It is a hormonal agent, the action of which is aimed at preventing unwanted pregnancy. In other words, it is a contraceptive drug that can block the action of gonadotropins.
The drug is manufactured in Hungary. The product is available in the form of tablets that are yellow and round shape. The price of the product in pharmacies in Russia is 440-500 rubles, in Ukraine - 180-200 hryvnia.
Description of birth control pills
As part of one tablet of the drug are such active ingredients as: ethinylestradiol and gestodene. In addition to the active ingredients, the composition of the product contains such excipients as: corn starch and lactose monohydrate.
Indications for use
The drug is a contraceptive for women, so the main and only indication for the use of such a drug is to prevent the occurrence of unwanted pregnancy.
Instructions for use
Tablets can be used by girls and women from the age of 18. Tablets are intended for oral administration. Start off it is necessary to take the drug from 1 tablet on the first day of menstruation. It is recommended to take the tablets for 21 days, one tablet at a time. After 21 days of taking the drug has passed, you should take a break for a week. During the week-long break, a woman should have menstrual-like bleeding.
After a week's break, you must start taking the drug again, regardless of whether the bleeding has ended or continues. V general view The scheme for using tablets is as follows: three weeks of taking the drug and one week of break.
To smoothly switch to Lindinet 30 from another contraceptive, you must immediately after taking a tablet of another oral remedy, take a Lindinet tablet on the first day of the onset of menstruation. If you do not take the pill on the first day of menstruation, then nothing terrible will happen, while you can transfer the drug to the second day of menstruation, only in this case you should use additional contraceptives.
If a woman or girl had an abortion in the first trimester pregnancy, then Lindinet 30 tablets can be used immediately after the completion of the operation. In this case, other methods of contraception do not need to be used.
After the birth of a child or after an abortion, the drug can be taken after only 27 days. During the first week, you need to use other methods of contraception. If, after the birth of a child or an abortion, a woman had sexual intercourse, then before using Lindinet 30 tablets, it is necessary to make sure that the woman is not pregnant.
If it so happened that a woman missed a birth control pill then it must be taken as soon as possible, preferably within 12 hours, since at this time the effect and effectiveness of the pill will not decrease. If for some reason a woman has not taken a pill within 12 hours, then at the next sexual contact, additional methods of contraception should be used.
If a woman after application birth control pills vomiting or diarrhea occurs within 4-5 hours, this may lead to a decrease in the effectiveness of the tablets. In this case, it is necessary to follow the “missed pills” regimen.
Lindinet 30: contraindications
Unlike other contraceptives, Lindinet 30 tablets have a huge number of serious contraindications. The instructions for use of the drug indicate that the drug is contraindicated in such cases:
- with angina pectoris;
- with diabetes;
- with jaundice;
- with hyperlipidemia;
- during pregnancy and lactation;
- with liver and kidney disease;
- at the risk of arterial and venous thrombosis;
- with migraine;
- age less than 18 years.
Side effects
While taking contraceptives tablets may experience side effects that manifest themselves in the form of:
- nausea;
- vomiting;
- headaches;
- allergic reactions.
Analogues
If it was not possible to purchase the contraceptive drug Lindinet 30 due to its absence in pharmacies or for some other reason, then you do not need to be upset, since this remedy has 5 worthy analogues which can be found in every pharmacy. Analogues of the drug include:
Let's take a closer look at some of the contraceptives from the above list.
Ginelea is a remedy that is used for contraception and normalization of the menstrual cycle. This product contains the same active ingredients as in Lindinet 30: Ethinylestradiol and Gestodene. The drug is produced in the form of a dragee and coated tablets. The product can be used by girls over 18 years of age. Side effects of the drug include headache, migraine, rash. Gineley is produced in Argentina. As for the price, in Russia such a tool costs between 1400–1600 rubles, in Ukraine - 600–700 hryvnias.
Lindinet 20 is a contraceptive almost identical to Lindinet 30, the difference between these drugs is only in the dosage. As for the price, the contraceptive Lindinet 20 is 10% cheaper than Lindinet 30. The drug is also available in the form of coated tablets. The manufacturer is Hungary.
Logest is a combined contraceptive. The drug is produced in the form of round tablets, which are coated and in the form of dragees. The active substances in the composition of the product are Gestodene and Ethinylestradiol. During the use of the drug, side effects such as nausea, an allergic reaction in the form of a rash, headache, abdominal pain, and diarrhea may occur. In most cases, the drug is well tolerated by patients and side effects do not appear. The manufacturer Logest is a pharmacological company in Germany. The price of the drug in Russia is 700-1 thousand rubles, in Ukraine -190-220 hryvnia.
Milvane is a contraceptive that is available in the form of pills and film-coated tablets. The active ingredients in the composition of the drug are the same components as in Lindinet 30. You can start taking Milvane only from the age of 18. Producer Milvane - Germany. The cost of Milvane in the Russian Federation is 150–200 rubles, in Ukraine it is 60–70 hryvnias.
Femoden is a remedy that can save girls reproductive age from unwanted pregnancy. Femoden is produced in the form of round white tablets. The drug is dispensed without a doctor's prescription. Producer Femoden - Germany. The average cost of Femoden in Russia is 700 rubles, in Ukraine - 130 hryvnias.
My article
There are many ways to prevent unwanted pregnancy. The most popular today is the use oral contraceptives(OK). For several decades, women all over the world have been using this method, which significantly reduces the number of abortions and, as a result, complications after them.
Hormonal contraception is designed not only to protect a woman from unwanted pregnancy, but also to improve the quality of life. The fact is that now women rarely turn to a gynecologist for the sole purpose of choosing a contraceptive. According to statistics, more than 60% of women have certain gynecological problems and need their correction. OCs are one of the methods for treating the pathology of the pelvic organs, whether it is rehabilitation after abortion, treatment of PMS or endometriosis, as well as mammary glands - mastopathy.
Very often, patients complain about the appearance of many side effects from taking OK: swelling, increased pressure, weight gain, severe symptoms of PMS, headache, stress. And the main complaints are connected precisely with this. Hence the question follows: how to choose hormonal contraception, is it possible to change the drug and how to avoid side effects?
It is worth noting that OK is selected by a doctor, taking into account your gynecological history and comorbidities. You can’t choose OK for yourself, based on the experience of friends or colleagues - what suits them may categorically not suit you.
Why do side effects occur?
All side effects are due to an increased level of estrogen in the blood, which is most often due to an incorrectly selected drug that contains a high dose of estrogen. But there is one “but” that gynecologists often do not take into account when choosing OK. The level of estrogen in the blood can be increased even without the use of OCs, and this may be associated with smoking, obesity, diseases of the gastrointestinal tract, chronic stress, thyrotoxicosis and chronic alcohol intoxication, taking certain drugs (diuretics, cardiac glycosides, narcotic analgesics, non-steroidal anti-inflammatory drugs (nurofen, ibuprofen), antibiotics, anticoagulants, hypoglycemic drugs). All of the above factors contribute to an increase in the content of estrogen in the blood. Therefore, when a smoking woman experiencing chronic stress comes to the gynecologist for OK and does not talk about her lifestyle to the doctor, then a situation may occur when the doctor prescribes not the lowest-dose drug, but layering on the already existing hyperestrogenism leads to the fact that when taking OK appear all known side effects.
