Femoden or Lindinet 30 which is better. Comparison of contraceptive drugs

There are a large number of contraceptives, but the leading position among the whole variety is occupied by contraceptive pills, which are characterized by a high degree of prevention of unwanted pregnancy. Consider each of the groups of drugs in order to know which birth control pills are best to choose, find out the names and read reviews about them.

Microdosed hormonal preparations

Preparations of this group of tablets are characterized by side effects at a minimum level.

Suitable for both girls from 18 years old, and women after 35 years old who have a constant sex life.

Zoely

The drug, which contains nomegestrol acetate and estradiol hemihydrate. These compounds are similar in structure to natural female hormones. The drug is aimed at suppressing ovulation. It also acts on the cervical mucus, changing its secretion.

claira

Highly effective combined oral contraceptive. Reduces the risk of cancer in women, minimally affects the liver. It is close in composition to the natural hormonal background of women, where the main active ingredient is estradiol valerate. Shown for all ages. Tablets should not be used during breastfeeding and in early pregnancy.

A monophasic drug that aims to suppress ovulation and changes in cervical secretion, which leads to a decrease in sperm permeability. Improves the regularity of menstruation, reduces pain. When using a contraceptive, the risk of cancer is reduced. The main active ingredient is ethinylestradiol, the auxiliary is drospirenone. You can use tablets after 40 years.

A new drug that, in addition to contraception, contains vitamins. Unlike Jess tablets, it contains calcium levomefolate. The drug is aimed at suppressing ovulation and minimizing sperm permeability. When it is taken, the effect of reducing pain during menstruation is observed.

Dimia

Microdosed oral contraceptive is a combination drug, which includes ethinyl estradiol and drospirenone. The action is based on the inhibition of ovulation and changes in the secretion of the cervix.

A drug aimed at contraception as a result of inhibition of ovulation and changes in the properties of uterine mucus. The main active ingredients are ethinylestradiol and levonorgestrel. It has a positive effect on the regularity of menstruation, suppresses pain. Due to its composition, it reduces the risk of developing iron deficiency anemia.

Lindinet-20

Monophasic tablets that are aimed at inhibiting the secretion of gonadotropic hormones from the pituitary gland. The active ingredients are ethinylestradiol and gestodene. Prevents the development of a viable egg, has a positive effect on the regularity of the menstrual cycle, reduces the risk of tumors in women.

Contraceptive drug, release form - pills. It interferes with the process of ovulation, increases the viscosity of the uterine mucus. Before you start using the drug, you should undergo a thorough gynecological examination. The active ingredients are ethinylestradiol and gestodene.

Novinet

A drug based on a combination of estrogen and progestogen, which suppresses ovulation and slows down the movement of spermatozoa. The active ingredients of the tablets are synthetic estrogen, progestogen desogestrel. In the process of taking it, blood loss during menstruation is noticeably reduced, so it is indicated for women with copious discharge.

Mercilon

As part of the drug, the main active ingredients are ethinylestradiol and desogestrel. Duration of admission - 21 days, then a break - 7 days and the resumption of admission.

Low dose drugs

Preparations that belong to this group are suitable not only for women who have given birth, but also for girls from 18 years old.

They are prescribed by gynecologists in case microdosed hormonal pills do not fit.

Yarina

Tablets of a new generation, which include ethinylestradiol and drospirenone. It is a multi-phase drug. In addition to contraceptive action, it has a cosmetic effect, reducing acne.

Midian

Contraceptive pills, which are characterized by a low content of hormones. The active ingredients of the drug are ethinylestradiol and drospirenone. It is also prescribed for cosmetic purposes in the fight against acne.

A contraceptive drug with a low hormone content. The main active ingredients are desogestrel and ethinylestradiol. Reduces pain during menstruation, improves skin condition with acne. It is desirable to use at the same time one tablet for 21 days with a break of 7 days. Especially suitable for girls over 18 years old and for women over 40 years old.

Lindinet-30

Monophasic contraceptive, which is characterized by suppression of the secretion of gonadotropic hormones of the pituitary gland, while preventing unwanted pregnancy. The main active ingredients are ethinylestradiol and gestodene. Release form - coated tablets are rapidly absorbed in the gastrointestinal tract.

Femodene

A drug to prevent unwanted pregnancy for regular use, as well as to normalize the menstrual cycle and regulate the intensity of discharge during menstruation. Refers to drugs with a low content of hormones. The main active ingredients are ethinylestradiol and gestodene. Indicated for scheduled use.

