Lindinet 20 missed 1 tablet what to do. Questions. Venous thrombosis and thromboembolism

Lindinet 20 is a drug included in the group of monophasic contraceptives, indicated for use to prevent unwanted pregnancies.

What is the composition and release form of the medication Lindinet 20?

Active components of Lindinet 20: gestodene - 75 micrograms and ethinyl estradiol 20 mcg. Pharmaceutical excipients: quinoline dye, calcium carbonate, talc, titanium dioxide, colloidal silicon dioxide, macrogol 6000, magnesium stearate, sodium calcium edetate, corn starch, lactose monohydrate, sucrose, povidone.

The drug Lindinet 20 is available in the form of white film-coated tablets. Supplied in packs of 21. Sold upon presentation of a prescription from a doctor.

What is the effect of Lindinet 20?

Monophasic contraceptive that inhibits the endocrine activity of the pituitary gland. The action is associated with several important mechanisms. The estrogenic component is represented by ethinyl estradiol, the gestagenic component is gestodene.

First of all, the drug suppresses the processes of egg maturation. Secondly, it changes the susceptibility of the endometrium to the blastocyst, which is a factor that prevents the implantation of the embryo into the uterus. In addition, the contraceptive changes the properties of cervical mucus, complicating the penetration of sperm into the uterine cavity.

In addition to the contraceptive effect, Lindinet 20 is capable of improving the functional state of the endocrine glands, normalizing the menstrual cycle, and helping to prevent the development of gynecological diseases, including cancer.

The oral contraceptive Lindinet 20, due to the low concentration of gestagens, has virtually no effect on other parts of the endocrine system. Long-term use of the pharmaceutical product does not lead to the development of obesity and does not modify carbohydrate metabolism.

When taken orally, it is actively absorbed from the intestine. The therapeutic concentration of active components in the blood is formed after an hour. The bioavailability coefficient is high, at least 99 percent.

Gestodene and ethinyl estradiol are excreted in the urine and, to a lesser extent, in the stool. The half-life ranges from 16 to 24 hours. Biological transformation reactions occur in the liver, with the formation of several inactive components.

What are the indications for use of Lindinet 20?

Taking Lindinet 20 is indicated for only one purpose - preventing unwanted pregnancies.

I remind you that unauthorized prescription of a contraceptive drug is inadmissible. Only after a comprehensive examination and exclusion of possible pathology can you start taking this pharmaceutical.

What are the contraindications for use of Lindinet 20?

The instructions for use prohibit taking the contraceptive Lindinet 20 in the following cases:

Cerebrovascular diseases;

Atrial fibrillation;

Pregnancy and lactation;

Pathology of the coronary arteries;

Severe arterial hypertension;

Migraine with neurological symptoms;

History of venous thromboembolism;

Smoking over 35 years of age;

Diabetes;

Pancreatitis;

Blood lipid disorders;

Liver tumors;

Hormone-dependent tumors of the genital organs;

Individual intolerance.

Relative contraindications: liver disease, arterial hypertension, obesity, severe depression, ulcerative colitis, prolonged immobilization, in addition, the use of drugs containing sex hormones.

What are the uses and dosage of Lindinet 20 tablets?

You need to take Lindinet 20 from days 1 to 5 of the cycle, strictly 1 tablet every day, for 21 days. For maximum effectiveness, it is recommended to take the medicine at the same time of day. After taking the last tablet you need to take a 7-day break.

In case of accidental omission, you need to continue taking the drug according to the standard regimen. If a significant break occurs, the contraceptive ability of the drug may decrease.

Drug overdose

Symptoms: vomiting, bloody or mucous discharge from the vagina. Treatment: no specific antidote is known. Therapy is symptomatic.

What are the side effects of Lindinet 20?

From the reproductive system: vaginal discharge, acyclic bleeding, galactorrhea, enlarged mammary glands, candidiasis, pain in the lower abdomen, inflammatory diseases of the gynecological organs.

Other side effects: depression, headache, mood lability, decreased hearing and visual acuity, allergic manifestations, hepatitis, dyspepsia, connective tissue diseases, coronary heart disease, myocardial infarction, deep vein thrombosis, hair loss, weight gain.

special instructions

The maximum contraceptive effect of the pharmaceutical product develops by the 14th day of taking the drug. Therefore, for the first two weeks you need to use other non-hormonal contraceptive methods. And we are on www.!

How to replace Lindinet 20, what analogues should I use?

Mirelle, Gestarella, Gestoden + Ethinylestradiol, Femoden, Logest, Lindinet 30, and Artisia.

Conclusion

The use of hormonal contraceptives is an effective means of preventing unwanted pregnancies. The Pearl index of the drug is only 0.05. In addition, taking the medication can have a positive effect on the functional state of the organs of the reproductive and endocrine systems, but only if supervised by a gynecologist.

The patient must independently study the instructions for use of the prescribed drug. Be healthy!

Compound

active ingredients: gestodene, ethinyl estradiol;

1 tablet contains gestodene 0.075 mg and ethinyl estradiol 0.02 mg

Excipients: sodium calcium edetate, magnesium stearate, colloidal silicon dioxide, povidone, corn starch, lactose, yellow quinoline (E 104), titanium dioxide (E 171), macrogol 6000, talc, calcium carbonate, sucrose.

Dosage form

Film-coated tablets.

Pharmacological group

Hormonal contraceptives for systemic use. Gestodene and estrogen (fixed combinations). ATC code G03A A10.

Indications

Oral contraception.

