Dimia pills when your period starts. Dimia - instructions for the use of contraceptive pills, indications, side effects, analogs and price

Good day!

Finally, I found time to write about oral contraceptives, which the gynecologist imposed on me in every possible way. For a long time I was categorically against contraceptive pills, and so was my husband. Heard that they are harmful, they gain weight, become covered with acne, etc., etc. Each of my visits to the gynecologist began with the fact that she was interested in what method my husband and I were protecting. For which I found 1000 and 1 reason just to excuse myself and not drink these pills. Well, they did not inspire confidence in me and that's it. And the gynecologists impose them in such a way that there are suspicions - for what purpose are they doing this, without prescribing any tests and examinations? That's right, commercial. It's no secret that our gynecologists are well paid by pharmaceutical companies to prescribe certain drugs to us ...

Well, now my review about dimia - micro-dose oral contraceptives. For a long time we protected ourselves with condoms. I can say that this method is completely unreliable. Our condom was constantly breaking. And the sensations are not the same. What can I say about dimia? Sex got better. And much more. Here are the dimia tablets themselves:

The package contains 28 tablets. 24 contraceptives, 4 empty - calculated for the red days of the calendar. That is, you drink them and your period begins almost immediately. Well, someone like that of course) Such a package costs about 500 rubles, though not all pharmacies have it.

Drinking them, of course, is not entirely convenient, since you need to take a pill every day at the same time, only in this case you will not forget that you took it. And if you drink as you have to, or rather as you remember, you can get confused. I also mark the numbers when I drank dimia just in case.

The instruction for contraceptive dimia is enormous. After reading all the contraindications and side effects, I was afraid to drink, but took the risk. I decided that if they don’t suit me and I feel bad, I’ll give it up. But I didn’t notice any side effects, I’ll even say that I feel better. The mood is always good. Maybe it's not contraceptive, but I stopped feeling sick on public transport, although it was like that all the time, before taking them.

I have not found any shortcomings for myself yet, I hope that the side will not appear.

So the pros of dimia:

Improved health, mood

Sex got better

You can shift your periods (just start drinking a new package, skipping the last 4 tablets from the previous one)

There are no side effects yet, I hope there won't be any!

Relatively affordable price, unlike other contraceptives

Of the shortcomings - you need to drink at the same time, otherwise you will forget whether you drank it or not. Well, there are many side effects. I think it's still harmful to drink them all the time.

So I can say whether to drink or not to drink contraceptive is of course up to you. Anything can happen and they are not suitable for everyone! So it all depends on your body. Dimia is my first contraceptive, so for now I put 4, because of contraindications. And we'll see)

In this article, you can read the instructions for using the medicinal product. Dimia... The reviews of website visitors - consumers of this medication, as well as opinions of doctors of specialists on the use of hormonal contraceptive Dimia in their practice are presented. A big request is to actively add your reviews about the drug: did the medicine help or did not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Dimia's analogs in the presence of available structural analogs. Use for contraception in women and prevention of unwanted pregnancy, as well as breastfeeding. Composition of the preparation.

Dimia- is a combined monophasic oral contraceptive containing drospirenone and ethinyl estradiol. In terms of its pharmacological profile, drospirenone is close to natural progesterone: it does not have estrogenic, glucocorticoid and antiglucocorticoid activity and is characterized by a pronounced antiandrogenic and moderate antimineralocorticoid effect. The contraceptive effect is based on the interaction of various factors, the most important of which are inhibition of ovulation, an increase in the viscosity of the cervical secretion and changes in the endometrium. Pearl Index, an indicator that reflects the frequency of pregnancy in 100 women reproductive age during the year of use of the contraceptive, is less than 1.

Compound

Ethinylestradiol + Drospirenone + excipients.

Pharmacokinetics

Drospirenone

When taken orally, drospirenone is rapidly and almost completely absorbed in the gastrointestinal tract. Bioavailability is 76-85%. Simultaneous intake with food does not affect the bioavailability of drospirenone. Drospirenone binds to serum albumin and does not bind to sex hormone binding globulin (SHBG) or corticosteroid binding globulin (transcortin). Only 3-5% of the total serum concentration of drospirenone exists as free steroids. Drospirenone is extensively metabolized after oral administration. Drospirenone is excreted only in trace amounts unchanged. Drospirenone metabolites are excreted by the kidneys and through the intestines with an excretion ratio of about 1.2: 1.4.

Ethinylestradiol

When taken orally, ethinyl estradiol is absorbed quickly and completely. The absolute bioavailability as a result of presystemic conjugation and first-pass metabolism is approximately 60%. Concomitant food intake reduced the bioavailability of ethinyl estradiol in about 25% of the patients surveyed; the others did not. Ethinylestradiol is a substrate for presystemic conjugation in the mucous membrane of the small intestine and in the liver. Ethinyl estradiol is primarily metabolized by aromatic hydroxylation, with the formation of a wide range of hydroxylated and methylated metabolites, which are present both in free form and as conjugates with glucuronic acid. Unchanged ethinyl estradiol is practically not excreted from the body. Ethinyl estradiol metabolites are excreted by the kidneys and through the intestines in a ratio of 4: 6.

Indications

oral contraception.

Forms of issue

Film-coated tablets in a blister of 24 pieces of white and 4 pieces of green (a total of 28 tablets).

Instructions for use and reception scheme

The tablets should be taken daily, at about the same time, with a little water, in the order indicated on the blister pack. The tablets are taken continuously for 28 days, 1 tablet per day. Taking pills from the next package begins after taking the last tablet from the previous package. Withdrawal bleeding usually begins 2-3 days after the start of the placebo pill (last row) and does not necessarily end by the start of the next pack.

How to start taking Dimia

If hormonal contraceptives have not been used in the last month, they start taking Dimia on the first day. menstrual cycle(i.e. the first day of menstrual bleeding). It is possible to start taking the pills on days 2-5 of the menstrual cycle, in this case, additional use of the barrier method of contraception is required during the first 7 days of taking the pills from the first package.

Switching from other combination contraceptives (combined oral contraceptives in pill form, vaginal ring, or transdermal patch)

It is necessary to start taking Dimia the next day after taking the last inactive tablet (for drugs containing 28 tablets) or the next day after taking the last active tablet from the previous package (possibly the next day after the end of the usual 7-day break) - for drugs containing 21 tablets per pack. If a woman uses a vaginal ring or a transdermal patch, it is preferable to start taking Dimia on the day they are removed or, at the latest, on the day when a new ring or patch is planned to be inserted.

