Choice | Drug | Dosage |
---|---|---|
1st choice | No drug treatment | see prescribing notes |
2nd choice | New generation COC e.g. Gedarel® 30/150 (desogestrel 150 micrograms, ethinylestradiol 30 micrograms) (3 x 21 pack) - consider for moderate premenstrual syndrome | See section 7.3.1 |
Fluoxetine 20mg capsules; liquid 20mg/5ml (for severe premenstrual syndrome) | Dose [unlicensed use]: 20mg daily from days 14 - 28 for 3 months, then reassess benefit before continuing |
Prescribing Notes
- For more information refer to CKS guidance on premenstrual syndrome.
- Hormonal manipulation may be useful, e.g. a new generation combined oral contraceptive, in some circumstances.
- The COC can be used cyclically or continuously for premenstrual syndrome.
- Fluoxetine is no longer licensed for the treatment of premenstrual tension but there is some evidence to support its use; informed consent should be obtained and documented.