e.g., long-haul flights), which increase clot risk—exercise legs and consider compression socks.
- Upcoming surgery—stop treatment 4 weeks prior to reduce clot risk.
- Smoking, obesity, or family history of clots.
Co-cyprindiol may interact with medications like antibiotics, antifungals, St John’s wort, or seizure drugs, potentially reducing contraceptive efficacy. Use barrier methods during and 28 days after such treatments.
How to take co-cyprindiol
Always follow the patient information leaflet (PIL) supplied with the pack for detailed instructions.
- Start on the first day of your period: Take one tablet daily for 21 days, followed by 7 pill-free days. Repeat the cycle.
- Take at the same time each day for optimal contraceptive protection.
- If you miss a dose: Take it as soon as remembered, even if it means two tablets that day. Use condoms for 7 days if more than one pill is missed or during the last week.
- Vomiting or severe diarrhea within 3-4 hours of a dose reduces effectiveness—use backup contraception for 7 days.
- After the 7 pill-free days, expect withdrawal bleeding. Start the next pack regardless of bleeding.
Do not use additional hormonal contraceptives with co-cyprindiol, as this doubles estrogen dose and VTE risk.
Getting the most out of your treatment
Skin improvements may take 3-6 months. Continue for up to 12 months if effective, then reassess. Maintain good skincare: wash gently twice daily, avoid oily products, and use non-comedogenic moisturizers. For hirsutism, combine with hair removal methods like bleaching or electrolysis.
Long-term use beyond skin resolution is not advised due to VTE and potential depression risks. Switch to standard contraceptives post-treatment.
Side-effects
Most side effects are mild and improve over time, but monitor for serious ones.
| Common side-effects (affecting more than 1 in 10 people) | What can I do if I experience this? |
|---|---|
| Feeling sick (nausea), tummy pain | Eat simple meals, avoid rich/spicy food |
| Headaches | Rest, use pharmacist-recommended painkiller. Seek advice for severe headaches |
| Breast tenderness, weight gain, mood changes | Discuss with doctor if persistent |
| Migraines, skin rashes, fluid retention | Monitor and report to doctor |
Serious side-effects (uncommon but urgent): Stop immediately and seek medical help for chest pain, breathlessness, leg swelling/pain, severe headache, vision changes, jaundice, or depression with suicidal thoughts.
Depression is a known risk; some women report low mood or psychiatric changes. Stop and consult a doctor if severe.
VTE signs: leg pain/swelling, chest pain, coughing blood. Risk is higher than standard pills, especially first year or with travel/surgery.
Frequently Asked Questions (FAQs)
Can co-cyprindiol be used solely as a contraceptive?
No, it should not be prescribed only for contraception due to higher VTE risk. Use only for acne/hirsutism with contraceptive need.
How long does it take to work for acne?
Typically 3-4 months for noticeable improvement; full effects may take 6 months.
Does it protect against STIs?
No, use condoms for STI protection.
What if I miss the 7-day break?
Start next pack immediately; bleeding may be delayed.
Is it safe for smokers?
No, smoking increases clot risk—contraindicated over age 35 or heavy smokers.
References
- Co-cyprindiol tablets – Patient.info — Patient.info. 2023. https://patient.info/medicine/co-cyprindiol-tablets-clairette-dianette
- Cyproterone acetate with ethinylestradiol (co-cyprindiol) – GOV.UK — UK Government MHRA. 2013-01-31. https://www.gov.uk/drug-safety-update/cyproterone-acetate-with-ethinylestradiol-co-cyprindiol-balance-of-benefits-and-risks-remains-positive
- Dianette Patient Information Leaflet — medicines.org.uk (Bayer). 2023. https://www.medicines.org.uk/emc/files/pil.1122.pdf
- Co-cyprindiol PIL — medicines.org.uk. 2023. https://www.medicines.org.uk/emc/files/pil.9760.pdf
- Dianette (cyproterone acetate & ethinylestradiol) — Association for Psychotropic Drug Dependence (april.org.uk). 2023. https://www.april.org.uk/medicines-adverse-effects-adverse-reactions/dianette-depression-cocyprindiol-diane35-weeping-pill/
Similar Articles
Read full bio of Sneha Tete