In connection with the foregoing, attention should be paid to the behavior of a woman at the gynecologist:
When you see your doctor, be sure to tell your doctor about your bad habits.
Tell us about your activities, focus on the stress factor of your work (whether you often have stress or not).
If your mother and/or grandmother had a heart attack, thrombosis, stroke, or varicose veins veins, then this should be reported to the doctor, the appointment of the drug will depend on this.
If you are taking antibiotics, painkillers, or other medications long time then also tell your doctor.
Do not tell your doctor that you have varicose veins. Often women give out visible wreaths on their legs for varicose veins. Remember that the diagnosis of "varicose veins" can be made either by a surgeon or a phlebologist based on certain examinations (ultrasound of the veins of the lower extremities, blood tests, certain physiological tests). If you pronounce such a diagnosis, then back it up with certificates from the surgeon or ask for an additional examination from a gynecologist.
Do not hide from the gynecologist the number of abortions performed and the duration of the last operation - this information is no less important when choosing OK.
Inform the doctor about the degree of PMS, about the duration of the cycle, about the duration, pain of menstruation and the amount of discharge.
It is important for your doctor to know when you are planning a pregnancy. The OK appointment scheme depends on this - prolonged or regular.
It is important to note that the normalization of lifestyle, the rejection of stress and bad habits helps to reduce the level of estrogen in the blood. But there are hardly any women who will change their lifestyle specifically for OK. Moreover, all OKs were created with the aim of improving a woman's life, which is why there are dozens of different drugs on the market. And not a single pharmaceutical company will miss its economic benefits and will not impose on a woman a change in her usual way of life. Rather, pharmaceutical companies will release a dozen more OCs in order to satisfy the need for contraception and improve the quality of life of every woman.
If the drug does not suit you.
First, let's figure out what "does not fit" means. Each OK has a certain period during which it must "integrate" into the body of a woman. This means that the drug, firstly, is a good contraceptive, secondly, it saves the woman from concomitant pathology (endometriosis, PMS, etc.) and, thirdly, it has ceased to produce side effects. This should take from three (on average) to six months. During these three months, you should have all the side effects from OK and you just should not notice the drug. If nothing has changed in these three months, and side effects remain, then there are 2 ways to solve the problem: 1. start to lead a healthy and calm lifestyle, and 2. replace OK. In the first case, the normalization of lifestyle will reduce the level of estrogen in the blood, due to which the side effects are leveled. And in the second case, the drug is replaced with one where the dose of estrogens is lower.
The replacement is as follows: you finish drinking a pack of OK, take a week break and start drinking a new drug. Of course, before that you should visit a gynecologist.
But even here it is not so simple. There are OK very similar in terms of estrogen content: 20 and 30 mcg. The gynecologist will choose a lower dosage if you are at high risk of thrombotic complications, if your close blood relatives have had heart attacks, strokes or thrombosis. Therefore, it is imperative to state everything in detail to the doctor, especially with regard to medical aspects.
You should not immediately buy a large package of OK, where the tablets are enough for three months, since the drug may not be suitable.
The doctor's view on the appointment of OK.
When selecting OK, a gynecologist takes into account the presence of a general and gynecological pathology in a woman. A general blood test is done and, if necessary, hormones. But it is very difficult to study the level of estrogen in the blood - the production of this hormone does not occur linearly, and one analysis is not enough. Therefore, the doctor is most often limited to standard examinations, such as examination, ultrasound of the pelvic organs, general blood and urine tests, questioning the patient (history taking). Additionally, the gynecologist may prescribe a study hormonal background, including thyroid hormones, examination of veins, gastrointestinal tract and so on. Your task is to state your complaints as clearly as possible, focusing on the main thing.
Currently, OKs are divided into several types:
According to the dosage of hormones:
1. Monophasic, containing the same dose of estrogen and progestogen
2. multi-phase (two- and three-phase). These OCs contain a variable (non-constant) dose of hormones, which is similar to the hormone production in a woman's natural cycle (without taking OCs). Currently, three-phase OK are the most popular.
Important! The action of three-phase OK:
ovaries decrease in size
temporary sterility occurs, i.e., there is no ovulation
many atretic "idle" follicles
atrophic phenomena occur in the endometrium, therefore, there is no attachment of a fertilized egg (if ovulation did occur)
the peristalsis of the fallopian tubes slows down, therefore, if ovulation occurs, the egg does not pass through the fallopian tubes.
Cervical mucus becomes viscous, making it very difficult for sperm to enter the uterus
Dosing hormones:
1. high-dose
2. low-dose
3. microdosed
To monophasic high-dose OK include: Non-ovlon, Ovidon. They are rarely used for contraception, for a short time and only for medicinal purposes.
To monophasic microdosed OK relate:
Logest 
Lindinet (generic Logest). Can be used for nulliparous girls from the age of 15. Favorably act with PMS, with painful menstruation, mastopathy and menstrual irregularities. They prevent fluid retention in the body, have an antiandrogenic effect.
Novinet (generic Mercilon), Mercilon. Can be used for nulliparous girls from the age of 15. They have an antiandrogenic effect. 
Minisiston 20 fem. Can be used for nulliparous girls from the age of 15. Good for painful menstruation. 
To monophasic low-dose applies to:
Marvelon 
Regulon 
both have weak antiandrogenic properties
Microgynon, Rigevidon, Minisiston - traditional OK
Silest, Femoden, Lindinet 30 - have a weak antiandrogenic property 
Jeanine - OK of the first choice with a therapeutic effect in endometriosis, acne, seborrhea
Diane-35 - is used for polycystic ovaries, with an increased level of testosterone. It has a pronounced antiandrogenic effect, shows the maximum therapeutic effect in seborrhea and acne. 
Belara - has a slight antiandrogenic effect - improves the condition of the skin and hair (reduces the secretion sebaceous glands) (compared to Diane-35 antiandrogenic activity - 15%),
Yarina 
- prevents fluid retention in the body, helps stabilize weight, improves the condition of the skin and hair (compared to Diane-35 antiandrogenic activity - 30%), eliminates PMS.
Midian 
Three-phase OK:
Triquilar 
Triziston, Tri-regol, Qlaira. imitate menstrual cycle. Shown to adolescents with delayed sexual development. Often cause weight gain. The side effects of estrogen are the most pronounced. 
Single-component progestin preparations:
Microlute, Exluton, Charozetta - can be used during lactation. Can be used for contraindications to COCs. The contraceptive effect is lower than that of COCs. Amenorrhea may develop while taking the drugs. 
Norkolut - has androgenic activity, is used mainly for therapeutic purposes to normalize the state of the endometrium.
Postinor, Genale - urgent contraception. Often causes uterine bleeding. It is not recommended to use more than 4 times a year. 
Escapelle - causes inhibition of ovulation, prevents the implantation of a fertilized egg, changes the properties of the endometrium, increases the viscosity of cervical mucus. When taken, menstrual irregularities and uterine bleeding often develop. 
