Klayra, instructions and side effects. How to take birth control pills How long can I take
(information for patients)
Registration number P N013534/01-140113
Tradename
Logest®
International non-proprietary name or grouping name
Gestodene + Ethinylestradiol
Dosage form
Coated tablets
Compound
Each tablet contains:
Core:
Active substances: 0.075 mg gestodene and 0.020 mg ethinyl estradiol.
Excipients: lactose monohydrate 37.155 mg, corn starch 15.500 mg, povidone 25 thousand 1.700 mg, magnesium stearate 0.550 mg.
Shell: sucrose 19.660 mg, povidone 700 thousand 0.171 mg, macrogol-6000 2.180 mg, calcium carbonate 8.697 mg, talc 4.242 mg, mountain glycol wax 0.050 mg.
Description
White film-coated tablets, round shape.
Pharmacotherapeutic group
Combined contraceptive (estrogen + gestagen)
ATX code G03AA10
Pharmacological properties
Logest is a low-dose monophasic oral combined estrogen-progestin contraceptive drug.
The contraceptive effect of Logest is carried out through complementary mechanisms, the most important of which include the suppression of ovulation and changes in the state of cervical mucus.
When used correctly, the number of pregnancies per 100 women per year is less than 1. If the pills are used incorrectly, including missing pills, the Pearl index may increase.
In women taking combined oral contraceptives, the cycle becomes more regular, soreness and intensity of menstrual-like bleeding decrease, resulting in a reduced risk of iron deficiency anemia. In addition, there is evidence that the risk of endometrial cancer and ovarian cancer is reduced.
Indications
Oral contraception (prevention of unwanted pregnancy).
Contraindications
Logest should not be used in the presence of any of the conditions/diseases listed below.
Thrombosis (venous and arterial) and thromboembolism at present or in the past (including deep vein thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular disorders (eg, stroke).
Conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at present or in the past.
The presence of severe or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see section "Special Instructions").
Migraine with focal neurological symptoms, present or in the past.
Diabetes mellitus with vascular complications.
Pancreatitis with severe hypertriglyceridemia, present or in the past.
Liver failure and severe liver disease (until liver tests return to normal).
Liver tumors (benign or malignant), present or in the past.
Identified hormone-dependent malignant neoplasms (including the genital organs or mammary glands) or suspicion of them.
Bleeding from the vagina of unknown origin.
Pregnancy or suspicion of it.
Breast-feeding.
Hypersensitivity to any of the components of the drug Logest.
If any of these conditions appear for the first time while taking Logest, stop taking this drug immediately and consult your doctor. In the meantime, use non-hormonal birth control. See also "Special Instructions".
Use with caution
If combined oral contraceptives are used in the presence of any of the conditions listed below, you may need to carefully monitor why - the doctor will explain. Tell your doctor before you start taking Logest
if you have any of the conditions and diseases listed below.
Risk factors for the development of thrombosis and thromboembolism: smoking; thrombosis, myocardial infarction or cerebrovascular accident at a young age in any of the immediate relatives; obesity; dyslipoproteinemia (for example, high blood cholesterol levels); arterial hypertension; migraine without focal neurological symptoms; heart valve disease; heart rhythm disturbances; prolonged immobilization (immobility), major surgery, extensive trauma.
Other diseases in which peripheral circulatory disorders may occur (diabetes mellitus without vascular complications; systemic lupus erythematosus; hemolytic uremic syndrome; Crohn's disease and ulcerative colitis; sickle cell anemia), as well as phlebitis of superficial veins.
Hypertriglyceridemia.
Liver diseases.
Diseases that first arose or worsened during pregnancy or against the background of a previous intake of sex hormones (for example, jaundice, cholestasis, gallbladder disease, otosclerosis with hearing loss, porphyria, herpes pregnant, Sydenham's chorea).
In women with hereditary angioedema, exogenous estrogens may cause or exacerbate the symptoms of angioedema.
Pregnancy and lactation
Logest should not be used during pregnancy and while breastfeeding. If pregnancy is detected while taking the drug Logest, the drug should be immediately discontinued and consult a doctor. However, extensive epidemiological studies have not found any increased risk of developmental defects in children born to women who received sex hormones before pregnancy, or who inadvertently took sex hormones in early pregnancy.
Children and teenagers
The drug Logest is indicated only after the onset of menarche.
Dosage and administration
When and how to take pills
The calendar package contains 21 tablets. In the package, each tablet is marked with the day of the week on which it should be taken. Take the tablets at the same time each day with a small amount of water. Follow the direction of the arrow until all 21 tablets have been taken. You do not take the drug for the next 7 days. Menstruation (withdrawal bleeding) must begin within these 7 days. It usually starts 2-3 days after taking the last Logest tablet. After a 7-day break, start taking the next pack, even if the bleeding has not yet stopped. This means that you will always start a new pack on the same day of the week, and that each month the "withdrawal" bleed will occur around the same day of the week.
Reception of the first package of Logest
If no hormonal birth control has been used in the previous month
Start taking Logest on the first day of the cycle, that is, on the first day of menstrual bleeding. Take the pill labeled with the corresponding day of the week. Then take the tablets in order. You can also start taking on days 2-5 of the menstrual cycle, but in this case, you must use an additional barrier method of contraception (condom) during the first 7 days of taking the tablets from the first package.
When switching from other combined oral contraceptives, vaginal ring or contraceptive patch.
You can start taking Logest the day after you take the last pill from your current pack of combined oral contraceptives (i.e., without a break in taking). If the current package contains 28 tablets, you can start taking Logest the next day after taking the last hormone-containing tablet. If you are not sure which tablet it is, ask your doctor. You can also start taking later, but in no case later than the next day after the usual break in taking (for preparations containing 21 tablets) or after taking the last inactive tablet (for preparations containing 28 tablets per pack).
