Cyclodynon (Vitex Agnus-Castus Extract)

What Is Cyclodynon and What Is It Used For?

Cyclodynon is a herbal medicinal product containing a standardised extract of Vitex agnus-castus (chasteberry) fruit. It is primarily used for the relief of premenstrual syndrome (PMS) symptoms and menstrual cycle irregularities, working through its dopaminergic activity to reduce excess prolactin levels.

Cyclodynon is manufactured by Bionorica SE, a German pharmaceutical company specialising in evidence-based phytotherapy. The active ingredient is a dry extract obtained from the ripe dried fruits of Vitex agnus-castus L. (Verbenaceae family), commonly known as chasteberry or monk's pepper. This plant has been used in traditional medicine for over two thousand years, with historical references dating back to Hippocrates and Dioscorides who recommended it for gynaecological complaints.

The primary indication for Cyclodynon is the treatment of premenstrual syndrome (PMS), a condition affecting an estimated 20–40% of women of reproductive age worldwide. PMS encompasses a range of physical and psychological symptoms that occur during the luteal phase of the menstrual cycle (typically 1–2 weeks before menstruation) and resolve shortly after the onset of menses. Common PMS symptoms that Cyclodynon is indicated for include cyclical mastalgia (breast pain and tenderness), abdominal bloating and fluid retention, headache and migraine, irritability, anxiety, mood swings, and depressive feelings.

Additionally, Cyclodynon is used in the management of menstrual cycle irregularities, particularly those associated with latent hyperprolactinaemia (mildly elevated prolactin levels). Elevated prolactin can disrupt the normal hormonal cascade required for regular ovulation and menstruation, leading to oligomenorrhoea (infrequent periods), polymenorrhoea (frequent periods), or other cycle disturbances. By normalising prolactin secretion, Cyclodynon helps restore a more regular menstrual pattern.

The mechanism of action of Cyclodynon is well-characterised in pharmacological studies. The diterpenes found in Vitex agnus-castus, particularly clerodadienols, act as dopamine D2 receptor agonists on the lactotroph cells of the anterior pituitary gland. This dopaminergic activity inhibits the release of prolactin. In women with PMS, mildly elevated prolactin levels during the luteal phase can lead to a relative progesterone deficiency and oestrogen dominance, which in turn drives many of the classic PMS symptoms. By reducing prolactin, Cyclodynon helps normalise the oestrogen-to-progesterone ratio during the second half of the menstrual cycle, thereby alleviating symptoms.

What Should You Know Before Taking Cyclodynon?

Before starting Cyclodynon, inform your doctor about all medical conditions (especially hormone-sensitive conditions, pituitary disorders, and a history of depression), allergies, and current medications. Cyclodynon is contraindicated in pregnancy, breastfeeding, and in individuals with known hypersensitivity to Vitex agnus-castus.

Contraindications

Do not take Cyclodynon if you are allergic (hypersensitive) to Vitex agnus-castus or any of the other ingredients in the tablet. Allergic reactions, while rare, can range from mild skin reactions to more serious anaphylactic responses. If you have previously experienced an allergic reaction to any product containing chasteberry, monk's pepper, or other members of the Verbenaceae plant family, you should not take Cyclodynon.

Cyclodynon is contraindicated in patients with hormone-sensitive conditions, including oestrogen receptor-positive breast cancer, endometriosis, uterine fibroids, and other conditions that may be exacerbated by changes in hormonal balance. Because Vitex agnus-castus affects prolactin secretion and indirectly influences the oestrogen-progesterone axis, it could theoretically influence the progression of hormone-dependent tumours. Patients with a personal or family history of hormone-sensitive cancers should discuss the risks with their oncologist before considering Cyclodynon.

Patients with pituitary gland disorders, particularly prolactinomas (prolactin-secreting pituitary tumours), should not take Cyclodynon without specialist medical supervision. The dopaminergic activity of Vitex agnus-castus could mask symptoms of a prolactinoma or interfere with diagnostic tests for pituitary function. If you have unexplained galactorrhoea (nipple discharge), amenorrhoea (absence of periods), or visual disturbances, these symptoms should be investigated before attributing them to PMS and initiating treatment with Cyclodynon.