It is clear that only for contraception it is best to use microdose preparations, since they contain a minimum amount of estrogen. Accordingly, when taking these OK, side effects will be minimized. Note that in each group of drugs, for example, in monophasic low-dose, many drugs are similar to each other. The question arises, what, in fact, is the difference? For example, Marvelon, Regulon, Microgynon, Rigevidoe have the same amount of estrogen (30 mcg) and progestogen (150 mcg). It's simple: firstly, it can be different manufacturing companies, and, secondly, there can be generics and original drugs. It is believed that original drugs are better than generics because they are better purified and have high bioavailability and better absorption. They are believed to have fewer side effects. Although, generics have existed for more than a decade and they are also produced with decent quality, like the original drugs.
At heavy and prolonged menstruation probably better tolerance of drugs with an enhanced progestin component - Microgynon, Miniziston, Femoden, Lindinet 30, Rigevidon, Diane-35, Belara, Zhanin, Yarina. With short and meager periods - with an enhanced estrogen component (Cilest)
Women with hypersensitivity to estrogen(nausea, vomiting, headache, tension of the mammary glands, increased vaginal mucus formation, heavy menstruation, cholestasis, varicose veins), it is advisable to prescribe combined OCs with a pronounced progestogen component.
Among women under 18 and over 40 preference should be given to drugs with a minimum content of estrogens and progestins (Logest, Lindinet20, Minisiston 20 Fem, Novinet, Mercilon)
Teenagers You should not use prolonged preparations (Depo-Provera, Mirena Navy), as they contain high doses of steroid hormones (estrogens and progestogens) and are poorly tolerated.
Alternative OK - intrauterine devices, Novaring ring and barrier methods
"Lindinet 20" is a combined drug, presented in the form of small round tablets. Tablets are distinguished by their contraceptive effect, they are used for permanent planned contraception for women.
"Lindinet 20" and analogues in the rating of sold drugs as contraceptives occupy a leading position. This is explained by the fact that studies conducted by scientists have confirmed that these drugs are highly effective in protecting against unplanned pregnancy. With their use, pregnancy rates do not exceed 0.05 per hundred women during one year of studies.
What drugs can replace the reception of "Lindinet 20"?
Unconditional analogues of "Lindinet 20" according to active ingredient in the composition, dosage form and regimen for today are considered:
- "Logest" is a drug that is also an oral contraceptive. White tablets are produced in France by Delpharm.
- "Femoden" is a highly effective estrogenic drug. Analogue of "Lindinet 20" in composition, but the dosage is increased. Produced in Germany by the Bayer team.
- "Gestarella" is a monophasic low-dose contraceptive drug. Producer - "Abbot Laboratories" in Germany.
Of all the analogues presented, Lindinet 20 is the cheapest, but more on that below. The German pharmaceutical company "Gedeon Richter" also manufactures a drug with the same name but with a high content of the active element ethinylestradiol up to 0.03 mg per tablet - "Lindinet 30". Above in the photo is an analogue of "Lindinet 20" - "Logest".
Composition of contraceptives
"Lindinet 20" and similar drugs in composition contain only 2 active ingredients - ethinylestradiol 0.02 mg and gestodene 0.075 mg. These two elements guarantee a reliable contraceptive result. The effect of estrogen-gestagen tablets makes it possible to suppress the pituitary secretion of gonadotropins. If expressed in plain language, then the effect of the drug is that both of these components do not allow the egg to form and mature. This effect prevents the possibility of fertilization.
The estrogenic effect of "Lindinet 20" and analogues causes a highly effective component - ethinyl estradiol. This is a hormonal agent of the estrogenic series, which is produced naturally by the ovaries and adrenal glands in the body of a woman. Together with progesterone, its tasks include stabilizing the woman's menstrual cycle, and, among other things, also dividing, multiplying endometrial cells and stimulating the development of the uterus in case of insufficiency of the gonads. Auxiliary function of ethinyl estradiol is to lower the level of cholesterol in the blood.
Gestodene is an artificial substance similar in structure to levonorgestrel. It inhibits the synthesis of follitropin and blocks natural monthly ovulation. With the exception of the effects described above, birth control pills increase the viscosity of mucus in the cervix, preventing sperm from entering there.
From customer reviews: "Lindinet 20" and analogues, when used systematically, give not only the effect of a contraceptive, but also restore the menstrual cycle. They significantly reduce the risk of developing neoplasms in the pelvic organs and diseases of the female reproductive system. "Lindinet 20" and analogues of the active substance are drugs from the prescription group and can be used strictly as prescribed by the attending physician after a thorough examination of the patient.
Release form of the drug
The dosage form is sold in the form of glossy tablets of a pale yellow hue, film-coated. Tablets of rounded shape without inscriptions. The drug is produced in cardboard packaging. Inside the package there may be one or three blisters with tablets. It can be 21 tablets or 63. The manufacturing company Lindineta 20 is from Hungary.
Indications for use
"Lindinet 20" and analogues are prescribed as modern facility contraception. Can be used to normalize the menstrual cycle.
Contraindications and restrictions
The drug is not indicated for girls before puberty and women after menopause. Contraindications to taking Lindinet 20 are the following chronic pathologies or diseases in history:
- hypersensitivity to single components of the drug or a combination of hormones from the composition;
- a clear predisposition or existing circumstances that provoke the formation of thrombosis;
- unstable blood pressure;
- cardiac ischemia;
- frequent migraines with neurological symptoms;
- thrombotic or thromboembolic lesions of veins and arteries;
- thromboembolic lesions of the veins in immediate family members;
- surgical intervention that causes prolonged immobility of the patient;
- damage to small vessels against the background of developing diabetes mellitus of all types;
- the state of inflammation of the pancreas, when the level of triglycerides in the blood is significantly elevated;
- the formation of fatty deposits on the walls of blood vessels - dyslipidemic syndrome;
- diseases or severe inflammation of the liver and kidneys;
- yellow skin due to steroid medications;
- cholelithiasis;
- progressive genetic disease -;
- neoplasms on the liver;
- damage to the capsule of the inner ear;
- hormone-sensitive neoplasms on the organs of the reproductive system or mammary glands;
- bleeding from the vagina;
- prolonged smoking;
- pregnancy and the period after childbirth;
- lactation period.
In the following situations, according to the reviews of doctors, "Lindinet 20" and analogues are allowed to be taken, but only if precautions are observed and under the supervision of the attending gynecologist:
- the age of the patient is more than 35 years;
- conditions that provoke the occurrence of thrombotic lesions of the veins;
- excess weight or obesity;
- migraine;
- hypertension;
- diabetes if vascular damage is excluded;
- ulcerative lesions of the colon;
- hereditary angioedema;
- diseases of the liver and kidneys;
- diseases that have intensified during pregnancy or from taking hormonal drugs;
- severe trauma;
- phlebeurysm;
- pathological processes of heart valves;
- change in indicators of a biochemical blood test;
- sudden onset of seizures;
- heart rhythm disturbances;
- prolonged immobility of the patient;
- extensive surgery;
- Libman-Sachs disease (lupus erythematosus);
- cardiac ischemia;
- severe depression;
- Crohn's disease;
- hereditary violation of the structure of the hemoglobin protein;
- elevated level triglycerides in the patient's blood;
- atypical hemolytic-uremic syndrome;
- a short period of time after childbirth.
