Ethinylestradiol is a synthetic analog of the endogenous estradiol, desogestrel has a strong progestational and antiestrogenic action similar to endogenous progesterone, a weak androgenic and anabolic activity. nandrolone phenylpropionate side effects has a beneficial effect on lipid metabolism: increases the concentration of high-density (HDL) lipoproteins in blood plasma without affecting the content of low-density lipoprotein (LDL).
Against the background of the drug showed a significant decrease in the number of monthly lost blood (with the original menorrhagia), normalizes the menstrual cycle, there is a beneficial effect on the skin (especially in the presence of acne vulgaris). Metabolism presystemic conjugation of ethinyl estradiol is significant. Bypassing the intestinal wall, (metabolism first phase) it is subjected to conjugation in the liver (the second phase metabolism). Ethinyl estradiol and its conjugates metabolism first phase (glucuronides and sulfates) are allocated in the bile and enter into the enterohepatic circulation. The clearance from the blood plasma of about 5 ml / min per 1 kg of body weight. Isolation of the organism Mean half-life of ethinyl estradiol is about 24 hours. About 40% is excreted by the kidneys and about 60% through the intestines. Stable concentration is set to 4.3 day, with serum levels of ethinyl estradiol is 30-40% higher than after a single dose
- pregnancy or suspicion of it;
- presence of severe and / or multiple risk factors for venous or arterial thrombosis (including hypertension moderate or severe with BP 160/100 mm Hg or more);
- precursors thrombosis (including transient ischemic attack, angina), including the anamnesis;
- migraine with focal neurological symptoms, including the anamnesis;
- venous or arterial thrombosis / thromboembolism (including deep vein thrombosis of the lower leg, pulmonary embolism, myocardial infarction, stroke) in the current or a history,
- the presence of venous thromboembolism in relatives;
- diabetes (the presence angiopathy);
- pancreatitis (including history), accompanied by severe hypertriglyceridemia;
- severe liver disease, cholestatic jaundice (including during pregnancy), hepatitis, including history (up to normalization of functional and laboratory parameters, and within three months after the return of these indicators in the norm);
- jaundice due to receive LC containing steroids;
- cholelithiasis now or history;
- Gilbert’s syndrome, Dubin-Johnson syndrome, Rotor;
- liver tumors (including in history);
- severe itching, otosclerosis or progression of otosclerosis during a previous pregnancy or while taking corticosteroids;
- hormone-dependent cancers and genital mammary glands (including suspected them);
- vaginal bleeding of unknown etiology;
- smoking at the age of 35 years (more than 15 cigarettes a day);
- individual hypersensitivity to the drug or its components.Precautions
states that increase the risk of venous or arterial thrombosis / embolism: age over 35, smoking, family history, obesity (body mass index over 30 kg / m²), dislipoproteinemia, hypertension, migraine, epilepsy, heart valve defects , atrial fibrillation, prolonged immobilization, major surgery, surgery on the lower extremities, severe trauma, varicose veins and superficial thrombophlebitis, postpartum period, the presence of severe depression, including in history, changes of biochemical parameters (activated protein C resistance, hyperhomocysteinemia, antithrombin III deficiency, deficiency of protein C or S, antiphospholipid antibodies, including antibodies to cardiolipin, lupus anticoagulant).
Diabetes is not complicated by vascular disorders, systemic lupus erythematosus (SLE), Crohn’s disease, ulcerative colitis, sickle-cell anemia; hypertriglyceridemia (including family history), acute and chronic liver disease.
Pregnancy and lactation
Use of nandrolone phenylpropionate side effects the drug during pregnancy and during breast-feeding is contraindicated.
Dosing and Administration
Inside. Taking the pills begin on the first day of the menstrual cycle and take 1 tablet a day for 21 days, if possible at one and the same time of day.
After taking the last pill from the package making a 7-day break, during which there is menstrualnopodobnoe bleeding due to cancellation drug.
the next day, after 7-day interval (four weeks after the first pill in the same day of the week), the drug is resumed from the next package, the tablet also comprising 21 even if the bleeding has stopped. Such a regimen of tablets adhere to until there is a need for contraception. Subject to the rules of admission, the contraceptive effect lasts and at the time of the 7-day break.
First the drug
reception the first tablet should be started from the first day of the menstrual cycle. In this case does not require use of additional forms of contraception.
Tablets and reception can begin with 2-5 days of menstruation, but in this case in the first cycle of use of the drug is necessary to apply additional methods of contraception during the first 7 days of taking the pills.