Silest

Combined drug, the action of which is aimed at the regulation of the gonads in order to prevent unwanted pregnancy. The main active ingredients are norgestimate and ethinylestradiol. Used for 21 days with a break of 7 days. Apply orally.

Janine

Low-dose monophasic contraceptive. The main active ingredients are ethinylestradiol and dienogest. It affects the body through three mechanisms: suppression of ovulation, increased mucus impermeability, changes in the endometrium. As a result of the application, an improvement in the regularity of menstruation is observed. Assign women for regular use to prevent unwanted pregnancy.

Silhouette

The main active ingredients of the drug are ethinylestradiol and levonorgestrel. Release form - dragee. The drug is rapidly absorbed in the intestine. Doctors prescribe to treat acne, normalize the menstrual cycle and prevent unwanted pregnancy. The drug is intended for regular use.

Combined drug for contraception in women. Prevents sperm from entering the egg. The main active ingredients are ethinylestradiol and desogestrel. Prescribed by a gynecologist to normalize the menstrual cycle and PMS as well. Characterized by regular use.

Marvelon

The main active ingredients are ethinylestradiol and desogestrel. It is characterized by oral use daily for 21 days with a break. Contain a small amount of hormones. It is aimed at suppressing ovulation and controlling the regularity of the menstrual cycle.

High dose tablets

Drugs that belong to the group of high-dose hormonal pills can only be taken with a doctor's prescription.

Prescribed for the treatment of hormonal diseases and for contraception during their treatment.

A three-phase therapeutic drug, which is aimed at contraception, is characterized by a high content of the hormone. The main active ingredients are ethinylestradiol and levonorgestrel. The drug blocks the maturation of a viable egg. It is prescribed by a doctor, and examinations are required every 6 months.

Triquilar

Combined contraceptive, which is characterized by high dosage. The main active ingredients are ethinylestradiol and levonorgestrel. It is applied three-phase for 21 days with a break. Women using this remedy observe the stabilization of the menstrual cycle and a high result of contraception.

A highly effective drug, which includes progestin and estrogen. Indications for use - prevention of unwanted pregnancy. It is characterized by good tolerance.

A contraceptive that contains estrogen and a progestin. These components have a high degree of activity compared to natural hormones and under their influence ovulation stops. The effect of the application is 100%.

Non-Owlon

The hormonal drug is available in the form of a green dragee, in a package - 21 tablets. It is characterized by a high level of hormone content. The main active ingredients are ethinylestradiol and norethisterone. It is indicated for use in order to prevent pregnancy, regulate the duration of the cycle, and treat psychological infertility.

mini pili

Minipills are medicines that prevent pregnancy. A distinctive feature is a gentle effect on the woman's body.

With regular use, the effect of the mini-pill is 99%.

They are an oral contraceptive.

A contraceptive based on the active substance - desogestrel. It affects the condition of the uterine mucus, making it thicker and less permeable to sperm. Approved for lactating women.

Charosetta

A drug that prevents unwanted pregnancy by reducing the possibility of ovulation and increasing the viscosity of the uterine mucus. Does not affect lipid processes in the human body. Normalizes the menstrual cycle in women. The main active ingredient is desogestrel.

Exluton

It is a contraceptive that can be used after childbirth. The main active ingredient is desogestrel. It is administered orally. The preparation of daily systematic use. In case of occasional use, the result is not guaranteed.

Microlute

A contraceptive that contains a progestogen, which makes it possible for women to be well tolerated. The main active ingredient is levonorgetrel. May be used during breastfeeding. It is also recommended to use it in conjunction with non-hormonal contraceptives.

Non-hormonal pills

A distinctive feature of non-hormonal pills is that they are inserted into the vagina, and not taken orally.

They act due to the active substance in the composition, which affects the spermatozoa, destroying them.

The main active ingredient is benzalkonium chloride. The drug does not affect the natural microflora of the vagina. It is prescribed in case of not being able to use stronger (hormonal) contraceptives.

Gynecotex

Vaginal tablets that have a contraceptive and antiseptic effect. The main active ingredient is benzalkonium chloride. Can be used during pregnancy and lactation. They are introduced into the vagina before intercourse for 5-10 minutes. Do not affect the natural microflora of the vagina.

