Norethindrone Administration and Monitoring Guidelines

Dosing and Administration

For teens >15 years and adults with acne, the American Academy of Dermatology recommends 1 pill daily at the same time for 21 days followed by 1 week of no tablets when used as part of a combined oral contraceptive 1
Norethindrone acetate combined with ethinyl estradiol is FDA-approved for acne treatment in women who also desire contraception, as stated by the American Academy of Dermatology 2

The American Academy of Dermatology suggests baseline monitoring of pregnancy status and blood pressure, and ongoing monitoring of blood pressure and health status changes 1
Pregnancy is a contraindication for norethindrone use, classified as Category X, according to the American Academy of Dermatology 1

The American College of Obstetricians and Gynecologists and other guideline societies recommend assessing patients for a history of breast cancer before initiating norethindrone therapy, as it is a contraindication 3

Clinical review should be performed annually for stable patients on norethindrone therapy, with more frequent monitoring during initial therapy, as recommended by the Human Reproduction Update guideline society 3
Liver function tests should be monitored periodically, especially for patients on higher doses of norethindrone (≥10 mg daily), with consideration of monitoring every 3-6 months initially, then annually if stable, according to the Clinical Nutrition guideline society 4