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Cyonanz Review

Cyonanz is a combination hormone drug which is used to prevent pregnancy. The drug contains 2 female hormones: norethindrone and ethinyl estradiol.


Indications for use

  • Hormonal contraception.

Mechanism of action

Cyonanz tablets prevent ovulation (pregnancy) and make it harder for sperm to get into the uterus.

Dosage and mode of application

Each package contains 28 tablets:

  • 21 white active tablets each containing 0.5 mg norethindrone and 35 mcg ethinyl estradiol;
  • 7 green non-hormonal tablets that serve as “reminders”.

To achieve maximum contraceptive effectiveness, you must take tablets exactly as directed on the leaflet and at about the same hour each day.

You can take the first tablet on the 1 day of your menstrual period or on the first Sunday after the beginning of your menstrual period.

Take tablets for 28 days in a row. After the last tablet has been taken, start a new course the next day. For the first cycle of a Sunday Start regimen, you should use an additional, non-hormonal method of birth control such as a condom or spermicide during the first 7 days of use.


Serious adverse reactions have not been reported following intake of large doses of norethindrone and ethinyl estradiol. Overdosage may cause nausea, headache, spotting/withdrawal bleeding. In case of severe negative reactions, seek emergency medical care.

Side effects

Most Cyonanz side effects are mild and typically occur within the first three months of use.

Common such include:

  • nausea;
  • vomiting;
  • weight gain;
  • breast tenderness;
  • bleeding between periods;
  • difficulty wearing contact lenses.

Serious side effects are rare and may include:

  • thrombophlebitis;
  • pulmonary embolism;
  • stoppage or rupture of a blood vessel in the brain (stroke);
  • heart attack or angina pectoris;
  • benign liver tumors;
  • high blood pressure.

Warning: smoking increases the risk of serious cardiovascular adverse reactions (heart attacks, strokes).


  • Thrombophlebitis or thromboembolic disorders;
  • Hypersensitivity to norethindrone and ethinyl estradiol;
  • Deep vein thrombophlebitis or thromboembolic disorders in the anamnesis;
  • Acute or chronic hepatocellular disease;
  • Pregnancy;
  • Liver disease;
  • Hepatic adenomas or carcinomas;
  • Diabetes with vascular complications;
  • Headaches with focal neurological symptoms;
  • Thrombophilic conditions;
  • Cerebral vascular or coronary artery disease (including in the anamnesis);
  • Valvular heart disease with complications;
  • Persistent high blood pressure;
  • Scheduled surgery with prolonged immobilization in the nearest future;
  • Carcinoma of the breast;
  • Carcinoma of the endometrium or other estrogen-dependent neoplasia;
  • Abnormal genital bleeding of unknown etiology;
  • Jaundice of pregnancy or jaundice associated with the prior use of sex hormones;
  • Use of hepatitis C drugs (ombitasvir/paritaprevir/ritonavir, with or without dasabuvir).


Major Cyonanz interactions include:

  • itraconazole;
  • voriconazole;
  • fluconazole;
  • grapefruit juice;
  • ketoconazole;
  • phenytoin;
  • barbiturates;
  • carbamazepine;
  • bosentan;
  • felbamate;
  • griseofulvin;
  • oxcarbazepine;
  • rifampicin;
  • topiramate;
  • products containing St. John’s wort;
  • acetaminophen;
  • clofibric acid;
  • morphine;
  • salicylic acid;
  • lamotrigine;
  • etravirine;
  • boceprevir;
  • telaprevir;
  • rifabutin;
  • rufinamide;
  • aprepitant;
  • lopinavir;
  • cyclosporine;
  • prednisolone;
  • theophylline;
  • tizanidine;
  • voriconazole;
  • nevirapine;
  • atorvastatin;
  • rosuvastatin;
  • nelfinavir;
  • ritonavir;
  • darunavir/ritonavir;
  • amprenavir.

Some interactions may lead to breakthrough bleeding and/or a decreased contraceptive effect.

Pregnancy and breastfeeding

Do not use Cyonanz during pregnancy. If you get pregnant or suspect you may be pregnant, discontinue hormonal contraception and visit your health care provider as soon as possible. After a childbirth or an abortion in the 2 trimester, you should wait 4 weeks prior to using combination oral contraceptives. Consult your doctor about alternative non-hormonal methods of preventing pregnancy.

Do not use Cyonanz if you are breastfeeding. The hormones may decrease the production of breast milk and alter its composition.

What if I miss a pill?

  • If you miss one “active” tablet in Weeks 1, 2, or 3, take it as the day you remember;
  • If you miss two “active” tablets in Week 1 or Week 2, take two tablets the day you remember and two tablets the following day; and then keep taking one tablet per day until you finish the pack. You must use a back-up method of contraception if you have sex in the seven days after missing tablets;
  • If you miss two “active” tablets in the Week 3 or miss three or more “active” tablets in a row during any week, keep taking one tablet per day until Sunday, then discard the remaining the remaining tablets and start a new pack that same day. You must use a back-up method of contraception if you have sex in the seven days after missing tablets;
  • If you miss any of the 7 “reminder” tablets, discard them and keep taking one tablet per day at your usual time until you finish the pack. In this case, you do not need to use a back-up method of contraception for 7 days.


Do not use this medication if you have not started your periods.

Use of Cyonanz in the event of a missed menstrual period:

  1. If you have not followed the prescribed dosing regimen and missed your menstrual period, you need to consider the possibility of pregnancy. Stop taking tablets if pregnancy is confirmed;
  2. If you have followed the prescribed dosing regimen and missed 2 menstrual periods in a row, you need to consider the possibility of pregnancy. Stop taking tablets if pregnancy is confirmed.

When using birth control pills, you need to visit a doctor every 6 months.

Discontinue hormonal contraception if any of the following conditions develops: arterial or venous thrombolism; papilledema; depression; uncontrolled dyslipidemias; intraepithelial neoplasia; proptosis; pancreatitis; acyclic vaginal bleeding after 3 months of use; breast cancer; cervical cancer; sudden loss of vision; diplopia; retinal vascular lesions; a significant increase in blood pressure; unusual regular headaches; oligomenorrhea; chloasma; angioedema; stroke; amenorrhea; myocardial infarction.

Smoking women (especially over the age of 35) should not use Cyonanz for birth control due to an increased risk of cardiovascular negative effects.

In women with diabetes, this drug may decrease glucose tolerance.

This drug will not protect you from sexually transmitted diseases.

Store at room temperature away from direct sunlight, heat and moisture.

Keep out of reach of children.

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