যেসব মেয়েদের মাসিকের সময় প্রচুর Bleeding বা রক্তপাত হয়, সেটা হতে পারে ইউটেরাইন ফাইব্রয়েড অথবা হতে পারে টিউমার, জরায়ু এর অস্বাভাবিক গঠন উপরের যে কোন কারনের জন্য মাসিকের সময় প্রচুর Bleeding হতে পারে, সেজন্য আমরা নিচের ওষুধটি ব্যবহার করতে পারি , কিন্তু ওষুধটি ব্যবহার করার পূর্বে অবশ্যই একজন গাইনোকোলজিস্ট এর পরামর্শ নিয়ে ওষুধটি ব্যবহার করা যাবে।
Tablet 1:- Rehanzil (40mg+1mg+0.5mg)
As a (Relugolix+Estradiol+Norethindrone) As a Gonadotropin-releasing hormone (GnRH) antagonist.
One tablet once daily for 7 days
1+0+0 Am For 7 days.
OR Tablet 2.Block-T 500 mg AS A Tranexamic Acid AS A Anti-fibrinolytic drugs, Haemostatic drugs.
Indications:-
This is indicated for the management of heavy menstrual bleeding associated with uterine leiomyomas (fibroids) in premenopausal women.
*
Pharmacology:-
This tablet is a combination of relugolix, estradiol (E2) and norethindrone acetate (NETA). Relugolix is a non-peptide GnRH receptor antagonist that competitively binds to pituitary GnRH receptors, thereby reducing the release of Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH), leading to decreased serum concentrations of the ovarian sex hormones estradiol and progesterone and reduced bleeding associated with uterine fibroids. Estradiol acts by binding to nuclear receptors that are expressed in estrogen-responsive tissues. As a component of this tablet, the addition of exogenous estradiol may reduce the increase in bone resorption and resultant bone loss that can occur due to a decrease in circulating estrogen concentrations from relugolix alone. Progestins such as norethindrone act by binding to nuclear receptors that are expressed in progesterone-responsive tissues. As a component of this tablet, norethindrone may protect the uterus from the potential adverse endometrial effects of unopposed estrogen.
Dosage & Administration
Exclude pregnancy and discontinue hormonal contraceptives prior to this initiation. Orally one tablet once daily. In case of missed dose, need to take as soon as possible the same day and then resume regular dosing the next day at the usual time. If concomitant use of oral P-gp inhibitors is unavoidable, need to take this tablet at least 6 hours before taking the P-gp inhibitor.
Safety and effectiveness of in pediatric patients have not been established.
Contraindications:-
High risk of arterial, venous thrombotic or thromboembolic disorder.
Pregnancy.
Known osteoporosis.
Current or history of breast cancer or other hormone sensitive malignancies.
Known hepatic impairment or disease.
Undiagnosed abnormal uterine bleeding.
Known hypersensitivity to relugolix, estradiol or norethindrone acetate.
Side Effects:-
Most common adverse reactions (incidence >3%) are: Hot flush, Hyperhidrosis or night sweats, Uterine bleeding, Alopecia, Decreased libido
Pregnancy & Lactation:-
Based on findings from animal studies and its mechanism of action, this may cause early pregnancy loss. Discontinue this tablet, if pregnancy occurs during treatment. There is no data on the presence of relugolix or its metabolites in human milk, the effects on the breastfed child or the effects on milk production. Relugolix was detected in milk in lactating rats. When a drug is present in animal milk, it is likely that the drug will be present in human milk.
Therapeutic Class:-
Gonadotropin-releasing hormone (GnRH) antagonist.
Raiyyan Tahsan 
Date:-18-04-2025 Friday Time:-09-21-45 Pm
- TC(1487).(56). General Medicine Department Case No (14): Presumed Treated Hypertension and Type 2 Diabetes with Possible Upper-GI Dyspepsia/Dysmotility and Cardiovascular Risk Management (1 Prescription + 0 Reports + 0 Supporting Images).5432
- TC(1486).(02). Dermatology Department Case No 107:- Suspected Superficial Dermatophytosis with Possible Coexisting Allergic Rhinitis: Clinical Diagnosis, Prescription Analysis and Evidence-Based Management (1PR+0RE+0IMG)4433
- TC(1485).(02). Dermatology Department Case No (106): Undifferentiated Genital Ulcer Disease with Associated Skin Rash and Generalized Weakness Suspected Syphilis versus Genital Herpes; Possible Secondary Bacterial Infection (1 PR+ 0RE + 0Img)7799
- TC(1484).(09).Obstetrics & Gynecology Case No 60:-High-Risk Pregnancy with History of Two Preterm Deliveries and Two Neonatal Deaths: Diagnosis, Drug Safety and Evidence-Based Management(1PR+0RE+0IMG)8090
- TC(1483).(09). Gynecology Department Case No. (59): Physician-Documented Mastitis with Fever — Possible Inflammatory or Bacterial Mastitis; Breast Abscess and Dengue Fever to Be Excluded (1Prescription + 0Reports + 0Images)0909