apleek
Ethinyl Estradiol, Gestodene
Inside, according to the order indicated on the package, every day at about the same time, with a small amount of water, 1 tablet per day continuously for 21 days. Taking the next package begins after a 7-day break in taking the tablets, during which there is usually withdrawal bleeding. Bleeding usually begins 2-3 days after taking the last pill and may not end until the start of taking a new package.
How to start receiving apleek®
In the absence of taking any hormonal contraceptives in the previous month
Receiving apleek® it begins on the first day of the menstrual cycle (i.e., on the first day of menstrual bleeding). It is allowed to start taking on the 2nd-5th day of the menstrual cycle, but in this case it is recommended to additionally use the barrier method of contraception during the first 7 days of taking the tablets from the first package.
When switching from other combined oral contraceptives, a vaginal ring, or a contraceptive patch
It is preferable to start receiving apleek® the day after taking the last active dragee from the previous package, but in no case later than the next day after the usual 7-day break (for drugs containing 21 dragees) or after taking the last inactive dragee (for drugs containing 28 dragees in the package). Taking the drug apleek® you should start on the day of removal of the vaginal ring or contraceptive patch, but not later than the day when a new ring should be inserted or a new patch applied.
When switching from contraceptives containing only progestogens (mini-pills, injectable forms, implants), or from a progestogen-releasing intrauterine contraceptive (Mirena®)
A woman can switch from mini-pili to apleek® on any day (without a break), from the implant or intrauterine contraceptive with gestagen — on the day of its removal, from the injection form-from the day when the next injection should be made. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.
After an abortion in the first trimester of pregnancy
A woman can start taking the drug immediately. If this condition is met, the woman does not need additional contraceptive protection.
After childbirth or abortion in the second trimester of pregnancy
It is recommended to start taking the drug on the 21st-28th day after delivery or abortion in the second trimester of pregnancy. If the reception is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if the woman has already lived a sexual life, before taking apleek® pregnancy should be excluded or it is necessary to wait for the first menstruation.
Taking missed pills
If the delay in taking the drug was less than 12 hours, the contraceptive protection is not reduced. The woman should take the pill as soon as possible, the next one is taken at the usual time.
If the delay in taking the pill was more than 12 hours, contraceptive protection may be reduced. In this case, you can follow the following two basic rules:
- the drug should never be interrupted for more than 7 days.
- 7 days of continuous tablet administration are required to achieve adequate suppression of hypothalamic-pituitary-ovarian regulation.
Accordingly, the following tips can be given if the delay in taking the tablets was more than 12 hours (the interval from the moment of taking the last tablet is more than 36 hours):
The first week of taking the drug
A woman should take the last missed pill as soon as she remembers (even if it means taking 2 tablets at the same time). The next pill is taken at the usual time. Additionally, a barrier method of contraception (such as a condom) should be used for the next 7 days. If sexual intercourse took place within a week before skipping the pill, it is necessary to take into account the likelihood of pregnancy. The more pills missed, and the closer they are to a break in the intake of active substances, the greater the likelihood of pregnancy.
The second week of taking the drug
A woman should take the last missed pill as soon as she remembers (even if it means taking 2 tablets at the same time). The next dragee is taken at the usual time.
Provided that the woman took the pills correctly in the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as when skipping 2 (or more) tables, it is necessary to additionally use barrier methods of contraception (for example, a condom) for 7 days.
The third week of taking the drug
The risk of reduced reliability is unavoidable due to the upcoming break in taking pills.
A woman should strictly adhere to one of the following two options. At the same time, if in the 7 days preceding the first missed pill, all the pills were taken correctly, there is no need to use additional contraceptive methods.
1. A woman should take the last missed pill as soon as she remembers (even if it means taking 2 tablets at the same time). The next tablet is taken at the usual time, until the pills from the current package run out. The next package should be started immediately. Withdrawal bleeding is unlikely until the second package is finished, but spotting and breakthrough bleeding may occur while taking the tablets.
2. A woman can also stop taking pills from the current package. Then she should take a break for 7 days, including the day of skipping the pill and then start taking a new package.
If a woman has missed taking the pill, and then during a break in taking the pills, she does not have withdrawal bleeding, it is necessary to exclude pregnancy.
Advice in case of vomiting and diarrhea
If a woman has had vomiting or diarrhea within up to 4 hours after taking active pills, the absorption may not be complete and additional contraceptive measures should be taken. In these cases, you should follow the recommendations when skipping the pill.
Changing the day of the beginning of the menstrual cycle
In order to delay the start of menstruation, the woman should continue taking the pills from the new package of apleek.® immediately after taking all the pills from the previous one, without a break in the reception. The pills from this new package can be taken for as long as the woman wishes (until the package is finished). Against the background of taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. Resume receiving apleek® from the new pack follows after the usual 7-day break.
In order to move the day of the beginning of menstruation to another day of the week, a woman should be recommended to shorten the nearest break in taking pills for as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding, and in the future, there will be spotting and breakthrough bleeding during the second package (as in the case when she would like to delay the onset of menstrual-like bleeding).
Additional information for individual patient groups
Patients of advanced age
Not applicable. The drug apleek® it is not indicated after the onset of menopause.
Patients with impaired renal function
The drug apleek® it was not specifically studied in patients with kidney disorders. The available data do not suggest a correction of the dosage regimen in such patients.