Logest should be started on the day the vaginal ring or patch is removed, but no later than the day a new ring is to be inserted or a new patch is pasted.
When switching from oral contraceptives containing only progestogen (mini-pill)
You can stop taking the mini-pill any day and start taking Logest the next day, at the same time. During the first 7 days of taking the tablets, you must also use an additional barrier method of contraception.
When switching from an injectable contraceptive, an implant, or a progestogen-releasing intrauterine contraceptive (Mirena®)
Start taking Logest on the day your next injection is due or on the day your implant or intrauterine contraceptive is removed. During the first 7 days of taking the tablets, an additional barrier method must also be used.
contraception.
After childbirth
If you have just had a baby, your doctor may recommend that you wait until the end of your first normal menstrual cycle before starting Logest. Sometimes, on the recommendation of a doctor, it is possible to start taking the drug earlier.
After a spontaneous miscarriage or abortion in the first trimester of pregnancy
Taking missed pills
If the delay in taking the next pill is less than 12 hours, the contraceptive effect of Logest is preserved. Take the pill as soon as you remember. Take the next tablet at the usual time.
If the delay in taking the tablets was more than 12 hours, contraceptive protection may be reduced. The more pills missed in a row, and the closer this gap is to the start of the intake or to the end of the intake, the higher the risk of pregnancy.
In this case, you can follow the following rules:
Forgotten more than one tablet from the package
Consult your doctor.
One tablet missed in the first week of taking the drug
Take the missed pill as soon as you remember (even if it means taking two pills at the same time). Take the next tablet at the usual time. Additionally, use a barrier method of contraception for the next 7 days. If sexual intercourse took place during the week before the pill was missed, the possibility of pregnancy should be considered. Consult your physician immediately.
One tablet missed in the second week of taking the drug
Take the missed pill as soon as you remember (even if it means taking two pills at the same time). Take the next tablet at the usual time. The contraceptive effect of Logest is preserved, and you do not need to use additional contraceptive measures.
One tablet missed in the third week of taking the drug
You can stick to either of the following two options without the need for additional contraceptive precautions.
1. Take the missed pill as soon as you remember (even if it means taking two pills at the same time). Take the next tablet at the usual time. Start the next pack as soon as you finish taking the pills from the current pack, so there is no break between packs. "Withdrawal" bleeding is unlikely until the pills in the second pack are finished, but there may be spotting or "breakthrough" bleeding on the days of taking the drug.
2. Stop taking the tablets from the current package, take a break of 7 days or less ( including skip day) and then start taking the new pack.
Using this schedule, you can always start your next pack on the day of the week you normally would.
If you do not have your expected period after taking the pill, you may be pregnant. Check with your doctor before starting a new pack.
If you have had vomiting or diarrhea (indigestion) within 4 hours of taking Logest tablets, the active substances may not have been completely absorbed. This situation is similar to skipping a drug. So follow the instructions for missed pills.
Delaying the onset of menstrual bleeding
You can delay the onset of menstrual bleeding if you start taking the next pack of Logest immediately after the end of the current pack. You can continue taking the tablets in this package for as long as you wish, or until the package runs out. If you want menstrual-like bleeding to start, stop taking the pills. While taking Logest from the second package, spotting or bleeding may occur on the days of taking the tablets. Start the next pack after the usual 7-day break.
Changing the day of onset of menstrual bleeding
If you take the pills as directed, you will have menstrual-like bleeding on about the same day every 4 weeks. If you want to change it, shorten (but don't lengthen) the amount of time you don't take pills. For example, if your menstrual cycle usually starts on Friday and in the future you want it to start on Tuesday (3 days earlier), the next pack should start 3 days earlier than usual. If the pill-free break is very short (eg, 3 days or less), "withdrawal" bleeding during the break may not occur. In this case, bleeding or spotting may occur while taking the tablets from the next pack.
Additional information for individual groups of patients
Elderly patients
Not applicable. The drug Logest is not indicated after menopause.
Patients with liver disorders
Logest is contraindicated in women with severe liver disease until liver function tests return to normal. See also section "Contraindications".
Patients with kidney disorders
Logest has not been specifically studied in patients with renal impairment. Available data do not suggest adjustment of the dosing regimen in these patients.
Side effect
When taking Logest, as well as other combined oral contraceptives, irregular bleeding (spotting spotting or bleeding) may occur, especially during the first months of use.
Against the background of taking combined oral contraceptives in women, other undesirable effects were observed, the relationship of which with the intake of drugs has not been confirmed, but not refuted.
| Organ system | Often (≥1/100) | Uncommon (≥1/1000 and<1/100) | Rarely (<1/1000) |
| Organ of vision | intolerance to contact lenses (discomfort when wearing them) | ||
| Gastrointestinal tract | nausea, abdominal pain | vomiting, diarrhea | |
| The immune system | hypersensitivity | ||
| General symptoms | weight gain | weight loss | |
| Metabolism | fluid retention | ||
| Nervous system | headache | migraine | |
| Mental disorders | decreased mood, mood swings | decreased libido | increased libido |
| Reproductive system and mammary glands | soreness of the mammary glands, engorgement of the mammary glands | mammary hypertrophy | vaginal discharge, breast discharge |
| Skin and subcutaneous tissues | rash, hives | erythema nodosum, erythema multiforme |
The following serious adverse events have been reported in women using combined oral contraceptives. Additional information about possible side effects of oral combined contraceptives, including Logest®, is presented in the "Special instructions" section:
Venous thromboembolic disorders.
