Prescription under medical supervision
- Combined hormonal contraceptive, estrogen-progestogen
- Oral contraception Presentation
- 21-day pack: 21 active tablets of 30 ^g ethinylestradiol + 150 ^g levonorgestrel
- 28-day pack: 21 active tablets of 30 ^g ethinylestradiol + 150 ^g levonorgestrel and 7 inactive tablets
- 21-day pack: 1 tablet daily at the same time, for 21 days, followed by a tablet-free interval of 7 days
- 28-day pack: 1 tablet daily at the same time, with no interruption, even during menstruation
Duration: if there are no adverse effects, as long as contraception is desired. Contra-indications, adverse effects, precautions
- Do not administer to women with breast cancer, uncontrolled hypertension, non equilibrated or complicated diabetes, history of thromboembolic disorders, coronary insufficiency, valvular disease, stroke, severe or recent liver disease, unexplained vaginal bleeding, migraine with neurological signs, renal impairment, hyperlipidaemia, to women smokers over age 35.
- May cause: oligo-amenorrhoea, vaginal candidiasis, nausea, weight gain, breast tenderness, mood changes, acne and headache. Other rare and severe adverse effects require discontinuation of treatment: hypertension, cardiovascular and thromboembolic disorders, jaundice, hepatic adenoma, migraine, visual disturbances.
- Hepatic enzyme inducers (rifampicin, rifabutin, nevirapine, nelfinavir, ritonavir, phenobarbital, phenytoin, carbamazepine, griseofulvin, etc.) reduce the contraceptive efficacy. Use a non-hormonal contraceptive method (copper intrauterine device, condoms) or an oral contraceptive containing 50 ^g ethinylestradiol (however there is still a risk of contraceptive failure and the risk of adverse effects is increased) or injectable medroxy-progesterone.
- Clinical examinations must be carried out before (blood pressure, breasts) and during treatment (blood pressure).
- Pregnancy: contra-indicated
- Breast-feeding: contra-indicated before 6 weeks; not recommended between 6 weeks and 6 months (except if it is the only available or acceptable contraceptive method); no contra-indication after 6 months.
- In a woman misses an active tablet, she should take it as soon as possible and continue treatment as normal. If she misses by over 12 hours, contraceptive protection will be lessened, it is therefore recommended to use an additional contraceptive method: condoms for 7 days and, if she has had sexual intercourse within 5 days before forgetting the tablet, emergency contraception.
- 28-day packs can simplify use as there is no interruption between two packs. Explain to the woman which are active and inactive tablets. She must be careful not to start with inactive tablets.
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