Contraindications

• Pregnancy or suspicion of it;
• genital bleeding of unknown etiology;
• the presence or history of references to arterial or venous thromboembolic diseases (for example, deep vein thrombophlebitis, pulmonary embolism, cerebrovascular disorders, myocardial infarction);
• there is a risk of arterial or venous thromboembolism (blood clotting disorder, heart disease, atrial fibrillation);
• presence of prodromal symptoms of thrombosis in history (transient cerebral ischemic attack, angina pectoris);
• cardiovascular disorders (pathology of heart valve(s), arrhythmias);
• severe arterial hypertension;
• presence of a benign or malignant tumor or severe liver disease
• a history of malignant tumors of the uterus or mammary glands;
• diagnosed or suspected malignant endometrial tumors or other estrogen-dependent neoplasms
• vascular ophthalmopathy;
• history of pregnancy herpes
• sickle cell anemia
• hyperlipidemia;
• diabetic angiopathy;
• migraine with focal neurological symptoms;
• history of pancreatitis if associated with severe hypertriglyceridemia;
• history of cholestatic jaundice during pregnancy or pruritus of pregnancy
• progression of otosclerosis during a previous pregnancy;
• Dubin-Johnson syndrome, Rotor syndrome;
• hypersensitivity to any of the components of the drug.

Directions for use and doses

The drug should be taken for 21 days, 1 tablet per day (if possible at the same time). Then take a 7-day break. During the 7-day break, menstrual-like bleeding appears due to drug withdrawal. Bleeding usually starts 2 or 3 days after taking the last tablet and may not stop until you start taking the next pack of tablets.

The next day after a 7-day break, begin taking tablets from the next package containing 21 tablets.

First dose of the drug.

Taking Lindinet 20 should be started on the first day of the menstrual cycle.

You can start taking the pills from days 2 to 5 of your period, but in this case you must use additional non-hormonal contraception for the first seven days of taking the pills during your first cycle.

Switching to taking Lindinet 20 from another oral contraceptive.

The first tablet of Lindinet 20 should be taken after taking the last tablet from the previous package of another oral hormonal contraceptive on the first day of menstrual-like bleeding, but no later than the day immediately after a break in taking tablets (or use of placebo) from the previous package of oral contraceptives.

Switching to taking Lindinet 20 from drugs containing only progestogen (mini-pill, injection, implant or intrauterine system).

From the “mini-pill” you can switch to taking Lindinet 20 on any day of the cycle. You can switch from the implant to taking Lindinet 20 on the day of removal of the implant or intrauterine system; from solution for injection - on the day when the next injection is necessary, instead of an injection.

In these cases, additional methods of contraception must be used in the first 7 days.

Taking Lindinet 20 after an abortion in the first trimester of pregnancy.

After an abortion, you can start taking the drug immediately; in this case, there is no need to use an additional method of contraception.

Taking Lindinet 20 after childbirth or after an abortion in the second trimester of pregnancy.

Information on the use of the drug during lactation is described in the section “Use during pregnancy or lactation.”

Women who are not breastfeeding can start taking the drug 21-28 days after childbirth or abortion in the second trimester of pregnancy. If a woman decides to take pills later than 21-28 days after childbirth or abortion, then additional methods of contraception must be used in the first 7 days.

If sexual intercourse has already taken place after childbirth or abortion, pregnancy should be excluded before taking the drug or wait until the first menstruation.

Missing an appointment.

If the delay in taking the pill does not exceed 12:00, the contraceptive effect of the drug is not reduced. The missed pill should be taken as soon as it is discovered. The next tablet in this pack should be taken at the usual time. If the delay in taking the pill exceeds 12:00, contraception may be reduced. In this case, you must follow two basic rules:

1. A break in taking pills can never be more than 7 days.

2. Adequate suppression of the hypothalamic-pituitary-ovarian system by continuous use of the drug for 7 days.

Accordingly, the following recommendations should be followed in daily life:

1st week

A woman should take the last missed pill as soon as possible, even if she has to take two pills at the same time. After this, she continues to take the pills at the usual time. In addition, you must use a barrier method of contraception, such as a condom, for the next 7 days. If sexual intercourse took place in the previous 7 days, the possibility of pregnancy should be taken into account. The more pill doses are missed and the closer the missed dose is to the 7-day break in taking the drug, the higher the risk of pregnancy.

2nd week

A woman should take the last missed pill as soon as possible, even if she has to take two pills at the same time. After this, she continues to take the pills at the usual time. If a woman has taken the pills correctly for 7 days before missing a pill, there is no need to use additional contraception. Otherwise, or if you miss more than one pill, it is recommended to additionally use a barrier method of contraception for 7 days.

3rd week

The likelihood of a decrease in the contraceptive effect is significant due to the upcoming 7-day break in the use of the drug. However, if you follow the pill regimen, you can avoid a decrease in contraceptive protection. If you stick to one of the lower-value options, there will be no need to use additional contraceptives, provided you take the pills correctly for 7 days before the missed period. If this is not the case, it is recommended that you stick to the first option below and use additional methods of contraception for the next 7 days.

1. A woman should take the last missed pill as soon as possible, even if she has to take two pills at the same time. After this, she continues to take the pills at the usual time. Taking tablets from a new package should begin immediately after finishing the previous one, that is, there should be no break in taking the drug. It is unlikely that menstrual bleeding will begin before you finish taking the tablets from the second pack, although spotting or breakthrough bleeding may occur.

2. You may also be advised to stop taking tablets from the current package. In the second case, the break in taking the drug should be 7 days, including days of missing pills; You should start taking the pills with the next pack.

If a woman misses a pill and does not have menstrual bleeding during a break from taking the drug, the possibility of pregnancy should be considered.

Measures to be taken in case of vomiting.

If vomiting begins within 3-4 hours after taking the drug, this means that the active substance from the tablet has not been completely absorbed. In this case, you must act in accordance with the paragraph “Skipping a pill.” If the patient does not want to deviate from the dosage regimen, the missed tablets must be taken from an additional package.

Delay or acceleration of the menstrual cycle.

To delay menstruation, you must continue taking the pills from a new package without interrupting the use of the drug. Menstruation can be delayed as long as necessary until the end of taking the last tablet from the second pack. If menstruation is delayed, breakthrough or spotting bleeding may occur. Regular use of Lindinet 20 can be resumed after the usual 7-day break.