Benatex

A remedy that prevents unwanted pregnancy and has the ability to get rid of unwanted microbes and fungi in the vagina. The main active ingredient is benzalkonium chloride. There are no contraindications for use during pregnancy and lactation.

Contraceptive, which includes the active substance - benzalkonium chloride. It destroys the structure of the sperm and thus prevents unwanted pregnancy. It must be inserted into the vagina before intercourse. Also serves as an antiseptic.

Countertex

Non-hormonal pills that are aimed at destroying the sperm membrane during intercourse. The main active ingredient is benzalkonium chloride. They are introduced into the vagina and tend to thicken the uterine mucus. May be used while breastfeeding.

Nonoxynol

Pills for contraception, which, in addition to the main property, have an antifungal capability. The main active ingredient is nonoxynol. They are prescribed by a doctor, including during lactation and pregnancy.

Traceptin

A vaginal remedy that is necessary for contraception. The introduction is recommended in the vagina for 5-10 minutes before sexual intercourse. The main active ingredient is potassium hydrotartrate. Non-hormonal agent that can be used during pregnancy and lactation.

All drugs for contraception must be prescribed by doctors with preliminary diagnostics on an individual basis.

And it should be remembered that the contraceptives in question have a much better effect on the woman's body than birth control pills after intercourse.

Compound Lindinet 20(1 tablet):

• - 0.02 mg;
• - 0.075 mg;
• magnesium stearate - 0.2 mg;
• povidone - 1.7 mg;
• corn starch - 15.5 mg;

Compound Lindinet 30(1 tablet):

• ethinylestradiol - 0.03 mg;
• gestodene - 0.075 mg;
• sodium calcium edetate - 0.065 mg;
• magnesium stearate - 0.2 mg;
• colloidal silicon dioxide - 0.275 mg;
• povidone - 1.7 mg;
• corn starch - 15.5 mg;
• lactose monohydrate - 37.165 mg.

Both pharmaceutical forms are supplied in the form of tablets, the shell of which has the following components:

• sucrose - 19.66 mg;
• - 8.231 mg;
• macrogol 6000 - 2.23 mg;
• titanium dioxide - 0.46465 mg;
• povidone - 0.171 mg;
• yellow quinoline dye (D + C yellow No. 10 - E 104) - 0.00135 mg.

Release form

In pharmacy kiosks, the drug is presented in the form of round, biconvex tablets, which are coated with a light yellow shell on both sides. There are no inscriptions or symbols. On a break, the tablet is white or close to white in color with a light yellow edging of the shell.

pharmachologic effect

Lindinet belongs to the group of monophasic combined oral medications based on sex hormones , respectively, is used mainly for the purpose of contraception. The main therapeutic effect of the drug is associated with several mechanisms of action, including a decrease in the secretion of gonadotropic hormones. , active obstruction of ovulatory processes and inhibition of the maturation of follicles in the ovaries.

First of all, it should be noted that ethinylestradiol , one of the biologically active constituents, is a synthetic analogue of the follicular hormone , which, together with the hormones of the corpus luteum, is involved in the regulation of the woman's menstrual cycle, largely inhibiting it at certain stages.

Another active ingredient is gestodene is a gestagenic 19-nortestosterone derivative and is a stronger and more selective version of natural secreted by the corpus luteum. This component is used in ultra low amounts, due to which it does not realize its androgenic capabilities (the chemical basis for gestodene is a variation of the male sex hormone) and has the weakest effect on the carbohydrate and lipid metabolism of the body.

In addition to the central mechanisms of action directly on sex hormones, the drug implements contraceptive properties indirectly through peripheral components. Under the influence of a pharmaceutical drug, susceptibility decreases to the blastocyst, which makes the process of implantation of the initial forms of the fetus almost impossible. The density and viscosity of the mucus localized in the cervix also increases, which becomes largely impassable for spermatozoa that make active movements towards the female egg.

Lindinet has not only contraceptive effects, the pharmaceutical drug contributes active prevention some gynecological diseases and not only. In particular, the possibility of the appearance of functional ovarian cysts And . Reduces the risk of in the mammary glands, congestive inflammatory processes practically disappear. The beneficial properties of the drug extend to skin , as their general condition improves and the degree of manifestation decreases (with regular use, dermatological defects disappear completely).

