Lo Simpesse is an extended-cycle combination drug that contains female hormones (levonorgestrel and ethinyl estradiol) that prevent ovulation.
Contents:
Indications for use
- Oral contraception.
Mechanism of action
Lo Simpesse inhibits ovulation. In addition, the drug increases the viscosity of the secretion on the mucous membrane of the cervix, thereby slowing the movement of sperm to the uterine cavity.
Regular use of birth control pills stabilizes the menstrual period, increases the resistance of the female body to gynecological diseases and neoplasms.
Dosage and mode of application
The calendar pack contains 91 tablets. Each tablet is marked with the day of the week in which it should be taken. Take the tablets orally at the same time each day, with a small amount of water. Follow the directions on the blister until all 91 tablets are taken. Menstruation (bleeding “cancellation”) should begin during 7 last days. Usually, it begins 2-3 days after taking the last active tablet of the contraceptive. Start taking pills from the next package without interruption, even if menstruation has not stopped. This means that you will always start a new package on the same day of the week and that each month the withdrawal bleeding will occur approximately on the same day of the week.
How to start taking Lo Simpesse pills?
If you did not take hormonal contraceptive in the previous month:
Start taking tablets on the first day of the period, that is, on the first day of menstrual bleeding. Take a tablet that is labeled with the appropriate day of the week. Then take the tablets in order. You can also start taking tablets on the 2-5 day of your menstrual period, but in this case, you must use the barrier method of contraception (condoms) during the first 7 days of taking the tablets from the first package.
When switching from other combined oral contraceptives, vaginal rings or contraceptive patches:
You can start taking tablets the next day after you take the last tablet of the current oral contraceptive (without interruption). If the current package contains 28 tablets, you can begin taking Lo Simpesse the day after taking the last hormone-containing tablet of the current contraceptive. You can also start taking it later, but in no case later than the next day after a normal 7-day break (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets).
Start taking Lo Simpesse on the day of removal of the vaginal ring or patch, but no later than the day when a new ring is to be inserted or a new patch is stuck.
When switching from only-gestagen oral contraceptives (mini-pills):
You can stop taking mini-pills on any day and start taking Lo Simpesse pills the next day, at the same time. During the first 7 days, it is necessary to use the barrier method of contraception.
When switching from a progestogen-releasing injectable contraceptive, an implant or an intrauterine contraceptive:
Start taking birth control pills on the day that the next injection is to be made, or on the day of removal of the implant or IUD. During the first 7 days, it is necessary to use the barrier method of contraception.
After childbirth:
If you have just given birth to a child, the doctor may recommend that you wait until the end of the first normal menstrual period. Sometimes, on the advice of a doctor, you can start taking the drug earlier.
After a spontaneous miscarriage or abortion in the first trimester of pregnancy:
Consult your doctor. Usually, it is recommended that you start taking birth control pills immediately.
Overdose
Serious negative effects with a single overdose of Lo Simpesse were not reported.
Symptoms that can be noted in an overdose: nausea, vomiting, spotting.
In case of overdose, consult your doctor.
Side effects
Lo Simpesse tablets can cause the following side effects:
- nausea, vomiting;
- vaginal candidiasis;
- increased fatigue;
- headache;
- breast engorgement;
- weight gain;
- hypertriglyceridemia;
- hyperglycemia;
- decreased libido and mood;
- coarsening of the voice;
- intermenstrual bloody discharge;
- eyelid edema;
- conjunctivitis;
- visual impairment;
- hearing loss;
- generalized pruritus;
- jaundice;
- calf muscle cramps;
- increased frequency of epileptic seizures;
- decreased glucose tolerance;
- increased blood pressure;
- thrombosis and venous thromboembolism;
- skin rashes;
- a change in the nature of vaginal secretion;
- diarrhea;
- discomfort when wearing contact lenses;
- chloasma.
Contraindications
Lo Simpesse is contraindicated in the presence of any of the conditions / diseases listed below. If any of these conditions occur, the drug should be immediately withdrawn:
- diabetes mellitus with vascular complications;
- thrombosis and thromboembolism (present or a history);
- migraine with focal neurologic symptoms in the anamnesis;
- pancreatitis with severe hypertriglyceridemia (present or a history);
- revealed hormone-dependent malignant diseases;
- bleeding from the vagina of unknown origin;
- pregnancy;
- hypersensitivity to active substances or any of the components of Lo Simpesse;
- lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
- severe liver disease (present or a history);
- liver tumors (present or a history);
- severe or multiple risk factors for venous or arterial thrombosis.