Switching from contraceptives containing only progestogens (mini-pills, injections, implants), or from an intrauterine system (IUD) that secretes progestogens

A woman can switch from taking a mini-pill to taking Dimia on any day (from an implant or from an IUD on the day of their removal, from injectable forms of drugs on the day when the next injection should have been made), but in all cases it is necessary to use it additionally barrier method of contraception during the first 7 days of taking the pills.

After an abortion in the 1st trimester of pregnancy

Taking Dimia can be started as directed by a doctor on the day of termination of pregnancy. In this case, the woman does not need to take additional contraceptive measures.

After childbirth or abortion in the 2nd trimester of pregnancy

A woman is recommended to start taking the drug on days 21-28 after childbirth (provided that she is not breastfeeding) or an abortion in the 2nd trimester of pregnancy. If the reception is started later, the woman should use an additional barrier method of contraception within the first 7 days after starting the drug Dimia. With the resumption of sexual activity (before taking the drug Dimia), pregnancy should be excluded.

Taking missed pills

Skipping a placebo tablet from the last (4th) row of the blister can be ignored. However, they should be discarded to avoid unintentionally prolonging the placebo phase. The instructions below only apply to missed tablets containing active ingredients.

If the delay in taking the pill is less than 12 hours, contraceptive protection is not reduced. The woman should take the missed pill as soon as possible (as soon as she remembers), and the next pill at the usual time.

If the delay exceeds 12 hours, contraceptive protection may be reduced. In this case, you can be guided by two basic rules:

Tablet-taking should never be interrupted for more than 7 days;
To achieve adequate suppression of the hypothalamic-pituitary-ovarian system, 7 days of continuous pill intake are required.

In accordance with this, women can be given the following recommendations:

Days 1-7

A woman should take the missed pill as soon as she remembers it, even if that means taking two pills at the same time. Then she should take the pills at the usual time. In addition, a barrier method such as a condom should be used for the next 7 days. If intercourse has occurred in the previous 7 days, the possibility of pregnancy should be taken into account. The more tablets are missed and the closer this pass is to the 7-day break in taking the drug, the higher the risk of pregnancy.

Days 8-14

A woman should take the missed pill as soon as she remembers it, even if it means taking two pills at the same time. Then she should take the pills at the usual time. If during the 7 days preceding the first missed pill, the woman took the pills as expected, there is no need for additional contraceptive measures. However, if she missed more than 1 pill, an additional method of contraception (barrier - for example, a condom) is needed for 7 days.

Days 15-24

The reliability of the method inevitably diminishes as the placebo pill phase approaches. However, adjusting the pill regimen can still help prevent pregnancy. When performing one of the two schemes described below, and if in the previous 7 days before skipping the pill, the woman adhered to the regimen of taking the drug, there will be no need to use additional contraceptive measures. If this is not the case, she should follow the first of the two regimens and use additional precautions for the next 7 days.

1. A woman should take the last missed pill as soon as she remembers it, even if it means taking two pills at the same time. She should then take the pills at the usual time until the active pills run out. The 4 placebo tablets from the last row should not be taken; the tablets should be started immediately from the next blister pack. Most likely, there will be no "withdrawal" bleeding until the end of the second pack, but "smearing" bloody issues or “withdrawal” bleeding on the days of taking the drug from the second pack.

2. The woman can also stop taking active tablets from the started package. Instead, she must take the last row of placebo pills for 4 days, including skipped days, and then start taking the next pack of pills.

If a woman misses a pill and does not subsequently experience withdrawal bleeding in the placebo pill phase, pregnancy should be considered.

Use of the drug for gastrointestinal upset

In the case of severe gastrointestinal disorders (for example, vomiting or diarrhea), the absorption of the drug will be incomplete, and additional contraceptive measures will be required. If vomiting occurs within 3-4 hours after taking the active pill, it is necessary to take a new (replacement) pill as soon as possible. If possible, the next tablet should be taken within 12 hours of the usual tablet-taking time. If more than 12 hours have passed, it is recommended to act as directed when skipping tablets. If the woman does not want to change her usual pill regimen, she must take an additional pill from a different package.

Delaying "withdrawal" menstrual bleeding

To delay bleeding, a woman should skip taking placebo tablets from the started package and start taking drospirenone + ethinyl estradiol tablets from a new package. The delay can be extended until the active tablets in the second pack run out. During a delay, a woman may experience acyclic profuse or spotting bleeding from the vagina. Regular use of Dimia is resumed after the placebo phase.

To shift the bleeding to another day of the week, it is recommended to shorten the upcoming phase of taking the placebo tablets by the desired number of days. With a shortening of the cycle, it is more likely that the woman will not have menstrual "withdrawal" bleeding, but will have acyclic profuse or spotting spotting from the vagina when taking the next pack (just like when lengthening the cycle).

Side effect

candidiasis, incl. oral cavity;
anemia, thrombocytopenia;
allergic reactions;
increase in body weight;
increased appetite;
anorexia;
weight loss;
emotional lability;
depression;
decreased libido;
nervousness;
drowsiness;
anorgasmia;
insomnia;
headache;
dizziness;
paresthesia;
vertigo;
conjunctivitis;
visual impairment;
migraine;
phlebeurysm;
increased blood pressure;
tachycardia;
vascular damage;
nose bleed;
nausea, vomiting;
abdominal pain;
diarrhea;
cholecystitis;
rash (including acne);
eczema;
alopecia (baldness);
acne dermatitis;
dry skin;
skin striae;
contact dermatitis;
photodermatitis;
backache;
pain in the limbs;
muscle cramps;
chest pain;
no bleeding "withdrawal";
vaginal candidiasis;
enlargement of the mammary glands;
vaginal discharge;
hot flushes;
vaginitis;
acyclic spotting;
painful menstrual bleeding;
profuse withdrawal bleeding;
scanty menstrual bleeding;
dryness of the vaginal mucosa;
painful intercourse;
vulvovaginitis;
postcoital bleeding;
breast cyst;
breast hyperplasia;
mammary cancer;
endometrial atrophy;
ovarian cyst;
enlargement of the uterus;
asthenia;
increased sweating;
feeling of discomfort;
venous thromboembolic diseases;
liver tumors.

