From the Guidelines
Diane-35, an oral contraceptive pill containing cyproterone acetate 2mg and ethinylestradiol 35mcg, is not recommended for women with hereditary angioedema caused by C1 inhibitor deficiency due to its potential to worsen the condition, as cyproterone acetate has been reported to exacerbate HAE-C1-INH 1. Instead, other progestins such as chlormadinone acetate or nomegestrol acetate may be considered as alternative options for women with HAE-C1-INH, as they have shown satisfactory results in some cases 1. When prescribing oral contraceptives, it is essential to weigh the risks and benefits, particularly in women with risk factors for venous thromboembolism, as the risk of blood clots is increased with COC use 1. The World Health Organization recommendations for COC usage eligibility should be considered, and caution should be exercised in women with certain medical conditions, such as hypertension, diabetes, or history of thromboembolism 1. In general, the use of COCs should be individualized, and women should be counseled on the potential risks and benefits, as well as the importance of adherence to the prescribed regimen 1. Key considerations for prescribing COCs include:
- Starting the pill on the same day as the visit or on the day following emergency contraception use
- Counseling on the use of back-up contraception or abstinence for at least 7 days
- Routine follow-up visits to address adverse effects or adherence issues
- Informing patients of common transient adverse effects, such as irregular bleeding, headache, and nausea
- Monitoring for potential contraindications, such as severe hypertension, ongoing hepatic dysfunction, or complicated valvular heart disease.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Diane OCP
- Diane is a type of oral contraceptive pill (OCP) that contains cyproterone acetate and ethinyl estradiol, used to treat symptoms of hyperandrogenism such as hirsutism, acne, and alopecia 2, 3, 4, 5, 6.
- The combination of cyproterone acetate and ethinyl estradiol has been shown to be effective in managing symptoms of hyperandrogenism, with response rates of 94% for acne, 85% for hirsutism, and 55% for alopecia 3.
- Studies have also demonstrated the efficacy of Diane in treating hyperandrogenic skin symptoms, including hirsutism, acne, seborrhea, and alopecia, with significant improvements in quality of life and psychological impairment 4.
- The safety and tolerability of Diane have been assessed, with most studies showing a low risk of adverse effects, including venous thromboembolism, which is comparable to that of third-generation combined oral contraceptives 2, 6.
- Diane has also been shown to have additional benefits, including cycle control and improvement in mood and perception of body image in some women 4.