Arterial thromboembolic disorders.
Cerebrovascular disorders.
Increase in blood pressure.
Hypertriglyceridemia.
Changes in glucose tolerance or effects on peripheral insulin resistance.
Tumors of the liver (benign and malignant).
Violation of the functional parameters of the liver.
Chloasma.
The onset or worsening of conditions for which the relationship with the use of combined oral contraceptives has not been proven: jaundice and / or itching associated with cholestasis; the formation of gallbladder stones; porphyrin disease; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes of pregnant women; hearing loss associated with otosclerosis; Crohn's disease; ulcerative colitis; cervical cancer.
The frequency of diagnosing breast cancer in women using oral contraceptives is increased very slightly. Breast cancer is rarely observed in women under 40 years of age, the excess frequency is insignificant in relation to the overall risk of breast cancer. A causal relationship of breast cancer with the use of combined oral contraceptives has not been established. For more information, see the section "Contraindications" and "Special Instructions".
As with other combined oral contraceptives, in rare cases, thrombosis and thromboembolism may develop (see also "Special Instructions").
Overdose
Serious violations in case of overdose have not been reported. In preclinical studies, no serious adverse effects were observed as a result of overdose.
Symptoms that may occur in overdose include nausea, vomiting, spotting or vaginal bleeding.
In case of overdose, you should consult a doctor.
Interaction with other drugs
Some medicines may reduce the effectiveness of Logest. These include drugs used to treat epilepsy (eg, primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate), tuberculosis (eg, rifampicin, rifabutin), and HIV infection (eg, ritonavir, nevirapine); antibiotics to treat some other infectious diseases (eg, penicillin, tetracyclines, griseofulvin); and drugs based on St. John's wort (used mainly in the treatment of depressed mood).
Oral combined contraceptives may interfere with the metabolism of other drugs (eg, cyclosporine and lamotrigine).
Always tell the doctor prescribing you Logest what medicines you are already taking. Also tell any doctor or dentist who prescribes other drugs, or any pharmacist who sells drugs to you at the pharmacy, that you are taking Logest.
In some cases, your doctor may recommend that you additionally use a barrier method of contraception (condom).
special instructions
The following warnings regarding the use of other combined oral contraceptives should also be taken into account when using Logest.
Thrombosis
Thrombosis is the formation of a blood clot (thrombus) that can block a blood vessel. When a thrombus breaks off, thromboembolism develops. Sometimes thrombosis develops in the deep veins of the legs (deep vein thrombosis), the vessels of the heart (myocardial infarction), the brain (stroke), and extremely rarely in the vessels of other organs.
The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increase in the incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders) when taking combined oral contraceptives. These diseases are rare.
The risk of developing venous thromboembolism (VTE) is highest in the first year of taking these drugs. An increased risk is present after the initial use of combined oral contraceptives or the resumption of use of the same or different combined oral contraceptives (after a break between doses of 4 weeks or more). Data from a large prospective study in 3 groups of patients show that this increased risk is predominantly present during the first 3 months.
The overall risk of VTE in patients taking low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола) в два-три раза выше, чем у небеременных пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах.
In very rare cases, venous or arterial thromboembolism can lead to serious functional impairment or death.
VTE manifesting as deep vein thrombosis or pulmonary embolism can occur with any combined oral contraceptive.
Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or vessels of the retina.
The risk of developing thrombosis (venous and / or arterial) and thromboembolism increases:
- with age;
- in smokers (with an increase in the number of cigarettes or an increase in age, the risk increases, especially in women over 35 years old);
in the presence of:
- family history (for example, venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
- obesity (body mass index more than 30 kg/m);
- dyslipoproteinemia;
- arterial hypertension;
- migraine;
- diseases of the heart valves;
- atrial fibrillation;
- prolonged immobilization, major surgery, any operation on the legs or major trauma. In these situations, it is advisable to stop the use of combined oral contraceptives (in the case of a planned operation, at least four weeks before it) and not resume taking within two weeks after the end of immobilization.
Tumors
The relationship between taking combined oral contraceptives and breast cancer has not been proven, although in women taking combined oral contraceptives, it is slightly more common than in women of the same age who do not use them. Perhaps this difference is due to the fact that when taking the drug, women are examined more often and therefore breast cancer is detected at an early stage.
In rare cases, against the background of the use of sex steroids, the development of benign, and in extremely rare cases, malignant liver tumors, which can lead to life-threatening intra-abdominal bleeding, was observed. The relationship with the use of drugs has not been proven. If you suddenly develop severe abdominal pain, consult your doctor immediately.
The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. Cervical cancer was detected slightly more often in women using combined oral contraceptives for a long period of time. The relationship with the use of combined oral contraceptives has not been proven. This may be due to more frequent gynecological examinations for cervical disease or to sexual behavior (more rare use of barrier methods of contraception).
Reduced efficiency
The effectiveness of combined oral contraceptives may be reduced in the following cases: when you skip pills, with vomiting and diarrhea, or as a result of drug interactions.
In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen the symptoms of angioedema.
Women with a tendency to chloasma while taking combined oral contraceptives should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.
Each tablet of the drug Logest contains 35 mg of lactose. Patients with rare hereditary diseases - galactose intolerance, lactase deficiency, glucose-galactose malabsorption, who are on a diet with the exception of lactose, should take into account information about the lactose content in the preparation.