Contraindications

The drug Dimia, like other combined oral contraceptives, is contraindicated in any of the conditions listed below:

thrombosis (arterial and venous) and thromboembolism at present or in history (including thrombosis, deep vein thrombophlebitis; pulmonary embolism, myocardial infarction, stroke, cerebrovascular disorders);
conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at present or in history;
multiple or severe risk factors for venous or arterial thrombosis, incl. complicated lesions of the valve apparatus of the heart, atrial fibrillation, diseases of the vessels of the brain or coronary arteries; uncontrolled arterial hypertension, volumetric surgery with prolonged immobilization, smoking over the age of 35, obesity with a body mass index> 30 kg / m2;
hereditary or acquired predisposition to venous or arterial thrombosis, for example, resistance to activated protein C, antithrombin 3 deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia, and antibodies against phospholipids (presence of antibodies to phospholipids - antibodies to cardiolipin, lupus); anticoagulant
pancreatitis with severe hypertriglyceridemia at present or in history;
existing severe liver disease (or history), provided that liver function is not currently normalized;
severe chronic or acute renal failure;
liver tumor (benign or malignant), current or history;
hormone-dependent malignant neoplasms of the genital organs or mammary gland, currently or in history;
vaginal bleeding of unknown origin;
migraine with a history of focal neurological symptoms;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
pregnancy and suspicion of it;
lactation period;
hypersensitivity to the drug or any of the components of the drug.

Carefully

risk factors for the development of thrombosis and thromboembolism: smoking under the age of 35, obesity, dyslipoproteinemia, controlled arterial hypertension, migraine without focal neurological symptoms, uncomplicated heart valve defects, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident in young people any of the next of kin);
diseases in which peripheral circulation disorders may occur: diabetes mellitus without vascular complications, systemic lupus erythematosus (SLE), hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia, phlebitis of superficial veins;
hereditary angioedema;
hypertriglyceridemia;
severe liver disease (before normalization of liver function tests);
diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (including jaundice and / or itching associated with cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, herpes during pregnancy, a history of chorea (Sydenham's disease), chloasma;
postpartum period.

Application during pregnancy and lactation

Dimia is contraindicated during pregnancy.

If pregnancy occurs while using the drug Dimia, it should be stopped immediately. Expanded epidemiological studies have not revealed an increase in the risk of birth defects in children born to women who took combined oral contraceptives (COCs) before pregnancy, or a teratogenic effect of COCs when taken unintentionally during pregnancy.

According to the data of preclinical studies, it is impossible to exclude undesirable effects that affect the course of pregnancy and fetal development due to the hormonal action of the active components.

The drug Dimia can affect lactation: reduce the amount of milk and change its composition. Small amounts of contraceptive steroids and / or their metabolites can be excreted in milk while taking COCs. These amounts can affect the baby. The use of the drug Dimia during breastfeeding contraindicated.

Application in children

The use of the drug before the establishment of menarche is not indicated.

special instructions

If there are any of the conditions / risk factors listed below, the benefits of taking COCs should be assessed individually for each woman and discussed with her before starting use. In case of an exacerbation of an undesirable phenomenon or in the event of any of these conditions or risk factors, a woman should contact her doctor. The doctor must decide whether to interrupt the use of the PDA.

Circulatory disorders

Taking any combined oral contraceptive pill increases your risk of venous thromboembolism (VTE). The increased risk of VTE is most pronounced in the first year of a woman's use of a combined oral contraceptive.

Epidemiological studies have shown that the incidence of VTE in women with no risk factors who took low doses of estrogen (< 0.05 мг этинилэстрадиола) в составе комбинированного перорального контрацептива, составляет примерно 20 случаев на 100 000 женщин-лет (для левоноргестрелсодержащих КПК "второго поколения") или 40 случаев на 100 000 женщин-лет (для дезогестрел/гестоденсодержащих КПК "третьего поколения"). У женщин, не пользующихся КПК, случается 5-10 ВТЭ и 60 беременностей на 100 000 женщин-лет. ВТЭ фатальна в 1-2% случаев.

Data from a large, prospective, 3-pronged study showed that the incidence of VTE in women with or without other risk factors for venous thromboembolism who used a combination of ethinylestradiol and drospirenone, 0.03 mg + 3 mg, coincides with the incidence of VTE in women using levonorgestrel-containing oral contraceptives and other PDAs. The degree of risk of venous thromboembolism while taking the drug Dimia is currently not established.

Epidemiological studies have also revealed a relationship between COC intake and an increased risk of arterial thromboembolism (myocardial infarction, transient ischemic disorders).

Very rarely, women taking oral contraceptives have thrombosis of other blood vessels, such as veins and arteries in the liver, mesentery, kidney, brain, or retina. Unanimous opinion regarding the connection of these phenomena with the reception hormonal contraceptives no.

Symptoms of venous or arterial thrombotic / thromboembolic events or acute cerebrovascular accidents:

unusual one-sided pain and / or swelling of the lower extremities;
sudden severe chest pain, regardless of whether it radiates into left hand or not;
sudden shortness of breath;
sudden onset of cough;
any unusual severe long-term headache;
sudden partial or complete loss of vision;
diplopia;
impaired speech or aphasia;
vertigo;
collapse with or without partial seizures;
Weakness or very noticeable numbness that suddenly affects one side or one part of the body;
movement disorders;
"sharp" stomach.

Before taking the PDA, a woman should consult with a specialist.

The risk of venous thromboembolic disorders when taking PDAs increases with:

increasing age;
hereditary predisposition (venous thromboembolism ever happened in siblings or parents at a relatively early age);
long-term immobilization, extended surgical intervention, any surgical intervention on lower limbs or major injury. In such situations, it is recommended to stop taking the drug (in the case of planned surgery, at least four weeks) and not resume until two weeks after the full recovery of mobility. If the drug has not been discontinued early, anticoagulant treatment should be considered;
obesity (body mass index over 30 kg / m2);
absence unanimous opinion about the possible role of varicose veins and superficial thrombophlebitis in the appearance or exacerbation of venous thrombosis.

The risk of arterial thromboembolic complications or acute cerebrovascular accident when taking PDAs increases with:

increasing age;
smoking (women over 35 are strongly advised to quit smoking if they want to take PDA);
dyslipoproteinemia;
arterial hypertension;
migraines without focal neurological symptoms; obesity (body mass index over 30 kg / m2);
hereditary predisposition (arterial thromboembolism ever in siblings or parents at a relatively early age). If a hereditary predisposition is possible, a woman should consult with a specialist before starting to take a PDA;
damage to the valves of the heart;
atrial fibrillation.

