Precautions and warnings

This medicine may increase the risk of blood clots in your arteries and veins, which can cause serious problems like heart attack, stroke, deep vein thrombosis, or pulmonary embolism. Use it with caution if you are obese (BMI over 30), have high blood pressure, high cholesterol, heart valve disease, atrial fibrillation, or if you are a heavy smoker over 35 years old. Stop using this medication at least 6 weeks before and for 2 weeks after any planned surgery that will require you to stay in bed for a long time. It may also make migraines worse or happen more often, and increase the risk of cervical cancer. This medication can affect your blood sugar levels. If you have severe diarrhea or vomiting, the effectiveness of oral contraceptives may be reduced. Take extra care if you are breastfeeding.

Drug Interactions

Using this medication with certain other drugs—like barbiturates, primidone, phenobarbitone, phenytoin, phenylbutazone, rifampicin, carbamazepine, or griseofulvin—can make contraceptives less effective. Short-term use of broad-spectrum antibiotics can also lower the effectiveness of oral contraceptives. Taking HIV medicines (protease inhibitors or non-nucleoside reverse transcriptase inhibitors) can change the way your body processes gestodene or ethinylestradiol.

This medication may raise the amount of ciclosporin in your blood and lower the amount of lamotrigine. Taking it with felbamate may cause your body to get rid of gestodene faster. Gestodene may also raise the amount of buprenorphine in your blood. Co-trimoxazole, miconazole, and etoricoxib may increase ethinylestradiol levels, while aprepitant, modafinil, and bosentan may lower them. Ethinylestradiol may slow down how your body breaks down omeprazole. Finally, taking paracetamol at the same time may increase how much ethinylestradiol your body absorbs.

Contraindications

Do not use this medication if you have any of the following conditions:
- Serious liver problems, such as severe liver disease, jaundice, ongoing itching during a past pregnancy, Dubin-Johnson syndrome, Rotor syndrome, or if you have or had liver tumors.
- A personal or family history of blood clots (venous thromboembolism) or risk factors for developing blood clots.
- Sickle-cell anemia, severe diabetes with blood vessel complications, or problems with fat metabolism.
- Unexplained abnormal vaginal bleeding.
- A history of herpes during pregnancy or worsening hearing loss (otosclerosis) during pregnancy.
- If you currently have or have had breast or uterine cancer.
- If you are pregnant.

Mode of actions

Gestodene is a type of progestogen and ethinylestradiol is an artificial form of estrogen. When these two are used together, they prevent ovulation by stopping the release of luteinising hormone in the middle of the menstrual cycle. This also makes the cervical mucus thicker, which blocks sperm from entering, and changes the lining of the uterus so that it is less likely to allow a pregnancy to begin.

Dosage & Administration

Adult: PO As combination product containing gestodene and ethinylestradiol in varying concentrations and pack sizes depending on brand. Use as directed. Generally, for a 21-day pack: 1 tab/day for 21 days starting on day 1 of cycle followed by 7 pill-free days. Start 2nd pack immediately on the day after the pill-free period.

Pregnancy & Lactation

This medicine must not be used during pregnancy. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict two effective types of birth control starting one month before and during treatment and for three years after stopping this medicine. Discuss with your doctors if you are not sure which types of birth control are effective for you. You must need to take pregnancy tests regularly during your treatment with this medicine and for at least three years after taking this medicine. If it seems that you do become pregnant stop taking this medicine and call your doctor immediately. If you really become pregnant, miss a menstrual period, or have sex without using two forms of birth control. In some cases, your doctor can prescribe emergency contraception to prevent pregnancy. People on this medicine should not donate blood during the treatment and for three years afterward.

This medicine is also contraindicated breast milk. Breastfeeding is not recommended while using this medication and for three years afterward.

Pack Size & Price