Frequency and severity of menstrual bleeding
As with the use of other combined oral contraceptives, when taking Logest during the first few months, irregular bleeding from the vagina (spotting spotting or "breakthrough" bleeding) in the intermenstrual period may be observed. Use hygiene products and continue taking the tablets as usual. Irregular bleeding usually stops as your body adapts to Logest (usually after 3 pill cycles). If they continue, become severe, or recur after stopping, see your doctor.
Absence of regular menstrual bleeding
If you have taken all the pills correctly and you have not vomited while taking the pills or taking other medications at the same time, then the chance of pregnancy is low. Continue taking Logest as usual.
If there are no two menstrual-like bleeding in a row, consult a doctor immediately. Do not start the next pack until your doctor has ruled out pregnancy.
Laboratory tests
Taking combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma transport proteins, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond the boundaries of normal values.
Influence on the ability to drive a car and mechanisms
Not found.
When to consult a doctor
Regular checkups
If you are taking Logest, your doctor will inform you about regular check-ups, which a woman should usually have at least once every 6 months.
Consult your doctor as soon as possible:
in case of any changes in health, especially any of the conditions listed in this package insert (see also: "Contraindications" and "Use with caution");
with local compaction in the mammary gland;
if you are going to use other medicines (see also "Interaction with other medicines");
if expected: prolonged immobility (for example, a cast on the leg), hospitalization or surgery is planned (consult a doctor at least 4-6 weeks before);
if you experience unusual heavy vaginal bleeding;
if you forgot to take a tablet in the first week of taking the pack and had sexual intercourse seven days or less before;
you have missed your next period twice in a row or suspect you are pregnant (do not start the next pack until you have consulted with your doctor).
Stop taking the tablets and tell your doctor immediately if you notice possible signs of thrombosis, myocardial infarction or stroke: unusual cough; unusually severe pain behind the sternum, radiating to the left arm; unexpected shortness of breath; unusual, severe or prolonged headache or migraine attack; partial or complete loss of vision or double vision; inarticulate speech; sudden changes in hearing, smell, or taste; dizziness or fainting; weakness or loss of sensation in any part of the body; severe pain in the abdomen; severe pain in the leg or sudden swelling of any of the legs.
Logest does not protect against contracting HIV infection (AIDS) or any other sexually transmitted disease.
The drug Logest is recommended by the doctor to you personally, do not pass the drug to others!
Release form
Coated tablets 75 mcg + 20 mcg. 21 tablets in a blister of PVC film and aluminum foil. 1 or 3 blisters are placed together with instructions for use in a cardboard box.
Storage conditions
Store at a temperature not exceeding 25°C.
Keep out of the reach of children.
Best before date
4 years.
Do not use after the expiration date!
Terms of dispensing from pharmacies
On prescription.
Legal entity in whose name the registration certificate is issued:
Bayer Pharma AG, Müllerstraße 178, 13353 Berlin, Germany
Bayer Pharma AG, Mullerstrasse 178, 13353 Berlin, Germany
Manufacturer:
Delpharm Lille SAS, Rue de Touffler, 59390 Lys-les-Lanois. France
Delpharm Lille SAS, Rue de Toufflers 59390 Lys Lez- Lannoy, France
Mode of application: for intake.
How to take Dimia®
The tablets should be taken daily, at about the same time, with a small amount of water, in the order indicated on the blister pack. Tablets are taken continuously for 28 days, 1 tablet per day. Taking pills from the next pack begins after taking the last pill from the previous pack. "Withdrawal" bleeding usually begins 2-3 days after the start of placebo tablets (last row) and does not necessarily end by the start of the next pack.
How to start taking Dimia®
Hormonal contraceptives have not been used in the last month
Dimia® is started on the first day of the menstrual cycle (i.e. on the first day of menstrual bleeding). It is also possible to start taking it on the 2nd-5th day of the menstrual cycle, in which case additional use of a barrier method of contraception is necessary during the first 7 days of taking the tablets from the first package.
Switching from other combined contraceptives (combined oral contraceptive pills, vaginal ring, or transdermal patch)
Dimia® should be started the next day after taking the last inactive tablet (for preparations containing 28 tablets) or the day after taking the last active tablet from the previous package (possibly the next day after the end of the usual 7-day break) - for preparations containing 21 tablets per pack. In the case of a woman using a vaginal ring or transdermal patch, it is preferable to start taking Dimia® on the day of their removal or, at the latest, on the day when a new ring or patch is planned to be inserted.
Switching from progestogen-only contraceptives (mini-pills, injections, implants) or from a progestogen-releasing intrauterine system (IUD)
A woman can switch from taking a mini-pill to taking Dimia® on any day (from an implant or from an IUD on the day they are removed, from injectable forms of drugs on the day the next injection was due), but in all cases it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.
After an abortion in the first trimester of pregnancy
Dimia® can be started on the day of termination of pregnancy as prescribed by the doctor. In this case, the woman does not need to take additional contraceptive measures.
After childbirth or abortion in the second trimester of pregnancy
A woman is recommended to start taking the drug on the 21-28th day after childbirth (provided that she is not breastfeeding) or abortion in the second trimester of pregnancy. If the reception is started later, the woman should use an additional barrier method of contraception during the first 7 days after starting Dimia®. With the resumption of sexual activity (before taking Dimia®), pregnancy should be excluded.
Taking missed pills
Missing a placebo tablet from the last (4th) row of the blister can be ignored. However, they should be discarded to avoid inadvertently prolonging the placebo phase. The indications below apply only to missed tablets containing the active ingredients.
If the delay in taking the pill was less than 12 hours, contraceptive protection is not reduced. The woman should take the missed pill as soon as possible (as soon as she remembers) and the next pill at the usual time.
