Name : I Gusti Putu Agus Anom

Student Number : 2208612009

Study Program : Pharmacist

CASE OF ORAL CONTRACEPTION

A 30-year-old mother came to the pharmacy with a pack of drugs that had run out. The package
reads "Cycloproginova". Previously, the patient had visited the pharmacy by redeeming the
same drug prescription. The patient buys the drug with the aim of delaying pregnancy
(contraception). The patient came to buy back the drug and asked the pharmacist.

Patient questions:
1. When should I start using this medicine?
Answer:
a. Cyclo-Progynova is a tablet consisting of a 21-day calendar package. You
should take one tablet daily in the order indicated on the package, starting with
the first day.
b. If the patient has used Cyclo Progynova, then they must take a break of 7 days
since the last use, before using a new package.
c. The new Cycloproginova packaging can be used on the 8th day. one tablet per
day or if the patient is menstruating, it is recommended to start taking
cycloproginova on the fifth day of the menstrual cycle until 21 tablets are used
up. White tablets taken within the first 11 days of each Cycloproginova cycle
contain only estradiol. Chocolate tablets taken within the next 10 days of each
cycle contain estradiol and norgestrel. Then the patient is given a free tablet rest
period for seven days before the next cycle begins.
d. The tablets should be swallowed whole with a drink. They can be taken either
with or without food.
e. Cycloproginova tablets must be taken at the same time every day; this will help
you remember to take it.
f. If forget to take a dose at usual time and it is less than 12 hours late when you
remember, you should take the missed dose. If it is more than 12 hours late you
 should just leave out the forgotten dose and take your next dose as usual at your
usual time. Don't take a double dose to make up for a missed dose (Netdoctor,
2015).

2. How does this drug work to delay pregnancy?

Answer:
Estradiol enters target cells freely (e.g., female organs, breasts, hypothalamus,
pituitary) and interacts with a target cell receptor. When the estrogen receptor has bound
its ligand it can enter the nucleus of the target cell, and regulate gene transcription which
leads to formation of messenger RNA. The mRNA interacts with ribosomes to produce
specific proteins that express the effect of estradiol upon the target cell. Estrogens
increase the hepatic synthesis of sex hormone binding globulin (SHBG), thyroid-
binding globulin (TBG), and other serum proteins and suppress follicle-stimulating
hormone (FSH) from the anterior pituitary.
Increases in the down-stream effects of ER binding reverses some of the
symptoms of menopause, which are primarily caused by a loss of estrogenic activity
(drugbank, 2023).
 BIBLIOGRAPHY

Netdoctor, 2015. Cyclo-Progynova (estradiol, norgestrel) (serial online) [cited 27 April 2023]
Available From URL: https://www.netdoctor.co.uk/medicines/a6492/cyclo-progynova-
estradiol-norgestrel/

DrugBank. 2023. (Cyclo-Progynova). Accessed on [cited 27 April 2023] Available From

https://go.drugbank.com/drugs/DB13956