In order to speed up the onset of menstrual bleeding, the 7-day break in the use of the drug is reduced by the desired number of days. The shorter the break in the use of the drug, the more likely it is that menstrual-like bleeding will not occur, and breakthrough or spotting bleeding will appear while taking the next package.

Adverse reactions

During the first period of using the drug, 10-30% of women may experience the following side effects: tension in the mammary glands, deterioration in health, spotting bleeding. These side effects are usually mild and disappear after 2-4 cycles.

Other possible adverse reactions.

Women taking oral contraceptives may experience: vaginitis, fluid retention, mood changes, headache, nausea, vomiting, acne, changes in the menstrual cycle, breast tension, changes in body weight and libido.

The use of oral contraceptives is associated with an increased development of the following conditions:

• arterial and venous thrombotic and thromboembolic complications, including myocardial infarction, stroke, venous thrombosis and pulmonary embolism;
• cervical intraepithelial neoplasia and cervical cancer;
• mammary cancer;
• benign liver tumors (focal nodular hyperplasia).

Infections and infestations: vulvovaginal candidiasis.

Benign, malignant and unspecified neoplasms (including cysts and polyps): breast cancer, hepatocellular carcinoma, liver adenoma.

From the blood and lymphatic system: hemolyticouremic syndrome.

From the immune system: anaphylactic reactions, urticaria, angioedema, severe allergic reactions with respiratory failure and circulatory symptoms, exacerbation of systemic lupus erythematosus, exacerbation of porphyria.

Nutritional and metabolic disorders: fluid retention, decreased or increased appetite, bloating, decreased glucose tolerance, hyperlipidemia, hypertriglyceridemia, ischemic colitis, inflammatory bowel disease (Crohn's disease, ulcerative colitis).

Mental disorders: mood changes, depression, decreased or increased libido, irritability, nervousness.

From the nervous system: migraine, headache, dizziness, exacerbation of chorea, optic neuritis *, stroke (LLT).

* Optic neuritis can lead to partial or complete loss of vision.

From the side of the organ of vision: intolerance to contact lenses, retinal artery thrombosis.

From the organs of hearing and balance: otosclerosis.

From the heart: myocardial infarction.

From the cardiovascular system: arterial hypertension, thrombosis, embolism.

From the digestive tract: nausea, vomiting, abdominal pain, pancreatitis.

From the liver and biliary tract: gallbladder diseases, cholelithiasis**, hepatocellular damage (including hepatitis and liver dysfunction).

** The use of combined oral contraceptives may worsen existing gallbladder disease and accelerate the progression of the disease in women who previously had no symptoms of the disease.

From the skin and subcutaneous tissue: acne, chloasma (melasma LLT), hirsutism, alopecia, erythema nodosum, erythema multiforme.

From the reproductive system and mammary glands: breakthrough bleeding, spotting between periods, pain in the mammary glands, engorgement of the mammary glands.

Laboratory indicators: weight loss or gain, decreased folate levels.

Serious and other adverse events are described in the section “Peculiarities of use”.

Overdose

After taking large doses of Lindinet 20, no severe symptoms were observed. Signs of overdose: nausea, vomiting, in young girls - slight vaginal bleeding. The drug does not have a specific antidote; treatment is symptomatic.

Use during pregnancy or breastfeeding

Pregnancy. Before starting to take Lindinet 20, pregnancy should be excluded.

If pregnancy occurs while using the drug, you must immediately stop taking oral contraceptives.

Extensive epidemiological studies have found neither an increased risk of congenital malformations in newborns born to women who took oral contraceptives before pregnancy, nor teratogenic effects (particularly heart defects and limb abnormalities) in cases where oral contraceptives were inadvertently taken early in pregnancy pregnancy.

Breastfeeding. The use of hormonal contraceptives during breastfeeding is not recommended, since these drugs reduce milk production, change its composition, and also penetrate into milk in small quantities.

Children

The drug is used for children.

Features of application

Diseases of the circulatory system.

Oral contraceptives increase the risk of myocardial infarction. The risk of myocardial infarction is higher in smokers who have other risk factors, such as hypertension, hypercholesterolemia, obesity and diabetes mellitus.

Smoking significantly increases the risk of cardiovascular complications that may occur when using oral contraceptives. This risk increases with age, so women over the age of 35 and those who smoke heavily have a significantly increased risk of cardiovascular complications. Women who take oral contraceptives are advised to stop smoking.

Lindinet 20 should be prescribed with caution to women at risk of cardiovascular disease.

The use of oral contraceptives increases the risk of developing cerebrovascular diseases (ischemic and hemorrhagic stroke) and venous thromboembolic disorders.

Increased blood pressure (BP) has been reported in women taking oral contraceptives. An increase in blood pressure was more often observed in older women, as well as with long-term use.

The data obtained indicate that the incidence of arterial hypertension increases depending on the amount of estrogen.

Those women who have previously had high blood pressure or have had diseases accompanied by high blood pressure, or who have had kidney disease, should be advised to use another method of contraception. If, despite this, a woman with arterial hypertension wishes to take oral contraceptives, she should be closely monitored and if a significant increase in blood pressure is observed, the drug should be discontinued.

In most women, blood pressure returns to normal after stopping the drug, and there is no subsequent increased risk of hypertension.

Venous and arterial thrombosis and thromboembolism.

The use of combined oral contraceptives is associated with an increased risk of venous and arterial thrombotic and thromboembolic complications. For each specific estrogen/progestogen combination, a dosing regimen should be prescribed that contains the minimum amount of estrogen and progestogen while maintaining a low failure rate and meeting the patient's needs.

Venous thrombosis and thromboembolism.

The use of any combined oral contraceptives (COCs) carries an increased risk of venous thromboembolic disease (VTD).