Pharmacodynamics and pharmacokinetics

Pharmacokinetic abilities of gestodene

After oral administration, the active component is absorbed from the gastrointestinal tract quite quickly and almost completely, because its bioavailability is about 99%, and the maximum concentration of 2-4 ng / ml is noted after 1 hour.

In the bloodstream gestodene contacts And specific globulin SHBG , only 1-2% of the amount of the active ingredient remains in free form. The pharmacokinetics of gestodene largely depends on the level of SHBG and the concentration of estradiol, because the amount of the selective carrier increases by 3 times under the influence of the sex hormone. The constant intake of oral contraceptives also contributes to the active saturation of gestodene, with its daily use, the concentration increases by 3-4 times.

The active component undergoes the main stages of biochemical transformation in the liver, after which it is excreted in the urine (60%) and feces (40%) only in the form of metabolites. The half-life of the active ingredient is biphasic and takes about 1 day, since the average plasma clearance is from 0.8 to 1 ml / million / kg.

Pharmacokinetic abilities of ethinylestradiol

The second active component has slightly lower absorption rates - due to presystemic conjugation and primary metabolism, the absolute bioavailability of the pharmacological component from the digestive tube is only 60%, and the maximum concentration of 30-80 pg / ml is reached after 1-2 hours.

On the distribution side, ethinylestradiol, on the contrary, outperforms gestodene, because 98.5% of the active substance binds to nonspecific albumins. Also, the active component induces an increase in the level of SHBG, which favorably affects the overall effectiveness of the oral contraceptive. A constant average level of ethinylestradiol is established by 3-4 days after the start of the therapeutic course, and it is 20% higher than after a single dose of the Lindinet tablet.

The biotransformation of the active substance occurs in the liver and is aromatic hydroxylation with the formation of methylated and hydroxylated metabolic products in free form or in the form of conjugates with sulfates or glucuronides. Metabolic clearance from blood plasma ranges from 5-13 ml.

Ethinylestradiol is excreted only in the form of metabolic products with urine and bile in a ratio of 2:3. The half-life, like that of gestodene, is biphasic and is about 1 day.

Indications for use

• contraception;
• functional disorders of the menstrual cycle.

Contraindications

• individual hypersensitivity to a pharmaceutical preparation or its constituent components;
• risk factors for arterial or venous thrombosis;
• moderate and severe;
• transient ischemic attack or as precursors of thrombosis;
• surgery with prolonged immobilization;
• with a pronounced increase in blood triglycerides;
• dyslipidemia ;
• severe liver disease ( hepatitis , cholestatic jaundice and etc);
• syndrome of Gilbert, Dubin-Johnson, Rotor;
• neoplasm localized in the liver;
• otosclerosis or the presence of it in the anamnesis of a previous pregnancy or after taking glucocorticosteroids;
• smoking over the age of 35;
• hormone-dependent malignant tumors genital organs and mammary glands;
• vaginal bleeding of unknown origin;
• period of lactation and childbearing.

Side effects

Adverse effects of treatment requiring immediate cancellation pharmaceutical therapy:

• From the side of cardio-vascular system: arterial hypertension, , , deep vein thrombosis of the lower extremities, venous or arterial thromboembolism hepatic, mesenteric, retinal or renal vessels.
• From the side sense organs: hearing loss due to otosclerosis .
• Others: porphyria , hemolytic-uremic syndrome, exacerbations of reactive , chorea of ​​Sydenham .

Side effects, after the appearance of which the expediency of further use of the drug is decided in individual order:

• From the side reproductive system: acyclic bleeding from the vagina of unknown etiology, , colpocytological changes in vaginal mucus, inflammatory diseases, pain, breast enlargement, galactorrhea .
• From the side central nervous system: hearing loss, , , mood lability.
• Dermatological reactions: or exudative erythema , incomprehensible rash, chloasma, increased .
• From the side digestive system: epigastric pain, nausea and vomiting, Crohn's disease , nonspecific ulcerative , jaundice and itching, which is due to it, cholelithiasis , liver adenoma, hepatitis.
• From the side metabolic processes: fluid retention in the body, decreased tolerance to carbohydrates, increased levels of triglycerides or blood glucose, weight gain.
• Other allergic reactions.

Application instruction of Lindinet (Way and dosage)

Lindinet 20, instructions for use

Contraceptive pills are used orally orally once a day, without chewing and drinking plenty of water, regardless of the meal. If possible, you should take the pills at the same time of day for 21 days, then you need to take a break for 7 days, and then resume the use of contraceptives. That is, the next tablet should be used 4 weeks after the start of the course on the same day of the week. During the break, uterine bleeding will be observed, which corresponds to menstruation in a normal cycle.

