Contents:
Indications for use
- Contraception;
- Dysmenorrhea;
- Infertility;
- Uterine hypoplasia.
Mechanism of action
Estrostep 21 is a combined estrogen-progestogen drug. It inhibits the pituitary secretion of gonadotropic hormones. The contraceptive effect is achieved due to the blocking effect of the gestagen and estrogen component in the drug on the hypothalamic-pituitary-ovarian system. The estrogen component is a highly effective oral drug, ethinyl estradiol, a synthetic analog of the follicular hormone estradiol, which is associated with the corpus luteum hormone (progestin, gestagen) in menstrual cycle implementation. The progestational component of the drug is norethisterone acetate, which inhibits the synthesis of LH and FSH by the pituitary gland (prevention of follicular maturation), blocks ovulation.
Due to the combination of estrogen with gestagen, the drug with appropriate regimens can both stimulate and delay menstruation and help stop acyclic uterine bleeding.
Mode of application and dose
Oral administration. The regimen: 1 tablet a day for 21 days, followed by a 7-day interval. During this interval, menstrual bleeding occurs. At the beginning of use, after a long interval or when switching from taking another drug, the first dragee should be taken on the first day of the menstrual cycle. The drug should be taken at the same time as possible (to ensure a constant concentration of hormones in the plasma, the interval between the next dose should not exceed 36 hours, it should be kept at 22-26 hours).
Contraindications
- Hypersensitivity;
- Pregnancy;
- Lactation;
- Liver failure;
- Congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes);
- Liver tumors (hemangioma, liver cancer);
- Thromboembolism (including a history of and an increased risk of its development);
- Cerebrovascular accident (ischemic stroke, hemorrhagic stroke),
- Coronary heart disease;
- Atherosclerosis;
- Heart disease;
- Myocarditis;
- Diabetes mellitus;
- Retinopathy;
- Angiopathy;
- Sickle cell anemia;
- Breast and endometrial cancer;
- Endometrial hyperplasia;
- Endometriosis;
- Breast fibroadenoma;
- Metrorrhagia;
- Metorrhagia;
- Jaundice or itching during a previous pregnancy;
- Otosclerosis worsening during pregnancy;
- Age over 40.
Take this birth control drug with caution in the following cases:
- diseases of the liver and gall bladder;
- epilepsy;
- depression;
- ulcerative colitis;
- uterine fibroids;
- mastopathy;
- chorea;
- porphyria;
- multiple sclerosis;
- varicose veins;
- tuberculosis;
- kidney disease;
- adolescence (without regular ovulatory cycles).
Side effects
- Headache;
- Gastralgia;
- Nausea;
- Vomiting;
- Tenderness of the mammary glands;
- Weight gain;
- Changes in libido;
- Decreased mood;
- Swelling of the eyelids;
- Skin rash;
- Conjunctivitis;
- Visual impairment;
- Hearing loss;
- Thrombophlebitis;
- Thromboembolism;
- Generalized pruritus;
- Jaundice;
- Intermenstrual bleeding.
Interactions
Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin) are able to enhance the metabolism of combined oral contraceptives. A decrease in effective concentration is observed with simultaneous use with certain antibiotics (ampicillin, rifampicin), which is associated with a changemicroflora in the intestines. Efficiency decreases with regular excessive use of ethanol. When taking progestogen-estrogenic drugs, it may be necessary to adjust the dosage regimen of hypoglycemic drugs.
What if I miss a dose?
In case of missed application of a dose, you must take the drug over the next 12h. With an interval in admission of over 36 hours, reliable contraceptive effect is not guaranteedact. During this period, it is recommended to use other non-hormonal methods of contraception.
Estrostep and pregnancy
Estrostep 21 is contraindicated during pregancy and breastfeeding. There may be found penetration in breast milk that may bring damage to the health of a newborn child.