If the delay exceeds 12 hours, contraceptive protection may be reduced. In this case, you can be guided by two basic rules:
1. Taking pills should never be interrupted for more than 7 days;
2. To achieve adequate suppression of the hypothalamic-pituitary-ovarian system, 7 days of continuous tablet intake are required.
Accordingly, women can be given the following recommendations:
- Days 1-7
A woman should take the missed pill as soon as she remembers, even if it means taking two pills at the same time. Then she should take her tablets at the usual time. Also, a barrier method such as a condom should be used for the next 7 days. If sexual intercourse has occurred in the previous 7 days, the possibility of pregnancy should be considered. The more pills missed and the closer this pass is to the 7-day break in taking the drug, the higher the risk of pregnancy.
- Days 8-14
The woman should take the missed tablet as soon as she remembers, even if it means taking two tablets at the same time. Then she should take her tablets at the usual time. If during the 7 days preceding the first missed pill, the woman took the pills as expected, there is no need for additional contraceptive measures. However, if she missed more than 1 tablet, an additional method of contraception (barrier - for example, a condom) is needed for 7 days.
- Days 15-24
The reliability of the method inevitably declines as the placebo pill phase approaches. However, correcting the pill regimen can still help prevent pregnancy. If one of the two schemes described below is followed, and if the woman has observed the drug regimen in the previous 7 days before skipping the pill, there will be no need to use additional contraceptive measures. If this is not the case, she must complete the first of the two regimens and use additional precautions for the next 7 days.
1. A woman should take the last missed tablet as soon as she remembers, even if it means taking two tablets at the same time. Then she should take the tablets at the usual time until the active tablets run out. 4 placebo tablets from the last row should not be taken, you must immediately start taking the tablets from the next blister pack. Most likely, there will be no "withdrawal" bleeding until the end of the second pack, but there may be "spotting" spotting or "withdrawal" bleeding on the days of taking the drug from the second pack.
2. A woman can also stop taking active tablets from the started package. Instead, she should take the placebo pills from the last row for 4 days, including the days she skipped pills, and then start taking the pills from the next pack.
If a woman misses a pill and does not subsequently experience "withdrawal" bleeding in the placebo pill phase, the possibility of pregnancy should be considered.
The use of the drug in gastrointestinal upset
In case of severe gastrointestinal disturbances (eg, vomiting or diarrhea), the absorption of the drug will be incomplete and additional contraceptive measures will be required. If vomiting occurs within 3-4 hours after taking the active tablet, a new (replacement) tablet should be taken as soon as possible. If possible, the next tablet should be taken within 12 hours of the usual tablet-taking time. If more than 12 hours have passed, it is recommended to proceed according to the instructions for missing tablets. If a woman does not want to change her usual pill regimen, she should take an additional pill from another pack.
Postponement of menstrual bleeding "withdrawal"
To delay bleeding, the woman should skip taking the placebo tablets from the started package and start taking the drospirenone + ethinyl estradiol tablets from the new package. The delay can be extended until the active tablets in the second pack run out. During the delay, a woman may experience acyclic copious or "spotting" bleeding from the vagina. Regular intake of Dimia® is resumed after the placebo phase.
To shift bleeding to another day of the week, it is recommended to shorten the upcoming phase of taking placebo tablets by the desired number of days. When the cycle is shortened, it is more likely that a woman will not have menstrual-like “withdrawal” bleeding, but will have acyclic copious or “spotting” vaginal bleeding on the next pack (same as with lengthening the cycle).
The search for new safe and effective contraceptives continues. Pharmaceutical companies regularly carry out new developments in this area, with regard primarily to birth control pills.
And if a few decades ago, birth control pills had a long list of side effects, which caused particular concern among women, today pharmacology is more successful in this area.
The market is constantly updated with new developments, which also include contraceptive pills Median. These are low-dose birth control pills prescribed for women who have not given birth and have given birth, as well as for women over the age of 35.
Birth control pills median
The median may also be prescribed in order to achieve a cosmetic effect. This drug is a monophasic contraceptive - all tablets contain the same dose of hormones (3 milligrams of drospirenone and 0.03 milligrams of ethinyl estradiol).
Pros of the Median
Drospirenone, which is part of the Median, has a cosmetic antiandrogenic effect. This means that the pills prevent the influence of male sex hormones (androgens) on the woman's body. Androgens are considered one of the main causes of acne and excessive sebum production. The median helps to normalize the work of the skin sebaceous glands and reduce the appearance of acne.
This drug also helps in reducing the symptoms of PMS, soreness before and after menstruation, and also helps in the normalization of the menstrual cycle. All these effects are achieved due to the regular intake of Median for at least two or three months.
Median tablet instruction
If you have not previously taken birth control pills, the first pill is taken on the first day of your period. In this situation, it is possible not to use condoms already from the beginning of taking the Median.
The start of taking the pills can also be carried out during the period from the second to the fifth day of menstruation, but in this situation, condoms must be used for another week after the first pill.
The median is recommended to be taken every day “by the alarm clock” at the same time, without attachment to food intake. However, small deviations, in principle, are not considered dangerous. If you are late to take the next pill by no more than 12 hours, then the effect of the drug will not decrease.
Tablets are taken in the order indicated in the instructions, but this is not a strict rule. All median tablets contain an equal dose of hormones, which is why the order of administration is not fundamental. It is also important to take one tablet per day.
At the end of the tablets in the blister, a seven-day break is necessary, during which the tablets are not taken. During this time, withdrawal bleeding, similar to a period, may occur.
The next package is started on the eighth day after the break. By the way, with all this, it does not matter at all whether menstruation has begun or has managed to end by the time the next package is taken.
