May be nausea, vomiting, girls – bloody discharge from the vagina.
The drug has no specific antidote, treatment is symptomatic.
If overdose symptoms occur within the first 2-3 hours after taking the drug, possible gastric lavage.
Interaction with other drugs
Drugs that induce durabolin hepatic enzymes, such as hydantoin, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, drugs containing St. John’s wort ordinary reduce the effectiveness of oral contraceptives and increase the risk of bleeding “breakthrough.” The maximum induction level is usually reached no earlier than 2-3 weeks, but can last up to 4 weeks. after discontinuation of the drug.
Ampicillin, Tetracycline – reduce the efficiency (mechanism of interaction is not installed).
If necessary, a joint reception, it is recommended to use an additional barrier method of contraception during treatment and for 7 days (for rifampicin – within 28 days) after the drug .
oral contraceptives may reduce tolerance to carbohydrates, increase the need for insulin or oral antidiabetic agents.
Before starting the drug and subsequently every 6 months. it is recommended to collect a detailed family and personal medical history and undergo general medical and gynecological examination (examination of the gynecologist, taking a Pap smear, breast examination and liver function, control of blood pressure (BP), the concentration of cholesterol in the blood, urine analysis). These studies must be repeated periodically, in connection with the need for timely detection of risk factors and any contraindications.
The drug is a reliable contraceptive drug: Pearl Index (a measure of the number of pregnancies occurring during the use of methods of contraception in 100 women for 1 year) when used correctly is about 0.05.
In each case, before the appointment of hormonal contraceptives alone are estimated benefits and possible negative effects of their reception. This issue should be discussed durabolin with the patient, who after receiving the necessary information to take a final decision on preference hormone or any other method of contraception. The health status of women should be carefully monitored. If during treatment appears or worsens at any of the following conditions / diseases, you need to stop taking the drug and switch to another, non-hormonal methods of contraception:
– hemostasis system diseases.
– Condition / illness, predisposing to the development of cardiovascular and renal disease.
– the risk of estrogen-dependent tumors or estrogen-dependent gynecological disorders;
– diabetes not complicated by vascular disease;
– severe depression (if depression is associated with impaired vitamin B6 can be used exchange of tryptophan, then for the purpose of correction);
– sickle cell anemia, because in some cases (eg, infection, hypoxia), estrogen-containing drugs in this disease can provoke thromboembolic phenomena.
– the emergence of abnormalities in laboratory tests of liver function assessment. – thromboembolic disease Epidemiological studies have shown that there is a connection between the use of oral hormonal contraceptives and an increased risk of arterial and venous thromboembolic diseases (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism). We prove an increased risk of venous thromboembolic disease, but it is much less than during pregnancy (60 cases per 100,000 pregnancies). When using the oral contraceptive pill is rarely observed arterial or venous thromboembolism hepatic, mesenteric, renal vessels or vessels of the retina. The risk of arterial or venous thromboembolic disease is increased: – age; – when smoking (heavy smoking and age older than 35 years are risk factors); – if there is a family history of thromboembolic disease (eg, parents, brother or sister). If you suspect a genetic predisposition, it is necessary before applying the medication to consult with a specialist. – Obesity (body mass index above 30 kg / m2); – if dislipoproteinemia; – in hypertension; – in diseases of the heart valves, complicated by hemodynamic disturbances – fibrillation atria; – diabetes mellitus complicated by vascular lesions; – during prolonged immobilization, after a big surgery, after surgery on the lower limbs after severe trauma. In these cases it is assumed temporary cessation of the drug: it is desirable to terminate no later than 4 weeks prior to surgery, and resume -. not earlier than 2 weeks after remobilization increases the risk of venous thromboembolic disease in women after childbirth. diseases such as diabetes mellitus, systemic durabolin lupus erythematosus, gemolitiko- uremic syndrome, Crohn’s disease, ulcerative colitis , sickle cell anemia, increase the risk of venous thromboembolic disease. These biochemical abnormalities as resistance to activated protein C, giperhromotsisteinemiya, deficiency of protein C, S, deficiency of antithrombin III of, the presence of antiphospholipid antibodies increase the risk of arterial or venous thromboembolic disease. in evaluation of benefit / risk ratio of the drug must be borne in mind that the targeted treatment of this condition reduces the risk of thromboembolism. Symptoms of thromboembolism include: – sudden chest pain that radiates to the left arm – sudden shortness of breath, – Any unusually severe headache, which lasts a long time or appearing for the first time, especially when combined with the sudden total or partial loss of vision, or diplopia, aphasia, dizziness, collapse, focal epilepsy), weakness or severe numbness in half of the body, movement disorders, severe unilateral pain in the calf muscles, acute abdomen). Neoplastic diseases some studies have reported a quickening of cervical cancer in women, who have long taken hormone contraceptives, but research results are contradictory. In the development of cervical cancer play an important role sexual behavior, infection with human papilloma virus, and other factors.Meta-analysis of 54 epidemiological studies showed that there is a relative increase in the danger of breast cancer among women taking oral hormonal contraceptives, but a higher detection rate of breast cancer could It is associated with a regular medical examination. Breast cancer is rare in women younger than 40 years, regardless of whether they are taking hormonal contraceptives or not, and increases with age. Receiving tablets can be regarded as one of many risk factors. However, women should be advised of the possible risk of cancer of breast, based on the evaluation of the ratio of benefits and risks (from ovarian cancer protection and endometrial). There are a few reports on the development of benign or malignant liver tumors in women, long-term taking hormonal contraceptives. It should be borne in mind in the differential diagnostic evaluation of abdominal pain, which may be associated with an increase in the size of the liver or intra-abdominal bleeding. It should warn women that the drug does not protect against HIV infection (AIDS) and other diseases, sexually transmitted diseases. The effectiveness the drug can be reduced under the following circumstances: . missed pills, vomiting and diarrhea, the simultaneous use of other drugs that reduce the effectiveness of birth control pills If the patient at the same time taking other drugs that may reduce the effectiveness of birth control pills, you should use additional methods of contraception. The efficacy of the drug can be reduced if the after a few months of their application appear irregular spotting or breakthrough bleeding, in such cases it is advisable to continue taking pills until their completion in the next pack. If at the end of the second cycle menstrualnopodobnoe bleeding begins or acyclic bleeding does not stop, stop taking the tablets and to resume it only after the exclusion of pregnancy. Chloasma chloasma can sometimes occur in those women from whom they have been in history during pregnancy. Those women who have a risk of chloasma, it is necessary to avoid exposure to sunlight or ultraviolet light while taking the pills. Changes in laboratory parameters Under the influence of oral contraceptive pills – due to the estrogen component – may change the levels of certain laboratory parameters (liver function indexes, renal , adrenal, thyroid, hemostasis, levels of lipoproteins and transport proteins). after acute viral hepatitis should be after normalization of liver function (no earlier than 6 months). When diarrhea or intestinal disorders, vomiting contraceptive effect may decrease (without stopping taking the drug, it is necessary to use additional non-hormonal methods of contraception). Women who smoke have an increased durabolin risk of developing cardiovascular disease with serious consequences (myocardial infarction, stroke). The risk depends on the age (especially in women older than 35 years) and the number of cigarettes smoked. During the period of lactation may reduce the milk in small quantities component drug is excreted in breast milk.