Warnings and Precautions

Talk to your doctor or pharmacist before taking Cyclodynon if you have any of the following conditions or circumstances:

• Hormone-sensitive conditions: Endometriosis, uterine fibroids, or a history of hormone-sensitive cancers require careful medical evaluation before starting Cyclodynon
• Pituitary disorders: Any known or suspected pituitary gland abnormalities, including prolactinomas, should be excluded before treatment
• History of depression: While Cyclodynon may help alleviate PMS-related mood symptoms, women with a history of clinical depression should be monitored carefully, as hormonal changes could affect mood stability
• Fertility treatment: If you are undergoing assisted reproduction (IVF or other fertility treatments), consult your reproductive endocrinologist before taking Cyclodynon, as it may interact with fertility medications
• Liver disease: Patients with significant hepatic impairment should exercise caution, as the metabolism of herbal extracts may be altered
• Adolescents: The safety and efficacy of Cyclodynon in females under 18 years of age have not been established

If your symptoms persist or worsen after three months of treatment with Cyclodynon, or if new symptoms develop, discontinue use and consult your healthcare provider. Persistent or severe premenstrual symptoms may indicate an underlying condition requiring further investigation, such as premenstrual dysphoric disorder (PMDD), endometriosis, or thyroid dysfunction. Regular medical follow-up is recommended during treatment with Cyclodynon to ensure appropriate response to therapy.

Pregnancy and Breastfeeding

Cyclodynon must not be used during pregnancy. Due to its dopaminergic mechanism and effects on the hypothalamic-pituitary-gonadal axis, Vitex agnus-castus could potentially disrupt the hormonal environment necessary for maintaining a healthy pregnancy. Although there is limited data on teratogenicity in humans, animal studies have not adequately assessed the reproductive toxicity of Vitex agnus-castus extract. If you become pregnant while taking Cyclodynon, discontinue use immediately and inform your healthcare provider.

Cyclodynon should not be used during breastfeeding. The dopaminergic activity of Vitex agnus-castus reduces prolactin secretion, which is the primary hormone responsible for stimulating and maintaining lactation. Taking Cyclodynon while breastfeeding could reduce milk production and adversely affect the ability to breastfeed. Furthermore, it is not known whether the active compounds or their metabolites pass into breast milk and what effects they might have on the nursing infant.

Women who are trying to conceive should discuss the use of Cyclodynon with their doctor. While some preliminary research suggests that Vitex agnus-castus may improve fertility in women with luteal phase defects by normalising progesterone levels, this use should only be undertaken under medical supervision. Once pregnancy is confirmed, Cyclodynon must be discontinued immediately.

How Does Cyclodynon Interact with Other Drugs?

Cyclodynon may interact with dopamine agonists, dopamine antagonists (including certain antipsychotics and anti-emetics), hormonal contraceptives, and hormone replacement therapy. Always inform your doctor and pharmacist about all medicines, supplements, and herbal remedies you are currently taking.

Drug interactions with Cyclodynon primarily stem from its dopaminergic mechanism of action. Because Vitex agnus-castus acts as a dopamine D2 receptor agonist, it can potentially interact with any medication that affects dopaminergic neurotransmission. These interactions may be pharmacodynamic (additive or antagonistic effects at the receptor level) or pharmacokinetic (altered absorption, metabolism, or elimination).

The most clinically significant interactions involve dopamine antagonists, which are widely used as antipsychotic medications and anti-emetics. Dopamine antagonists work by blocking D2 receptors — the exact receptors that Vitex agnus-castus activates. Concurrent use could result in reduced efficacy of either the dopamine antagonist or Cyclodynon, potentially leading to a worsening of psychiatric symptoms or a loss of PMS symptom control. This interaction is particularly important for women who are being treated with antipsychotic medications and should never be overlooked.