A course of conservative contraception should be started from the 1st to the 5th day of the menstrual cycle, if other oral contraceptives have not been used before. Otherwise, the 1st tablet must be taken after the last dose of the previous hormone-containing pharmaceutical preparation, on the 1st day of bleeding after withdrawal.

Transition from progestogen-containing agents on Lindinet requires the use of an additional method of contraception in the first week. The date of the first intake of a new contraceptive must be consistent with the pharmaceutical form of the previous drug:

• in the form of mini-tablets - on any day of the menstrual cycle;
• in the case of injections - on the eve of the last injection;
• implant - the next day after its removal.

Lindinet 30, instructions for use

Since this pharmaceutical form is an enhanced version of Lindinet 20 with a higher concentration of ethinylestradiol, it is recommended to prescribe it after abortion so that the restoration of the physiological hormonal background takes place much faster and less painfully.

If the abortion was performed in 1st trimester of pregnancy , then there is nothing to worry about. Oral contraceptives can be started immediately after gynecological manipulation and there is no need to use additional methods of contraception.

If the abortion or childbirth occurred during 2nd trimester of pregnancy , then taking the pharmaceutical preparation can be started only on the 21-28th day after the obstetric operation. With a later start of the course of conservative protection in the first week, a barrier method of contraception should be used. If a full-fledged sexual intercourse took place before the start of taking the drug, then before taking contraceptives, you must make sure that there is no new pregnancy.

Missing an oral contraceptive pill

If the next pill was missed, then the missing amount of the pharmaceutical drug in the bloodstream must be replenished as quickly as possible. With a delay that duration does not exceed 12 hours , the clinical effects of the contraceptive are not reduced and the need for additional protection by other methods of contraception itself disappears. Subsequent tablets are taken according to the usual regimen.

If a woman misses a pill and did not make up for her loss within 12 hours , then the pharmacological efficacy of the drug is reduced, which requires special measures and precautions. First of all, as soon as possible, you should resume taking the drug and continue to carry it out as usual. It is recommended to use any other methods of contraception for a week after the pass.

This situation may become more difficult if less than 7 tablets left in the package . How to take in this case - start the next pack without observing the necessary weekly break, which is carried out only at the end of the 2nd pack of contraceptives. It should be noted that during the use of the 2nd pack, spotting or even breakthrough bleeding may be observed, which can indirectly indicate the presence of pregnancy. If hemorrhages have not stopped at the end of the 2nd package, then before continuing to take contraceptives, you should consult a doctor and exclude the presence of a developing fetus in the womb.

Overdose

Taking an excessive amount of contraceptive is accompanied by the following symptoms:

• nausea;
• vomit;
• vaginal bleeding in small amounts.

There is no specific pharmaceutical antidote for the drug, therefore, symptomatic therapy of individual clinical manifestations of intoxication is used.

Interaction

The contraceptive properties of a pharmaceutical product are reduced when it is used with drugs such as , , , barbiturates, primidon , , Phenylbutazone , Phenytoin , , Oxcarbazepine .

Therefore, if it is necessary to share these drugs with Lindinet, it is necessary to use additional non-hormonal contraceptives for 7 days (it is recommended to visit an additional consultation with your doctor and clarify the period for certain). It is also possible the appearance of spotting or breakthrough bleeding, menstrual irregularities, or some other side effects.

In conditions increased peristalsis or diarrhea the residence time of the contraceptive in the lumen of the gastrointestinal tract is reduced, which significantly reduces the absorption properties of the hormonal contraceptive. Any drug that shortens the presence of Lindinet in the digestive tube leads to a decrease in the concentration of active constituents in the blood, and, accordingly, to a decrease in their beneficial effect.

Drug Interactions at the stage of absorption are modeled on the combined use of a contraceptive with, since biologically active substances are equally exposed to sulfation in the intestinal wall, which inhibits metabolic chains and increases the bioavailability of ethinyl estradiol.

Terms of sale

The acquisition of the medicinal product is allowed only on the basis of the prescription form.

Storage conditions

It is necessary to save the pharmaceutical product in a dry place, protected from direct sunlight, inaccessible to young children at a temperature not exceeding 25 degrees Celsius.

