Combined Hormonal Contraceptives

About combined hormonal contraceptives

This belongs to the group of medicines known as combined hormonal contraceptives.

Combined hormonal contraceptives tablets contain two different hormones: an oestrogen and a progestogen.

The strengths and types of oestrogen and progestogen vary from product to product. Your doctor will have chosen the product most suitable for you. In some products there will be two or even three different strength tablets to take at different times during your cycle.

Combined hormonal contraceptives may be used to treat menstrual problems as well as to prevent pregnancy.

Combined hormonal contraceptives prevent pregnancy in three ways:

- by stopping you from ovulating (producing an egg)

- by thickening secretions round your cervix (making it harder for sperm to get through)

- by making the lining of the womb thinner (therefore less welcoming to the egg).

It is also sometimes known as: BiNovum; Brevinor; Cilest; Eugynon 30; Femodene; Femodene ED; Femodette; Loestrin 20; Loestrin 30; Logynon; Logynon ED; Marvelon; Mercilon; Microgynon 30; Microgynon 30 ED; Minulet; Norimin; Norinyl-1; Ovranette; Ovysmen; Synphase; Tri-Minulet; Triadene; Trinordiol; Tri-Novum; Yasmin. You may notice the use of any of these names on the packaging of your medicine.

Before taking combined hormonal contraceptives

Before taking any of this medicine make sure your doctor or pharmacist knows:

• if you are breast feeding or think you may be pregnant
• if you suffer from thrombosis (blood clots) or arterial disease or have a history or family history of these conditions
• if you suffer from heart disease, migraine, high blood pressure, porphyria (blood disorder) or systemic lupus erythematosus (arthritis affecting skin, joints & internal organs)
• if you suffer from liver problems, jaundice (yellowing of the skin and whites of the eyes), gallstones or diabetes mellitus (a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot use it properly)
• if you have just been treated for hydatidiform mole (a growth formed in the uterus at the start of pregnancy)
• if you suffered from itching or a rash while you where pregnant
• if you have had breast cancer or cancer of the uterus (womb), or if there is a history of breast cancer in your family
• if you suffer from chorea (jerky involuntary movements) or pemphigoid gestation (severe itchy, blistering disorder)
• if you suffer from abnormal vaginal bleeding other than your normal monthly period
• if you suffer from long-term immobilisation
• if you are obese, smoke or are over 35 years of age
• if you have a history of depression
• if you suffer from hyperprolactinaemia (excess prolactin), haemolytic uraemic syndrome (blood disorder), sickle cell disease (inherited blood disorder affecting red blood cells), inflammatory bowel disease or varicose veins
• if you have ever had an allergic reaction to this medicine
• if you are taking any other medicines, including those available to buy without a prescription, herbal or complementary medicines. Some medicines may stop the combined oral contraceptive from working properly.

How to take combined hormonal contraceptives

• If you are taking this particular pill for the first time, read the manufacturer's leaflet carefully which will tell you when to start taking it and how.
• Important: You must take your pill at the same time each day. It is important not to miss any doses. If your forget to take your pill, take it as soon as you remember, and the next dose at your usual time. If you are 12 or more hours late taking a dose (especially the first in the packet) the pill may not work. Continue taking the pill as normal, as soon as you remember. However, you may not be protected for the next seven days and must either not have sexual intercourse or use another method of contraception, such as a condom. If these seven days run beyond the end of your packet, start the next packet at once when you have finished the present one i.e. do not have a break between packets. This will mean you may not have a period until the end of two packets, but this will do you no harm. Nor does it matter if you see some bleeding on the tablet taking days. If you are using an everyday (ED) pill, miss out the seven inactive pills (the pills you take while you are having a period). If you are not sure which these are or if you are unsure about the advice, speak with your doctor or pharmacist.
• Important: If you miss a pill, speak to your doctor or pharmacist for advice on what to do.
• This medicine is for you, never give it to others.
• Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine, contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if empty.

Getting the most from your treatment

• Before taking any 'over-the-counter' medicines, check with your pharmacist which medicines are safe for you to take alongside this medicine.
• You must keep your regular appointments with the doctor or clinic.
• If you suspect that you may be pregnant, stop using this medicine at once and consult your doctor as soon as possible.
• Important: If you are sick within 2 hours of taking your contraceptive pill, or have severe diarrhoea, this can affect the absorption of the pill. Additional precautions should be used during and for seven days after recovery. If the sickness and diarrhoea occurs during the last seven tablets, the next pill-free break should be omitted. If you are taking the everyday (ED) pill, miss out the seven inactive pills (the pills you take while you are having a period). If you are not sure which these are or if you are unsure about the advice, speak with your doctor or pharmacist.
• Important: Oral contraceptives can be less effective when taken with antibiotics. To prevent an unwanted pregnancy you should use a barrier method of contraception such as a condom while you are taking the antibiotics and for at least 7 days after the course of treatment has ended. If the week following the antibiotic course runs into your pill free week, the next pack of oral contraceptives should be started immediately, without a break. If you are taking the form of contraceptive pill which is taken every day (ED), or need further advice, speak to your doctor or pharmacist.
• Before having any kind of surgery, including dental and emergency treatment you must tell the doctor, dentist or surgeon that you are taking a combined oral contraceptive pill.
• If you wear contact lenses and you notice your lenses become irritating, ask your optician for advice.
• Important: Travelling that involves long periods of immobility (more than five hours) can increase the risk of serious side effects affecting the blood circulation and in rare cases may lead to blood clots. Taking appropriate exercise during the journey and possibly wearing elastic hosiery can reduce this risk. If you are concerned, speak to your doctor or pharmacist.

Can combined hormonal contraceptives cause problems?

As well as their useful effects all medicines can cause unwanted symptoms. Speak to your doctor or pharmacist if any of the following symptoms continue or become troublesome.

Feeling or being sick, headache, breast enlargement or tenderness, changes in body weight, fluid retention, changes in sex drive, low mood, breakthrough bleeding or absence of bleeding on pill withdrawal, jerky movements, brown patches on skin.

Important: If you experience any of the following contact your doctor immediately:- Pain or swelling of one calf muscle (the lower leg muscle) of one leg, severe pain in the chest or stomach, sudden breathlessness or a cough with blood-stained phlegm, fainting attacks or collapsing, unusual headaches, a disturbance of speech, hearing or eyesight, numbness or weakness of a limb, first unexplained fit.

If you experience any other worrying or troublesome symptoms which you think may be due to this medicine, discuss them with your pharmacist.

How to store combined hormonal contraceptives

• Keep all medicines out of the reach of children.
• Store these tablets in a cool, dry place away from direct light and heat.
• Do not keep unwanted or out of date medicines. Discard unwanted medicines safely, out of the reach of children, or take them to your pharmacist will dispose of them for you.

© EMIS and Cegedim Pharmacy Services Ltd 2006   Updated: 14/02/2006