Jeanine tabs #21

Jeanine user manual

You can buy Jeanine online

Composition

As active components in the composition of Jeanine includes 2 mg of dienogest and 30 μg of ethinyl estradiol.
In addition to these substances, lactose in the form of monohydrate, potato starch, magnesium stearate, talc, gelatin are present in the tablet formulation. The shell is made using sucrose, dextrose, macrogol 35000, calcium carbonate, polyvidone, titanium dioxide, carnauba wax.

Form of issue

Dragee with a smooth, white surface. The drug Jeanine is packaged in blisters of 21 tablets. One pack of cardboard may contain 1 or 3 blisters.

pharmachologic effect

Monophasic pill with anti-androgenic activity.

Pharmacodynamics and pharmacokinetics

The action of the dragee is aimed at suppressing the secretion of gonadotropic pituitary hormones, inhibition of ripening of follicles and suppression of ovulation. Against the background of the use of the drug, the viscosity of the filling of the cervical channel of mucus increases, which creates obstacles to the penetration of spermatozoa into the uterine cavity.
The reception of Jeanine's dragees is accompanied by the normalization of the menstrual cycle, a reduction in the soreness of menstruation and the intensity of excretions, which significantly reduces the risk of anemia associated with iron deficiency.
Dienogest - the progestogen component of the drug - is a derivative of nortestosterone. Clinical studies of the use of this substance in patients with acne have made it possible to establish its pronounced antiandrogenic activity. In addition, dienogest is characterized by the ability to increase the concentration of high density lipoprotein in the blood.
After p / os taking 1 dragee, the dienogest is quickly and completely absorbed from the digestive tract. Plasma concentration reaches a maximum after 2 hours and 30 minutes. The absolute bioavailability index is at the level of 96% (and this value is preserved in combination with the estrogen component of the tablets of Jeanine).
About 1/10 of the accepted dose of dienogest is stored in plasma in free form, the remaining 90% binds non-specifically to albumin. The substance does not bind to specific transport proteins. And this is due to the fact that it does not displace cortisol and testosterone from the bonds with CSG and SHBG, respectively.
The effect of the first passage is insignificant. The resulting metabolic products are inactive.
The half-life of dienogest with a single intake is about 9 hours, with a multiple intake of about 10 hours. After ingestion, slightly more than 85% of the dose is excreted in 6 days (about half during the first day).
After p / os administration, ethinyl estradiol is rapidly and fully absorbed from the digestive tract, the maximum plasma concentration is reached in the next 1.5-4 hours after taking one pills.
The substance is exposed to the effect of the first passage, which is caused by its low bioavailability (this indicator usually does not exceed 44%).
In the free form, about 1.5% of ethinyl estradiol is present in the plasma, about 98.5% of the substance binds to albumin. Ethinyl estradiol enhances the biosynthesis of CSH and SHBG without binding to these transport proteins.
After taking one dragee, the half-life of ethinylestradiol is 10 hours. After three cycles of the drug, it rises to 15 hours.
From 30 to 50% of metabolic products are excreted in the urine, about 30-40% - with the contents of the intestine.

Indications for use

The drug is used as a means of hormonal contraception, for the treatment of acne, the removal of manifestations of hirsutism, androgenic alopecia and seborrhea.

Contraindications

Contraindications to the use of contraceptive pills are:
    thrombosis of veins and arteries (including in anamnesis, including including PE, DVT, myocardial infarction, cerebrovascular disorders);
    previous thrombosis of the condition (including history, for example, angina pectoris or cerebral or cerebrovascular accident related disorders of cerebral or cerebral disorders);
    flowing with vascular complications of diabetes mellitus;
    severe and / or multiple factors, which increase the risk of vein or arterial thrombosis;
    severe forms of liver disease (including in history, reception of the drug is allowed only if the liver samples are normal);
    liver tumors;
    the malignant diseases of mammary glands or organs of the reproductive system caused by imbalance of hormones (and also suspicion of them);
    vaginal bleeding, unspecified etiology;
    established or suspected pregnancy;
    Hypersensitivity to the substances contained in the pills.

