Pharmacologically active ingredients and typical strength

This product contains two actives in the usual UK formulation:

  • Cyproterone acetate 2 mg - a progestogen that reduces androgen activity and helps control acne and hirsutism.
  • Ethinylestradiol 35 micrograms (0.035 mg) - an estrogen component that stabilises the menstrual cycle and supports contraceptive effect.

Packs are commonly supplied as 21 active tablets. For dosing schedules see How to take on a task this Diane 35 pill.

Who may be offered this medicine

Prescribers usually consider co-cyprindiol for adult patients where androgen excess is the main clinical issue. Typical signals include:

  • Women with polycystic ovary syndrome (PCOS) presenting with irregular periods plus acne or hirsutism.
  • Moderate to severe acne that has not responded adequately to topical therapy or appropriate courses of antibiotics.
  • Clinically significant hirsutism believed to be due to androgen excess.

When contraception is the primary goal, other combined oral contraceptives are often chosen first-line. For personalised assessment consult your GP, sexual health clinic or dermatologist; see Status of legality of the United Kingdom and prescribing practice for more on prescriber roles.

Diane 35 instructions for use

Follow the directions on the patient information leaflet plus the instructions from the clinician who prescribed it. Typical use:

  • One tablet daily, taken at the same time each day to maintain steady hormone levels.
  • Standard packs usually contain 21 active tablets followed by a seven day tablet-free interval, during which withdrawal bleeding occurs.
  • Do not chew the tablets; swallow with water unless advised otherwise.

If you need to change the time you take the tablet, seek advice about temporary extra contraceptive protective protocols. For information about late or missed tablets consult Missed tablet instructions or contact a pharmacist or prescriber.

Inspections for safety and precautionary actions before starting

A clinical review is important prior to initiation. Typical checks include:

  • Confirming pregnancy status and discussing breastfeeding, as combined hormonal treatments are not advised in pregnancy and are usually avoided while breastfeeding.
  • Evaluating liver health: do not start if there is active or severe liver disease, liver tumours or unexplained jaundice.
  • Assessing thromboembolic risk: combined products increase the risk of venous thromboembolism; this risk is higher with smoking and increasing age.
  • Reviewing migraine history, especially migraine with aura which is usually a contraindication.
  • Considering cardiovascular and metabolic risk factors such as obesity, hypertension and diabetes when choosing a contraceptive or acne treatment.

Disclose any personal or family history of blood clots, heart disease, stroke or hormone-sensitive cancers. For details on conditions that make treatment unsuitable see Conditions where use is not advised and Important Warning alerts.

Reasons to avoid use and high priority cautions issued

Avoid Diane 35 (co-cyprindiol) if any of the following apply:

  • History or current evidence of venous or arterial thrombosis, for example deep vein thrombosis, pulmonary embolus, myocardial infarction or stroke.
  • Advanced hepatic disease that is active, liver tumours or unexplained vaginal bleeding.
  • Known or suspected hormone-dependent malignancy such as breast cancer.
  • Migraine with premonitory aura.
  • Pregnancy or breastfeeding, unless a clinician explicitly advises its use.
  • Heavy smoking in combination with age 35 years or older or other significant cardiovascular risks.

If you are unsure whether any of these apply to you, do not start the medicine before getting medical advice.

Potential collateral effects and when to contact urgent medical support

Many users have no or mild adverse reactions. Commonly reported effects include:

  • Feeling nauseous or having a queasy stomach.
  • Tension type experiencing a headache and realistically possible increase in migraine frequency for some people.
  • Mood alterations, including depressive symptoms in a minority of users.
  • Breast tenderness symptoms or changes.
  • Fluid retention and small weight changes.

If you notice any of the following symptoms, seek medical help right away. signs that may indicate a blood clot: sudden swelling or pain in one limb, chest pain, shortness of breath, sudden severe head pain, speech disturbance or visual problems. For broader risk information see Safety inspections and proactive precautions.