The additional risk of developing venous thromboembolic disease increases in the first year of COC use in women who have not yet taken such drugs. This risk is much lower than the risk of VTD in pregnant women. Out of every 100,000 pregnant women, approximately 60 have VTZ and 1-2% of all VTZ cases are fatal.

The incidence of VTD in women taking 50 mcg or less of ethinyl estradiol in combination with levonorgestrel is approximately 20 cases per 100,000 women per year. The incidence of VTD in women taking gestodene in combination is approximately 30-40 cases per 100,000 women per year.

The risk of thromboembolism (arterial and/or venous) increases:

• with age;
• when smoking (excessive smoking and age, especially over 35 years, are additional risk factors);
• with a burdened family history (for example, diseases of the father or brother or sister at a young age). If there is a congenital tendency to thromboembolic diseases, you should consult a specialist before using the drug
• for obesity (body mass index above 30 kg/m2);
• for disorders of fat metabolism (dyslipoproteinemia)
• with arterial hypertension;
• for migraine
• for diseases of the heart valves
• for atrial fibrillation (atrial fibrillation)
• with prolonged immobilization, severe operations, operations on the lower extremities, severe injuries. Due to the fact that the risk of thromboembolic diseases increases in the postoperative period, it is proposed to stop taking the drug 4 weeks before surgery and start taking it 2 weeks after the patient’s remobilization.

Since the period immediately after childbirth is associated with an increased risk of thromboembolism, Lindinet 20 should be started no earlier than 28 days after childbirth or abortion in the second trimester of pregnancy.

Arterial thrombosis and thromboembolism.

Lindinet 20 increases the risk of developing arterial thrombotic and thromboembolic complications. Described complications include myocardial infarction and cerebrovascular disorders (ischemic and hemorrhagic stroke, transient ischemic attack). The risk of developing arterial thrombotic and thromboembolic complications is higher in women with additional risk factors.

Lindinet should be prescribed with caution to women who have risk factors for the development of thrombotic and thromboembolic complications.

Women with migraine who take COCs (especially those with migraine with aura) have an increased risk of stroke.

The administration of the drug should be stopped immediately if the following signs of thromboembolism appear: pain in the chest, radiating to the left arm, unusually severe pain in the legs, swelling of the legs, stabbing pain when inhaling or when coughing, bloody discharge from the bronchi.

Biochemical indicators indicating a tendency to thromboembolic diseases: resistance to activated protein C (APC), hyperhomocysteinemia, deficiency of antithrombin III, protein C and protein S, the presence of antiphospholipid antibodies (anticardiolipin, lupus anticoagulant).

Tumors.

Some studies have reported an increased incidence of cervical cancer in women taking oral contraceptives long-term, but the results are mixed. The likelihood of developing cervical cancer depends on sexual behavior and other factors (for example, human papillomavirus).

Cases of breast cancer in women taking oral contraceptives were identified and were clinically observed at an earlier stage than in women not taking these drugs.

There have been isolated reports of the development of benign liver tumors in women taking hormonal contraceptives for a long time.

An association has been established between the occurrence of benign liver tumors and the use of oral contraceptives, although such benign tumors are rare. When these tumors rupture, intra-abdominal bleeding occurs, which can be fatal.

The development of a malignant liver tumor has rarely been observed in women taking oral contraceptives for a long time.

Patients with a history of cholestatic jaundice or itching during pregnancy, as well as patients who have previously taken combined oral contraceptives, are at higher risk of developing these diseases. If such patients take Lindinet 20, careful monitoring of their condition is necessary, and if the pathological condition returns, the use of the drug must be discontinued.

Other states.

When using oral contraceptives, thrombosis of the retinal vessels can sometimes occur. The drug should be discontinued in case of loss of vision (complete or partial), exophthalmos, diplopia, or swelling of the optic nerve nipple or disorders in the retinal vessels and undergo additional medical examination.

Studies have shown that the relative risk of developing gallstones increases with age in women taking oral contraceptives or medications containing estrogen. Recent studies have shown that the risk of cholelithiasis occurs when using drugs with a low dose of hormones.

With the appearance or intensification of migraine attacks, with the appearance of persistent or repeated unusually severe headaches, the drug should be discontinued.

Taking Lindinet 20 tablets should be stopped immediately if itching occurs or an epileptic seizure occurs.

Effect on carbohydrate and lipid metabolism.

Women taking Lindinet 20 may experience a decrease in carbohydrate tolerance. Therefore, women with diabetes mellitus taking Lindinet 20 , must be closely monitored.

Increases in blood triglyceride levels have been found in some women using oral contraceptives. A number of progestogens reduce high-density lipoprotein (HDL) levels. Due to the fact that estrogen increases the level of HDL cholesterol in the blood plasma, the effect of Lindinet 20 on lipid metabolism depends on the balance between estrogen and progestogen and on the dose and form of the progestogen.

Women with hyperlipidemia who nevertheless decide to take contraceptives should be closely monitored.

In women with hereditary hyperlipidemia who took an estrogen-containing drug, a sharp increase in plasma triglycerides was found, which could lead to pancreatitis.

Menstrual irregularities.

When using Lindinet 20, especially in the first three months, irregular (breakthrough) bleeding may occur. If such bleeding occurs for quite a long time or appears after regular cycles have formed, their cause is usually non-hormonal; an appropriate gynecological examination should be performed to rule out pregnancy or malignancy. If a non-hormonal cause is excluded, you need to switch to taking another drug.

In some cases, menstrual-like bleeding does not appear after discontinuation of the drug during a 7-day break. If, due to the absence of bleeding, the drug dosage regimen was disrupted or if there is no bleeding after taking the last tablet from the second package, then pregnancy should be excluded before continuing to use the drug.

Conditions requiring special caution.

Medical checkup.

Before starting to use the drug Lindinet 20, it is necessary to collect a detailed family history and undergo a general medical and gynecological examination. These studies should be repeated regularly. During a physical examination, it is necessary to measure blood pressure, examine the mammary glands, palpate the abdomen, conduct a gynecological examination with a cytological smear, as well as laboratory tests.