Best before date

special instructions

Pregnancy after using hormonal contraceptives

Oral hormonal contraceptives are a group of pharmaceutical preparations based on synthetic analogues of female sex hormones (estrogen and progesterone) that prevent ovulation from occurring, preventing the very possibility of fertilization. Of course, a large audience of women is convinced that it is harmful to use them for contraceptive purposes, since a normal, physiological pregnancy after a drug change in hormonal levels most likely will not occur. However, this is one of the myths about this group of drugs.

After stopping the use of hormonal contraceptives and at the end of the course of conservative contraception, the effects of the drugs gradually disappear. The only peculiarity is that pregnancy planning you should find out the exact timing of the optimal moment for fertilization in the antenatal clinic or from your personal gynecologist. After all, every time a woman takes a pill for a headache, she does not worry about the health of an unconceived child, in this case the situation is almost identical.

When you can not be protected by barrier methods of contraception

Lindinet is a reliable hormonal contraceptive, which can be found in a special indicator of the number of pregnancies that occurred during the course of oral contraception in 100 women for 1 year. For this pharmaceutical, it is only 0.05 if the contraceptive is used correctly and only according to the scheme of application. However, the pharmacological effects of Lindinet do not develop fully immediately, but only by the 14th day from the start of taking the tablets, because in the first 2 weeks It is recommended to use barrier methods of contraception.

Lindinet 20 and Lindinet 30 - what's the difference?

A large number of visitors to pharmaceutical forums for women are asked by the following series of questions: “Lindinet 20 and 30 - what is the difference?”, As well as whether the drugs are interchangeable and, finally, which is the best of the two forms of contraception. The difference in the forms of the same contraceptive lies in concentration one of the active ingredients is ethinylestradiol. In oral tablets, its level can be 0.02 mg and 0.03 mg, respectively, which in biochemical terms really puts them in different categories.

Lindinet 20 has a milder pharmacological effect and to a lesser extent contributes to an increase in the selective SHBG transporter, which allows it to be used for contraception, however for therapeutic needs , as a rule, a stronger form of the drug is required, therefore Lindinet 30 is used. What distinguishes the more concentrated form of the drug from weaker tablets is not advertised, since sometimes, according to individual indications, even as a contraceptive, it is necessary to use Lindinet 30, which can be perceived by a woman as an unfair load of a hormonal drug.

It is categorically contraindicated to replace pharmaceutical forms of a drug on your own, because a qualified specialist who prescribes contraceptives or therapeutic agents relies on the results of clinical studies, their interpretation and many years of experience in their field, and not on an approximate idea of ​​the biomechanism of the female body. If you experience any side effects or other adverse effects, you should seek advice and resolve this issue on an individual basis.

Since Lindinet is produced in Hungary, its cost in pharmacy kiosks is much lower than that of a drug produced jointly by French and German pharmacists, but this in no way speaks of the effectiveness of the first, because the choice of a contraceptive should be entrusted to a qualified specialist, because he based on individual indicators of hormonal balance and some other medical aspects.

Which is better: Novinet or Lindinet 20?

Novinet - monophasic oral contraceptive, which, in addition to ethinyl estradiol, contains a synthetic progestogen , which somewhat changes the mechanism of action of the contraceptive drug. Like all artificial pharmaceutical components of this nature, desogestrel has a high affinity for progesterone receptors located in the hypothalamic-pituitary region, on which its effects are based. In sufficiently small quantities, it is able to “turn on” the negative feedback mechanism, resulting in a sharp inhibition of the release and production of gonadotropins and complete blocking of ovulation.

Since Novinet includes such a potent pharmaceutical component as one of the active substances, accordingly, its price is almost twice as high as that of Lindinet. However, with certain individual indications or contraindications, a woman does not have the opportunity to use a cheaper contraceptive, which makes it possible to include Novinet in a conservative contraceptive course.

Alcohol and Lindinet

Biochemical studies have shown that alcohol in small quantities does not affect the effectiveness of oral contraception. Moderate dosages of alcoholic beverages are considered to be up to 3 glasses of wine or 50 grams of cognac, but no more, since an increase in the amount of alcohol in the blood increases the risk of a possible pregnancy.