Hormonal interactions are also relevant. Since Cyclodynon indirectly affects the oestrogen-progesterone balance by modulating prolactin levels, it could theoretically interact with exogenous hormonal treatments. The clinical significance of such interactions has not been fully established in controlled studies, making it essential to consult a healthcare provider before combining Cyclodynon with any hormonal medication.

Potential Drug Interactions

The table above is not exhaustive. Other medications, including certain antidepressants (particularly those affecting dopaminergic pathways), anti-emetics, and other herbal products with hormonal activity, may also interact with Cyclodynon. Always carry a complete list of all your medications and share it with every healthcare provider you visit. If you experience any unexpected symptoms after starting Cyclodynon alongside another medication, contact your doctor promptly.

What Is the Correct Dosage of Cyclodynon?

The standard dose of Cyclodynon is one film-coated tablet taken once daily, continuously (without interruption during menstruation). Treatment should be continued for at least three consecutive menstrual cycles to assess therapeutic effect. Always follow your doctor's specific dosage instructions.

Cyclodynon is formulated as a film-coated tablet containing a standardised dry extract of Vitex agnus-castus fruit (equivalent to approximately 40 mg of dried fruit per tablet). The standardisation ensures consistent levels of the pharmacologically active diterpenes and flavonoids across different batches. The recommended dose has been established through clinical trials and is designed to provide optimal prolactin-reducing activity while maintaining a favourable safety profile.

Adults

Children and Adolescents

Elderly Patients

Missed Dose

If you forget to take your daily dose of Cyclodynon, take it as soon as you remember on the same day. However, if you do not remember until the following day, skip the missed dose and continue with your regular once-daily schedule. Do not take a double dose to compensate for the one you missed. The therapeutic effect of Cyclodynon builds gradually over several weeks, so missing an occasional dose is unlikely to significantly impact overall efficacy. However, consistent daily dosing is important for optimal results.

If you frequently forget to take your medication, consider setting a daily alarm on your phone or placing the tablet pack next to something you use every morning (such as your toothbrush or coffee cup). Consistent timing helps maintain steady blood levels of the active compounds and supports the gradual hormonal rebalancing that Cyclodynon aims to achieve. If you have missed multiple consecutive doses, contact your pharmacist or doctor for guidance on how to resume treatment.

Overdose

What Are the Side Effects of Cyclodynon?

Cyclodynon is generally well tolerated. The most commonly reported side effects include headache, nausea, gastrointestinal discomfort, and skin reactions (acne, rash, itching). Allergic reactions are rare but possible. Contact your doctor if you experience any persistent or concerning symptoms.

Like all medicinal products, Cyclodynon can cause side effects, although not everybody gets them. Clinical trials and post-marketing surveillance data indicate that Cyclodynon has a favourable safety profile compared to conventional pharmacological treatments for PMS. The majority of side effects reported with Vitex agnus-castus preparations are mild to moderate in severity and resolve upon discontinuation of treatment.

The side effect profile of Cyclodynon is consistent with its pharmacological mechanism. As a dopamine D2 receptor agonist, it may occasionally cause adverse effects related to dopaminergic stimulation, such as headache, nausea, and dizziness. Skin reactions, including acne, may occur due to the indirect hormonal effects of the medication. It is important to note that some women experience temporary changes in their menstrual cycle when starting Cyclodynon, including slight changes in cycle length or flow. These changes typically stabilise within the first two to three cycles of treatment.

Serious adverse reactions are rare with Cyclodynon. However, as with any medicinal product, the possibility of severe allergic reactions (anaphylaxis) exists, particularly in individuals with a history of allergies to plants or herbal products. Women should be aware of the signs of a serious allergic reaction and seek immediate medical attention if they occur.

