Are you having difficulty carrying out your daily activities due to heavy menstrual bleeding caused by uterine fibroids? Or are you suffering from unbearable pain caused by endometriosis? Today we are talking about a special medicine that doctors recommend to treat such conditions. The brand name of this is Myfembree.
What does this pill contain?
This is actually a combination of three drugs. That means there are three main ingredients in one pill. Let's see what they are and what they do.
1. Relugolix: Simply put, this works by reducing the production of certain hormones in your body, such as estrogen. When these hormone levels are reduced, heavy bleeding and pain are controlled.
2. Estradiol: As mentioned above, Relugolix reduces the estrogen hormone, which can lead to bone loss over time. The hormone Estradiol is added to this to reduce that risk.
3. Norethindrone: This is a type of hormone called progestin. Norethindrone helps reduce the very small risk of some types of cancer (e.g., uterine cancer) when estradiol is used alone.
That means, while this medicine controls your symptoms on the one hand, it also reduces other risks that may arise from that control.
Things you need to tell your doctor before starting medication
It is important for your doctor to know your complete health history before deciding if this medication is right for you. Be sure to tell your doctor if you have any of the conditions listed below.
| Do you have these conditions? | Why should you inform? |
|---|---|
| A history of blood clots or stroke. | This medication may slightly increase the risk of blood clots. |
| Hormone-dependent cancers such as breast, cervical, and uterine cancers. | The hormones contained in this medicine may affect some cancer conditions. |
| Heart disease, high blood pressure, high cholesterol. | This medication should be used with caution in people with heart disease risk factors. |
| Diabetes, liver or kidney disease. | These conditions can affect the way the drug is excreted from the body. |
| Migraine, mental health problems (depression, suicidal thoughts). | Hormonal changes can affect these conditions, so care should be taken. |
| Smoking (especially if over 35 years of age). | Smoking, when combined with this medication, significantly increases the risk of blood clots and stroke. |
| Vaginal bleeding of unknown cause. | The cause of the bleeding must be accurately identified before treatment can begin. |
| If you are pregnant, trying to get pregnant, or breastfeeding. | This medicine is not suitable for use during pregnancy. It may harm the baby. |
How should I use this medicine?
Take this medicine exactly as your doctor tells you. Usually, you should take one tablet a day, at the same time every day, with water. It doesn't matter whether you take it before or after a meal. However, if you feel an upset stomach, it is better to take it with a meal. Continue taking it until your doctor tells you to stop.
When you get this medicine from the pharmacy, you will receive a special information leaflet (MedGuide) with it. Don't forget to read it carefully every time. It contains important information.
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take two pills at once for any reason.
What do you do if you drink too much?
If you think you have taken more medicine than you thought, even by mistake, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other medications that may interact with this medicine
When taking this medicine, there may be interactions with other medications you are taking. Therefore, it is very important to tell your doctor about all medications you are taking, including vitamins and herbal remedies.
| Medicines that should not be taken with these medicines (Do NOT take with) | |
|---|---|
| Aromatase inhibitors | Ex: anastrozole, letrozole |
| Elagolix, Cisapride, Dronedarone | Taking these together can cause serious problems. |
| Other things that may interact with | |
| Some antibiotics | Eg: erythromycin, clarithromycin |
| Some medications for HIV or Hepatitis | |
| Seizure medications | Ex: carbamazepine, phenytoin |
| Grapefruit juice | |
| St. John's Wort (herbal supplement) | |
| Blood thinners (e.g. Warfarin) | |
Important: This list is not complete, so tell your doctor about any medications you are taking.
Things to keep in mind when taking medication
- Regular check-ups: Your doctor should see you regularly to check how you are doing. You should also have regular breast and pelvic exams.
- Changes in your menstrual cycle: While taking this medicine, your menstrual cycle may become irregular, the amount of bleeding may change, or you may stop having periods altogether. This is normal.
- Avoid pregnancy: You should avoid getting pregnant while taking this medicine. This can cause serious harm to the unborn baby. Therefore, it is essential to use a barrier method of birth control, such as a condom. Continue to use this method of birth control even for a week after stopping the medicine.
- Smoking and Risk: If you are a smoker, especially if you are over 35, your risk of blood clots and stroke is much higher while taking this medication. Therefore, it is best to completely avoid smoking while taking this treatment.
- Bone health: Long-term use of this medication may cause a decrease in bone density. Therefore, it is important to eat foods rich in calcium and vitamin D and talk to your doctor about bone health.
What are the possible side effects?
Like any medication, this one can have side effects. Some are serious, some are common.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Symptoms of a blood clot | Leg pain, swelling, warmth, difficulty breathing, chest pain. |
| Symptoms of a stroke | Sudden numbness or weakness of the face, arm or leg, difficulty speaking, difficulty walking, severe headache. |
| Symptoms of liver damage | Pain in the upper right side of the stomach, loss of appetite, yellowing of the skin or eyes, dark urine. |
| Mental changes | Increased depression, suicidal thoughts. |
| If it persists or is bothersome, tell your doctor. | |
| Hot flashes | Headache, dizziness, fatigue. |
| Hair loss | Change in sexual desire. |
Take-Home Message
- This medication is a special hormonal treatment for heavy bleeding caused by uterine fibroids and the pain of endometriosis.
- Before starting the medication, be sure to tell your doctor about all of your medical conditions and other medications you are taking.
- Take the pill at the same time every day. If you miss a dose, never take two pills at the same time.
- Smoking while taking this medicine greatly increases the risk of blood clots and stroke.
- Avoid becoming pregnant during treatment. Talk to your doctor about appropriate birth control.
- If you experience any serious side effects such as chest pain, difficulty breathing, or difficulty speaking, seek medical advice immediately.
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