Switching from other contraceptives
If you decide to switch to Median from any other birth control pills, you need to follow some recommendations.
1. If the blister of the previous drug contained 28 tablets, Median should be taken the next day after the last tablet in the blister of the previous drug.
2. If the blister of the previous drug contained 21 tablets, Median begins to drink after the completion of the previous drug or after a break on the next day.
Even during the first week of taking the median, experts advise additional protection.
Switching to Median from an IUD, vaginal ring, or hormone patch
In this situation, the first tablet of Median is taken on the day of the removal of the vaginal ring or the removal of the hormonal patch. You can also start taking the drug on the day when you would need to attach a new patch or insert a vaginal ring. In order to avoid pregnancy, during the week of taking the tablets, it is recommended not to neglect additional methods of contraception.
When switching to Median from the IUD, the drug must be started on the day of the removal of the spiral, and then another week must be protected additionally.
Median after abortion
In the case of an abortion before 12 weeks of pregnancy, Median should be taken on the day of the procedure. In the case of an abortion for a period of more than 12 weeks, the median is taken on the 21-28th day after the abortion. For another week, you are protected additionally.
If unprotected sexual intercourse took place between the abortion and taking the drug, it is necessary to exclude the presence of pregnancy before taking the drug.
Median after delivery
After childbirth, the drug can be taken only if the woman is not breastfeeding. The fact is that for nursing mothers there are other special drugs that cannot harm the baby. Therefore, the question is recommended to consult a gynecologist.
If a woman is not breastfeeding, the drug can be taken 21-28 days after birth. In the presence of unprotected intercourse before taking the drug, it is important to make sure that there is no pregnancy.
Missing a pill
If the delay in taking the next pill is no more than 12 hours, then the effectiveness of the drug does not suffer from this. If the delay is more than 12 hours, you must take into account which tablet you missed on the bill.
If it is tablet 1 to 7, the missed tablet is taken as soon as it is remembered, even if two tablets need to be taken at the same time. After that, you need to use other contraceptives for a week.
If it is tablet 8 to 14, the missed tablet is taken even if it is necessary to take two tablets at once. After that, if 7 days before the pass everything was done according to the rules, without passes, it is not necessary to use condoms.
If there were other passes during the previous week before the pass, you will have to use condoms for another week.
If it is a tablet from 15 to 21, it is necessary, as in other cases, to take the missed tablet, drink the blister to the end, and then start a new blister without a break of seven days. If there were no other passes before this pass, additional means of protection can not be used.
If during the previous week there were certain errors in taking the pills, another week should be additionally protected.
Missing multiple pills
If you missed several tablets in a row, you need to drink two tablets within two days. So in two days you will catch up with all the pills you need on the bill. If you miss three tablets in a row, you will have to drink two tablets for three days.
In case of missing four tablets or more, it is necessary to additionally consult with a specialist about their further actions.
If several tablets are missed in a row, additional protection should be used within 7 days after the resumption of the drug.
One or two days after the missed period, breakthrough bleeding may occur, which is similar to menstruation, or spotting. Do not be afraid, because it is not dangerous. You need to continue taking the pills according to the instructions, and these discharges will stop by themselves.
Breaks in the reception of the Median - necessary or not?
There is an opinion that about once every 6-12 months it is necessary to take a 1-2-month break in the course of taking birth control pills. But this is not true.
Significant interruptions in taking the drug will not bring any benefit to the body, as this is a significant stress for the ovaries.
As studies on this topic have shown, Median can be taken up to 5 years in a row, and without long breaks. This does not affect the likelihood of a future pregnancy at all. You can conceive a baby almost immediately after stopping the pills.
If you take a break for a month, the likelihood of becoming pregnant during the period of pill withdrawal increases. Condoms must be used to avoid pregnancy. At the same time, it is necessary to remember about the unreliability of interrupted intercourse in terms of protection against pregnancy, so this method should be abandoned.
After a break, many women suffer from cycle disorders, delayed menstruation, hair loss, acne, as well as a deterioration in well-being and other symptoms. That is why, if you take such breaks, you need to be prepared for such side effects.
Median and other medicines
The contraceptive effect of the Median may decrease with the use of certain drugs, and this, in turn, may result in an unwanted pregnancy. We are talking about antibiotics (penicillins, tetracyclines, Rifampicin), drugs for epilepsy (Phenytoin, Carbamazepine), sleeping pills (Phenobarbital), drugs used in the treatment of fungal infections (Griseofulvin) and drugs containing St. John's wort (Novo-passit), etc. .
A decrease in the effectiveness of the drug when taking these drugs can cause spotting or even breakthrough bleeding. This is not dangerous, so you should not deviate from the schedule for taking the Median. During the treatment period, as well as seven days after its completion, additional protection should not be neglected.
Median and alcohol
Small doses of alcohol do not affect the effectiveness of the drug. But the allowable rate of alcohol depends on metabolism, age, weight and other factors. On average, during the reception of the Median, no more than 50 milliliters of vodka, 200 milliliters of wine and 400 milliliters of beer are allowed. In case of exceeding the mentioned dose, it is worth protecting yourself additionally for 7 days after drinking alcohol.
How to take birth control pills
If there is a need to delay menstruation after the end of one blister of the drug, it is necessary to start the next blister the very next day, without taking a week break, and drink it to the end. In this situation, menstruation will be delayed by about 2-4 weeks, but perhaps in the middle of taking the next blister, spotting will appear.
It must be remembered that menstruation can be delayed only if the drug was started at least a month before the delayed period.