The woman must be warned that the drug does not protect her from sexually transmitted infections, in particular AIDS.

Liver function.

In case of acute or chronic impairment of liver function, use of the drug should be discontinued until liver enzymes normalize. If the activity of liver enzymes is impaired, the metabolism of steroid hormones may be disrupted.

Affective disorders.

For those women who experience depression while taking contraceptives, it is advisable to discontinue the drug and temporarily switch to another method of contraception until the cause of the depressive state is determined. Women with a history of depression should be closely monitored and oral contraceptives should be discontinued if depression returns.

Folate levels.

When using oral contraceptives, the level of folic acid in the blood may decrease. This is only clinically significant when conception occurs shortly after completion of a course of oral contraceptives.

Chloasma.

The appearance of chloasma is especially common in women with a history of chloasma during pregnancy. Women prone to chloasma should avoid exposure to the sun, as well as exposure to ultraviolet radiation while taking COCs.

In addition to the above conditions, special attention should be paid to the condition of a woman with the following diseases: otosclerosis, multiple sclerosis, epilepsy, chorea minor, intermittent porphyria, tetanic conditions, renal failure, obesity, systemic lupus erythematosus, uterine fibroids.

Under the influence of oral contraceptives the level of some laboratory indicators(indicators of liver, kidney, adrenal, thyroid, blood coagulation and fibrinolytic factors, lipoproteins and transport proteins) may change. Despite this, the indicators remain within normal limits.

Patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactase malabsorption syndrome should not use the drug.

Patients with rare hereditary forms of fructose intolerance, sucrose-isomaltase deficiency or glucose-galactase malabsorption syndrome should not use the drug.

The ability to influence the reaction rate when driving vehicles or other mechanisms

Studies regarding the possible effect of the drug on the ability to drive a car or use other mechanisms have not been conducted.

Interaction with other drugs and other types of interactions

Interactions between ethinyl estradiol and concomitant drugs may result in increased or decreased plasma ethinyl estradiol levels.

A decrease in the level of ethinyl estradiol in plasma can lead to an increase in the number of breakthrough bleeding and menstrual irregularities, and sometimes a decrease in the contraceptive effect of Lindinet 20 is also observed. Therefore, in the case of simultaneous use of ethinyl estradiol and drugs that reduce the level of ethinyl estradiol in plasma, in addition to taking Lindinet 20, it is recommended to use non-hormonal contraceptive methods (eg condoms, spermicides). If long-term use of drugs containing such active substances is necessary, the possibility of abandoning the use of hormonal contraceptives as the main method of contraception should be considered.

After stopping medications that reduce the concentration of ethinyl estradiol in the blood, it is recommended to use additional non-hormonal methods of contraception for at least 7 days. After discontinuation of medications that can cause the induction of microsomal liver enzymes and lead to a decrease in the concentration of ethinyl estradiol in the blood serum, it is recommended to use additional non-hormonal methods of contraception for a longer period. Sometimes, depending on the dose, duration of treatment and the rate of elimination of the drug causing enzyme induction, it may take weeks before liver enzyme induction completely stops.

Active substances that may reduce the serum concentration of ethinyl estradiol:

• any active substance that reduces gastrointestinal transit time and therefore reduces absorption;
• substances that induce liver microsomal enzymes, such as rifampicin, rifabutin, barbiturates, primidone, phenylbutazone, phenytoin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil, carbamazepine, oxcarbazepine, felbatam and nevirapine;
• hypericum perforatum(St. John's wort) and ritonavir (due to its ability to induce liver enzymes)
• some antibiotics (for example, ampicillin and other penicillins, tetracycline), since they reduce the enterohepatic recirculation of estrogens.

Active substances that may increase serum concentrations of ethinyl estradiol:

• atorvastatin;
• drugs that also undergo sulfation in the wall of the gastrointestinal tract, such as ascorbic acid (vitamin C) and paracetamol;
• substances that inhibit cytochrome P450 3A4 isoenzymes, for example indinavir, fluconazole, troleandomycin.

Troleandomycin, when used in combination with oral contraceptives, may increase the risk of intrahepatic cholestasis.

Interactions associated with drug absorption. With diarrhea, intestinal motility increases and hormone absorption decreases. Any drug, by its action, shortens the time of presence of a hormonal drug in the large intestine, reduces the level of the hormone in the blood.

Effect on the metabolism of other drugs.

Ethinyl estradiol may affect the metabolism of other drugs by blocking liver enzymes or accelerating conjugation (primarily hepatic). Because of this, the levels of other drugs in the blood may increase (for example, cyclosporine, theophylline, corticosteroids) or decrease (for example, lamotrigine, levothyroxine, valproate).

When ritonavir is used concomitantly with an oral contraceptive, a higher dose of ethinyl estradiol should be prescribed or non-hormonal methods of contraception should be used.

Pharmacological properties

Pharmacological. Combined oral contraceptives block the action of gonadotropins. The primary effect of these drugs is aimed at inhibiting ovulation. The drug leads to changes in cervical mucus, which makes it difficult for sperm to pass into the uterine cavity and affects the endometrium, thereby reducing the possibility of implantation. All this helps prevent pregnancy.

Oral contraceptives, in addition to preventing pregnancy, have a number of positive properties.

Effect on the menstrual cycle. The menstrual cycle becomes regular. The amount of blood loss during menstruation is reduced and iron loss is reduced. The frequency of dysmenorrhea decreases.

Storage conditions

Store at a temperature not exceeding 25 °C in the original packaging to protect from light and moisture.

Keep out of the reach of children.

Package

21 film-coated tablets in a blister, 1 or 3 blisters each, along with a cardboard case for storing the blister in a cardboard package.

Which not only prevent unwanted pregnancy, but also have a pronounced healing property for gynecological diseases. One of these drugs is Lindinet 20 And 30 . In this article we will introduce you to the instructions, method of use and other important points regarding these birth control pills.

