Before using Andalan, it is suggested to carry out breast and pelvic organ examination including a Pap smear.
The administration of Andalan should be done carefully for patients with epilepsy, migraines, asthma, cardiac or renal dysfunction because progesterone may cause fluid retention.
In case of breakthrough bleeding, organic causes should be considered and a diagnostic examination should be carried out. It is not suggested to use estrogen as a routine or as a long term additional treatment to control excessive or prolonged bleeding. If prolonged bleeding is experienced and causes discomfort to the user, another contraceptive should be considered.
Be aware of patients with mental depression history; the treatment must be discontinued if the depression recurs to a serious degree.
A decrease of glucose tolerance test is seen in some acceptors using progestogen. The mechanism of this decrease is still unclear. For that reason, diabetic patients should be observed carefully during progestogen treatment.
Body weight may increase with the usage of Andalan.
The following laboratory tests may be affected by the use of Andalan: Plasma gonadotropin level; Plasma progesterone level; Urinary pregnanediol level; Plasma estrogen level (in the female); Plasma Cortisol level; Glucose tolerance test.
The usage of Andalan may mask the onset of the climacteric symptom.
Certain endocrine test and liver function tests may be affected by using Andalan. If such tests prove to be abnormal in patients using Andalan, it is recommended to repeat the tests after the treatment is stopped for 4-6 months.
Due to the prolonged effect and the resulting difficulty to predict the time of withdrawal bleeding following injection, Andalan is not recommended for treatment of secondary amenorrhea or dysfunctional uterine bleeding.
Pathologist should be informed that the patient have been treated with progestogen when relevant specimens are submitted.