Having one major risk factor for vein disease or multiple risk factors for arterial disease may also be a contraindication. Anticoagulant therapy should also be considered. Women taking COCs should be properly instructed on the need to inform the attending physician in case of suspicion of symptoms of thrombosis. If thrombosis is suspected or confirmed, the COC should be discontinued. It is necessary to start an adequate alternative contraception due to the teratogenicity of anticoagulant therapy (indirect anticoagulants - coumarin derivatives).

Consideration should be given to the increased risk of thromboembolism in the postpartum period.

Other medical conditions associated with adverse vascular events include diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis), and sickle cell disease.

An increase in the frequency or severity of migraine while taking COCs may be an indication for the immediate cancellation of combined per oral contraceptives.

Tumors

The most significant risk factor for cervical cancer is human papillomavirus infection. Some epidemiological studies have reported an increased risk of cervical cancer with long-term use combined oral contraceptives, but there are conflicting opinions about the extent to which these findings are related to co-factors, such as testing for cervical cancer or the use of barrier methods of contraception.

A meta-analysis of the results of 54 epidemiological studies revealed a slight increase in the relative risk (RR = 1.24) of breast cancer in women who are currently taking COCs. The risk gradually decreases over the course of 10 years after stopping the use of COCs. Since breast cancer rarely develops in women under 40, an increase in the number of diagnosed cases of breast cancer among those using COCs has little effect on the overall likelihood of breast cancer. These studies did not find sufficient evidence for a causal relationship. An increased risk may be due to an earlier diagnosis of breast cancer in those using COCs, the biological effect of COCs, or a combination of both factors. The diagnosed breast cancer in women who have ever taken COCs was clinically less severe due to the early diagnosis of the disease.

Rarely, women taking COCs developed benign liver tumors and, even more rarely, malignant liver tumors. In some cases, these tumors were life-threatening due to intra-abdominal bleeding. This should be taken into account when making a differential diagnosis in case of severe pain in the abdomen, enlarged liver, or signs of intra-abdominal bleeding.

Other conditions

The progestogen component of Dimia is an aldosterone antagonist that retains potassium in the body. In most cases, an increase in potassium is not expected. However, in a clinical study in some patients with mild to moderate kidney disease who took potassium-sparing drugs, the serum potassium content slightly increases while taking drospirenone. Therefore, it is recommended to monitor serum potassium during the first cycle of treatment in patients with renal insufficiency in whom the serum potassium concentration before treatment was at the upper normal limit and, especially, while taking potassium-sparing drugs.

In women with hypertriglyceridemia or a hereditary predisposition to it, the risk of pancreatitis may be increased when taking COCs.

Although a slight increase in blood pressure was observed in many women taking COCs, a clinically significant increase was rare. Only in these rare cases is the immediate discontinuation of the PDA justified. If, when taking a PDA in patients with concomitant arterial hypertension, blood pressure constantly increases or significantly increased blood pressure cannot be corrected with antihypertensive drugs, the PDA should be discontinued. After normalization of blood pressure with the help of antihypertensive drugs, the use of COCs can be resumed.

The following diseases appeared or worsened both during pregnancy and during the intake of the PDA, however, the evidence of their relationship with the intake of the PDA is inconclusive: jaundice and / or itching associated with cholestasis, gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; rheumatic chorea (Sydenham's chorea); herpes during pregnancy; otosclerosis with hearing loss.

In women with hereditary angioedema, exogenous estrogens can induce or exacerbate symptoms of edema.

Acute or chronic liver disease may be an indication for stopping the use of PDAs until the liver function indicators return to normal. Recurrence of cholestatic jaundice and / or itching associated with cholestasis, which developed during a previous pregnancy or with earlier use of sex hormones, serve as an indication for stopping the use of COCs.

Although MMRs can affect peripheral insulin resistance and glucose tolerance, changes in the treatment regimen in patients with diabetes mellitus while taking PDAs with a low content of hormones (containing< 0.05 мг этинилэстрадиола) не показано. Однако следует внимательно наблюдать женщин с сахарным диабетом, особенно на ранних стадиях приема КПК.

During the use of COCs, an aggravation of endogenous depression, epilepsy, Crohn's disease and ulcerative colitis was observed.

Chloasma may occur from time to time, especially in women who have had a history of chloasma during pregnancy. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet light while taking PDAs.

Drospirenone + ethinyl estradiol coated tablets contain 48.53 mg of lactose monohydrate, placebo tablets contain 37.26 mg of anhydrous lactose per tablet. Patients with rare hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption who are on a lactose-free diet should not take this drug.

In women who are allergic to soy lecithin allergic reactions may occur.

The efficacy and safety of Dimia as a contraceptive have been studied in women of reproductive age. It is assumed that in the post-pubertal period up to 18 years, the efficacy and safety of the drug are similar to those in women after 18 years. The use of the drug before the establishment of menarche is not indicated.

Medical examinations

Before starting or re-using Dimia, a complete medical history (including family history) should be collected and pregnancy should be ruled out. It is necessary to measure blood pressure, conduct a medical examination, guided by contraindications and precautions. The woman needs to be reminded of the need to carefully read the instructions for use and adhere to the recommendations indicated in it. The frequency and content of the survey should be based on existing practice guidelines. The frequency of medical examinations is individual for each woman, but should be carried out at least once every 6 months.

The woman needs to be reminded that oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Decreased efficiency

The effectiveness of the PDA may decrease, for example, when you skip taking drospirenone + ethinyl estradiol tablets, gastrointestinal disorders while taking drospirenone + ethinylestradiol tablets, or while taking other medications.

Insufficient cycle control

As with the use of other PDAs, a woman may experience acyclic bleeding (spotting or "withdrawal" bleeding), especially in the first months of admission. Therefore, any irregular bleeding should be assessed after a three-month adaptation period.

If acyclic bleeding recurs or begins after several regular cycles, the possibility of developing disorders of a non-hormonal nature should be considered and measures should be taken to exclude pregnancy or cancer, including therapeutic and diagnostic curettage of the uterine cavity.

In some women, withdrawal bleeding does not occur during the placebo phase. If the PDA was taken in accordance with the instructions for use, then it is unlikely that the woman is pregnant. However, if the rules of admission were violated before the first missed menstrual-like "withdrawal" bleeding, or if two bleedings were missed, pregnancy should be excluded before continuing to take the PDA.

Influence on the ability to drive vehicles and use mechanisms

Not found.

Drug interactions

The effect of other drugs on Dimia

Interactions between oral contraceptives and other medicinal products may result in acyclic bleeding and / or contraceptive ineffectiveness. The interactions described below are reflected in the scientific literature.

