Blisovi 24 Fe is a hormonal medication which contains 2 hormones, norethisterone and ethinyl estradiol. The drug is used to prevent pregnancy.
Contents:
Indications for use
- Oral contraception.
Mechanism of action
The mechanism of action is associated with the inhibition of ovulation (the release of a mature egg from the ovary). In addition, the drug helps to increase the production of more viscous cervical mucus, which hampers the penetration of sperm into the uterus. Under the influence of the active substances, adverse conditions are created for the implantation of a fertilized egg in the endometrium (inner layer of the uterus).
Dosage and mode of application
Blisovi 24 Fe 28-day pack contains 24 active tablets each containing 1 mg norethindrone/20 mcg ethinyl estradiol, and 4 inert tablets each containing ferrous fumarate 75 mg.
Take tablets daily according to a schedule for 28 days in accordance with the symbols on the blister by day of the week. It is advisable to take tablets at the same time of a day. Do not make any breaks. A new blister is started on the same day of the week on which the previous package was started. Withdrawal bleeding is observed 2-3 days after you start taking inert tablets containing ferrous fumarate. Menstruation cancellation does not necessarily end before taking the first pill of the next 28-day course.
First use of Blisovi 24 Fe:
- The first dose of the drug: The first tablet is taken on the first day of menstruation. You can also start using the drug on days 2-5 of the menstrual period but in this case, you should use a backup method of contraception for 7 days (the first pack only);
- Switching from other oral contraceptives: The first tablet is taken immediately after taking the last tablet of the previous drug;
- Switching from contraceptive means for cutaneous and intravaginal use: When removing the transdermal system or the intravaginal ring, the first tablet is taken on the day of removal. It is necessary to use additional birth control methods during the week;
- Switching from the progestogen preparations: The first tablet is taken on any day, breaks are not required. It is necessary to use additional methods of contraception during the week;
- Switching from an implant or an IUD with a progestogen: The first tablet is taken on the day of removal. It is necessary to use additional methods of preventing pregnancy during the week;
- Switching from the injection forms of gestagens: The first tablet is taken instead of the next planned injection. It is necessary to use backup method of contraception during the week;
- Use after an abortion (I trimester): Option 1: the day of abortion. Additional methods of birth control are not required. Option 2: another day. Backup methods of contraception are required;
- Use after childbirth, abortion (II trimester): The first dragee is taken on days 21-28. When taken later, additional methods of birth control should be used during the week.
Overdose
No serious side effects caused by an overdose of Blisovi 24 Fe have been reported.
Symptoms may include nausea, vomiting, vaginal bleeding (adolescents).
There is no specific antidote; treatment is symptomatic.
Side effects
- Common side effects: nausea, vomiting, headache, engorgement of the mammary glands, increased body weight, decreased libido and mood, coarsening of the voice, intermenstrual bleeding, eyelid edema, conjunctivitis, blurred vision, discomfort when wearing contact lenses (these phenomena are temporary and disappear after withdrawal without any therapy);
- With prolonged use: chloasma, hearing loss, generalized itching, jaundice, cramps of the calf muscles, an increase in the frequency of epileptic seizures;
- Rare side effects: hypertriglyceridemia, hyperglycemia, decreased glucose tolerance, increased blood pressure, thrombosis and venous thromboembolism, skin rashes, changes in the nature of vaginal secretion, vaginal candidiasis, fatigue, diarrhea.
Contraindications
Blisovi 24 Fe contraindications include:
- hypersensitivity to norethisterone and ethinyl estradiol;
- liver failure;
- congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes);
- liver tumors (hemangioma, liver cancer);
- malignant tumors (especially breast cancer or endometrium);
- the presence or a history of severe cardiovascular and cerebrovascular diseases, thromboembolism and predisposition to this condition (ischemic or hemorrhagic stroke, widespread atherosclerosis, myocarditis, decompensated chronic heart failure, heart defects, severe forms of arterial hypertension);
- severe diabetes mellitus (accompanied by retinopathy and microangiopathy);
- sickle cell anemia;
- chronic hemolytic anemia;
- vaginal bleeding of unknown etiology;
- migraine;
- otosclerosis;
- bubble skid;
- otosclerosis with impaired hearing;
- idiopathic jaundice or itching during a previous pregnancy;
- congenital hyperlipidemia;
- age over 40 years.
With caution: diseases of the liver and gallbladder, epilepsy, depression, ulcerative colitis, uterine fibroids, mastopathy, tuberculosis, kidney disease, adolescence (girls without regular ovulatory cycles).
Interactions
When used with barbiturates, rifampicin, ampicillin, griseofulvin, butadiene, antiepileptic drugs, the effectiveness of birth control pills are reduced. Women receiving antidiabetic therapy may experience changed glucose tolerance.
When receiving a course of any drug that reduces contraceptive reliability, it is necessary to use a barrier method of contraception.
Pregnancy and breastfeeding
Blisovi 24 Fe cannot be used in the period of pregnancy and breastfeding. If pregnancy is detected while taking birth control pills, their use should be immediately discontinued.
The contraceptive agent can reduce the amount of breast milk and change its composition, so its use is not recommended during lactation. A small amount of sex steroids can be excreted in milk.
What if I miss a pill?
- The delay does not exceed 12 hours: Take the next tablet on the schedule at the usual time. The contraceptive effect remains the same. Backup methods of birth control are not required;
- The delay is more than 12 hours in the first week of the course: Take tablets as soon as you remember. This may mean taking 2 tablets at a time if so it turns out on schedule. The subsequent tablet is taken at the usual time. Backup methods of birth control are required for 7 days. If a patient had sexual intercourse a week before missing a dose, pregnancy may occur;
- The delay is more than 12 hours in the second week of the course: Take tablets as soon as you remember. This may mean taking 2 tablets at a time if so it turns out on schedule. If you had no errors in the schedule for taking pills a week before, then backup methods of birth control are not required. If you skip more than 1 tablet, backup methods of birth control are required for 7 days;
- The delay is more than 12 hours in the third week of the course: Option 1: Take tablets as soon as you remember. This may mean taking 2 tablets at a time if so it turns out on schedule. If you had no errors in the schedule for taking pills a week before, then backup methods of birth control are not required. Begin a new Blisovi 24 Fe pack immediately after the last active tablet; Option 2: Stop taking pills from the current package, take a seven-day break, and then start using a new blister.
Precautions
Before taking tablets containing norethisterone and ethinyl estradiol, it is necessary to collect a family history and conduct a thorough medical examination, including measurement of blood pressure, examination of the mammary glands and abdominal cavity, gynecological examination in order to identify the existing endometrial hyperplasia. With long-term use, you need to undergo preventive examinations at least 1 time per year.
The risk of cardiovascular complications increases with smoking (especially after the age of 35 years).
The drug is immediately canceled if the following symptoms appear: early signs of phlebitis, thrombosis, vascular impairment, unusual pain in the legs, chest pain or a feeling of tightness in the chest, unusual migraines, sudden impairment of hearing and vision, movement disorders.
The drug is withdrawn 6 weeks before the planned surgery. The risk of thrombosis increases with high blood pressure.
The contraceptive is canceled with hepatitis, jaundice, itching, cholestasis, increased epilepsy attacks, primary or secondary porphyria.
If vomiting or diarrhea occur 3-4 hours after taking an active tablet (1-24 tablets in the blister), take an additional pill and use other methods of preventing pregnancy for 7 days.