Side effects of Jeanine

The most common side effects of taking estrogen-progestational oral contraceptives for oral use are:
    increase in the size and tension of the mammary glands, their soreness, and the appearance of discharge from them;
    bloody discharge from the genital tract of various intensity (can be both smearing and carry the character of bleeding breakthroughs);
    headaches (migraine attacks are also possible);
    mood lability;
    change in libido;
    deterioration of the tolerance of contact lenses;
    visual impairment;
    abdominal pain;
    nausea;
    rashes on the skin;
    vomiting;
    changes in the nature of vaginal discharge;
    nodular (nodular) or erythema multiforme;
    cholestatic jaundice;
    generalized itching;
    fluctuations in weight;
    fluid retention;
    allergic reactions.
Sometimes, the side effects of Jeanine are expressed in the form of increased plasma concentrations of triglycerides, diarrhea, increased fatigue, reduced carbohydrate tolerance, and chloasma (especially the risk of focal hyperpigmentation in women who have had a chlorosis during pregnancy).
Like other combined hormonal contraceptives for oral administration, Jeanine can cause thrombosis or thromboembolism.

Contraceptive pills Jeanine, instructions for use (Method and dosage)

Jeanine tablets are designed for regular use, a violation of the standard scheme of use provokes intermenstrual bleeding, and also reduces the contraceptive and therapeutic effectiveness of the drug.
According to instructions for the use of Jeanine, take daily with water in the order indicated on the package. One cycle consists of 21 days of taking dragees and 7 days of interruption, during which (usually on days 2 or 3) a woman starts menstrual bleeding. Sometimes bleeding cancellation does not stop before the beginning of taking the pills from the new package.

How do I take Jeanin's pills for the first time?

If in the previous month the woman was not protected by hormonal preparations, the dragees start to drink from the 1st day of the menstrual cycle (on the first day of bleeding). If the reception is started from 2 to 5 days of the cycle for a week after taking the first pill, barrier contraceptives should be used.
How to take the drug correctly when switching from other contraceptives?
When switching from other combined hormonal agents, the dragee is taken on the next day after the last tablet with the active substances of the previous preparation is taken.
Reception should be started no later than:
    the next day after the standard weekly break (in case the woman used a drug containing 21 tablets);
    the next day after receiving the last dragee - "placebo" (in case if packing No. 28 is used).
When switching from a progestational drug (implant, mini-pili, injectable contraceptives), the dragees start taking without interruption:
    Any day, if the transition is from a mini-saw;
    from the day when the next injection was planned, if the transition is made from contraceptives in injections;
    on the day of implant removal.
In all of the above cases, barrier contraceptives should be used in the first week of taking Jeanine's dragees.

Rules for admission after childbirth or abortion

After the termination of pregnancy in its first 13 weeks, the drug can be started taking immediately. Additional contraception is not needed.
After the termination of pregnancy at the term between 14 and 27 weeks, and also if the pregnancy ends with childbirth, the dragees are taken for 21-28 days. If the first pills are taken later, in the first week of taking the drug, barrier contraceptives should be used.
If sexual intercourse occurred between the taking of the drug and childbirth / abortion, you should exclude the possibility of pregnancy or wait for the first months before taking Jeanine.

How to drink pills in case of skipping?

The missed dragee should be taken as soon as possible, the next from the packaging - at the usual time. Delay for less than 12 hours does not reduce the contraceptive effect of the drug.
Breaks between taking the tablets should not be more than 7 days, because it is during 7 days of continuous application of the drug that adequate suppression of the functional activity of the hypothalamus-pituitary-ovary system is achieved.
If the delay exceeds 12 hours in the first 14 days of taking the drug, the following drops are taken immediately when they are remembered (even if it involves taking two pills simultaneously). In the next 7 days, barrier contraceptives should be used.
The more pills are missed and the closer the pass to the standard weekly break, the higher the risk for a woman to become pregnant.
If a delay of more than 12 hours occurred from 15 to 21 days of taking the drug, the next dragee should be taken immediately when it is remembered (even if it involves taking two pills simultaneously).
In the future, the reception continues as usual and at the same time. In the following after a 7-day skip, barrier contraceptives should be used. In addition, the reception of a dragee from a new package will have to be started immediately, when the previous one ends, ie. not surviving a seven-day break.
Usually bleeding cancellations in this case do not begin before the second package is finished. Nevertheless, the possibility of spotting bloody discharge and even breakthrough bleeding is not excluded.
The absence of bleeding cancellation after skipping the dragee in a day free of Jeanin's seven-day period is the basis for presuming pregnancy.
Vomiting within three to four hours after taking the dragee reduces the absorption of the drug's active ingredients. In this case, it is necessary to follow the recommendations when skipping tablets.
If the woman does not plan to change the usual reception scheme, if necessary, it is recommended to take additional pellets from the following package.
To delay the onset of cyclic bleeding, the drug continues to be taken continuously using a new package. Take the pills from the new pack can be as long as the woman wants (until the pack is finished). At this time, masticious discharge and bleeding are possible.