The mechanism of interaction with hydantoin, barbiturates, primidone, carbamazepine and rifampicin; oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin and St. John's wort (Hypericum perforatum) preparations are based on the ability of these active substances to induce liver microsomal enzymes. The maximum induction of liver microsomal enzymes is not achieved within 2-3 weeks, but after that it persists for at least 4 weeks after discontinuation of drug therapy.

Contraceptive ineffectiveness has also been reported with antibiotics such as ampicillin and tetracycline. The mechanism of this phenomenon is not clear.

Women with short-term treatment (up to one week) with any of the above groups of drugs or mono-drugs should temporarily use (during the period of simultaneous administration of other drugs and for another 7 days after its termination), in addition to CPC, barrier methods of contraception.

Women receiving rifampicin therapy, in addition to taking COCs, should use a barrier method of contraception and continue using it for 28 days after stopping rifampicin treatment. If taking concomitant medications lasts longer than the expiration date of the active tablets in the package, you should stop taking the inactive tablets and immediately start taking drospirenone + ethinyl estradiol tablets from the next package.

If a woman is constantly taking drugs - inducers of liver microsomal enzymes, she should use other reliable non-hormonal methods of contraception.

The main metabolites of drospirenone in human plasma are formed without the participation of the cytochrome P450 system. Inhibitors of cytochrome P450 are therefore unlikely to interfere with the metabolism of drospirenone.

The effect of the drug Dimia on others medicines

Oral contraceptives can affect the metabolism of some other active ingredients. Accordingly, the concentration of these substances in blood plasma or tissues can either increase (for example, cyclosporine) or decrease (for example, lamotrigine).

Other interactions

In patients without renal failure, concomitant use of drospirenone and ACE inhibitors or non-steroidal anti-inflammatory drugs (NSAIDs) does not significantly affect serum potassium. But still, the simultaneous use of the drug Dimia with aldosterone antagonists or potassium-sparing diuretics has not been studied. In this case, during the first cycle of treatment, it is necessary to monitor the concentration of serum potassium.

Laboratory tests

Taking contraceptive steroids can affect the results of some laboratory tests, including the determination of biochemical parameters of liver function, thyroid gland, adrenal and kidney, plasma protein (transporter) concentrations, for example corticosteroid-binding proteins and lipid / lipoprotein fractions, parameters of carbohydrate metabolism and parameters of blood coagulation and fibrinolysis. In general, changes remain within the normal range. Drospirenone causes an increase in the activity of renin in the blood plasma and - due to a small atimineralocorticoid activity - reduces the concentration of aldosterone in the plasma.

Analogs of the drug Dimia

Structural analogues for the active substance:

Yarina.

Analogs on pharmacological group(estrogens and gestagens in combinations):

Activel;
Angelique;
Anteovin;
Belara;
Gynodian Depot;
Gynoflor E;
Dailla;
Desmoulins;
Jess;
Jess Plus;
Diana 35;
Divina;
Divitre;
Evra;
Janine;
Genetten;
Zoely;
Individual;
Klayra;
Klymene;
Klimonorm;
Kliogest;
Lindinet 20;
Lindinet 30;
Logest;
Marvelon;
Mercilon;
Midiana;
Microginon;
Novairing;
Novinet;
Non Ovlon;
Ovidon;
Oralcon;
Pauzogest;
Revmelid;
Regulon;
Rigevidon;
Silest;
Silhouette;
Three Mercy;
Three regolas;
Triaclim;
Trigestrel;
Triquilar;
Trisequencing;
Femoden;
Femoston;
Proginov's cycle;
Eviana;
Egestrenol;
Yarina;
Yarina Plus.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and see the available analogues for the therapeutic effect.

Dimia is one of the latest contraceptive pills for women with signs of hyperandrogenism. This is an analogue of Yarina with a reduced concentration of estrogen in each tablet. Dimia is a monophasic oral contraceptive, which means that the hormone content in each serving is the same, with the exception of pacifiers (placebo).

But the functioning of the female reproductive system occurs in cyclical modes. That is why cycle irregularities often occur when using tablets. What to do if there is no period while taking Dimia, when should I see a doctor?

Read in this article

Reasons for the absence of menstruation

Ideally, when taking birth control pills, the girl should not have any problems and questions. But in practice, you have to deal with the opposite: often there are various disruptions of the cycle, ranging from daub to the absence of menstruation for several months.

In the first month of admission

Dimia, like most popular birth control pills, is a monophasic contraceptive. This has its pros and cons. The advantages include the fact that due to the low concentration of hormones in each tablet, the incidence of side effects is lower. But the woman's body from the moment of puberty functions cyclically, it is thanks to these processes that the growth and maturation of follicles, the release of the egg, take place. At every minute, the level of hormones fluctuates in one direction or another. Therefore, it is so difficult to treat any violations of their production.

Taking Dimia, the woman's body gets into new conditions, when the same dose of the hormone is supplied every day. This inhibits the ovarian's own function. And for some time there is an addiction to the new regime. For some, it runs without a trace, while others note that when taking Dimia there are no periods.

A similar picture can develop in two cases:

While taking contraceptives, the girl had no complaints. But menstruation did not come at the right time. You should not worry if the schedule for taking the medicine has not been violated, such a reaction of the body is allowed. You should take a break of four days, as expected, and then start the next package. As a rule, things are getting better next month.
It happens that against the background of taking hormonal contraceptives in a woman there are periodic ones throughout the entire cycle. Sometimes they are quite plentiful and bring a lot of anxiety and discomfort. In this case, after taking Dimia, there are scanty periods at the right time, or they do not exist at all. The fact is that the endometrium does not have time to grow due to constant daub. In most cases, everything returns to normal in the second month of admission. If it continues, it is imperative to consult a doctor.

Dummy pills not taken

Often, girls want to change the length of their menstrual cycle. This can be done by not taking all of the placebo tablets or by skipping them altogether. In this case, there will also be no menses until a placebo is taken.

Lost the cycle

You should be aware that menstrual bleeding occurs only when the drug is discontinued. But some girls noticed that against the background of using Dimia, all the active pills were finished. This is allowed.

It also happens that women, for some reason, do not finish part of the package, after which they begin to daub. The beginning of such a discharge should be considered the first day of a new cycle. Not knowing this, the girls are waiting for the next menstruation according to the "old" schedule, and are worried when they are not there.

After complete withdrawal of the drug

When they finish the pack and decide not to drink any more hormone pills, many people think that the cycle will be kept on a regular basis. However, this is not always the case. Own hormonal background is restored within 2 - 4 months, sometimes up to six months. During this time, various failures may occur.

