Microgynon tabs #21

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Instruction for Microgynon

Composition

In 1 pill, levonorgestrel 0.15 mg, ethinyl estradiol 0.03 mg.
Lactose, cornstarch, talcum, polyvidone 25000, magnesium stearate as auxiliary substances.

Form of issue

Tablets № 21.

pharmachologic effect

Contraceptive.

Pharmacokinetics and pharmacodynamics

Pharmacodynamics

Microgynon is a combined monophasic estrogen-progestogen preparation for contraception, in which hormones are kept in low doses. The mechanism of action is to suppress ovulation at the hypothalamus and pituitary levels, change the cervical secret, which becomes insurmountable for spermatozoa. At the same time, it causes changes in the endometrium, which makes implantation impossible.
When taking combined contraceptives, the menstrual cycle is restored, painful menstruation disappears, and the intensity of bleeding decreases.

Pharmacokinetics

Levonorgestrel is rapidly absorbed and its maximum concentration in the blood is determined after 1 hour. Bioavailability is almost complete. It binds to blood proteins, and 1.3% is in free form. Completely metabolized. Concentration in the blood decreases in two phases. T1 / 2 of the final phase 20-23 hours. It is excreted in urine and bile only in the form of metabolites. With daily admission, the level of levonorgestrel is increased 3-4 times, and in the second half of the cycle an equilibrium concentration is reached.
Ethinyl estradiol is also well absorbed. The maximum concentration in the blood - after 1-2 hours. Metabolized in the liver, its bioavailability is about 45%. 98% bound with albumin. Reduction in blood concentration also occurs in two phases. T1 / 2 in the second phase - 10-20 hours. Metabolites are excreted by the kidneys and liver. After one week of administration, an equilibrium concentration is achieved.

Indications for use

Prevention of unwanted pregnancy.

Contraindications

Microgynon can not be used when:
    cardiovascular diseases (heart valve lesions, rhythm disturbances, hypertension, ischemic heart disease);
    thrombophlebitis, thrombosis and thromboembolism;
    migraine with focal neurological manifestations;
    long-term immobilization and surgical operations on the legs;
    breast cancer;
    myometrium carcinoma;
    estrogen-dependent tumors;
    liver diseases;
    pancreatitis with severe hypertriglyceridemia;
    diabetes mellitus with vascular lesions;
    pregnancy and lactation;
    uterine bleeding, unspecified genesis;
    epilepsy;
    impaired renal function;
    hemophilia and low blood clotting;
    severe immune diseases;
    excessive body weight;
    hypersensitivity.

Side effects

Microgynon can cause:
    increased mammary glands, their soreness and tension;
    headache, migraine;
    discharge from the mammary glands;
    mood swings;
    bloody discharge or copious uterine bleeding;
    change in libido;
    increased fatigue;
    impaired vision and intolerance of contact lenses;
    nausea, vomiting, diarrhea, abdominal pain;
    changes in vaginal secretion;
    generalized itching and skin rash;
    erythema nodosum;
    development of thrombosis and thromboembolism;
    cholestatic jaundice;
    fluid retention and weight gain.

Instructions for use Microgynon (Method and dosage)

Take inside every day in order, better at the same time. Take 21 days continuously, after a week break start to receive the next package. During the break for 1-3 days after the last pill, bleeding cancellation begins. It may not end before the time of receiving a new package.
Begin reception on the first day of menstrual bleeding. If the dragee is started on the 2nd-5th day of the cycle, it is necessary to additionally apply barrier contraception within 7 days.
When switching from other oral contraceptives, it is necessary to start taking the drug immediately after taking an active drug of another drug or after a one-week break of the Microgynon. If you used to take a mini-pili contraceptive or use a Mirena contraceptive, then you can go to this medication on any given day without interruption, but you also need to apply barrier contraception within a week of taking the new drug.
After delivery, you should start taking the medication on the 21-28th day. If the time has elapsed, the barrier method of contraception must be applied additionally. It is important that pregnancy is excluded, in this case it is better to wait for the first menstruation.
If the dragee is missed and the delay is less than 12 hours, the protection is not reduced. The drug intake should not be interrupted for more than 7 days, since it is the week of continuous reception that is necessary to suppress ovarian regulation from the hypothalamic-pituitary system.
The Instruction on Microgynon contains a detailed explanation of how to take the drug in different situations: after abortion, to change the day of the onset of menstruation, how to behave in case of vomiting, and what to do if the day of taking the pills is missed. Having carefully read the instructions and performing it, you can avoid side reactions and unforeseen situations.