Method of application and dosage of the medicinal product and its analogues
According to the instructions, "Lindinet 20" and analogues are taken orally with a moderate amount of water or other liquid. Reception is carried out regardless of meals, one tablet once a day, preferably at the same time. After 21 days from the moment you start taking the pills, you must definitely take a break for seven days. During seven day break withdrawal bleeding (imitation of menstruation) occurs from the use of hormones. Then the tablets from the new blister are taken on the eighth day of the break.
If Lindinet 20 is taken for the first time, then it is advisable to take the initial blister tablet from the first to the fifth day from the onset of menstruation. In the first two weeks from the start of taking "Lindinet 20" and analogue tablets, it is important to take advantage of auxiliary contraceptives in order to avoid unwanted pregnancy.
Switching from other contraceptives
If the drug "Lindinet 20" is used as a replacement for another contraceptive, then the reception is started without a seven-day interval. That is, when drinking the final pill from the pack of the previous drug, it is very important to start taking Lindinet 20 the next day. It is allowed to switch to "Lindinet 20" from contraceptive preparations "mini-drank" any day. Nevertheless, in the first week of using Lindinet 20, you should not rely on it, so it is better to use additional methods of contraception.
With the appearance of sudden vomiting or diarrhea some time after taking the pill, the absorption of the drug is defective. If the symptomatology ended within twelve hours, then it is advisable to take another pill and continue taking it according to the scheme. If the symptoms last more than twelve hours, then additional contraception is absolutely necessary for the next seven days.
Abortion in the first trimester
After an abortion in the first trimester, Lindinet 20 is prescribed from the first day, immediately after the mechanical abortion. In this case, there is no need for additional contraception.
Use after childbirth or after an abortion in the second trimester
Use "Lindinet 20" and analogues can be started 21-28 days after childbirth or abortion. It is allowed to start taking after childbirth only if the woman is not breastfeeding. If you start taking the pills later than the specified period, you will need an additional barrier protection from pregnancy within a week.
Postponement of menstruation
In case of urgent need to delay menstruation and prolong the cycle, you can resume taking the tablets from the next package without a seven-day break. The appearance of spotting bleeding in this case does not reduce the contraceptive effect.
From the instructions for use of "Lindinet 20" and analogues: if the tablet was not taken on time, and no more than twelve hours have passed since the missed one, then you need to drink the missed tablet and continue taking the drug "Lindinet 20" according to the scheme. If more than twelve hours have passed, then the effectiveness of the drug as a contraceptive decreases, and it is recommended to use additional barrier contraceptives, such as a condom.
Missed tablet in the first and second week of the cycle: the next day, take two tablets at once and continue the regular intake of the drug according to the scheme, using additional protection until the end of the cycle. Missed tablet in the third week of the cycle: take a tablet and do not take a seven-day break before the next pack.
Side effects
While taking "Lindinet 20" and analogues, there are often disturbances in the work of the following body functions:
- Breast glands: aching pain from the side and from above, an increase in breast volume, discomfort, a feeling of heaviness, discharge from the nipples.
- Reproductive system - a change in libido (a decrease occurs much more often), inflammation in the vagina, lack of menstruation after discontinuation of the drug, non-cyclic bloody spotting from the vagina.
- Disorders of the gastrointestinal tract: pain in the stomach, nausea, vomiting, diarrhea, inflammation of the colon, liver damage, bile stasis, development of cholelithiasis.
- Skin: rashes, pigmentation, alopecia.
- Neurology: headaches, psycho-emotional instability, depressive states, migraines.
- Metabolism: rapid weight gain without change in diet, edema due to fluid retention, increased blood glucose, increased triglycerides in the blood.
- Sense organs: discomfort in the eyes, hearing impairment.
Rarely occurring side effects from "Lindinet 20" and analogues of the drug:
- Thromboembolic damage to the veins and circulatory system, including the brain.
- Damage to the veins of the lower extremities.
- Complication of lupus erythematosus.
Extremely exceptional violations:
- Damage to the arteries of the kidneys and liver.
- Retinal injury.
Cancellation of the drug is indicated in case of development of the following disorders:
- Sustained increase in blood pressure.
- progression of porphyria.
- Blockage of blood vessels by blood clots.
- Hearing loss due to otosclerosis.
Strengthening the symptoms of one of the above diseases during the use of hormones requires urgent discontinuation of the drug and the use of non-hormonal contraception.
Special instructions before using oral contraceptives
During the period of pregnancy and lactation, the described remedy is strictly contraindicated. Therefore, some time before the start of the reception, it is better to do a pregnancy test or donate blood for hCG. Reason: in the first months of pregnancy, sluggish menstruation is possible.
Before using Lindinet 20, it is important to collect all the required information about the health status of the patient and immediate family members. While taking "Lindinet 20" and analogues in the reviews and instructions, it is said that every six months it is necessary to undergo a medical examination, as well as a gynecological examination for the timely identification of possible risk factors.
Since the persistent contraceptive effect of the pills is achieved two weeks after the start of use, doctors recommend that additional non-hormonal methods be adopted these days to protect against pregnancy. Reception hormonal contraceptives is individual in each individual case.
Before starting, it is important to evaluate all the possible advantages and disadvantages of using the drug, after consulting in person with the attending gynecologist. Before you start taking drugs, it is important to consider that the relationship between taking oral hormonal contraceptives and the occurrence of thrombosis has been scientifically confirmed.
The risk of developing thromboembolic lesions is due to provoking factors:
- mature age of the patient;
- prolonged smoking;
- heredity;
- hypertension;
- diabetes;
- prolonged immobility of the patient.
The postpartum period significantly increases the risk of thromboembolism. Unfortunately, there is information about the increased incidence of cervical cancer in the case of prolonged use of hormonal contraceptives. However, research data contradict each other, since there are many conditions for the development of cervical cancer, and the effect of oral contraceptives will not necessarily be dominant. It is also known that the regular use of oral contraceptives can cause the development of breast cancer.
When taking "Lindinet 20" and analogues in composition, it is important to remember that the drug is not able to protect against infection with HIV and other types of sexually transmitted diseases. condom - The best way protection from infection.
The effectiveness of hormonal contraceptives can decrease if:
- missing pills;
- vomiting;
- repeated diarrhea;
- a long period of time between taking pills;
- the use of drugs that reduce the effect of contraceptives.
After a long time after taking Lindinet 20, the effectiveness of the drug may decrease. If non-cyclic bleeding of unknown origin appears and does not stop until the end of the blister, then it is necessary to stop taking the drug and not resume until pregnancy is excluded at the gynecologist's appointment.
The estrogens contained in Lindinet 20 can affect the performance of laboratory tests of organs such as the kidneys and liver, thyroid, adrenals. Viral liver damage delays taking the drug for six months.
Smoking while taking Lindinet 20 birth control pills and analogues increases the occurrence of possible vascular diseases, which is extremely dangerous for patients over 35 years of age. There is no research data regarding the safety of reception when driving a motor vehicle and other activities that require increased concentration and speed.
Hormone overdose
Medicine is not aware of cases of serious side effects from a significant increase in the daily dosage of oral contraceptives. In isolated cases, situations are possible when nausea or vomiting occurs. In young girls, slight bleeding from the vagina is possible. However, exceeding the dosage of the drug is a reason for an urgent visit to the doctor to inform him about it.