Often, after discontinuation of Dimia, there is no period for several months. This happens in the following cases:

If, even before the appointment of hormonal drugs, the woman had irregular menstruation. Indeed, taking pills, the effect is fixed only for the period of treatment, for a maximum of a month or two after the drug is discontinued. Then, your own hormonal background is restored with the same disturbances that were before.
If a woman has been taking birth control for several years. The longer this method of contraception is used, the more difficult it is for the ovaries to restore their function later. The same applies to age: in young girls, the cycle normalizes faster. You can meet with the fact that there are no menstruation for 3 - 6 months, sometimes longer. In such situations, it is always necessary to contact a gynecologist and be observed by him until menstruation is restored. Sometimes it is necessary to prescribe additional treatment.

No period while taking placebo

Some girls believe that as soon as the active pills in the package are finished and the placebo is started, menstruation should go. And when they are gone for a day or two or even three, they start to worry. It is assumed that menstruation will go within a week after the last active pill. In this case, you should not worry, and after taking a placebo, you should immediately switch to a new package. Every girl should know the main situations while taking Dimia, when menstruation should begin normally. This way you can avoid unnecessary anxiety.

Ovarian wasting

Sometimes, against the background of taking hormonal drugs, there is a complete suppression of the own function of the ovaries, their depletion is noted. The risk of this increases with the following points:

with long-term continuous use hormonal pills;
if the woman is over 35 years old;
in the case when ovarian operations were previously performed;
if it is a multiparous woman.

Having these risk factors, you should pay special attention to the restoration of menstruation. And if this does not happen within two months after the drug is discontinued, you should consult a doctor as soon as possible.

Pregnancy

Hormonal contraceptives are one of the most effective methods of preventing pregnancy. However, to achieve this effect, you must strictly follow the rules for taking pills. If you miss even one, the likelihood of unplanned conception increases. Therefore, in all situations when there are no periods on time while taking oral contraceptives, pregnancy should be excluded. This can be done using a regular urine test. But it is better and more reliable - which shows a 100% real result already from the 10th day after fertilization, if it happened.

In the case when, against the background of using Dimia, menstruation does not stop, it is also first of all necessary to exclude pregnancy, especially if the schedule for taking the pills is violated.

Watch the video about hormonal contraception:

Why bleeding may start

In most cases, menstruation with Dimia tablets is regular, not abundant, almost painless. They can even acquire a smearing character. But it happens that breakthrough bleeding occurs or very much. What is the reason for this? There are several reasons:

After the cancellation of Dimia, strong periods can be in the second or third month, when the body is fully recovering from synthetic hormones. This is especially true if, before the pills, a woman was bothered by heavy menstruation.
If a girl skips dummy pills for several cycles in a row to remove critical days, then at any time she may experience breakthrough bleeding. This is due to the fact that the endometrium constantly grows under the influence of estrogens and gestagens, but is not rejected - for this it is necessary to sharply reduce their level, for example, stop drinking or replace with a placebo. In the end, it is so wide that it is removed on its own, this is manifested by profuse bleeding. Moreover, even a single skip of a placebo increases the risk of spotting and even heavy discharge in addition to critical days.
In the case when Dimia is prescribed not according to indications, and the woman may lack a dose of the hormone. In this case, bleeding will not be critical.
If a girl missed more than two pills, then the risk of developing abundant discharge from her over the next five days increases sharply. This is menstrual bleeding. In such a situation, it is better to stop taking the old pack and start the next one after a four-day break.
In the first month of admission, if the use of the tablets is started after childbirth or termination of pregnancy at any time, breakthrough bleeding also occurs. As a rule, all violations disappear in the second or third month of admission.

What to do

What to do if your period after taking Dimia did not come on time? The algorithm of actions is as follows:

For reliability and reliability, you should first do a urine pregnancy test. But it is even better to take a blood test for hCG, it shows a reliable result already from the 10th day after fertilization, if it happened. If all signs point to pregnancy, you should make an appointment with your doctor right away.
If there is no menstruation for only a couple of days after the active pills, you should not worry, most likely they will go in a few days. Allowed time up to a week.
In the event that menstruation did not come in some month, especially at the beginning of the intake, and there are no signs of pregnancy, most likely this is an adaptation of the body to synthetic sex hormones. It is necessary to continue taking it strictly according to the instructions. The absence of bloody discharge for more than 2 - 3 cycles is a significant reason for seeking medical attention. Most likely, hormonal drugs will have to be canceled for a while in order to restore ovarian function.
If your period does not come when you skip the placebo pills, it should be so. But when, after the complete cancellation of Dimia, the delay in menstruation is more than three months, especially in women after 35 years, you should immediately consult a doctor. There is a possibility that the ovary supply is depleted. In situations like this, it is sometimes necessary to take hormone replacement therapy until the age of menopause.

Dimia is one of the most popular and modern contraceptive drugs, an analogue of Yarina. With its help, it is possible to carry out not only protection from pregnancy, but also treatment - it has an antiandrogenic and mineralocorticoid effect. While taking the drug, various violations of the menstrual cycle may occur, especially if there were errors in the application.

It happens that after Dimia there is no menstruation for more than one cycle, or there are smearing and sometimes profuse bleeding of a different nature. If any disorders appear, only a specialist can establish the true cause and prescribe an effective and safe treatment for a woman.

Pharmacological action

The combined drug Dimia is a monophasic oral drug. This medicine contains ethinyl estradiol and drospirenone (an analogue of progesterone of natural origin). The active substances that make up the drug do not have estrogenic, antiglucocorticoid, glucocorticoid abilities. The drug achieves its effectiveness thanks to a change in the endometrium, inhibition of ovulation and an increase in the viscosity of the cervical secretion, which prevents the penetration of sperm into its cavity.

After taking the drug inside, the active ingredients are completely absorbed into the bloodstream from the small intestine. They are distributed evenly over all tissues of the body. The maximum concentration of the drug is reached two hours after administration. The decay products of ethinyl estradiol and drospirenone are excreted from the body mainly in the urine.

