What are Ryeqo and Vissane?

Ryeqo and Vissane: Medications for Endometriosis and Uterine Fibroids

Ryeqo and Vissane are combination medications containing dienogest, a progestogen with strong endometrial efficacy, used primarily for treating endometriosis-associated pain and uterine fibroids.

Dienogest: The Common Active Ingredient

• Dienogest is a 19-nortestosterone derivative (C-19 progestogen) with a cyanomethyl group at the C-17 position instead of an ethinyl group, which may result in fewer hepatic effects compared to other nortestosterone derivatives 1
• It exhibits highly selective binding to the progesterone receptor with significant progestational and antiandrogenic activity 2
• Dienogest has a short plasma half-life of approximately 10 hours, preventing drug accumulation, and high oral bioavailability exceeding 90% 1

Mechanism of Action

• Dienogest inhibits ovulation, produces secretory transformation of the endometrium, and has antiproliferative effects 2
• It demonstrates strong endometrial efficacy, providing high menstrual cycle stability when combined with estrogens 1
• The medication has antiproliferative and anti-inflammatory effects on endometriotic lesions 1

Clinical Applications

• Dienogest 2 mg daily has been studied for treating endometriosis in adolescents and adults, showing substantial reduction in endometriosis-associated pain 3
• In one study, mean endometriosis-associated pain scores decreased from 64.3 mm to 9.0 mm (on a visual analog scale) after 48 weeks of treatment 3
• Unlike GnRH analogues, dienogest maintains some estradiol levels, which helps preserve bone mineral density and other beneficial estrogen effects 1

Safety Considerations

• The most common adverse effects are typical of progestogens but notably lack androgenic side effects 2
• In adolescents, a 52-week study showed a mean decrease in lumbar bone mineral density of 1.2%, with partial recovery observed 6 months after treatment discontinuation 3
• Dienogest has minimal clinically significant effects on metabolic, lipid, and hemostatic parameters 2
• Special consideration is needed for adolescents due to the critical nature of bone accretion during this developmental period 3

Distinguishing Between Similar Drug Names

• Confusion between similar drug names is a common cause of medication errors 4
• It's important to note that Ryeqo and Vissane are distinct formulations containing dienogest, and should not be confused with other medications with similar names 4
• When prescribing these medications, clear written instructions and patient education about the nature and risks of therapy are essential 4

Monitoring Recommendations

• Regular assessment of bone mineral density may be warranted, particularly in adolescents or those on long-term therapy 3
• Monitoring for improvement in endometriosis-associated pain using standardized pain scales can help assess treatment efficacy 3
• Patients should be educated about potential side effects and the importance of adherence to the prescribed regimen 4