Reception from the next pack starts after a week-long break.

How long can I take Janine? If the drug is well tolerated, it can be used for as many years as there is a need for contraception.

Jeanine and endometriosis

The exact cause of the appearance of endometriosis is not established, it is known only that hormonal imbalance plays a significant role in the development of the pathological process. The effectiveness of the drug in endometriosis is due to the mechanism of its action.
In the second phase of the cycle, after ovulation, there is an intensified preparation of the organs of the reproductive system for pregnancy, one manifestation of which is the proliferation of the uterine mucosa.
Jeanine prevents the egg from leaving the ovary (that is, ovulation), and, consequently, reduces the severity of post-ovulatory changes in the endometrium of the uterus.

What are the tablets prescribed for endometriosis?

In accordance with the instructions, the action of the drug Jeanine is aimed at stopping pain, normalizing the impaired cycle, reducing the intensity of bleeding, that is, eliminating the symptoms that are the main (although not the only) in endometriosis.
The allocation of blood at monthly intervals is normal due to the fact that the mucous membrane formed in the second half of the cycle is rejected, and the vessels are damaged. Since Jeanine suppresses ovulation, the endometrium does not grow so actively, accordingly, the tissues around do not inflame and do not squeeze the nerve trunks.
In addition, like any hormone, the drug allows you to normalize the cycle, making it strictly periodic.

How should I take it with endometriosis?

Jeanine is effective both in genital and extragenital (outside the genitals) endometriosis. The components of the drug show high activity in the body, which allows using them in the lowest possible dose.
Several schemes of application of the drug Jeanine in endometriosis have been developed. At the same time, for each woman, the doctor should choose the treatment individually.
In some cases, it is advisable to drink pills in accordance with the contraceptive scheme: one per day, from the first day of the cycle. After three cycles of "21 days of taking + 7 days off", the patient should be tested for blood coagulability, monitor the condition of the foci of endometriosis, and also assess the functional state of the liver by biochemical blood analysis.
It is also possible to take the drug on a prolonged schedule, according to which the dragees should be taken continuously for 63 or 84 consecutive days, and then make a one-week break.
In addition to direct influence of the active components of the drug on tissues and organs, this regimen reduces the number of menstrual bleeding (instead of 3-4, usually one passes), which also has a beneficial effect on the patient's condition.
The doctors' comments about Jeanine with endometriosis testify to the high effectiveness of the drug. Their statements are also confirmed by the results of numerous studies and practical experience: according to statistics, the use of the drug allows achieving positive results in about 85% of cases.
In addition, experts note that Jeanine is well absorbed in the body (its bioavailability is 90%) and rarely provokes side effects.

Overdose

Symptoms of overdose are nausea, vomiting, the appearance of spotting bloody discharge from the genital tract or bleeding of varying degrees of intensity.
Therapy is symptomatic. The drug has no antidote.

Interaction

Simultaneous use of Jeanin contraceptive pills with agents that induce microsomal enzymes of liver cells (including barbiturates, hydantoins, rifampicin, carbamazepine, primidon, and probably Topiramate, Griseofulvin, Felbamate), provokes an increase in the clearance of dienogest and ethinylestradiol, which may cause a decrease in the contraceptive effect.
As a rule, the maximum activity of liver enzymes is observed 2-3 weeks after the beginning of treatment with the indicated drugs, however, it can be noted during the next 4 weeks after the completion of the course.
Against the background of the use of Jeanine in combination with preparations of ampicillin and tetracycline series, the concentration of ethinyl estradiol decreases.
It should be remembered that women who take any of the above funds in a short course should additionally use barrier contraceptives throughout the treatment period and within 7 days after completion.
If a woman undergoes treatment with Rifampicin, the need for additional contraceptive measures persists for a full 4 weeks after completion. In the event that concomitant therapy is started at the end of taking the package of hormonal tablets, the next one should begin, not keeping the usual break.

