Dimia tablets 3 + 0.02mg, No. 28

Oral contraception.

Inside, daily, at about the same time, with a little water, in the order indicated on the blister pack. Tablets are taken continuously for 28 days, 1 table. per day. Taking pills from the next package begins after taking the last tablet from the previous package. Withdrawal bleeding usually begins 2-3 days after the start of the placebo pill (last row) and does not necessarily end by the start of the next pack.

The procedure for taking the drug DimiaЃ

Hormonal contraceptives have not been used in the last month. Taking DimiaЃ begins on the 1st day of the menstrual cycle (i.e., on the 1st day of menstrual bleeding). It is also possible to start taking the pills on the 2-5th day of the menstrual cycle, in this case, additional use of the barrier method of contraception is required during the first 7 days of taking the pills from the first package.

Switching from other combined contraceptives (COC pills, vaginal ring or transdermal patch). It is necessary to start taking DimiaЃ the next day after taking the last inactive tablet (for drugs containing 28 tablets) or the next day after taking the last active tablet from the previous package (possibly the next day after the end of the usual 7-day break) - for preparations containing 21 tablets. packaged. If a woman uses a vaginal ring or a transdermal patch, it is preferable to start taking DimiaЃ on the day they are removed or, at the latest, on the day when a new ring or patch is planned to be inserted.

Switching from contraceptives containing only progestogens (mini-pills, injections, implants), or from an intrauterine system (IUD) that secretes progestogens. A woman can switch from taking mini-pills to taking DimiaЃ on any day (from an implant or from an IUD - on the day of their removal, from injectable forms of drugs - on the day when the next injection was to be made), but in all cases it is necessary use an additional barrier method of contraception during the first 7 days of taking the pills.

After an abortion in the first trimester of pregnancy. Taking DimiaЃ can be started as directed by a doctor on the day of termination of pregnancy. In this case, the woman does not need to take additional contraceptive measures.

After childbirth or abortion in the second trimester of pregnancy. A woman is recommended to start taking the drug on the 21-28th day after childbirth (provided that she is not breastfeeding) or an abortion in the second trimester of pregnancy. If the reception is started later, the woman should use an additional barrier method of contraception within the first 7 days after starting the drug DimiaЃ. With the resumption of sexual activity (before taking DimiaЃ), pregnancy should be excluded.

Taking missed pills

Skipping placebo tablets from the last (4th) row of the blister can be ignored. However, they should be discarded to avoid unintentionally prolonging the placebo phase. The instructions below only apply to missed tablets containing active ingredients.

If the delay in taking the pill is less than 12 hours, contraceptive protection is not reduced. The woman should take the missed pill as soon as possible (as soon as she remembers), and the next pill at the usual time.

If the delay exceeds 12 hours, contraceptive protection may be reduced. In this case, you can be guided by two basic rules:

1. Tablet-taking should never be interrupted for more than 7 days.

2. To achieve adequate suppression of the hypothalamic-pituitary-ovarian system, 7 days of continuous pill intake are required.

In accordance with this, women can be given the following recommendations:

Days 1-7. A woman should take the missed pill as soon as she remembers it, even if that means taking two pills at the same time. Then she should take the pills at the usual time. In addition, a barrier method, such as a condom, should be used for the next 7 days. If intercourse has occurred in the previous 7 days, the possibility of pregnancy should be taken into account. The more tablets are missed and the closer this pass is to the 7-day break in taking the drug, the higher the risk of pregnancy.

Days 8-14. A woman should take the missed pill as soon as she remembers it, even if it means taking two pills at the same time. Then she should take the pills at the usual time. If during the 7 days preceding the first missed pill, the woman took the pills as expected, there is no need for additional contraceptive measures. However, if she missed more than 1 table, an additional method of contraception (barrier, such as a condom) is needed for 7 days.

Days 15-24. The reliability of the method inevitably diminishes as the placebo pill phase approaches. However, adjusting the pill regimen can still help prevent pregnancy. When performing one of the two schemes described below, and if in the previous 7 days before skipping the pill, the woman adhered to the regimen of taking the drug, there will be no need to use additional contraceptive measures. If this is not the case, she should follow the first of the two regimens and use additional precautions for the next 7 days.

