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Dianette is a hormone treatment for severe acne in women. It may be prescribed when acne hasn't got better with antibiotics. It's also used to treat hirsutism in women, a condition where hair grows excessively on the face or chest. Both these problems are common in women with polycystic ovary syndrome (PCOS).

Dianette is also an effective contraceptive pill, but your doctor will never prescribe it solely for contraception, because it carries a slightly higher risk of causing blood clots than other contraceptive pills.

Cyproterone acetate is a type of medicine called an anti-androgen. Androgens are male sex hormones that stimulate the growth of the skin, including the sebaceous glands that produce oil (sebum), and the hair that grows from the skin. Cyproterone works by reducing the production and actions of androgens. As a result it reduces the production of sebum and stops excessive hair growth.

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You should notice that your skin becomes less greasy within a few weeks of taking Dianette, but it may take at least three months of treatment before you see a definite improvement in your acne or hair growth.

Co-cyprindiol works as a combined oral contraceptive pill by over-riding your natural menstrual cycle. Cyproterone and ethinylestradiol are synthetic versions of the naturally occurring female sex hormones, oestrogen and progesterone. They stop your ovaries from releasing an egg each month (ovulation) and also increase the thickness of your cervical mucus, making it more difficult for sperm to cross from the vagina into the womb. They also thin the womb lining, making it more difficult for any successfully fertilised eggs to implant there.

Your doctor may need to weigh up the risks and benefits of taking Dianette if you have various other conditions, including those below. If two or more of these apply your doctor will usually recommend that you don't take Dianette:

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Dianette tablets come in a calendar pack marked with days of the week. You take one pill at the same time every day for 21 days and then have a seven day break.

During your seven day break you'll usually get a withdrawal bleed that is similar to your normal period. Start your next pack after the seven pill-free days are up, even if you are still bleeding.

You'll still be protected against pregnancy in your pill-free week, provided you took all the pills correctly, you start the next packet on time and nothing else happened that could make the pill less effective (eg sickness, diarrhoea, or taking certain other medicines - see below).

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It can take a few months of treatment before your acne or hirsutism has completely cleared up. You'll need to stop taking Dianette after your skin has got better, rather than keep taking it just for contraception. If you still need a contraceptive your doctor will prescribe you a different pill.

If you forget to take your pill at your usual time, take it as soon as you remember. A missed pill is one that is 24 hours or more late. If you miss a pill, follow the instructions below.

If you forget to take ONE pill, or start your new pack one day late, you should take the pill you missed as soon as possible, even if this means taking two pills at the same time. Then continue taking the rest of the pack as normal. You will still be protected against pregnancy and you don't need to use extra contraception.

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If you forget to take TWO or more pills, or start your new pack two or more days late, you won't be protected against pregnancy. You should take the last pill you missed as soon as possible, even if this means taking two pills at the same time. Leave out the other missed ones. Then continue to take your pills, one every day, as normal. You should either not have sex, or use an extra barrier method of contraception, eg condoms, for the next seven days.

If the pills you missed were in the last week of your pack, finish the pack as usual but then start a new pack straight away without a break. This means skipping your pill-free week.

If you had unprotected sex in the seven days before you missed pills, you may need emergency contraception (the morning after pill). Ask for medical advice.

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If you are confused about any of this, you can get individual advice for your circumstances from your doctor, pharmacist or local family planning clinic.

If you vomit within two hours of taking a pill, you should take another pill as soon as you feel well enough. Then take your next pill at your usual time. You should still be protected from pregnancy.

If you keep being sick, or if you have very severe diarrhoea for more than 24 hours, this can make your pill less effective. Keep taking your pill at your normal time, but treat each day that you are sick or have severe diarrhoea as if you had forgotten to take a pill and follow the missed pill instructions above.

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Before you start taking Dianette, make sure you tell your doctor or pharmacist if you're already taking any other medicines, because some medicines can make Dianette less effective at treating acne and hirsutism and at preventing pregnancy. For instance, if you regularly take any of the medicines below Dianette probably won't work for you:

If you're prescribed a short course (up to two months) of any of these medicines while you're taking Dianette this can also make it less effective, and your doctor will usually recommend that you temporarily use a different form of contraception. If you want to keep taking Dianette, talk to your doctor about what to do. You'll also need to use an extra method of contraception (eg condoms) for as long as you take the extra medicine and for at least four weeks after stopping it.

While you're taking Dianette it's a good idea to check with your doctor or pharmacist before you take any other new medicines.

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Antibiotics (other than rifampicin or rifabutin - see above) won't make Dianette less effective, unless they give you diarrhoea or make you sick. If this happens, follow the instructions for diarrhoea and vomiting described above.

The same applies for any other medicine that makes you vomit or gives you diarrhoea - common culprits include laxatives and the weight loss medicine orlistat (brand names Alli and Xenical).

The morning-after pill ellaOne (containing ulipristal) can make Dianette less effective. If you take this type of emergency contraception while taking Dianette you should use extra contraception, such as condoms, for 14 days after taking it.

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The following are some of the side effects that may be associated with Dianette. Just because a side effect is stated here doesn't mean that everyone taking Dianette will experience that or any side effect. Medicines affect people in different ways.

The risk of getting a blood clot in a vein is temporarily increased if you're immobile for long periods of time, for example if you have a major accident or major surgery. You'll need to stop taking Dianette four to six weeks before planned surgery, and also if you're confined to bed or have a leg in plaster. You shouldn't start taking it again until at least two weeks after you are fully mobile.

The risk of blood clots is also increased if you're travelling for long periods of time where you will be sat still (over three hours). Ask your doctor or pharmacist for advice on using travel stockings, calf exercises or aspirin.

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❗ Stop taking Dianette and see a doctor immediately if you get symptoms of a blood clot such as: stabbing pains and/or unusual swelling in one leg, pain on breathing or coughing, coughing up blood, sudden breathlessness, sudden severe chest pain, migraine or severe headache, sudden disturbance in vision, hearing or speech, sudden weakness or numbness on one side of the body, or if you collapse.

As with other hormonal contraceptives, it's possible that taking the combined pill may slightly increase your risk of being diagnosed with breast cancer. Research into this is still ongoing, but the risk doesn't go up the longer you take the pill, and goes back to normal ten years after you stop taking the pill.

Women who take the pill for longer than five years may also have a small increase in the risk of being diagnosed with cervical cancer, which again goes back to normal ten years after you stop taking it.

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You should discuss the risks and benefits of the pill (which include reduced risks of cancer of the ovary, womb and colon) with your doctor before you start taking it.

Read the leaflet that comes with your pills, or talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects or risks of Dianette. If you think you have experienced a side effect, did you know you can report this using the yellow card website?Dianette (also known as co-cyprindiol), is commonly used as a contraceptive tablet in women, Dianette is also used to treat skin conditions such as acne, very oily skin and excessive hair