What is the composition of Primalut N (norethisterone), a synthetic progestogen, in the treatment of hormonal imbalances in adult females?

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Primalut N Tablet Composition

Primalut N contains norethisterone (also called norethindrone) as its active ingredient, typically formulated as 5 mg tablets of norethisterone or norethisterone acetate, which is a synthetic progestogen derived from 19-nortestosterone. 1

Active Pharmaceutical Ingredient

  • Norethisterone (norethindrone) is the sole active component, classified as a normethyltestosterone derivative progestin with mild androgenic activity 1
  • The standard formulation contains 5 mg norethisterone per tablet, though 10 mg formulations also exist for specific indications 1
  • Norethisterone belongs to the estrane group of 19-nortestosterone derivatives, distinguishing it from progesterone-derived progestins 2

Inactive Ingredients (Typical Formulation)

Based on norethisterone tablet formulations, inactive ingredients commonly include: 3

  • Corn starch
  • Lactose anhydrous
  • Microcrystalline cellulose
  • Povidone
  • Magnesium stearate
  • Sodium starch glycolate
  • Talc
  • Ethyl cellulose
  • Coloring agents (may vary by manufacturer)

Pharmacological Classification

  • Norethisterone is a synthetic progestogen with potent antigonadotropic properties when used at doses of 5-10 mg daily 1
  • At therapeutic doses (5-15 mg daily), it functions as a potent antigonadotropic agent with mild androgenic activity, distinguishing it from pure progestational molecules 1, 2
  • Unlike natural progesterone, norethisterone can display metabolic and vascular side effects related to its androgenic potency, though these are less pronounced than with danazol 1

Clinical Dosing Context

  • For menstrual regulation and hormonal imbalances, norethisterone is typically prescribed at 5 mg daily for 10-14 days per cycle 1
  • For menstrual suppression (such as during chemotherapy or thrombocytopenia), doses of 5-15 mg daily continuously may be used, though higher doses carry increased thrombotic risk 4
  • For hormone replacement therapy, norethisterone acetate 1 mg daily provides adequate endometrial protection with a superior cardiovascular profile compared to higher doses 1, 4

Important Pharmacological Distinctions

  • Norethisterone differs fundamentally from natural micronized progesterone, which has a more favorable cardiovascular and metabolic safety profile 1, 4
  • The androgenic properties of norethisterone can cause adverse effects on lipid profiles, vasomotion, and blood pressure, particularly when combined with ethinyl estradiol rather than natural estradiol 1
  • Norethisterone acetate (the acetate ester form) has enhanced oral bioavailability compared to natural progesterone but maintains similar androgenic effects 1, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Second-Line Progestogen Options

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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