How to use Lindinet, a brief overview of the instructions

Taking pills 1 time per day for 21 days. You need to drink it at the same time of day daily.

For example, you took the first pill at 09:00, which means that all subsequent days you take the pills at 09:00.

When all the tablets (21 pieces) have been taken, a seven-day break is taken, during which bleeding should occur.

Then, on the same day of the month when the first tablet was taken (for example, the 18th of January), the use of the drug is resumed again (the 18th of February). And so on every month.

The first contraceptive pill must be taken from the 1st to the 5th day of menstruation.

In the case when there is a transition from one oral contraceptive (combined type) to Lindinet, the very first tablet is taken immediately on second day after stopping the previous contraceptive.

After an abortion, which took place in the 1st trimester of pregnancy, Lindenet should be started on the second day or on the day after surgery. There is no need to resort to auxiliary methods of protection.

But after an abortion in the 2nd trimester, as well as after childbirth, you can start taking pills no earlier than 21-28 days.

In this case, additional methods of contraception will be required in the first 7 days.

What is the difference between Lindinet 20 and Lindinet 30?

Only a doctor can prescribe which pills are right for you, based on tests.

Lindinet 20 is more designed for young nulliparous girls. The hormone content in it is less than in Lindinet 30 tablets.

If you do not take into account the characteristics of the body of each specific woman, then if you are 20 years old, most likely the doctor will prescribe Lindinet 20, and, accordingly, after 30 years old, he will prescribe Lindinet 30.

Features of taking Lindinet 20 and Lindinet 30 tablets

When taking Lindinet birth control pills form 20 or 30, it is necessary to take into account that if drugs such as ampicillin, tetracycline, felbamate, fluconazole are used, the activity of the contraceptive is reduced.

Therefore, if you take Lindinet along with these medications, take care of additional contraceptive measures, for example, based on spermicides, or any of the barrier methods.

Also, St. John's wort tea reduces the level of Lindenet in the blood and can cause pregnancy or intermediate bleeding.

Therefore, if you take Lindenet 20 or Lindenet 30 together with other medications, you should consult your doctor and make sure that they do not reduce the active substance of birth control pills.

It is worth noting that the drug should not be taken during pregnancy, diabetes, lactation, venous insufficiency, or any disorders associated with the kidneys and liver.

Side effects from taking Lindinet

The individual characteristics of each woman also have their own side effects from taking Lindinet. If one or more of the side effects listed below occur, you should stop taking the drug.

These side effects include:

1. Cardiovascular system disorders. It manifests itself in the form of arterial hypertension or thromboembolism.

2. Hearing loss.

3. Sindenham's chorea.

4. Candidiasis.

5. Bleeding.

6. Galactorrhea.

7. Nausea and vomiting.

8. Breast enlargement and pain in it.

9. Hepatitis.

10. Rash.

11. Erythema nodosum.

12. Headache.

13. Depression.

14. Weight gain.

15. And other allergic reactions.

If you experience any of the above after taking Lindinet birth control pills, tell your doctor immediately.

What to do if you missed a Lindinet dose?

If for some reason you missed a Lindinet 20 or 30 tablet, you should take it immediately if possible.

Less than 12 hours

If the interval between taking pills was no more than 12 hours, the contraceptive properties of the drug will not decrease. You do not need to resort to additional contraception.

Taking subsequent tablets should continue as usual.

More than 12 hours

When the interval between taking a contraceptive is more than 12 hours, the effectiveness of the drug may decrease.

There is no need to take the missed dose.

But within a week you will need to use additional contraceptives (condoms, suppositories) to avoid pregnancy.

Menstruation while taking Lindinet

Menstruation may occur while taking Lindinet if the cyclical use of the contraceptive drug has been disrupted. But in any case, whether there was a failure to take the pills or not, you need to contact a gynecologist.

The cause of bleeding while using Lindinet may be diseases of the genital tract. Therefore, you should immediately consult a doctor, who, after an examination, will be able to detect the true cause of the bleeding.

The drug "Lindinet 20" is used for contraception. It is also prescribed for functional defects of the menstrual cycle. Reviews of Lindinet 20 from satisfied consumers will be presented in this article.

The drug is taken orally, regardless of food intake, always at the same time. The first tablet is taken from the first to the fifth day of menstruation. The use of this remedy involves taking one tablet per day for 21 days, after which a week-long break is taken, that is, menstruation actually begins. Reviews of Lindinet 20 confirm that this is how most contraceptives work.

Tablets from another blister are taken on the first day after a seven-day break at the same time as in the previous cycle. To switch from another combination, you need to take the first tablet of the drug the next day after the previous package is completed, at the beginning of the menstrual cycle. What reviews are there about Lindinet 20 for women over 30?

They write in their comments that while using the mini-pill, you can start switching to Lindinet 20 on any day of your cycle. If an implant was used before, then the next day after it is removed. If injections were used, then before the next injection. To switch from single drugs, you need to accompany this stage with the use of barrier contraceptive methods as a supplement during the first week. If an abortion was performed in the first trimester of pregnancy, it is recommended to take the pills immediately after the operation, without using additional methods of contraception.

After an abortion

After an abortion in the second trimester or after childbirth, use of the drug should be started after 21-28 days, also without using additional methods of contraception. If a woman had an intimate relationship before starting contraception, then the drug should be taken after pregnancy has been ruled out or with the onset of menstruation.

Reviews of the Lindinet 20 birth control pills confirm this.

If the next dose was missed at the prescribed time, then if the delay is less than twelve hours, the tablet should be taken as soon as the missed dose was remembered (the contraceptive effect of the drug has not yet been disrupted), the next tablets should be taken at the usual time. If you are more than twelve hours late, you do not need to take the missed pill, but continue to use the drug in accordance with the regimen and using additional contraceptive methods over the next week.