1. A woman should take the last missed pill as soon as she remembers it, even if it means taking two pills at the same time. She should then take the pills at the usual time until the active pills run out. 4 placebo tablets from the last row should not be taken, you should immediately start taking the tablets from the next blister pack. Most likely, withdrawal bleeding will not occur until the end of the second pack, but spotting spotting or withdrawal bleeding may occur on the days of taking the drug from the second pack.

2. The woman can also stop taking active tablets from the started package. Instead, she must take the last row of placebo pills for 4 days, including skipped days, and then start taking the next pack of pills.

If a woman misses a pill and does not subsequently experience withdrawal bleeding in the placebo pill phase, pregnancy should be considered.

Use of the drug for gastrointestinal upset

In the case of severe gastrointestinal disorders (for example, vomiting or diarrhea), the absorption of the drug will be incomplete, and additional contraceptive measures will be required. If vomiting occurs within 3-4 hours after taking the active pill, it is necessary to take a new (replacement) pill as soon as possible. If possible, the next tablet should be taken within 12 hours of the usual tablet-taking time. If more than 12 hours have passed, it is recommended to act as directed when skipping tablets. If a woman does not want to change her usual pill regimen, she must take an additional pill from a different package.

Delaying menstrual bleeding with withdrawal

To delay bleeding, a woman should skip taking placebo tablets from the started package and start taking drospirenone + ethinyl estradiol tablets from a new package. The delay can be extended until the active tablets in the second pack run out. During the delay, a woman may experience acyclic profuse or spotting bleeding from the vagina. Regular intake of DimiaЃ is resumed after the placebo phase. To shift the bleeding to another day of the week, it is recommended to shorten the upcoming phase of taking the placebo tablets by the desired number of days. With a shortening of the cycle, it is more likely that the woman will not have menstrual withdrawal bleeding, but will have acyclic profuse or spotting bleeding from the vagina when taking the next pack (just like when lengthening the cycle).

DimiaЃ, like other COCs, is contraindicated in any of the conditions listed below:

hypersensitivity to the drug or any of the components of the drug;

thrombosis (arterial and venous) and thromboembolism at present or in history (including thrombosis, deep vein thrombophlebitis, pulmonary embolism, myocardial infarction, stroke, cerebrovascular disorders). Conditions preceding thrombosis (including transient ischemic attacks, angina pectoris), currently or in history;

multiple or severe risk factors for venous or arterial thrombosis, incl. complicated lesions of the valve apparatus of the heart, atrial fibrillation, diseases of the vessels of the brain or coronary arteries; uncontrolled arterial hypertension, volumetric surgery with prolonged immobilization, smoking over the age of 35, obesity with a body mass index> 30;

hereditary or acquired predisposition to venous or arterial thrombosis, for example, resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia, and antibodies against phospholipids (presence of antibodies to phospholipids - antibodies to cardiolipin, lupus anticoagulant);

pregnancy and suspicion of it;

lactation period;

pancreatitis with severe hypertriglyceridemia at present or in history;

existing (or history) severe liver disease, provided that liver function is not currently normalized;

severe chronic or acute renal failure;

liver tumor (benign or malignant), currently or in history;

hormone-dependent malignant neoplasms of the genital organs or mammary gland, currently or in history;

vaginal bleeding of unknown origin;

migraine with a history of focal neurological symptoms;

lactase deficiency, lactose intolerance, glucose-galactose malabsorption, Lapp lactase deficiency.

With caution: risk factors for thrombosis and thromboembolism - smoking under the age of 35, obesity, dyslipoproteinemia, controlled arterial hypertension, migraine without focal neurological symptoms, uncomplicated heart valve defects, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or impaired blood flow a young age of one of the closest relatives); diseases in which peripheral circulation disorders may occur (diabetes mellitus without vascular complications, systemic lupus erythematosus (SLE), hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia, phlebitis of superficial veins); hereditary angioedema; hypertriglyceridemia; severe liver disease (before normalization of liver function tests);diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (including jaundice and / or itching associated with cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, herpes during pregnancy in history, chorea (Sydenham's disease); chloasma; the puerperium.