Pak Anggoro, pls help pak, cari tahu dong...Makasih.
Coba nanti saya tanyakan ke DOSG saya ya bu. Kalau dulu beliau bicara nggak
ada efeknya. Biasanya beliau mengatakan yg sebenarnya kok, kebetulan istri
beliau juga menggunakannya.

----- Original Message -----
From: pearl tosa <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, July 05, 2003 12:50 AM
Subject: RE: [balita-anda] PIL KB????


Saya sebetulnya juga sangat tertarik mau coba pil diane ini, tapi setelah
baca artikel ini kok jadi ragu ya, apakah ibu2 memang sudah ada yg dapat
penjelasan pasti dari dokternya  mengenai efek samping dari pil ini ( selain
drpd kelebihannya yg digembargemborkan dpt menghaluskan kulit ?)
Pris
 Important Safety Information about DIANE®-35 and the risk of venous
thromboembolism
- Berlex Canada Inc.
- Health Professional Advisory
The Marketed Health Products Directorate (MHPD), Therapeutic Products
Directorate (TPD) and Biologics and Genetic Therapies Directorate (BGTD)
post safety alerts, public health advisories, press releases and other
notices from industry as a service to health professionals, consumers, and
other interested parties. Although MHPD, TPD and BGTD approve therapeutic
products, MHPD, TPD and BGTD do not endorse either the product or the
company. Any questions regarding product information should be discussed
with your health professional.

This is duplicated text of a letter from Berlex Canada Inc. Contact the
company for a copy of any references, attachments or enclosures.


April 10,2003

IMPORTANT DRUG SAFETY INFORMATION
ABOUT DIANE®-35 AND THE RISK OF VENOUS
THROMBOEMBOLISM




   DIANE®-35, as with all estrogen/progestogen combinations, is
contraindicated in women with thrombophlebitis, thromboembolic disorders, or
a history of these conditions.
   DIANE®-35 users appear to have an elevated risk of venous thromboembolic
events compared to users of combination oral contraceptives in some
published studies.
   DIANE®-35 should not be prescribed for the purpose of contraception
alone.
   During treatment with DIANE®-35, other oral contraceptives should not be
used.


Dear Health Care Professional(s),

Berlex Canada Inc., following discussions with Health Canada, would like to
inform you about recent published information on the risk of venous
thromboembolism (VTE) with DIANE®-35 (cyproterone acetate and ethinyl
estradiol). DIANE®-35, like all estrogen/progestogen combinations, is
associated with an increased risk of VTE compared with no use.

DIANE®-35 is a therapeutic agent indicated for the treatment of women with
severe acne, unresponsive to oral antibiotic and other available treatments,
with associated symptoms of androgenization, including seborrhea and mild
hirsutism. It should be discontinued 3 to 4 cycles after signs have
completely resolved. DIANE®-35 has many properties in common with
combination oral contraceptives and the same contraindications, warnings and
precautions apply to DIANE®-35.

Based on an independent analysis, commissioned by Berlex, of recently
published information1-7, cases of non-fatal VTE ranging in incidence from
1.2 to 9.9 events per 10,000 women-years have been observed in users of
DIANE®-35. As context, the incidence of VTE in non-users of any oral
contraceptive is estimated to be 0.5 to 1 event per 10,000 women-years, and
increases to 4 events per 10,000 women-years in long-term users of low
estrogen content (< 50 :g ethinyl estradiol) combination oral
contraceptives8. These event rates are rare, but still justify caution in
the use of DIANE®-35.

Since market introduction in 1998, Health Canada has received 11 reports of
VTE (deep vein thrombosis, pulmonary embolism, and stroke) equivalent to a
reporting rate of 0.33 events per 10,000 women-years. One of these cases
involved a death. It should be noted that reporting rates determined on the
basis of spontaneously reported post-marketing adverse events are generally
presumed to underestimate the risks associated with drug treatments.

Women with androgen-related conditions (e.g., severe acne or hirsutism) may
have an inherently increased cardiovascular risk. The excess risk of VTE is
highest during the first year a woman ever uses a combination oral
contraceptive.

Berlex Canada Inc. is committed to providing you with the most current
product safety information on its products. We hope this information will be
helpful to you in caring for your patients on DIANE®-35. The official
DIANE®-35 Product Monograph is being updated to reflect this new
information.

The identification, characterization, and management of drug-related adverse
events are dependent on the active participation of health care
professionals in adverse drug reaction reporting programmes. Health care
professionals are asked to report any suspected adverse reactions in
patients receiving DIANE®-35 directly to Berlex Canada Inc. at the following
address:

Berlex Canada Inc.
334 Avro Avenue
Pointe-Claire, Quebec H9R 5W5
Tel: (800) 361-0240 or by
fax at (514) 631-4721

Your professional commitment in this regard has an important role in
protecting the well-being of your patients by contributing to early signal
detection and informed drug use.

If you have any questions regarding DIANE®-35, please contact Berlex Canada
at 1-800-361-0240.

Yours sincerely,

original signed by

Dr. Jean-Louis Stril, M.D.
Manager, Disease Management and Drug Safety
Berlex Canada Inc.

1 Lidegaard O. et al. Contraception 2002; 65:187-196.
2 Pini M et al. Rec Prog Med 1996; 87:331-337.
3 Farmer RDT et al. Br J Clin Pharmacol 2000; 49:580-590.
4 Vasilakis-Scaramozza C and Jick H. The Lancet 2001; 358:1427-1429.
5 Seaman HE et al. Human Reproduction 2003; 18:522-526.
6 WHO 1995 Lancet 1995; 346:1582-1588.
7 Farmer RDT. Hum Rep Upd 1999; 5:688-706.
8 The European Agency for the Evaluation of Medicinal Products (EMEA). EMEA
committee for proprietary medicinal products (CPMP) Public Assessment
Report. Combined oral contraceptives and venous thromboembolism. 28
September 2001. http://www.emea.eu.int/pdfs/human/regaffair/0220101en.pdf

Any suspected adverse reactions can also be reported to:

Canadian Adverse Drug Reaction Monitoring Program (CADRMP)
Marketed Health Products Directorate
HEALTH CANADA
Address Locator: 0201C2
OTTAWA, Ontario, K1A 1B9
Tel: (613) 957-0337 or Fax: (613) 957-0335
Toll free for consumers and health professionals:
Tel: 866 234-2345, Fax: 866 678-6789
[EMAIL PROTECTED]

The AR Reporting Form and the AR Guidelines can be found on the TPD web site
or in The Canadian Compendium of Pharmaceuticals and Specialties.







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