You are encouraged to report any suspected side effects to your healthcare provider or to your national pharmacovigilance authority. In the European Union, you can report side effects via the national reporting systems listed on the EMA website. Reporting side effects helps regulatory agencies and pharmaceutical companies identify previously unknown adverse reactions and improve the safety information available for all patients. Even if you are unsure whether a symptom is related to Cyclodynon, reporting it contributes to the ongoing safety monitoring of the product.

How Should You Store Cyclodynon?

Store Cyclodynon at room temperature below 25°C (77°F) in the original packaging. Keep out of reach and sight of children. Do not use after the expiry date printed on the packaging.

Proper storage of Cyclodynon is essential to maintain the quality, safety, and effectiveness of the herbal extract. The film-coated tablets should be stored in a cool, dry place at a temperature not exceeding 25°C (77°F). Avoid exposing the medication to excessive heat, direct sunlight, or moisture, as these environmental conditions can degrade the active phytochemical compounds, particularly the diterpenes and flavonoids that are responsible for the therapeutic effect.

Keep the tablets in their original packaging (blister pack or bottle) until you are ready to take them. The original packaging is specifically designed to protect the medication from light, moisture, and air exposure. If the tablets are supplied in blister packs, do not remove a tablet from the blister until immediately before use. If supplied in a bottle, keep the lid tightly closed after each use and ensure the desiccant (if present) remains inside the bottle.

Always keep Cyclodynon and all medications out of the reach and sight of children. Store medications in a locked cabinet or a location that children cannot access. Accidental ingestion of medications by children is a medical emergency and requires immediate medical attention.

Do not use Cyclodynon after the expiry date stated on the carton, blister pack, or bottle label. The expiry date refers to the last day of that month. Expired herbal products may have reduced potency as the active phytochemicals degrade over time, and they could potentially contain breakdown products of unknown safety. Check the expiry date regularly and return any unused or expired tablets to your pharmacist for safe, environmentally responsible disposal.

What Does Cyclodynon Contain?

Each Cyclodynon film-coated tablet contains a standardised dry extract of Vitex agnus-castus fruit (equivalent to approximately 40 mg of dried chasteberry fruit), along with pharmaceutical excipients that support the tablet's structure, stability, and film coating.

The active ingredient in Cyclodynon is a dry extract obtained from the ripe dried fruits of Vitex agnus-castus L. (chasteberry). The extraction process uses a defined solvent (typically ethanol 60% v/v) to obtain a concentrated extract standardised for its content of pharmacologically active constituents. Each tablet contains an extract quantity equivalent to approximately 40 mg of the native dried fruit material. The drug-to-extract ratio and standardisation parameters ensure batch-to-batch consistency in terms of the key active compounds, including diterpenes (such as rotundifuran and vitexilactone), flavonoids (casticin and penduletin), and iridoid glycosides (agnuside and aucubin).

The pharmacological activity of the Vitex agnus-castus extract is attributed primarily to the diterpene fraction, which demonstrates affinity for dopamine D2 receptors. The flavonoid fraction may contribute additional anti-inflammatory and antioxidant properties. The specific combination and concentration of these phytochemicals in the standardised extract is what distinguishes Cyclodynon from simple chasteberry dietary supplements, which may not undergo the same level of quality control or standardisation.

In addition to the active extract, Cyclodynon tablets contain inactive ingredients (excipients) that serve various pharmaceutical functions. These typically include tablet binders (such as povidone), fillers (such as lactose monohydrate or microcrystalline cellulose), disintegrants (such as croscarmellose sodium), lubricants (such as magnesium stearate), and the film-coating components (such as hypromellose, titanium dioxide, talc, and iron oxide pigments). The film coating provides protection from environmental factors and facilitates easy swallowing.

If you have known allergies or intolerances to any pharmaceutical excipients, such as lactose intolerance, discuss this with your doctor or pharmacist before starting Cyclodynon. They can verify the specific excipients in the current formulation and recommend alternatives if necessary. The complete list of excipients is available in the patient information leaflet included in the packaging and in the Summary of Product Characteristics (SmPC) maintained by the national regulatory authority.

Frequently Asked Questions About Cyclodynon