If there is no period during the seven-day break
If the drug was taken in the previous month according to the rules, there is no reason to worry. Menstruation in this case may well not come during a break, which is not dangerous. You just need to start a new pack, even if there were no periods. If the menstruation does not come in the next month, you need to do a pregnancy test and go to the gynecologist.
If during the previous month there were missed pills, or if you took drugs that reduce the effectiveness of the Median, it is not recommended to start the next pack after a week break. First you need to do a pregnancy test and do not resume taking the drug until you completely rule out the possibility of pregnancy.
If pregnancy occurs while taking the drug Median, you should immediately stop taking the pills and go to an appointment with a gynecologist.
Reception of the Median in the early stages of pregnancy cannot provoke anomalies in the development of the fetus, so the pregnancy can be saved. You just need to start taking folic acid as soon as possible.
Last update of the description by the manufacturer 25.09.2014
Filterable List
Active substance:
ATX
Pharmacological group
Nosological classification (ICD-10)
Compound
pharmachologic effect
pharmachologic effect- contraceptive, estrogen-progestin.Dosage and administration
inside.
When and how to take dragees
The blister contains 21 tablets. Each dragee is marked with the day of the week on which it must be taken.
Take the dragee every day at the same time with a small amount of water. It is necessary to follow the direction of the arrow until all 21 pills have been taken. Over the next 7 days - a break in taking the drug. Menstruation (withdrawal bleeding) must begin within these 7 days. Usually it starts 2-3 days after taking the last pill.
After a 7-day break (on the 8th day), start taking the pills from the next package, even if the bleeding has not yet stopped. This means that you should always start a new pack on the same day of the week and that withdrawal bleeding will occur around the same day of the week each month.
Taking the first pack of Microgynon ®
When no hormonal birth control was used in the previous month
Start taking Microgynon ® on the 1st day of the cycle, i.е. on the 1st day of menstrual bleeding. Take a dragee that is marked with the corresponding day of the week. Then take the pills in order. You can also start taking on the 2nd-5th day of the menstrual cycle, but in this case it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills from the first package.
When switching from other combined oral contraceptives
Reception of Microgynon ® can be started the day after the last tablet of the current package of the combined oral contraceptive is taken (ie without interruption in taking the tablets). If the current package contains 28 tablets, you can start taking Microgynon ® the next day after taking the last one. active pills. If a woman is not sure which tablet it is, she should ask her doctor. You can also start taking later, but in no case later than the next day after the usual break in taking (for preparations containing 21 tablets) or after taking the last inactive tablet (for preparations containing 28 tablets in a package).
When switching from oral contraceptives containing only progestogen ("mini-pill")
You can stop taking the "mini-pill" any day and start taking Microgynon ® the next day, at the same time. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception.
When switching from an injectable contraceptive or implant
You should start taking Microgynon ® on the day the next injection is due or on the day the implant is removed. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception.
After childbirth
If a woman has just had a baby, her doctor may recommend that she wait until the end of her first normal menstrual cycle before starting Microgynon ® . Sometimes, on the recommendation of a doctor, it is possible to start taking the drug earlier.
After a spontaneous miscarriage or abortion
Taking missed pills
If the delay in taking the next pill is less than 12 hours, the contraceptive effect of Microgynon ® is preserved. Take the dragee as soon as possible. The next dragee is taken at the usual time.
If the delay in taking the pill was more than 12 hours, contraceptive protection may be reduced. The more pills missed in a row, and the closer this pass is to the beginning or end of the intake, the higher the risk of pregnancy.
In this case, you can follow the following rules:
Forgotten more than one dragee from the package
You should consult with your doctor.
One tablet was missed in the first week of taking the drug
Take the missed pill as soon as possible (even if it means taking two pills at the same time). The next dragee is taken at the usual time. Additionally, you should use a barrier method of contraception for the next 7 days. If sexual intercourse took place within a week before skipping the dragee, the likelihood of pregnancy should be considered. You must immediately consult a doctor.
One tablet was missed in the second week of taking the drug
You should take the missed pill as soon as possible (even if it means taking two pills at the same time). The next dragee is taken at the usual time. The contraceptive effect of Microgynon ® is preserved, and there is no need to use additional contraceptive measures.
One tablet was missed in the third week of taking the drug
It is possible to adhere to any of the following two methods without the need for additional contraceptives:
1. Take the missed pill as soon as possible (even if it means taking two pills at the same time). The next dragee is taken at the usual time. Start taking from the next pack immediately after taking the pills from the current pack, so there will be no break between packs. Withdrawal bleeding is unlikely until the pills in the second pack are finished, but there may be spotting or breakthrough bleeding on the days of taking the pills.
2. Stop taking the pills from the current package, take a break for 7 days or less (including the day of skipping dragees) and then start taking pills from a new package.
Using this schedule, a woman can always start her next pack on the day of the week she usually does.
If, after a break in taking the dragee, there is no expected menstruation, pregnancy may have occurred. You should consult your doctor before starting a new pack.
If a woman has had vomiting or diarrhea (indigestion) within 3 to 4 hours after taking a Microgynon ® tablet, the active substances may not have been completely absorbed. This situation is similar to skipping a drug. Therefore, the instructions for missed pills should be followed.
Delaying the onset of menstruation
You can delay the onset of your period by starting the next pack of Microgynon ® immediately after finishing the current pack. The woman can continue taking the pills from this package for as long as she wants, or until the package runs out. If a woman wants to start menstruation, you should stop taking the dragee. While taking Microgynon ® from the second package, spotting or breakthrough bleeding may occur on the days of taking the dragee. The next pack should be started after the usual 7 day break.
