Midiana tablets 3 + 0.03mg, No. 63

Contraception.

Inside, if necessary with a small amount of liquid.

The tablets must be taken every day at about the same time in the sequence shown on the blister pack. It is necessary to take 1 table. per day for 21 consecutive days. Taking the tablets from each subsequent package should begin after the 7-day interval in taking the tablets, during which menstrual bleeding usually occurs. It usually starts 2-3 days after the last pill is taken and may not be over by the time the next pack starts.

How to take MidianaЃ

If you have not previously used hormonal contraceptives (in the last month). The reception of combined oral contraceptives begins on the 1st day of the woman's natural menstrual cycle (i.e., on the 1st day of menstrual bleeding).

In case of replacement of another combined oral contraceptive, vaginal ring or transdermal patch. It is preferable for a woman to start taking MidianaЃ the next day after taking the last active tablet of the previous combined oral contraceptive; in such cases, taking MidianaЃ should not start later than the next day after the usual break in taking pills or taking inactive pills from a previous combined oral contraceptive. When replacing the vaginal ring or transdermal patch, it is advisable to start taking the MidianЃ oral contraceptive on the day the previous drug is removed; in such cases, MidianaЃ should be taken no later than the day of the planned replacement procedure.

In case of replacement of the method using only progestins (mini-pills, injectable forms, implants) or intrauterine contraceptives with progestin release. A woman can switch to taking MidianaЃ from a mini-drink on any day, from an implant or intrauterine contraceptive on the day it is removed, from an injection form from the day the next injection was to be made. However, in all these cases, it is desirable to use an additional barrier method of contraception during the first 7 days of taking the pills.

After termination of pregnancy in the first trimester. The woman can start taking it immediately. If this condition is met, there is no need for additional contraceptive measures.

After childbirth or termination of pregnancy in the second trimester. It is advisable for a woman to start taking MidianaЃ on the 21-28th day after childbirth or termination of pregnancy in the second trimester. If the reception is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. In the case of sexual intercourse, pregnancy should be excluded before the start of taking the drug, or it is necessary to wait for the 1st menstruation.

Taking missed pills

If the delay in taking the pill is less than 12 hours, contraceptive protection is not reduced. The woman needs to take the pill as soon as possible, the following pills are taken at the usual time. If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. Tactics when skipping a drug is based on the following 2 simple rules.

1. Taking pills should not be stopped for more than 7 days.

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

Accordingly, in daily practice, the following recommendations can be made.

Week 1. It is necessary to take the last missed tablet as soon as possible, even if it means taking 2 tablets. at the same time. The next pill is taken at the usual time. Additionally, a barrier method of contraception must be used for the next 7 days. If you have had sexual intercourse within 7 days before skipping the pill, the likelihood of pregnancy must 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.

Week 2. It is necessary to take the last missed tablet as soon as possible, even if it means taking 2 tablets. at the same time. The next pill is taken at the usual time. If the woman has taken the pills correctly within the previous 7 days, there is no need to use additional contraception. However, if she missed more than 1 tab., It is necessary to use additional contraceptive measures in the next 7 days.

Week 3. The probability of a decrease in the contraceptive effect is significant (due to the upcoming 7-day break in taking pills). However, by adjusting the pill schedule, you can prevent a decrease in contraceptive protection.

If you follow any of the following 2 tips, you will not need additional methods of contraception if the woman has taken all the pills correctly within the previous 7 days before skipping the pill. If not, she must follow 1 of 2 methods and also use additional contraception for the next 7 days.

1. It is necessary to take the last missed tablet as soon as possible, even if it means taking 2 tablets. at the same time. The next pill is taken at the usual time. Taking pills from a new package should be started as soon as the current package ends, i.e. without a break between taking 2 packs. Most likely, withdrawal bleeding will not be until the end of the 2nd package, but spotting spotting or breakthrough uterine bleeding may occur on the days of taking the pills.

2. The woman may be advised to stop taking the tablets from this package. Then it is necessary to stop taking the pills for 7 days, including the days when she forgot to take the pills, and then start taking the pills from a new package. If you miss taking the pills and there is no withdrawal bleeding in the first drug-free interval, pregnancy must be excluded.

How to delay withdrawal bleeding. To postpone the day of the onset of withdrawal bleeding, it is necessary to continue taking MidianaЃ from a new package without interruption. The delay is possible until the end of the tablets in the 2nd package. During the lengthening of the cycle, there may be spotting spotting from the vagina or breakthrough uterine bleeding. You should resume taking MidianaЃ from a new pack after the usual 7-day break. To postpone the day of the onset of withdrawal bleeding to another day of the week, the next break in taking the pills should be shortened by as many days as necessary. The shorter the interval, the higher the risk that withdrawal bleeding will not occur,and while taking the pills from the 2nd package, there will be spotting spotting and breakthrough uterine bleeding (as in the case of a delay in the onset of withdrawal bleeding).

Recommendations for gastrointestinal disorders

In the case of severe gastrointestinal reactions (such as vomiting or diarrhea), absorption may be incomplete and additional contraceptive measures must be taken. In case of vomiting within 3-4 hours after taking the pill, take a new replacement pill as soon as possible. If possible, a new pill should be taken within 12 hours after the usual time of administration. If more than 12 hours are missed, it is necessary to follow the rules for taking the drug if possible.

If the patient does not want to change the normal dosage regimen, she must take an additional tablet (or several tablets) from a different package.

MidianaЃ should not be prescribed for any of the conditions listed below. If any of these conditions develops for the first time while taking the drug, immediate withdrawal is required.

hypersensitivity to the drug or any of its components;

the presence of vein thrombosis at present or in history (deep vein thrombosis, pulmonary embolism);

the presence of arterial thrombosis at present or in history (for example, myocardial infarction);

precursors of thrombosis (including transient ischemic attack, angina pectoris), incl. history;

complicated lesions of the heart valve apparatus, atrial fibrillation, uncontrolled arterial hypertension;

serious surgical intervention with prolonged immobilization;

smoking over the age of 35;

liver failure;

current or history of cerebrovascular disease;

the presence of severe or multiple risk factors for arterial thrombosis (diabetes mellitus with vascular complications, severe arterial hypertension, severe dyslipoproteinemia);

hereditary or acquired predisposition to venous or arterial thrombosis, such as resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia, and the presence of antiphospholipid antibodies (antibodies to cardiolipin, lupus anticoagulant);

pancreatitis, incl. history, if severe hypertriglyceridemia was noted;

severe liver disease at present or in history (before normalization of liver function tests);

severe chronic renal failure or acute renal failure;

liver tumors (benign or malignant), current or history;

hormone-dependent malignant diseases of the reproductive system (genitals, mammary glands) or suspicion of them;

vaginal bleeding of unknown origin;

migraine with a history of focal neurological symptoms;

pregnancy or suspicion of it;

lactation period;

hereditary galactose intolerance, lactase deficiency, glucose-galactose malabsorption.

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, systemic lupus erythematosus (SLE), hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia, phlebitis of superficial veins; hereditary angioedema; hypertriglyceridemia; liver disease; diseases,first emerging or aggravated 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 minor - a disease Sidengama); chloasma; postpartum period.