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 hormone of the corpus luteum 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 tablet of Lindinet 30 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 taking Lindinet 30 from drugs containing only progestogen ("mini-pill", 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 / spotting 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 for 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 any of the immediate relatives), hemolytic- uremic syndrome, hereditary angioedema, liver diseases, diseases that first arose or worsened during pregnancy or against the background of previous use 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 the lower extremities, severe trauma, varicose veins and superficial thrombophlebitis, postpartum period (non-lactating women /21 days postpartum/; 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, incl. . antibodies to cardiolipin, lupus anticoagulant), diabetes mellitus not complicated by vascular disorders, SLE, Crohn's disease, ulcerative colitis, sickle cell anemia, hypertriglyceridemia (including family history), acute and chronic liver diseases.

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 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 connection 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 the left arm;

- sudden shortness of breath;

- any unusually severe headache that lasts 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 occurrence 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.

Modern oral contraceptives have a lot of positive qualities, and therefore every year they become more and more in demand. Ease of use, almost 100% results and a beneficial effect on the reproductive system - all this allows women to enjoy life without fear of unnecessary pregnancy. In addition, thanks to pharmacists, more and more advanced drugs are appearing, in which the number of side effects is steadily decreasing. Therefore, it is worth taking a closer look at such popular OKs as Marvelon, Logest, Novinet or Yarina to find out what is best for this or that case.

The drug is a product from the German pharmacists of the Bayer Pharma concern. According to many experts, one of the most effective today and therefore is prescribed most often.

The contraceptive belongs to the group of monophasic low-dose oral agents. Its action is provided by two active substances of artificial origin, which have the properties of endogenous hormones. Presented in a low dosage: ethinyl estradiol - 30 mcg, drospirenone - 3 mg.

After entering the body, substances affect the state of the endometrium, blocking its growth, and inhibits the maturation of the egg. At the same time, it increases the density of the cervical secret, which makes it impossible for spermatozoa to pass into the uterus. Yarina also normalizes menstruation, and due to the fact that the content of male hormones in the body decreases, the drug has a beneficial effect on the skin, eliminating acne and blackheads. And, what is important for all women, without exception, it does not give weight gain.

The drug is available in tablets, which must be taken daily one at a time for 21 days. After that, you need to take a break for a week and then resume taking the contraceptive.

The competitor is also manufactured by Bayer. Contains ethinylestradiol in the same amount (30 μg), but the second substance is represented by dienogest (2 mg).

OK has a similar effect: it suppresses ovulation, changes the composition of the cervical secretion, facilitates MC, and regulates the growth of the endometrium. Therefore, like Yarina, it is used in the treatment of endometriosis.

The tool is available in tablets. The scheme of admission is identical: drink one at a time for 3 weeks with the obligatory observance of a break.

If it is necessary to switch from the first OK to Jeanine, then it must be taken after the end of the previous course on the next day. Or wait a week break and take a pill Janine on the first day. In this case, the interval should not be more than 7 days.

A complete comparison of Janine and Yarina is located

The contraceptive is a Bayer Pharma product. It is considered one of the best modern OK - some experts even call it the remedy of the century. Contains a composition similar to Yarina - ethinyl estradiol and drospirenone: 20 μg and 3 mg, respectively. Therefore, the contraceptive is less pronounced, but there are fewer side effects. First of all, this concerns the state of the vessels - OK almost does not give complications. In addition, it is well accepted by the digestive tract.

The difference between the drugs lies in the method of administration. Unlike the first OK, Jess must be drunk constantly, without any breaks: first, active pills are taken for 21 days, after they are finished, they drink a placebo.

Considering that the drug is a microdosed OK, you can switch to Jess after 40 years, when there is no need to take strong drugs due to a decrease in the likelihood of conception.

If there is a need to use other OKs, then the transition from Jess is carried out according to the conditions for receiving a new remedy.

A complete comparison of Jess and Yarina is located

The drug is produced by the Hungarian company Gedeon Richter. Unlike the contraceptive, Yarina is a microdosed agent and the second active ingredient is desogestrel.

OK is also produced in the form of coated tablets. The scheme of application is identical to Yarina: you need to drink Novinet one pill for 21 days, after which a seven-day break is observed.

The action of the drug is determined by a combination of active ingredients: ethinyl estradiol and desogestrel. The content of substances is 20 and 150 μg, respectively.

• The first component is artificial estrogen. It has a positive effect on the development of female organs (uterus, tubes), affects the state of the endometrium, regulates lipid levels, enhances calcium absorption. In large doses, it can affect the water balance.
• Desogestrel is an artificially created progestin. The structure is similar to levonorgestrel. Able to influence the state of the endometrium in the polyferative phase, forcing the transition to the secretory. The hormone blocks the onset of ovulation, affects the structure of the mucus produced by the glands of the cervix.