If a dose is missed less than seven days before the end of the pack, then you need to start using the drug from the next blister without interruption. In this case, menstruation begins after the second blister is completed; oral contraception should be continued only after pregnancy has been ruled out.

Reviews from women about Lindinet 20 indicate that pills are skipped quite often, but with the correct further actions, no one experienced an unwanted pregnancy.

When is an additional pill required?

If the patient develops diarrhea and/or vomiting within 3-4 hours after taking the tablet, which disrupts the absorption process and reduces the clinical effect of the drug, then in this case there are two ways of further treatment. So, one of them is based on the fact that the next tablet is taken at the prescribed time according to the schedule, after which measures are taken that comply with the recommendations that are associated with skipping the use of the drug. Another way is for a woman to take the same pill from a different blister, without deviating from her usual contraception regimen. If acceleration of the onset of menstruation is required, it is recommended to reduce the break in the use of Lindinet 20, according to doctors.

It should be borne in mind that the shorter the break, the higher the risk of breakthrough or spotting bleeding while taking tablets from another blister (similar to situations with a delay in menstruation). If you need to postpone menstruation to a later time, then you should continue taking the pills from a new pack without a week's break. The onset of menstruation can be delayed for the desired period, even until the end of the drug from the second package. During the planned delay of bleeding, spotting or bloody breakthrough discharge may appear. After a week's break, you must continue to use Lindinet 20 regularly. There are reviews on this matter.

Contraindications

The following are contraindications:

• severe and/or multiple signs of risk of thrombosis of veins or arteries (including atrial fibrillation, which is complicated by disorders of the heart valve apparatus, severe or moderate arterial hypertension (blood pressure of 160/100 mm and above), disease of the coronary vessels or arteries of the brain brain);
• ischemic transient attack, angina pectoris and other precursors of thrombosis;
• venous thromboembolism;
• long immobilization after surgical interventions;
• migraine with neurological symptoms of focal type;
• thromboembolism of veins or arteries or thrombosis (deep vein thrombosis of the leg, pulmonary artery embolism, myocardial infarction, stroke);
• liver tumors;
• jaundice when using glucocorticoids;
• pancreatitis;
• hyperlipidemia;
• liver pathologies of a pronounced nature, cholestatic jaundice (the period of gestation is also considered), hepatitis (including in the anamnesis) - until the period when functional and laboratory parameters are not restored, after their normalization for three months;
• cholelithiasis;
• Gilbert, Dubin-Johnson, Rotor syndromes;
• severe itching;
• diabetes mellitus, which is complicated by angiopathy;
• vaginal bleeding of unknown origin;
• otosclerosis with further progression during a previous pregnancy or with the use of corticosteroids;
• malignant hormone-dependent neoplasms of the mammary glands and various organs of the reproductive system, or suspicions of them;
• breastfeeding time;
• smoking by people over 35 years of age (more than fifteen cigarettes per day);
• hypersensitivity to the constituent components of the product;
• pregnancy or its suspicion.

Carefully

Reviews from women about Lindinet 20 confirm that you need to be extremely careful when using the drug for patients with risk factors that increase the likelihood of venous or arterial thrombosis, as well as thromboembolism. Risk factors:

• the patient’s genetic predisposition to thrombosis (thrombosis, cerebral circulatory defects and myocardial infarction in youth in close relatives);
• age over 35 years;
• smoking;
• liver pathologies;
• angioedema hereditary;
• herpes of pregnant women;
• chloasma;
• Sydenham's chorea;
• porphyria;
• chorea minor and other diseases that appear or worsen during previous use of sex hormones or during pregnancy;
• obesity with a weight index of over 30 kg per m 2;
• arterial hypertension;
• hemolytic-uremic syndrome;
• valve defects, dyslipoproteinemia, atrial fibrillation;
• epilepsy, prolonged immobilization, migraine, severe trauma;
• surgical intervention in the lower extremities, major surgery, superficial thrombophlebitis, sickle cell anemia, Crohn's disease, postpartum period, varicose veins, diabetes mellitus (not complicated by vascular disorders), ulcerative colitis, acute and chronic liver pathologies, systemic lupus erythematosus , abnormalities in biochemical tests, deficiency of antithrombin III and protein C or S, including antibodies to cardiolipin, severe depression, hyperhomocysteinemia, lupus anticoagulant, antiphospholipid antibodies, activated protein C resistance, hypertriglyceridermia.

Side effects

According to reviews, Lindinet 20 can cause the following side effects:

• sense organs: hearing loss due to otosclerosis;
• vascular and cardiac system: arterial hypertension;
• in more rare cases - myocardial infarction, stroke, pulmonary artery thromboembolism, deep vein thrombosis of the legs and other arterial and venous thromboembolism;
• in very rare cases - thromboembolism of the hepatic, mesenteric, retinal, hepatic veins and arteries.

But most often, the use of Lindinet 20, according to reviews, does not provoke negative reactions in the body.

In addition, the drug can cause other side effects. Not as severe, but occurring more often:

• genital organs: vaginal acyclic bleeding and discharge, candidiasis, deformation of the vaginal mucosa, after cessation - amenorrhea, development of vaginal inflammation processes, increase in the size of the mammary glands, their pain and tension, galactorrhea;
• from the nervous system: unstable mood, headache, depression, migraine;
• metabolism: weight gain, hyperglycemia, fluid retention in the body, decreased tolerance to carbohydrates, increased thyroglobulin concentration;
• digestive system: pain in the epigastrium, nausea, ulcerative colitis, vomiting, Crohn's disease, cholelithiasis, hepatitis, hepatic adenoma, itching or exacerbation due to cholestasis, jaundice;
• dermatological reactions: erythema nodosum, rash, severe hair loss, chloasma, exudative erythema;
• sense organs: increased corneal sensitivity in patients with contact lenses, hearing impairment;
• others: development of allergic reactions.