Storage conditions

Store in a place difficult to reach at a temperature of 25 ° C or less.
Shelf life - 36 months.

special instructions

The use of the drug Jeanine is contraindicated before the onset of menarche and after the onset of menopause.
In some cases, the use of drugs of sex hormones can cause the development of tumors in the liver. An increase in liver size, severe abdominal pain, as well as signs of intraperitoneal bleeding, must be taken into account when making a differential diagnosis.
We take the drug Jeanine can be accompanied by irregular bleeding (both in the form of smearing excretions, and in the form of bleeding breakthroughs), especially in the first months of therapy. In this regard, the assessment of irregular bleeding should be carried out only after a period of adaptation, which is approximately 3 cycles.
If such bleeding recurs or occurs after the preceding regular cycles, a non-hormonal cause should be sought. Diagnosis is carried out in order to exclude the presence of the patient malignant neoplasm or pregnancy. In some cases, it may be necessary to perform diagnostic scraping.
Janine does not protect against STDs and HIV infection.

Analogues

Analogues of Jeanine on the mechanism of action: Yarina, Midiana, Yaz, Logest.

Which is better: Janine or Diane 35?

Diane-35 is a combination of cyproterone (2 mg) and ethinylestradiol (35 μg). If Jeanine is prescribed primarily to prevent pregnancy in women with endometriosis, then the use of Diane-35 is appropriate for contraception in women who have strong signs of androgenation.

Use with alcohol

In the instructions to the drug the manufacturer does not give any recommendations regarding the possibility of using tablets of Jeanine with alcoholic beverages.
The recommended dose of alcohol for a woman taking oral contraceptives is 20 grams of ethanol (a glass of wine).
Nevertheless, it should be remembered that:
    the reaction of different organisms to the same dose of alcohol can differ;
    hormonal drugs are an additional burden for the liver, which is responsible for the cleavage of ethyl alcohol (ie, with an alcohol overdose the consequences can be quite serious for both the liver and the body as a whole);
    with increased activity of hepatic enzymes due to alcohol overdose, decay and elimination of the substances contained in the preparation are substantially accelerated (ie, the contraceptive effect can be reduced);
    an overdose of alcohol, accompanied by vomiting, leads to the fact that the active substances of tablets do not have time to be absorbed from the digestive tract, as a consequence - the effectiveness of the drug decreases.
According to doctors, between taking tablets and alcoholic beverages should be kept for at least 3 hours.

In pregnancy

In the course of epidemiological studies it was found that Janine does not increase the risk of teratogenicity in a child whose mother was pregnant or, in ignorance, in the first few weeks she took birth control pills.
However, during pregnancy, taking the drug is contraindicated.
Since combined hormonal drugs are characterized by the ability to suppress lactation and affect the composition of breast milk, lactating women are advised to refrain from taking them.
When planning a child, stop using contraceptive pills. Try to get pregnant doctors advised from the beginning of a new cycle. Pregnancy after taking pills usually comes quickly enough.

Reviews about Jeanine

Reviews about Jeanine on the forums are quite diverse. Most of them are positive, as the drug is well tolerated by a woman, it is convenient to use, it copes well with its main task.
In addition, patients and doctors in the responses about Jeanine note that the drug, in addition to contraceptive, has a number of other positive side effects: it helps against acne, normalizes the menstrual cycle, reduces the intensity and painfulness of bleeding. Women who stop taking pills Jeanine because of the desire to become pregnant, pregnancy after the abolition of the funds often occurs already in the first 2-3 cycles.
Due to the ability of the drug to stabilize the hormonal background and suppress the foci of abnormal growth of the endometrium, it often proves effective in myoma and endometriosis (usually in situations when the disease is not too run).
Nevertheless, there are negative reviews about the drug, which are associated either with a lack of result in the treatment of endometriosis, or with side effects that have significantly worsened the quality of life of a woman. Experts are inclined to think that such phenomena can arise if the remedy was chosen without taking into account contraindications to the application, or simply does not fit a particular woman.
Analyzing the responses of doctors to the contraceptive pills Jeanine, we can conclude that experts respond about this drug positively. Such a high score is due to the fact that as a low-dose agent, the latter has a pronounced contraceptive effect, helps restore hormonal imbalance and positively affects the general condition of a woman.