Interaction with other drugs
The semi-synthetic antibiotic "Rifampicin" reduces the contraceptive effect and increases the occurrence of breakthrough bleeding, and also provokes menstrual irregularities. "Carbamazepine" and "Primidon" also reduce the effect of the drug "Lindinet 20". In this regard, during the period of therapy with these drugs, it is necessary to use additional measures to protect against pregnancy.
Laxatives lower the level of hormones in the blood. "Fluconazole" increases the level of ethinylestradiol in the patient's blood. Antibiotics of the tetracycline series reduce the level of estradiol in the blood. St. John's wort and drugs based on it can not be combined with oral contraceptives.
Storage conditions
According to the manufacturers, "Lindinet 20" is suitable for use within three years from the date of production, which is indicated on the carton of the drug. After the expiration date, the use of the drug and its analogues is strictly prohibited. If a day is not specified, then the expiration date is the last day of the marked month.
Proper storage medicines:
- avoid direct sunlight and moisture on medicines and even packaging;
- Keep out of the reach of children;
- the optimum storage temperature should not be less than 15 degrees and not exceed 25 degrees.
Disposal of tablets
In order to be able to properly dispose of medicines, you can seek advice from a pharmacist. This knowledge will help protect environment.
Judging by the reviews, the rating of analogues and Lindinet 20 is quite high, the last remedy occupies a leading position due to its low price. The average cost of Lindinet 20 tablets, from customer reviews, varies greatly across the country and depends on the region. So, for example, in Moscow, prices for a pack of 21 tablets vary from 450 to 570 rubles. For a package with three blisters (63 tablets), you will have to pay from 960 to 1220 rubles.
After analyzing the pharmaceutical market, we can conclude that Lindinet 20 is cheaper than its counterparts. For example, the average cost of a package of "Logest", where 21 tablets, is as much as 740 rubles.
Lindinet 30 is an oral contraceptive. This hormonal drug not only prevents the onset of unwanted pregnancy, but also helps in the treatment of gynecological diseases of a tumor nature.
Form, composition and pharmacological action
The drug Lindinet 30 is available in the form of tablets. Packing - 21 and 63 pcs. packaged. The active substance is ethinyl estradiol, its dosage is 30 mcg per 1 tablet. It is a synthetic analogue of the female hormone estradiol. It is responsible for the maturation of follicles and the regulation of the menstrual cycle. Another active ingredient is gestodene. It is a derivative of 19-nortestosterone. Its concentration is 75 mcg.
Auxiliary substances in the composition:
- povidone;
- sucrose;
- lactose monohydrate;
- magnesium stearate;
- titanium dioxide;
- colloidal silicon dioxide;
- sodium calcium edetate;
- corn starch;
- talc;
- calcium carbonate;
- macrogol;
- dye.
The drug belongs to monophasic oral contraceptives. It has a contraceptive effect due to the following effect:
- inhibits the secretion of gonadotropic hormones;
- stops the maturation of follicles, thereby preventing the onset of ovulation;
- changes the nature of the cervical fluid, as a result of which spermatozoa do not penetrate into the uterus;
- reduces the risk of ectopic pregnancy.
The drug Lindinet 30 is also effective in gynecological diseases. It normalizes the menstrual cycle, reduces congestion and inflammation, reduces blood loss, thereby preventing the development of oncological diseases of the female reproductive system. The tool reduces the likelihood of ovarian cysts, fibroadenomas and fibrous formations in the mammary glands.
Indications and contraindications for use, special instructions
Lindinet 30 is intended for contraception and the treatment of ovarian dysfunction. The components of the drug are absorbed by the gastrointestinal tract, enter the bloodstream, are processed by the liver, and excreted by the kidneys and intestines. That is why the drug has a lot of contraindications:
- individual intolerance to the components in the composition;
- hormone-dependent tumors of the organs of the reproductive system or mammary glands;
- thrombosis or predisposition to this disease;
- severe diseases of the cardiovascular system (arterial hypertension, coronary artery disease, coronary artery disease, myocarditis);
- lipid metabolism disorder;
- venous thromboembolism in relatives;
- thrombosis or thromboembolism in the past;
- diabetes mellitus, which is accompanied by angiopathy;
- liver or kidney failure;
- pancreatitis;
- hyperbilirubinemia or cholestatic jaundice;
- severe liver disease (cirrhosis, hepatitis, tumor-like formations);
- cholelithiasis;
- ulcerative colitis;
- anemia;
- malignant and benign formations;
- Gilbert, Rotor or Dubin-Johnson syndrome;
- postoperative recovery period;
- bleeding of unknown origin, including spotting bloody issues;
- pregnancies complicated by a history of allergic manifestations;
- migraine;
- postpartum period (for non-lactating women - 21 days after childbirth);
- depression, other disorders of emotional and mental health.
The drug should be used with caution in women over the age of 35, people with bad habits, obesity and the presence of severe chronic diseases in the family.
Important: pregnancy and breast-feeding are an absolute contraindication to taking the drug.
Instructions for use
The treatment regimen depends on the type of disease. For contraceptive purposes, the Lindinet 30 tablet should be taken once a day at the same time for 21 days. Then you need to take a week break. In it time will pass menstruation.
Note. Withdrawal bleeding should occur upon completion of the drug. If it is absent, pregnancy must be excluded.
When using Lindinet 30 for the first time, the first tablet is taken from the 1st to the 5th day of the menstrual cycle. If taking the drug was preceded by treatment with another hormone-containing drug, then it is necessary to start therapy on the first day of menstruation. You can use the pill immediately on the second day after the end of the previous hormonal course.
Note. It is important not to miss taking Lindinet 30.
If there is a missed dose, then you need to take the pill as soon as possible. If less than 12 hours have passed, then the contraceptive effect does not decrease. If the gap was more than 12 hours, additional contraceptive measures are necessary.
In case of abortion in the first trimester, the drug is used immediately the next day. During childbirth or fading of pregnancy in the second trimester, the use of a contraceptive should be abandoned for at least 3 weeks.
With the use of Lindinet 30, menstruation can be delayed. For this, you should not take breaks in treatment. But you can not use more than 2 packs in a row without a break. During a delay in menstruation, spotting bleeding is possible on the days of possible menstruation.
Side effects and precautions
The likelihood of adverse reactions depends on the individual characteristics of the organism and the history of diseases. Possible side effects:
- nausea, vomiting, diarrhea;
- hemolytic-uremic syndrome;
- porphyria;
- arterial hypertension;
- thromboembolism;
- migraine, depression;
- increased blood sugar;
- weight gain;
- hair loss;
- hearing loss;
- skin rashes, itching.
It is impossible to combine several hormonal contraceptives at the same time.
Important. The contraceptive effect is fully manifested on the 14th day after the start of the intake, therefore, in the first 2 weeks, other methods of contraception should be used.
For the prevention of serious diseases and a general deterioration in well-being against the background of hormonal therapy, it is important to undergo a comprehensive gynecological and general medical examination every six months.