With caution:
- adolescence (without regular ovulatory cycles);
- diseases of the liver and gallbladder;
- mastopathy;
- tuberculosis;
- epilepsy;
- depression;
- ulcerative colitis;
- uterine myoma;
- kidney disease.
Interactions
Influence on hepatic metabolism: the use of drugs that induce microsomal enzymes of the liver can lead to an increase in the clearance of sex hormones. Such medicines include: phenytoin, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John’s wort (Hypericum perforatum).
HIV protease inhibitors (ritonavir) and non-nucleoside reverse transcriptase inhibitors (nevirapine) and their combinations also have the potential to affect hepatic metabolism.
Effect on intestinal hepatic recirculation: some antibiotics (penicillins and tetracyclines) can reduce intestinal hepatic recycling of estrogens, thereby reducing the concentration of ethinylestradiol.
When using drugs that affect microsomal enzymes of the liver and within 28 days after their withdrawal, you need to use the barrier method of contraception.
When taking antibiotics (penicillins and tetracyclines) and within 7 days after their withdrawal, you need to use the barrier method of contraception.
Levonorgestrel and ethinyl estradiol may affect the metabolism of other drugs, leading to an increase (cyclosporine) or a decrease (lamotrigine) in their concentrations in plasma and tissues.
When taking Lo Simpesse, you may need to adjust the dosage regimen for hypoglycemic drugs and indirect anticoagulants.
The interaction of birth control pills with other drugs can lead to breakthrough bleeding and / or a decrease in contraceptive reliability.
Pregnancy and breastfeeding
The drug is not used during pregnancy. If you become pregnant when on birth control pills, they should be immediately canceled.
Levonorgestrel and ethinyl estradiol can reduce the amount of breast milk and change its composition, therefore, the use of Lo Simpesse is not recommended during lactation.
What if I miss a pill?
If you miss 1 active pill:
- Take a missed pill as soon as you remember about it. Take the next pill at your usual time. This means you may take 2 pills per day.
- You do not need to use an additional barrier contraceptive method if you have sex.
If you miss 2 active pills in a row:
- Take 2 pills on the day when you remember about your failure, take 2 pills the next day.
- Then keep on taking 1 pill per day until the pack is empty.
- You could get pregnant if you have unprotected sexual intercourse in the 7 days after you miss 2 active pills. You should use an additional barrier contraceptive method (condoms) for the next 7 days.
If you miss 3 or more active pills in a row:
- Discard the missed pills. Continue taking 1 pill per day according to the instructions until the pack is empty;
- You could get pregnant if you have sex during the days of missed pills or during the first 7 days after restarting your pills;
- You should use an additional barrier contraceptive method (condoms) for the first 7 days. If you do not have menstruation when you are taking inactive pills, visit your doctor because you may be pregnant.
If you miss any inert pill (last 7 pills):
- Discard the missed pills;
- Continue taking the pills at your usual time until the pack is empty;
- You do not need to use an additional barrier contraceptive method.
If you are not sure what to do when you missed birth control pills, use an additional barrier contraceptive method anytime you have sex and continue taking 1 pill per day until you visit your doctor.
Precautions
Before starting contraception and every 6 months, a general medical and gynecological examination is recommended (including breast examination, liver function, blood pressure control and cholesterol concentration in the blood, urinalysis).
After discontinuation of the drug, fertility is restored quickly, during 1-3 menstrual cycles.
Levonorgestrel and ethinyl estradiol are excreted in breast milk in small amounts. If it is necessary to use Lo Simpesse during lactation, breastfeeding should be stopped
Treatment should be stopped immediately if a woman becomes pregnant, has unusual headache, unusual pain or bloating of the veins on the legs, visual impairment, cerebrovascular disorders, jaundice, stitching pains of unclear etiology when breathing or coughing, pain and tightness in the chest, an increase in blood pressure, 3 months before the planned pregnancy and 6 weeks before the planned surgery followed by prolonged immobilization.
Smoking women have an increased risk of vascular diseases with serious consequences (myocardial infarction, stroke). The risk increases with age and the number of cigarettes smoked per day (especially over the age of 35).
Moderate spotting between periods does not require discontinuation of the drug.
Diarrhea and vomiting may reduce the contraceptive effect of Lo Simpesse. In this case, you need to use additional non-hormonal birth control methods (condoms).