Norethindrone Acetate

INDICATIONS AND USAGE Norethindrone Acetate Tablets, USP are indicated for the treatment of secondary amenorrhea, endometriosis, and abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as submucous fibroids or uterine cancer. Norethindrone Acetate Tablets, USP are not intended, recommended or approved to be used with concomitant estrogen therapy in postmenopausal women for endometrial protection.

DOSAGE AND ADMINISTRATION Therapy with norethindrone acetate tablets must be adapted to the specific indications and therapeutic response of the individual patient. Secondary amenorrhea, abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology: 2.5 to 10 mg norethindrone acetate tablets may be given daily for 5 to 10 days to produce secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen. Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing norethindrone acetate tablets therapy. Patients with a past history of recurrent episodes of abnormal uterine bleeding may benefit from planned menstrual cycling with norethindrone acetate tablets. Endometriosis: Initial daily dosage of 5 mg norethindrone acetate tablets for two weeks. Dosage should be increased by 2.5 mg per day every two weeks until 15 mg per day of norethindrone acetate tablets is reached. Therapy may be held at this level for six to nine months or until annoying breakthrough bleeding demands temporary termination.

CONTRAINDICATIONS • Known or suspected pregnancy. There is no indication for norethindrone acetate in pregnancy. (See PRECAUTIONS ). • Undiagnosed vaginal bleeding • Known, suspected or history of cancer of the breast • Active deep vein thrombosis, pulmonary embolism or history of these conditions • Active or recent (e.g., within the past year) arterial thromboembolic disease (e.g., stroke, myocardial infarction) • Impaired liver function or liver disease • As a diagnostic test for pregnancy • Hypersensitivity to any of the drug components

ADVERSE REACTIONS See WARNINGS and PRECAUTIONS The following adverse reactions have been observed in women taking progestins: Breakthrough bleeding Spotting Change in menstrual flow Amenorrhea Edema Changes in weight (decreases, increases) Changes in the cervical squamo-columnar junction and cervical secretions Cholestatic jaundice Rash (allergic) with and without pruritus Melasma or chloasma Clinical depression Acne Breast enlargement/tenderness Headache/migraine Urticaria Abnormalities of liver tests (i.e., AST, ALT, Bilirubin) Decreased HDL cholesterol and increased LDL/HDL ratio Mood swings Nausea Insomnia Anaphylactic/anaphylactoid reactions Thrombotic and thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, retinal vascular thrombosis, cerebral thrombosis and embolism) Optic neuritis (which may lead to partial or complete loss of vision) To report SUSPECTED ADVERSE REACTIONS, please call Ingenus Pharmaceuticals, LLC toll-free at 1-877-748-1970 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

DESCRIPTION Norethindrone Acetate Tablets, USP (17-hydroxy-19-nor-17α-pregn-4-en-20-yn-3-one acetate), a synthetic, orally active progestin, is the acetic acid ester of norethindrone. It is a white, or creamy white, crystalline powder. The structural formula is as follows: C 22 H 28 O 3 M.W. 340.46 Each Norethindrone Acetate Tablet, USP for oral administration, contains norethindrone acetate, USP 5 mg. In addition, each tablet contains the following inactive ingredients: anhydrous lactose, magnesium stearate, and microcrystalline cellulose. Norethindrone Acetate structural formula

HOW SUPPLIED Norethindrone Acetate Tablets, USP are available as: 5 mg: White, oval, flat-faced, beveled-edge, scored tablet. Debossed with stylized b on one side and 211/5 on the scored side. Available in bottles of 50 tablets (NDC 51407-599-50). Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required). Store at 20o to 25oC (68o to 77oF) [See USP Controlled Room Temperature]. Keep this and all medications out of the reach of children. Manufactured For: Teva Pharmaceuticals Parsippany, NJ 07054 Rev. B 11/2022 Marketed by: GSMS, Inc. Camarillo, CA 93012 USA