Overdose

It shows symptoms: spotting, nausea, vomiting. Symptomatic treatment is being undertaken.

Interaction

The contraceptive effect is reduced when taking ampicillins and tetracyclines. Sulfonamides and derivatives of Pyrazolone increase metabolism.
With long-term treatment with drugs that induce liver enzymes (Primidone, Rifampicin, Phenytoin, barbiturates, Carbamazepine, Oxcarbazepine, Topiramate, Ritonavir, Felbamate, Griseofulvin), which is accompanied by increased clearance of sex hormones and leads to massive bleeding and a decrease in contraceptive activity.
Affects the metabolism of cyclosporine, changing its concentration in the plasma. When taking the drug, correction of doses of indirect anticoagulants and hypoglycemic drugs is necessary.

Storage conditions

Storage temperature not higher than 25 ° C.
Shelf life - 5 years.

Reviews about Microgynon

By activity, the most effective are combined oral contraceptives containing analogues of female hormones, which are produced in different phases of the cycle - estrogen and gestagen.
There are monophasic preparations in which doses of estrogens and gestagens are constant in all tablets and throughout the cycle of their concentration in the blood will be the same. These include Microinon, Femoden, Diane-35, Rigevidon, Janine, Logest. And there are two- and three-phase preparations in which the content of estrogens and gestagens varies. Variable doses of hormones imitate the physiological level of hormones during the menstrual cycle.
The doctors' comments about the Microgynon are related primarily to the fact that there is no better or worse drug for contraception - it's all about portability and no side effects. But from the point of view of the physiology of women, three-phase COCs that more accurately simulate the content of hormones in the blood, combine greater efficacy and a minimum of side effects.
There are women who for years (3-8 years) take this drug and are very happy with it, because they do not cause unwanted reactions. And there are those who could not take it more than a month.
The main criterion for choosing a drug for protection from pregnancy is the smallest dose of steroids, which is sufficient for reliable protection. Preference should be given to drugs in which estrogens are not more than 30-35 μg, and progestins - a dose equivalent to 150 μg of levonorgestrel. It is these requirements that this drug meets.

How to choose a contraceptive drug?

Women who have increased sensitivity to estrogen (engorgement of the mammary glands, nausea, headache, varicose veins, hypermenorrhea, expressed vaginal mucus), it is advisable to use contraceptives with a predominant gestagenic component (Microinon, Ovidon, Cilest, Continuum, Ovrett, Trinovium).
Women who are hypersensitive to gestagens (hirsutism, amenorrhea, decreased libido, hypomenorrhea, fatigue, seborrhea, acne) should choose contraceptives with the estrogen component (Marvelon, Antotevin, Non-Ovlon).
With abundant menstruation, the best tolerability of drugs with the gestagen component, and with meager - with the estrogen component.
Teenagers should not use prolonged drugs, because they contain high doses of estrogens and progestins. Modern low-dose drugs less often cause adverse reactions, and can reduce the manifestation of youthful acne.
In the reviews often there are complaints about the occurrence of headaches, gravity in the stomach, mammary gland tension, bleeding and weight gain. After the termination of reception of the Microgynon the reproductive function is restored. The recovery period depends on the characteristics of the body, some women managed to become pregnant immediately after the drug was withdrawn. The use of this drug before pregnancy does not adversely affect the fetus.
Microgynon is also used for medical purposes: for menstrual disorders, endometriosis, polyposis, hyperestrogenia, algodismenore.