If such diseases occur, it is necessary to choose another contraceptive:
- epilepsy;
- thromboembolic diseases;
- migraine;
- diseases of the hemostasis system;
- kidney failure;
- the likelihood of estrogen-dependent diseases of the reproductive system;
- significant deviations in liver function.
If surgery is planned, then Lindinet 30 should be stopped one month in advance.
Interaction with drugs
When treating diseases of the reproductive system with Lindinet 30 tablets, it is worth excluding other medicines. The effectiveness of the drug is affected by:
- barbiturates, eg Barbital, Butalbital, Secobarbital;
- antibiotics, in particular Ampicillin, Rifampicin, Tetracycline;
- anticonvulsants, eg carbamezapine, primidone, phenytoin;
- NSAIDs, namely Phenylbutazone.
When taken simultaneously, the risk of bleeding and menstrual irregularities increases.
Increase the bioavailability of the hormonal drug inhibitors of liver enzymes and vitamin C.
Similar funds
Lindinet 30 has analogues in composition:
| A drug | Photo | Price |
|---|---|---|
| from 860 rub. | ||
| from 2039 rub. | ||
| clarify |
The active substance is ethinylestradiol and gestodene. Produced in the form of a dragee.
The drug Yarina has a similar effect. This is a hormonal agent based on ethinyl estradiol and drospirenone. A similar composition in Midian tablets. They normalize the cycle, reduce the volume of menstrual flow, reduce the risk of iron deficiency anemia, endometrial and ovarian cancer.
pharmachologic effect
Monophasic oral contraceptive. It inhibits the secretion of gonadotropic hormones from the pituitary gland. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is ethinylestradiol, a synthetic analogue of the follicular hormone estradiol, which, together with the corpus luteum hormone, participates in the regulation of the menstrual cycle. The progestogen component is gestodene, a derivative of 19-nortestosterone, which is superior in strength and selectivity of action not only to the natural corpus luteum hormone progesterone, but also to other synthetic progestogens (for example, levonorgestrel). Due to its high activity, gestodene is used in low dosages, in which it does not exhibit androgenic properties and has practically no effect on lipid and carbohydrate metabolism.
Along with the indicated central and peripheral mechanisms that prevent the maturation of an egg capable of fertilization, the contraceptive effect is due to a decrease in the susceptibility of the endometrium to the blastocyst, as well as an increase in the viscosity of the mucus in the cervix, which makes it relatively impassable for spermatozoa. In addition to the contraceptive effect, the drug, when taken regularly, also has a therapeutic effect, normalizing the menstrual cycle and helping to prevent the development of a number of gynecological diseases, incl. tumor nature.
Pharmacokinetics
Gestodene
Suction
After oral administration, it is rapidly and completely absorbed from the gastrointestinal tract. After a single dose, Cmax is noted after 1 hour and is 2-4 ng / ml. Bioavailability - about 99%.
Distribution
Gestodene binds to albumin and sex hormone-binding globulin (SHBG). 1-2% is in plasma in free form, 50-75% specifically binds to SHBG. An increase in the level of SHBG in the blood caused by ethinyl estradiol affects the level of gestodene: the fraction associated with SHBG increases and the fraction associated with albumin decreases. Average V d - 0.7-1.4 l / kg. The pharmacokinetics of gestodene depends on the level of SHBG. The concentration of SHBG in the blood plasma under the influence of estradiol increases by 3 times. With daily intake, the concentration of gestodene in the blood plasma increases by 3-4 times and in the second half of the cycle reaches a state of saturation.
Metabolism and excretion
Gestodene is biotransformed in the liver. The average plasma clearance is 0.8-1.0 ml / min / kg. The level of gestodene in the blood serum decreases biphasically. T 1/2 in the β-phase - 12-20 hours. Gestodene is excreted only in the form of metabolites, 60% in the urine, 40% in the feces. T 1/2 metabolites - about 1 day.
Ethinylestradiol
Suction
After oral administration, ethinylestradiol is absorbed rapidly and almost completely. Average Cmax in blood serum is achieved 1-2 hours after ingestion and is 30-80 pg / ml. Absolute bioavailability due to presystemic conjugation and primary metabolism is about 60%.
Distribution
Completely (about 98.5%), but non-specifically binds to albumin and induces an increase in the level of SHBG in the blood serum. Average V d - 5-18 l / kg.
C ss is set to 3-4 days of taking the drug, and it is 20% higher than after a single dose.
Metabolism
It undergoes aromatic hydroxylation with the formation of hydroxylated and methylated metabolites, which are present in the form of free metabolites or in the form of conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma is about 5-13 ml.
breeding
Serum concentration decreases biphasically. T 1/2 in the β-phase is about 16-24 hours. Ethinylestradiol is excreted only in the form of metabolites, in a ratio of 2:3 with urine and bile. T 1/2 metabolites - about 1 day.
Indications
- contraception.
Dosing regimen
Assign 1 tablet / day for 21 days, if possible at the same time of day. After taking the last tablet from the package, a 7-day break is taken, during which withdrawal bleeding occurs. The next day after a 7-day break (i.e. 4 weeks after taking the first tablet, on the same day of the week), the drug is resumed.
The first tablet of Lindinet 30 should be taken from the 1st to the 5th day of the menstrual cycle.
At switching to Lindinet 30 from another combined oral contraceptive The first Lindinet 30 tablet should be taken after taking the last tablet from the package of another oral hormonal contraceptive, on the first day of withdrawal bleeding.
At switching to Lindinet 30 from progestogen-only preparations ("mini-pili", injections, implant), when taking a "mini-drink", Lindinet 30 can be taken on any day of the cycle, you can switch from using an implant to taking Lindinet 30 the next day after the removal of the implant, when using injections - on the eve of the last injection. In these cases, additional methods of contraception should be used in the first 7 days.
After an abortion in the first trimester of pregnancy you can start taking Lindinet 30 immediately after surgery. In this case, there is no need to use additional methods of contraception.
After childbirth or after an abortion in the second trimester of pregnancy taking the drug can be started on the 21-28th day. In these cases, additional methods of contraception must be used in the first 7 days. With a later start of taking the drug in the first 7 days, an additional, barrier method of contraception should be used. In the case when sexual contact took place before the start of contraception, before starting the drug, pregnancy should be excluded or the start of the drug should be postponed until the first menstruation.
At pass taking the pill, the missed pill should be taken as soon as possible. If the interval in taking the tablets was less than 12 hours then the contraceptive effect of the drug is not reduced, and in this case there is no need to use an additional method of contraception. The remaining tablets should be taken at the usual time. If the interval is more than 12 hours then the contraceptive effect of the drug may decrease. In such cases, you should not make up for the missed dose, continue taking the drug as usual, but in the next 7 days, you need to use an additional method of contraception. If at the same time there are less than 7 tablets left in the package, the drug from the next package should be started without interruption. In this case, withdrawal bleeding does not occur until the completion of the second pack, but spotting or breakthrough bleeding may occur.
If withdrawal bleeding does not occur after the end of taking the drug from the second package, then pregnancy should be excluded before continuing to take the drug.
If within 3-4 hours after taking the drug begins vomiting and/or diarrhea may reduce the contraceptive effect. In such cases, you should proceed in accordance with the instructions for skipping pills. If the patient does not want to deviate from the usual contraceptive regimen, the missed pills should be taken from another package.