Changing the day of your period
If a woman takes the pills as recommended, she will have her period on about the same day every 4 weeks. If you need to change the menstrual cycle, you should shorten (but not lengthen) the period of time free from taking pills. For example, if the menstrual cycle usually starts on Friday, and in the future it is necessary that it starts on Tuesday (3 days earlier), the next pack should be started 3 days earlier than usual. If the break free from pills is very short (for example, 3 days or less), menstruation may not occur during the break. In this case, there may be breakthrough bleeding or spotting on the days of taking the pills from the next package.
Release form
Hormonal preparations with contraceptive properties are recognized as the most effective method of preventing unwanted pregnancy. Properly taking birth control pills according to the manufacturer's instructions provides an effect in 98% of cases. But what to do if you missed 1 birth control pill?
The degree of reduction in the effectiveness of the contraceptive depends on the amount of time lost. If a woman has forgotten to take a birth control pill, then the correct solution would be the local use of barrier methods of contraception for up to 7 days. Further tactics will depend on the day of the menstrual cycle. Emergency measures are seen as an exception to the rule.
| cycle day | What to do? | Additional methods of contraception |
| First week (1-7 days) | Take the missed tablet as soon as possible. Take the next pill in the pack at the usual time, even if it means taking two pills at once | Use condoms or spermicides for 7 days |
| Second week (7-14 days) | Take the missed pill. Take the next pill from the pack at the right time | Additional methods of contraception are not required if 1 tablet is missed and is required if 2 or more tablets were missed (within 7 days) |
| First week (14-21 days) | Take the missed tablet and continue to drink the drug as usual. Start taking a new package without a 7-day break. Or stop taking the pills from the current package and after a 7-day break start taking the pills from the next pack | Additional contraceptive measures are not required if the woman has not missed a pill in the last 7 days. It is necessary to use condoms or spermicides within 7 days if there have been violations in the last week in taking the drug |
| Fourth week, active tablets (21-24 days) - only for COCs containing 28 tablets | ||
| Fourth week, placebo tablets (24-28 days) - only for COCs containing 28 tablets | Throw away the missed pill. Take another pill at the usual time | Additional methods of contraception are not required |
Mechanism of action of hormonal contraceptives
- liver dysfunction;
- functional disorder of the digestive system;
- the appearance of intermenstrual bleeding or amenorrhea;
- development of thrombosis;
- violations of the microbial landscape of the vagina;
- pressure increase;
- weight gain;
- migraine;
- discomfort in the mammary glands.
A high dose of the hormone contained in one pill does not provide for its re-use ahead of time.
Monophasic contraceptives contain an equal amount of estrogen and progestogen, which remains unchanged throughout the course of use. These drugs include Regulon, Janine, Femoden, Silhouette, Gestodene, Logest, Rigevidon, Miniziston, Yarina, Jess. These funds are taken from the first day of the menstrual cycle. If at least one tablet was missed, then doctors recommend switching to spermicides or condoms for the next 7 days. A new package is drunk from 1 to 21 days of the menstrual cycle. After a seven-day break, they continue to drink a monophasic remedy even if menstruation has not stopped.
Actions for skipping a tablet are presented in the table:
Table 1
Oral contraceptives, which include natural estrogen (estradiol valearate), deserve special attention. In the pharmacological market, this group of hormonal agents is represented by Qlaira. Tactics when skipping one tablet of the drug in this case is different.
table 2
Missing the birth control pill requires the use of additional protection against unwanted pregnancy in the form of non-hormonal local contraceptives. In such cases, it is recommended to use a cervical cap along with a spermicidal gel, a condom or intravaginal suppositories Pharmatex, Benatex.
Biphasic contraceptives, consisting of estrogen and progestogen, are widely used among women of different ages (Femoston, Anteovin, Binordiol, Sequilar). In such preparations, the dosage of estrogen is the same in all tablets, and the dose of progestogen changes in the first and second periods of the cycle. Tablets should be taken from day 1 to day 28 of the cycle daily.
If, for any reason, a woman missed taking the medicine (lost or took a break), the missed pill should be taken as early as possible within 12 hours. If 2-3 days of admission are missed, the effectiveness of the contraceptive is significantly reduced. However, this is not a reason for refusing to use the drug. The medicine is continued to be taken to avoid the premature onset of menstruation. Spermicidal preparations are used topically for the purpose of prophylaxis during sexual intercourse during this period (Patentex, Oval).
Contraindications
When taking birth control pills with a high content of hormones, it is necessary to understand the degree of risk to the body. A sharp change in the hormonal background negatively affects all organs and systems.
Particularly sensitive to hormonal imbalance are women with existing systemic diseases of the endocrine, genitourinary system (diseases of the liver and kidneys, biliary tract, Crohn's disease).
The following factors are absolute contraindications to the use of emergency contraception:
- the onset of pregnancy;
- lactation period;
- existing blood diseases (coagulation disorders, thrombosis, bleeding of unknown etiology);
- severe liver disease;
- individual intolerance to the drug;
- diabetes mellitus (severe form);
The presence of at least one provoking factor creates the prerequisites for additional consultation with the attending physician.
Once disturbed, the natural level of hormones is subsequently difficult to recover. It can take months or even years to restore normal physiological parameters.
A decrease in efficiency is noted with functional disorders of the digestive system (Crohn's disease).
memo
Timely taken systemic contraceptive prevents unplanned pregnancy. Topical contraceptives reduce the chance of conception in the absence of systemic therapy. When deciding on emergency preventive measures, it is necessary to realistically assess the risk of complications due to a sharp change in hormonal levels. Consulting a gynecologist will be the best option to resolve this situation.