Thus, the contraceptive is similar in action to Yarina: it inhibits the synthesis of gonadotropins, which increases the viscosity of vaginal mucus, neutralizes ovulation, and maintains the state of the endometrium at a level at which attachment of the zygote is impossible.

Novinet, like Yarina, has a good effect on appearance, as it regulates the secretion of sebum and, accordingly, eliminates the cause of acne and acne. The advantage of Novinet is the ability to regulate the content of harmful and beneficial cholesterol in the body: reduce the first and help maintain the second. In addition, the drug reduces the intensity of blood loss during menstruation, which protects a woman from iron deficiency anemia.

But, unlike Yarina, the contraceptive does not help with swelling - on the contrary, it can retain fluid in the body.

As for the price, Novinet compares favorably with Yarina, as it is cheaper.

The contraceptive is manufactured in the Netherlands by Organon. Its actions are determined by the same substances that are present in Novineta. But their content is higher: 30 micrograms of ethinylestradiol and 150 micrograms of desogestrel. Due to this, the drug has a stronger effect.

The tool is available in the form of tablets that you need to drink for 21 days with a week break.

When choosing between OK Novinet or Marvelon, it should be borne in mind that the Dutch remedy belongs to low-dose drugs. Therefore, it is better suited to older ladies - of mature age. Marvelon is also prescribed if the action of drugs with a low content of hormones does not give the desired effect.

The drug is included in the group of microdosed drugs. Produced by the same manufacturer as Yarina. The dosage form of Logest is dragee. The scheme of application is similar: drink a 21-day course with a weekly interval.

The active ingredients are the synthetic hormones ethinylestradiol (20 mcg) and gestodene (75 mcg). Thanks to their action, the cervical secret becomes denser, becoming a barrier to spermatozoa, the process of ovulation is inhibited and the possibility of attaching a zygote is eliminated.

In addition, the drug protects against the occurrence of malignant tumors of the genital organs and has a positive effect on the nature of the menstrual cycle.

A complete comparison of Lindinet 20 and Logest is located

The preparation of the Hungarian company Gedeon Richter. It is produced with different content of hormonal substances: in Lindinet 20, the composition and concentration of components are similar to OK Logest.

The tool is designed for young women who have not given birth, who are under 25 years old. Older ladies who have never used OK are also advised to stop at Lindinet-20.

The manufacturer also provided a stronger agent with a high concentration of ethinylestradiol - 30 mcg. The content of gestodene in Lindinet -30 is given in the same proportion as in the first remedy.

The oral remedy is produced by the Gedeon Richter concern. The composition of the components is identical to Yarina, differs only in the content of ethinylestradiol: its amount is less - 20 mcg. The second hormone - drospirenone is given in the same proportion.

The contraceptive is included in the group of microdosed OK. the contraceptive effect is achieved by slowing down the process of ovulation and changing the structure of the mucus produced by the cervical receptors.

The drug is produced in the form of tablets, but, unlike Yarina, they must be drunk differently. The course is designed for 28 days: first, active (white) pills (24 pcs.) Are taken, after which they switch to green placebos (4 pcs.). As soon as they run out, they are again taken for white, that is, no intervals should be made.

With the advent of hormonal OK, it has become much easier and safer for women to prevent unnecessary pregnancy. Contraceptives not only prevent conception, but if this happens, they act like micro-abortions, contributing to the rejection of the egg. But in order to achieve a guaranteed result, you need to choose the right OK. It is rather difficult for a non-specialist to determine which one is better - Yarina or another contraceptive. Although each of them contains ethinylestradiol, the effect of OK is determined by its dosage and the properties of the second component. Therefore, it is wiser to leave the right of choice to the gynecologist, who understands all the nuances of drugs.

My article

There are many ways to prevent unwanted pregnancy. The most popular today is the use of oral contraceptives (OC). 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 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 heart attacks, thrombosis, strokes or varicose veins, then you should inform the doctor about this, the prescription of the drug will depend on this.
If you are taking antibiotics, painkillers, or other medications for a long time, 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 of the hormonal background, including thyroid hormones, examination of the 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 of the 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. Simulate the 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, Nuvaring ring and barrier methods