For acceleration of the onset of menstruation you should reduce the break in taking the drug. The shorter the break, the more likely the occurrence of breakthrough or spotting bleeding while taking the pills from the next pack (similar to cases with delayed menstruation).
For delayed start of menstruation the drug should be continued from a new package without a 7-day break. Menstruation can be delayed as long as necessary until the end of the last pill from the second package. With a delay in menstruation, breakthrough or spotting bleeding may occur. Regular intake of the drug Lindinet 30 can be restored after the usual 7-day break.
Side effect
Side effects requiring discontinuation of the drug
From the side of the cardiovascular system: arterial hypertension; rarely - arterial and venous thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism); very rarely - arterial or venous thromboembolism of the hepatic, mesenteric, renal, retinal arteries and veins.
From the sense organs: hearing loss due to otosclerosis.
Others: hemolytic-uremic syndrome, porphyria; rarely - exacerbation of reactive systemic lupus erythematosus; very rarely - Sydenham's chorea (passing after discontinuation of the drug).
Other side effects are more common but less severe. The expediency of continuing the use of the drug is decided individually after consultation with a doctor, based on the benefit / risk ratio.
From the reproductive system: acyclic bleeding / bloody discharge from the vagina, amenorrhea after discontinuation of the drug, changes in the state of vaginal mucus, the development of inflammatory processes in the vagina, candidiasis, tension, pain, enlargement of the mammary glands, galactorrhea.
From the digestive system: epigastric pain, nausea, vomiting, Crohn's disease, ulcerative colitis, occurrence or exacerbation of jaundice and / or itching associated with cholestasis, cholelithiasis, hepatitis, liver adenoma.
Dermatological reactions: erythema nodosum, erythema exudative, rash, chloasma, increased hair loss.
From the side of the central nervous system: headache, migraine, mood lability, depression.
From the sense organs: hearing loss, increased sensitivity of the cornea (when wearing contact lenses).
From the side of metabolism: fluid retention in the body, a change (increase) in body weight, a decrease in carbohydrate tolerance, hyperglycemia, an increase in TG levels.
Others: allergic reactions.
Contraindications for use
- the presence of severe and / or multiple risk factors for venous or arterial thrombosis (including complicated lesions of the valvular apparatus of the heart, atrial fibrillation, diseases of the cerebral vessels or coronary arteries, severe or moderate arterial hypertension with blood pressure ≥ 160/100 mm rt.st.);
- the presence or indication in the anamnesis of the precursors of thrombosis (including transient ischemic attack, angina pectoris);
- migraine with focal neurological symptoms, incl. in history;
- venous or arterial thrombosis / thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower leg, pulmonary embolism) at present or in history;
- the presence of venous thromboembolism in history;
- surgical intervention with prolonged immobilization;
- diabetes mellitus (with angiopathy);
- pancreatitis (including history), accompanied by severe hypertriglyceridemia;
- dyslipidemia;
- severe liver disease, cholestatic jaundice (including during pregnancy), hepatitis, incl. in history (before the normalization of functional and laboratory parameters and within 3 months after their normalization);
- jaundice when taking GCS;
- cholelithiasis at present or in history;
- Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome;
- liver tumors (including history);
- severe itching, otosclerosis or its progression during a previous pregnancy or taking corticosteroids;
- hormone-dependent malignant neoplasms of the genital organs and mammary glands (including if they are suspected);
- vaginal bleeding of unknown etiology;
- smoking over the age of 35 (more than 15 cigarettes per day);
- pregnancy or suspicion of it;
- lactation period;
- Hypersensitivity to the components of the drug.
WITH caution the drug should be prescribed in conditions that increase the risk of developing venous or arterial thrombosis / thromboembolism: age over 35 years, smoking, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate relatives), hemolytic- uremic syndrome, hereditary angioedema, liver diseases, diseases that first arose or worsened during pregnancy or against the background of a previous intake of sex hormones (including porphyria, herpes in pregnancy, chorea / Sydenham's disease /, Sydenham's chorea, chloasma), obesity (BMI over 30 kg / m 2), dyslipoproteinemia, arterial hypertension, migraine, epilepsy, valvular heart disease, atrial fibrillation, prolonged immobilization, extensive surgery, surgery on lower limbs, severe trauma, varicose veins and superficial thrombophlebitis, postpartum period (non-lactating women /21 days after childbirth/; lactating women after the end of the lactation period), the presence of severe depression (including history), changes in biochemical parameters ( activated protein C resistance, hyperhomocysteinemia, antithrombin III deficiency, protein C or S deficiency, antiphospholipid antibodies, including antibodies to cardiolipin, lupus anticoagulant), diabetes mellitus not complicated by vascular disorders, SLE, Crohn's disease, ulcerative colitis, sickle -cellular anemia, hypertriglyceridemia (including family history), acute and chronic liver disease.
Use during pregnancy and lactation
The drug is contraindicated for use during pregnancy and lactation.
In small quantities, the components of the drug are excreted in breast milk.
When used during lactation, milk production may decrease.
Overdose
Severe symptoms are not described after taking the drug in high doses.
Symptoms: nausea, vomiting, vaginal bleeding (in young girls).
Treatment: symptomatic therapy is prescribed, there is no specific antidote.
drug interaction
The contraceptive activity of Lindinet 30 is reduced when taken simultaneously with ampicillin, tetracycline, rifampicin, barbiturates, primidone, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine. The contraceptive effect of oral contraceptives is reduced with the use of these combinations, breakthrough bleeding and menstrual disorders become more frequent. While taking Lindinet 30 with the above drugs, as well as within 7 days after completing the course of taking them, it is necessary to use additional non-hormonal (condom, spermicidal gels) methods of contraception. When using rifampicin, additional methods of contraception should be used within 4 weeks after completion of the course of its administration.
When used simultaneously with Lindinet 30, any drug that increases gastrointestinal motility reduces the absorption of active substances and their level in blood plasma.
Sulfation of ethinyl estradiol occurs in the intestinal wall. Drugs that also undergo sulfation in the intestinal wall (including ascorbic acid) competitively inhibit the sulfation of ethinylestradiol and thereby increase the bioavailability of ethinylestradiol.
Inducers of microsomal liver enzymes reduce the level of ethinylestradiol in blood plasma (rifampicin, barbiturates, phenylbutazone, phenytoin, griseofulvin, topiramate, hydantoin, felbamate, rifabutin, oscarbazepine). Liver enzyme inhibitors (itraconazole, fluconazole) increase plasma levels of ethinylestradiol.
Some antibiotics (ampicillin, tetracycline), preventing the intrahepatic circulation of estrogens, reduce the level of ethinylestradiol in plasma.
Ethinylestradiol, by inhibiting liver enzymes or accelerating conjugation (primarily glucuronidation), can affect the metabolism of other drugs (including cyclosporine, theophylline); the concentration of these drugs in the blood plasma may increase or decrease.
With the simultaneous use of Lindinet 30 with St. John's wort (including infusion), the concentration of active substances in the blood decreases, which can lead to breakthrough bleeding, pregnancy. The reason for this is the inducing effect of St. John's wort on liver enzymes, which continues for another 2 weeks after the completion of the course of taking St. John's wort. This combination of drugs is not recommended.