If more than 5 days after the start of menstruation should postpone the start of the drug before the next menstrual period.
Taking the drug after birth
breast feeding women can not start taking pills not before 21 days after delivery, after consultation with the doctor. In this case, there is no need to use other contraceptive methods.
If, after giving birth already had sexual intercourse, then with taking pills, you must wait until the first menstrual period.
If a decision on the admission of the drug later than 21 days after birth, then in the first 7 days is necessary use additional methods of contraception.
Taking the drug after abortion
after abortion, in the absence of contraindications, begin taking the tablets should be from the first day, and in this case there is no need to use additional contraceptive methods.
Switching from another oral contraceptive
Reception after using other hormonal oral contraceptive containing 30 mcg ethinyl estradiol, 21 day scheme:
The first tablet it is recommended to take the next day after completion of the previous drug. You do not need to withstand a 7-day break, or wait for the onset of menstruation. No need to use additional contraceptive methods.
When you go to with a formulation containing 28 tablets, it should be the next day after the finished tablets per pack, start a new pack nandrolone phenylpropionate side effects .
The first tablet must be taken on the first day of the cycle. There is no need to use other methods of contraception.
If the reception of mini-pill arises menstruation, after exclusion of pregnancy can start receiving any day of the cycle, but in this case, the first 7 days necessary to apply additional methods of contraception.
In the above cases, an additional contraceptive method is recommended to use the following non-hormonal methods: the use of the cervical cap with spermicide gel, condom, or abstinence from sexual intercourse. The use of the calendar method is not recommended in these cases.
Postponement of the menstrual cycle
if there is a need to postpone menstruation, it is necessary to continue taking tablets from a new package, without the 7-day break, in the usual way. With the postponement of menstruation may appear breakthrough bleeding or spotting, but it does not reduce the contraceptive effect of the drug. Regular intake can be restored after the usual 7-day break.
If the woman has forgotten to take the pill in a timely manner, and after crossing took less than 12 hours, simply take the forgotten pill, and then continue taking the usual time. If between taking tablets has been more than 12 hours – it is considered skipping pills, contraceptive reliability in this cycle is not guaranteed and it is recommended the use of other contraceptive methods.
If you forget a tablet at the first or second cycle week, you must take 2 tablets in the next day and then continue the regular reception, using additional methods of contraception until the end of the cycle.
When skipping pills on the third week of the cycle it is necessary to take the forgotten pill, continue regular intake and do a 7-day break. It is important to remember that in connection with a minimum dose of estrogen increases the risk of ovulation and / or bleeding while passing taking the pill and is therefore recommended the use of other contraceptive methods.
What to do if vomiting or diarrhea?
If, after taking the drug appears vomiting or diarrhea, then the absorption of the drug may be defective. If the symptoms have stopped for 12 hours, it is necessary to take another pill later. Thereafter pills should continue as usual. If symptoms persist for more than 12 hours, it is necessary to use additional methods of contraception during vomiting or diarrhea, and in the next 7 days.
Side effects Side effects, when they appear, require immediate discontinuation of the drug: – hypertension; – hemolytic uremic syndrome – porphyria; – loss of hearing due to otosclerosis. Rare: arterial and venous thromboembolism (incl myocardial infarction , stroke, deep vein thrombosis of the lower extremities, pulmonary embolism); . reactive exacerbation of systemic lupus erythematosus is extremely rare:arterial or venous thromboembolism hepatic, mesenteric, renal, retinal arteries and veins; Sydenham’s chorea (taking place after the drug).
Other side effects are less severe, but more common. Whether to continue the drug is solved individually after consultation with the doctor, based on the benefit / risk ratio. – Reproductive System: acyclic bleeding / spotting from the vagina, amenorrhea after discontinuation of the drug, the change of state of the vaginal mucus, the development of inflammatory processes of the vagina (eg .: candidiasis) . – The mammary glands: stress, pain, breast enlargement, galactorrhea. – Gastrointestinal and hepato-biliary system: nausea, vomiting, Crohn’s disease, ulcerative colitis, the emergence or worsening jaundice and / or pruritus related to cholestasis, cholelithiasis . – Skin: node / erythema, rash, chloasma. – Central nervous system: headache, migraine, mood changes, depression. – Metabolic disorders: fluid retention in the body, a change (increase) of body weight, decreased carbohydrate tolerance. – eyes: sensitization nandrolone phenylpropionate side effects of the cornea while wearing contact lenses. – Other: allergic reactions