Indication

Endometriosis

RAG rating

Amber initiation

Document type

Decision document

Place

Hertfordshire and West Essex ICB

Output type

Pharmacy / Prescribing

Dienogest

HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC)

Dienogest for endometriosis

AMBER INITIATION

Recommended for initiation by specialists, ongoing prescribing in primary care.

Name: generic (trade) Dienogest 2mg oral tablets

What it is Oral progestogen

Indication Licensed for the treatment of endometriosis

Date decision last revised June 2023

Decision status Final

NICE / SMC Guidance NA

HWE APC recommendation:

Dienogest 2mg tablets are recommended for use as a third line treatment option, for initiation by specialists only, when alternative and conventional treatments have already been trialled but not tolerated or has been ineffective. This includes a trial of combined hormonal therapy (unless contra-indicated) AND other progestogen only therapies AND the available next treatment option would usually be Gonadotropin-releasing hormone (GnRH) agonist and/or surgery.

AMBER INITIATION:

Recommended for initiation by specialists

Specialists* are to continue prescribing for a minimum of 3 months or until specialist review has taken place to establish stabilisation on therapy and to allow for a review on tolerability and efficacy (eg pain and/or endometrial lesions)

*Specialists are considered those with experience in managing endometriosis in secondary as well as community care settings

Thereafter, ongoing prescribing in primary care

Refer to SPC for further information.

Approved by Herts and West Essex Area Prescribing Committee, June 2023