Ritonavir reduces the AUC of ethinylestradiol by 41%. In this regard, during the use of ritonavir, a hormonal contraceptive with a higher content of ethinyl estradiol should be used or additional non-hormonal methods of contraception should be used.
It may be necessary to correct the dosing regimen when using hypoglycemic agents, tk. oral contraceptives may reduce carbohydrate tolerance, increase the need for insulin or oral antidiabetic agents.
Terms of dispensing from pharmacies
The drug is dispensed by prescription.
Terms and conditions of storage
The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 25°C. Shelf life - 3 years.
Application for violations of liver function
Contraindicated in diseases or severe violations of the liver, liver tumors (including history).
Prescribed with caution in liver failure, cholestatic jaundice (including a history of pregnant women).
In case of acute or chronic liver dysfunction, the drug should be discontinued until the values of liver enzymes are restored. With impaired liver function, the metabolism of steroid hormones may be impaired.
special instructions
Before starting the use of the drug, it is necessary to conduct a general medical (detailed family and personal history, measurement of blood pressure, laboratory tests) and gynecological examination (including examination of the mammary glands, pelvic organs, cytological analysis of a cervical smear). A similar examination during the period of taking the drug is carried out regularly, every 6 months.
The drug is a reliable contraceptive: the Pearl index (an indicator of the number of pregnancies that occurred during the use of a contraceptive method in 100 women for 1 year), when used correctly, is about 0.05. Due to the fact that the contraceptive effect of the drug from the start of taking is fully manifested by the 14th day, it is recommended to additionally use non-hormonal methods of contraception in the first 2 weeks of taking the drug.
In each case, before prescribing hormonal contraceptives, the benefits or possible negative effects of their use are individually assessed. This issue must be discussed with the patient, who, after receiving the necessary information, will make the final decision on the preference for hormonal or any other method of contraception.
The state of health of women must be carefully monitored. If any of the following conditions / diseases appear or worsen while taking the drug, you must stop taking the drug and switch to another, non-hormonal method of contraception:
- diseases of the hemostasis system;
- conditions / diseases predisposing to the development of cardiovascular, renal failure;
- epilepsy;
- migraine;
- the risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;
- diabetes mellitus, not complicated by vascular disorders;
- severe depression (if depression is associated with impaired tryptophan metabolism, then vitamin B 6 can be used to correct it);
- sickle cell anemia, tk. in some cases (for example, infections, hypoxia), estrogen-containing drugs in this pathology can provoke thromboembolism;
- the appearance of deviations in laboratory tests for assessing liver function.
Thromboembolic diseases
Epidemiological studies have shown that there is a link between taking oral hormonal contraceptives and an increased risk of developing arterial and venous thromboembolic diseases (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism). An increased risk of venous thromboembolic disease has been proven, but it is significantly less than during pregnancy (60 cases per 100,000 pregnancies). When using oral contraceptives, arterial or venous thromboembolism of the hepatic, mesenteric, renal or retinal vessels is very rarely observed.
The risk of developing arterial or venous thromboembolic diseases increases:
- with age;
- when smoking (heavy smoking and age over 35 are risk factors);
- if there is a family history of thromboembolic diseases (for example, in parents, a brother or sister). If a genetic predisposition is suspected, it is necessary to consult a specialist before using the drug;
- with obesity (BMI over 30 kg / m 2);
- with dyslipoproteinemia;
- with arterial hypertension;
- in diseases of the heart valves, complicated by hemodynamic disorders;
- with atrial fibrillation;
- with diabetes mellitus complicated by vascular lesions;
- with prolonged immobilization, after major surgery, after surgery on the lower extremities, after a severe injury.
In these cases, a temporary discontinuation of the drug is expected (no later than 4 weeks before surgery, and resumed no earlier than 2 weeks after remobilization).
Women after childbirth have an increased risk of venous thromboembolic disease.
It should be borne in mind that diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia, increase the risk of developing venous thromboembolic diseases.
It should be borne in mind that resistance to activated protein C, hyperhomocysteinemia, deficiency of proteins C and S, deficiency of antithrombin III, the presence of antiphospholipid antibodies increase the risk of developing arterial or venous thromboembolic diseases.
When assessing the benefit / risk ratio of taking the drug, it should be taken into account that targeted treatment of this condition reduces the risk of thromboembolism. The symptoms of thromboembolism are:
- sudden chest pain that radiates to left hand;
- sudden shortness of breath;
- any unusually severe headache that lasts for a long time or appears for the first time, especially when combined with sudden complete or partial loss of vision or diplopia, aphasia, dizziness, collapse, focal epilepsy, weakness or severe numbness of one half of the body, movement disorders, severe unilateral pain in calf muscle, acute abdomen.
Tumor diseases
Some studies have reported an increase in the incidence of cervical cancer in women who have taken hormonal contraceptives for a long time, but the results of the studies are conflicting. Sexual behavior, human papillomavirus infection and other factors play a significant role in the development of cervical cancer.
A meta-analysis of 54 epidemiological studies showed that there is a relative increase in the risk of breast cancer among women taking oral hormonal contraceptives, but the higher detection of breast cancer could be associated with more regular medical examinations. Breast cancer is rare among women under 40, whether they are taking hormonal birth control or not, and increases with age. Taking pills can be regarded as one of many risk factors. However, women should be advised of the potential risk of developing breast cancer based on a benefit-risk assessment (protection against ovarian and endometrial cancer).
There are few reports of the development of benign or malignant liver tumors in women who take hormonal contraceptives for a long time. This should be kept in mind in the differential diagnostic evaluation of abdominal pain, which may be associated with an increase in the size of the liver or intraperitoneal bleeding.
Chloasma
Chloasma can develop in women who have a history of this disease during pregnancy. Those women who are at risk of developing chloasma should avoid contact with sunlight or ultraviolet radiation while taking Lindinet 30.
Efficiency
The effectiveness of the drug may decrease in the following cases: missed pills, vomiting and diarrhea, simultaneous use of other drugs that reduce the effectiveness of birth control pills.
If the patient is simultaneously taking another drug that can reduce the effectiveness of birth control pills, additional methods of contraception should be used.
The effectiveness of the drug may decrease if, after several months of their use, irregular, spotting or breakthrough bleeding appears, in such cases it is advisable to continue taking the tablets until they are finished in the next package. If at the end of the second cycle, menstrual bleeding does not begin or acyclic spotting does not stop, stop taking the tablets and resume it only after pregnancy has been ruled out.
Changes in laboratory parameters
Under the influence of oral contraceptive pills - due to the estrogen component - the level of some laboratory parameters (functional parameters of the liver, kidneys, adrenal glands, thyroid gland, hemostasis indicators, levels of lipoproteins and transport proteins) may change.
Additional Information
After suffering acute viral hepatitis, the drug should be taken after normalization of liver function (not earlier than after 6 months).
With diarrhea or intestinal disorders, vomiting, the 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 risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk depends on age (especially in women over 35) and on the number of cigarettes smoked.
A woman should be warned that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Influence on the ability to drive vehicles and control mechanisms
Studies on the effect of the drug Lindinet 30 on the ability to drive a car and work machinery have not been conducted.