Release form and composition

The drug Dimia is produced in the form of round, biconvex white film-coated tablets with a special G73 marking on one side. Also, the composition of the drug additionally includes placebo tablets of green color, which do not contain active active ingredients. One package of the drug includes 28 tablets, packaged in one or three blisters. The composition of the product is presented in the table:

How to take Dimia

Dimia hormonal tablets should be taken daily, at the same time, with water, in the order indicated on the blister pack. The medicine should be taken continuously for 28 days, one piece per day. Taking pills from the subsequent package should be started after the product from the previous box has run out. Only a doctor will be able to tell you how to take Dimia correctly, without health consequences. As a rule, the beginning of using the product is different:

When switching from other OK (oral contraceptives), it is necessary to start drinking Dimia the next day after taking the last tablet of another drug (28 pieces) or a week after using the drug containing 21 capsules. When using a transdermal patch or vaginal ring, dimia can only be taken after they have been removed.
Before you start taking the pills, if the woman has not used other OCs for a month, you must start drinking dimia from the first day of the menstrual cycle. You can take the remedy from the 3rd day of the onset of menstruation, but you should use condoms for a week.
After deleting intrauterine device, the use of tablets begins on the day of the procedure.
If a woman has taken progesterone-based non-combination drugs, then the contraceptive can be started on any day.
If a pregnancy is terminated in the first trimester, a woman, as directed by a doctor, can take pills on the same day.
After an abortion or childbirth, experts advise starting taking pills on day 28.

If a woman missed taking another pill, you must adhere to the following recommendations in relation to resuming their use:

skipping a placebo pill can be ignored and then you must continue taking the next day according to the scheme indicated in the instructions;
if less than 12 hours have passed since the missed appointment, then the patient should take the pill as soon as possible;
if more than 12 hours have passed since the last use of the drug, then the woman should take a pill when she remembers it, even if it coincides in time with the next one (in this case, you can take 2 pills at once).

Indications and contraindications for taking pills

Contraceptives Dimia are indicated for women of reproductive age to prevent unwanted pregnancy. In addition, the use of the drug is possible in the treatment of such diseases:

fibroids;
endometriosis;
dysfunction of the menstrual cycle;
iron deficiency anemia;
polycystic ovary syndrome;
premenstrual syndrome.

The use of tablets is contraindicated in the following situations:

thrombophlebitis, thromboembolism (movement of blood clots through arterial vessels) or thrombosis (the appearance of blood clots in the lumen of venous or arterial vessels);
malignant hormone-dependent neoplasms of the mammary glands or organs of the reproductive system;
hereditary or acquired predisposition to thrombosis (lack of protein, hyperhomocysteinemia);
individual intolerance to the main or auxiliary components of the drug;
pancreatitis (inflammation of the pancreas);
pathological processes preceding the appearance of severe thrombosis (transient ischemic attack, myocardial infarction, angina pectoris);
the transferred surgical intervention with further immobilization of the body;
acute or chronic severe kidney failure;
the presence in the female body of processes that can lead to cardiovascular diseases (damage to the heart valves, violation of the rhythm of contractions, pathology of the coronary vessels);
smoking over the age of 35;
lactation period;
hypertension;
liver disease;
acquired or congenital lactase deficiency;
the presence of pathological bleeding from the vagina;
confirmed pregnancy.

The drug should be taken with caution in the postpartum period and with concomitant pathologies leading to impaired peripheral circulation:

Crohn's disease;
diabetes mellitus;
sickle cell anemia;
systemic lupus erythematosus;
hereditary angioedema,
phlebitis of superficial veins;
hypertriglyceridemia (increased blood triglyceride levels).

Side effects

Before using a contraceptive medication, a woman should consult a doctor, because there is a risk of thromboembolic complications. In addition, the use of the drug can lead to the development of such side effects:

emotional instability;
nausea, vomiting;
dizziness;
migraine;
stomach ache;
inflammation of the gallbladder (cholecystitis);
headache;
depression;
drowsiness;
tremors (tremors) of the hands;
muscle cramps;
increased blood pressure;
tachycardia (increased heart rate);
thrombocytopenia (decreased platelet count);
phlebitis (inflammation of the veins);
anemia (anemia);
development of vaginal candidiasis;
increase in body weight;
back pain;
dyspareunia (painful intercourse);
enlargement of the mammary glands;
acne (acne);
dryness of the vaginal mucosa;
alopecia (hair loss);
allergic reactions.

If you develop side effects or complications (coughing up blood, double vision, sudden or partial loss of vision), you should immediately seek medical help. The risk of negative symptoms and vascular thrombosis increases with arterial hypertension, alcohol abuse, increased body weight, over 40 years of age. The use of the drug does not exclude the possibility of infection infectious diseases sexually transmitted diseases.

Interaction of Dimia with other drugs

The effectiveness of the contraceptive can be weakened by joint administration of the drug with barbiturates (a group of drugs, derivatives of barbituric acid) and drugs that affect liver enzymes: Griseofulvin, Oxcarbazepine, Topiramate, Phenytoin, Primidon, Felbamat, Rifampicin. In addition, the instructions indicate that drugs that contain St. John's wort in their chemical composition, when used simultaneously with dimia, induce (stimulate) microsomal liver enzymes, which also negatively affects the female body.

A decrease in the circulation of estrogens and, at the same time, the effectiveness of the contraceptive occurs when used simultaneously with the antibiotics Ampicillin and Tetracycline. HIV protease inhibitors and their combinations have a negative effect on the hepatic metabolism of the drug. Women with short-term treatment with any of the above means should temporarily use barrier methods of contraception (condom).

Analogs

The manufacturer of the drug Dimia is the Hungarian firm Gedeon Richter. Absolute structural analogs of the agent, similar in the mechanism of action and chemical composition are:

Midiana;
Angelique;
Yarina;
Jess;
Vidora;
Dailla;
Belara;
Simicia;
Yarina plus;
Anabella;
Delsia;
Modell trend.

Dimia tablets price

You can buy dimia at any pharmacy, but you will need to get a prescription from your doctor. You cannot start taking pills on your own or on the recommendation of friends; before using it, you should definitely visit a specialist. The cost of the drug depends on the region of distribution and the number of tablets in the package, on average, the price for 28 pieces is 700 rubles. approximate cost contraceptive in Moscow is presented in the table.

Combined oral contraceptives, with correct reception Is the most reliable way contraception. In addition, such drugs contain female sex hormones in a strictly verified, small dosage. And this allows you to solve the set women's problems with health, improve the condition of the skin, hair and nails.

Dimia is a modern, multi-phase contraceptive that has received a lot of positive reviews. What features does the drug have, according to what scheme to use the pills and who should refrain from using OC?

Compound

The contraceptive drug is in the form of round, white and green tablets with a marker "G73", is available in a blister, in a pack of 28 pieces. Dispensed by doctor's prescription.

White tablets contain the following ingredients:

Active. This is microfollin, a progestogen, a derivative of spironolactone.
Auxiliary. This category includes lactoline, corn dextrin, polyethylene glycol copolymer, stearic acid, polymer of hypothetical vinyl alcohol with structural formula repeating compound link.