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Tell your prescriber and pharmacist about all medicines, supplements and herbal products you take. Key dynamics include:

  • Anticoagulants, including warfarin, are used to reduce clot risk. may need real time monitoring adjustments while you use hormonal products.
  • Certain antiretroviral medicines and some hepatitis C antivirals can change hormone levels.
  • Enzyme-inducing anticonvulsants such as phenytoin, carbamazepine, phenobarbital and topiramate can reduce contraceptive effectiveness.
  • Antituberculosis drugs like rifampicin or rifabutin can lower hormone concentrations.
  • Common Saint Johns wort can reduce the effectiveness of combined hormonal contraceptives.
  • Lamotrigine levels may fall when combined hormonal contraceptives are used; dose changes could be required for seizure control.

If you start or stop a medicine that could interact, get advice on whether additional contraceptive safety guidelines or system monitoring are needed.

Missed tablet instructions

If you miss one tablet take it as soon as you remember. If the next dose is due shortly, skip the missed pill and continue with the regular schedule; avoid doubling doses unless a healthcare professional tells you to. If you have missed multiple tablets or are several days late, consult the patient leaflet or contact a pharmacist or clinician for tailored guidance and whether extra contraceptive cautionary measures are necessary.

Emergency she overdosed response assistance: what to do

Taking more than the recommended dose may simply increase expected secondary effects such as nausea, vomiting or aching head. If an a drug overdose is suspected contact NHS 111 (or your local urgent care service) for advice and take the medicine packaging with you when seeking help.

Storage and warehousing

  • Keep tablets in their original blister until you need them to protect from moisture.
  • Store at temperatures below 25 C in a cool dry place away from direct sunlight and heat.
  • Keep this out of reach and out of sight for children.

Equivalent medicines and optional options

Choice of treatment depends on whether the main aim is acne management, control of PCOS symptoms or contraception. Commonly available options used in the UK include:

  • Other combined oral contraceptives containing ethinylestradiol with different progestogens (for example drospirenone or desogestrel) which may improve acne for some users.
  • Progestogen-only methods: the desogestrel pill, levonorgestrel intrauterine system (Mirena) or the contraceptive implant, suitable when estrogen is not appropriate.
  • Non-hormonal contraception: copper intrauterine device for long-term pregnancy prevention without hormones.
  • Topical and systemic dermatology treatments: topical retinoids, benzoyl peroxide, oral antibiotics, and specialist drugs such as isotretinoin for severe acne (isotretinoin requires specialist supervision and regular supervision and monitoring such as pregnancy testing and blood tests).
  • Anti-androgen medicines such as spironolactone, which is sometimes used off-label for acne or hirsutism under specialist oversight with appropriate monitoring for potassium and renal function where indicated.

Cost and observation and tracking vary: combined pills are often low cost on the NHS, whereas private provision or specialist drugs can have higher fees and observation and tracking requirements. Discuss advantages and disadvantages with your clinician to choose the most suitable option.

Estimated costs in the UK

Prices vary depending on NHS supply, private purchase and any associated consultation fees. Typical estimates in Great Britain:

  • NHS prescription charge in England: around 9.90 pounds per item for those who pay; many residents in Scotland, Wales and Northern Ireland receive prescriptions free depending on eligibility.
  • Private medicine-only cost for a 21-tablet pack of co-cyprindiol: approximately 8 to 20 pounds, with clinics or pharmacies potentially adding consultation or dispensing fees.
  • Other combined oral contraceptives bought privately often range from about 3 to 10 pounds per monthly supply depending on brand and quantity.
  • Long-acting reversible contraception such as the levonorgestrel IUS or implant may have higher private upfront costs (often over 100 pounds) but low ongoing costs; these are frequently provided free on the NHS when clinically indicated.
  • Specialist acne therapy like isotretinoin is usually managed in secondary care; medication costs can vary but the main considerations are observation and tracking visits and blood tests rather than the tablet cost alone.

For current local prices check with your pharmacy, clinic or a licensed UK online prescriber. See Options and similar medications for options with different cost profiles and watchful oversight needs.

Additional aspects about Diane 35