This information is available in the instructions and reviews for Lindinet 20. The decision on the possibility of further use of the drug should be made only after consultation with a specialist on an individual basis, analyzing the risks and benefits of this contraceptive method.

special instructions

Lindinet 20 must be used after a medical consultation and a gynecological and general medical examination.

It is recommended to be examined every six months. Taking into account the clinical condition of the patient and the risk factors for side effects, the disadvantages and advantages of oral contraception are determined, and the question of the advisability of its use is decided.

Reviews about Lindinet 20 tablets are contradictory.

The specialist must inform the woman about the possible worsening of her existing diseases, the undesirable effects of the drug and a mandatory visit to the doctor if her health changes in a bad direction. Hormonal contraception is also canceled if any of the following conditions or diseases worsen or occur: epilepsy, pathologies. They can cause the development of renal and cardiovascular failure, diseases of the hemostatic system, migraines, the likelihood of developing gynecological estrogen-dependent diseases, diabetes mellitus without vascular defects, severe depression, deviations in the results of laboratory testing of the functional state of the liver, sickle cell anemia.

The medication is characterized by a good contraceptive effect two weeks after the start of use, and therefore, to exclude pregnancy during this time, it is recommended to use additional contraceptive barrier methods. This is confirmed by the instructions and reviews of Lindinet 20.

While taking hormonal oral contraceptives, the likelihood of arterial and venous thromboembolic diseases increases. It is necessary to take into account the possible (but very rare) occurrence of venous or arterial thromboembolism of mesenteric, renal, hepatic or retinal vessels.

Risk factors

Factors that increase the risk of developing venous or arterial thromboembolic pathologies are: hereditary predisposition, obesity, excessive smoking, the patient’s arterial hypertension, dyslipoproteinemia, pathologies of the heart valves with the presence of hemodynamic defects, diabetes mellitus with vascular lesions, atrial fibrillation. We’ll look at women’s reviews of Lindinet 20 for 20 years at the end of the article.

The risk also increases with the patient's age, with prolonged immobilization due to extensive surgical intervention, including surgery on the lower extremities, or after a serious injury. During planned operations, it is recommended to discontinue the drug four weeks before the event, and resume its use fourteen days after remobilization. According to reviews and instructions for use, Lindinet 20 requires constant medical supervision for diagnosed Crohn's disease, systemic lupus erythematosus, diabetes mellitus, hemolytic-uremic syndrome, nonspecific ulcerative colitis, sickle cell anemia, as well as during the postpartum period. The likelihood of developing thromboembolic pathologies of veins or arteries is increased by resistance to activated protein C, a lack of antithrombin III, proteins S and C, as well as the presence of antiphospholipid antibodies. Taking the drug is regarded as one of many factors that influence the development of cervical or breast cancer.

So you should take Lindinet 20 with caution. There are a lot of reviews about contraceptive drugs online that will help you make the right decision.

The increase in the number of registrations of such diseases in patients taking hormonal contraceptives may be associated with irregular medical supervision and appropriate examinations. With prolonged hormonal oral contraception, it is necessary to take into account the possible appearance of a liver tumor of a malignant or benign nature in the differential diagnostic study of abdominal pain associated with bleeding inside the peritoneum or an increase in liver volume.

This is confirmed by reviews of Lindinet 20. For women over 35 years of age who are predisposed to chloasma, it is advisable to spend less time in direct sunlight or ultraviolet radiation.

The product reduces its contraceptive effect when the next dose is missed, with diarrhea and vomiting, or while taking medications that may affect its effectiveness. To avoid conception, the patient must use additional protective barrier agents as recommended. If irregular breakthrough or spotting bleeding occurs, and there is no menstruation during a week's break, this may indicate pregnancy. That is why, before using tablets from a new blister, you must discuss all the nuances with your doctor, and start treatment again only after pregnancy has been ruled out. The presence of an estrogenic component in the drug may affect the results of laboratory tests of the level of lipoproteins and transport proteins, functional data of the kidneys, thyroid gland, liver, hemostasis, and adrenal glands. This is confirmed by the instructions and reviews of doctors about Lindinet 20.

You can use the drug after acute viral hepatitis no earlier than six months later, if the functioning of the liver has been normalized. Smoking patients are at increased risk of developing vascular diseases, especially after the age of 35 (the level of risk is also determined by age parameters and the number of cigarettes smoked during the day). Lindinet 20 is not able to protect against infection with various sexually transmitted infections, including HIV infections. The effect of the product on a woman’s ability to operate machinery and vehicles has not been identified.

Interaction with other drugs

Inducers of hepatic microsomal enzymes (barbiturates, Oxcarbazepine, Rifampicin, Hydantoin, Felbamate, Phenylbutazone, Rifabutin, Griseofulvin, Topiramate, Phenytoin), antibiotics (Tetracycline, "Ampicillin") help reduce the level of ethinyl estradiol in the blood plasma.

Liver enzyme inhibitors increase the level of ethinyl estradiol in the blood plasma.

Drugs that increase gastrointestinal motility reduce the absorption of active ingredients and their concentration in the blood plasma when used with Lindinet 20.

Ascorbic acid and other agents that are subject to sulfation in the intestinal wall slow down the sulfation of ethinyl estradiol and increase its bioavailability. The simultaneous use of Tetracycline, Ritonavir, Rifampicin, Ampicillin, barbiturates, Primidon, Carbamazepine, Topiramate, Phenylbutazone, Phenytoin, Griseofulvin also leads to a decrease in the contraceptive effect of the drug. , Felbamata, Oxcarbazepine.

That is why during treatment and for a week (if used simultaneously with Rifampicin - four weeks) after treatment with the listed medications, the patient needs to use indirect barrier contraceptive methods.

It is undesirable to simultaneously prescribe drugs with St. John's wort, as the likelihood of breakthrough bleeding increases. Patients diagnosed with diabetes mellitus may need to adjust the dosage of hypoglycemic medications.