Green pills are placebo. Contain:

Milk sugar.
Dietary fiber of purified cotton cellulose.
Stearic acid.
Corn dextrin.
The adsorbent is pyrogenic silicon dioxide.

Self-medication, in particular, improper use of the medication, can cause side effects or reduce the contraceptive function of the drug.

Pharmacology

Dimia is, first of all, an effective contraceptive. He can be prescribed by a doctor as nulliparous and artificially terminated pregnancy in the first and second trimesters. It is also recommended for women who have given birth who are not breastfeeding.

In addition to direct prescription (protection against unwanted pregnancy), the drug can be prescribed to girls of reproductive age for the treatment of acne, seborrhea, severe dysmenorrhea. In addition, taking COCs reduces the likelihood of developing:

Genital cancer.
Pelvic inflammatory disease.
Osteoporosis.

Tablets are prescribed for women who have had or have a predisposition to ectopic pregnancy... Also suffering from infertility (increase the likelihood of fertilization after stopping the use of COCs).

It should be borne in mind that the body of every woman has its own characteristic features. Therefore, before using a contraceptive, you should, without fail, pass all required analyzes on the subject of the portability of the constituents of the medication. It would be a good idea to take a complete medical history and consult with your gynecologist.

Side effects

Taking birth control Dimia tablets can have unpleasant consequences with an incorrectly selected dosage of the drug, regular violations by the patient of the drug regimen. The most common side effects of COC use are: dizziness, nausea, sleep disturbance, loss of consciousness, increased pressure, depression, depression, bleeding from the nasal cavity. The heavier ones include:

Skin diseases and allergic responses of the body to the active or auxiliary components of the drug (itching, rashes, burning sensation).
Inflammation of the gallbladder, vaginal mucosa, local proliferation of tissues of the cervical canal and breast.
Sexual dysfunction and decreased desire for intercourse.
Stopping menstruation.
Pathology of the breast cavity with liquid-like contents, chest pain.
Vaginal pain, vaginal dryness, thrush.
Abdominal bloating or pain.
Headache, muscle pain (spasmodic), pain in the lumbosacral region, limbs.
Disorder of motor function.

No cases of drug intoxication from taking Dimia have been reported. But potential syndromes of drug use in excess of the norm (based on other COCs) can be: nausea, vomiting, insignificant blood excretion of the vagina.

Contraindications

Like most OK, contraceptive Dimia is prohibited to use during pregnancy, breastfeeding. This is attributed to the fact that an increased concentration of hormones can adversely affect the natural development of the fetus. Also, the active substances in the composition of the product can not only reduce its amount, but also change the composition.

Contraindications to the use of contraceptive are the presence of a woman:

Intolerance to one or more of the constituent components of the drug.
Acute inflammation of the pancreas.
Malignant tumors of generative organs, mammary glands, liver.

Violations of one or more functions of the liver.
High blood pressure, blockages of arterial vessels, veins.
Quantitative and qualitative violations of the composition of blood lipoproteins.
Diseases associated with an insufficient amount or activity of the C1-inhibitor, impaired blood circulation in the peripheral arteries.
Migraine with pronounced focal neurological symptoms.
Diseases associated with impaired absorption of glucose, lactose.
Supraventricular tachyarrhythmias with chaotic atrial electrical activity.

It is imperative to consult a doctor to prescribe the most effective dosage of Dimia contraceptive pills in the presence of work-related diseases:

Liver.
Heart muscle.
Blood flow and in other acute or chronic conditions.

In addition, women in the postnatal period should be treated with special care and caution in the use of Dimia. Also, with caution, the agent is prescribed for those who have suffered diseases provoked by pregnancy or the use of hormone-containing drugs (herpes, jaundice, porphyrin disease, etc.).

Women suffering from obesity, tobacco intoxication, heart pathologies have an increased risk of side effects.

Admission rules

Taking Dimia is designed for 28 days, during which a woman should take one tablet (alternating active and placebo) every day. Approximately necessary at the same time, drinking plenty of clean, still water. After the packaging is over, you need to start taking a new one immediately, without interruption. The use of medicines from one blister should not be interrupted for more than one week (7 days).

If a woman has not taken oral contraceptives before or took a break in taking for 30-31 days, then the start of taking the drug should fall on the first day of menstruation. It is permissible for 2-5 days of the cycle, but at the same time during intercourse, you should additionally protect yourself with barrier contraceptives.
When switching to Dimia from other OCs, the intake should be started the next day after taking a placebo tablet (medicines for 28 days) or tablets with an active substance (for contraceptives designed for 21 days).
If you refuse implants, injections, hormonal minimal pills or intrauterine contraceptives in favor of COCs, the use of oral contraceptives is recommended to start on the day the injections stop or the contraceptive forms are withdrawn.
Taking the drug with a delay of no more than 12 hours will not affect the quality of the contraceptive protection of the medication. If, after the estimated time of taking, more than 12 hours have passed without using the medication, then the pill should be drunk as soon as the woman remembered this, even if this leads to the joint taking of several pills. Further, the reception of the contraceptive should take place according to the usual scheme.

The adaptation period (with primary and secondary) but after a significant break in the use of a contraceptive is on average up to three months.

If, after this period, the use of contraceptives is accompanied by discomfort, then you should contact a female doctor to adjust the regimen or a new appointment.

Interaction with other medicines

By reacting with other medications, the effectiveness of Dimia can be either reduced or increased. So, a decrease in the main function of the contraceptive is observed with the simultaneous use of antibiotics (especially ampicillin, tetracycline).

OC can enhance the process of metabolism of active substances:

Antiviral and sedative medications.
Medicines prescribed for the treatment of respiratory and urinary tract, liver and gastrointestinal tract infectious nature.
The effect of oral contraceptives can be enhanced and increased by taking metronidazole and vitamin C.

However, fast metabolism active substances of OK are prevented by:

Pomegranate juice.
Lipid-lowering drugs of the third generation from the statin group.

In addition, COCs can also affect the level of drug concentration in the blood. So, the drug is capable of:

Reduce the plasma concentration of some drugs from the group: aldehydes (Paracetamol), IV generation fluoroquinolones (Trovafloxacin), salicylic acid.
To increase the degree of influence on the body of caffeine, some antidepressants (imipramine), immunosuppressants (for example, such as cyclosporine).

Dimia is excellent contraceptive drug, but even it must be taken with the permission of the gynecologist.