How to replace Janine if it doesn’t fit. Cheap analogues of Janine. What is Visanne used for endometriosis?
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The active components of Janine include 2 mg and 30 mcg .
In addition to these substances, the tablets contain lactose in the form of monohydrate, potato starch, magnesium stearate, talc, and gelatin. The shell is made using sucrose, dextrose, macrogol 35000, polyvidone, titanium dioxide, carnauba wax.
Release form
Dragee with a smooth, white surface. The drug Janine is packaged in blisters of 21 tablets. One cardboard pack may contain 1 or 3 blisters.
pharmachologic effect
Contraindications
Contraindications to the use of birth control pills are:
- veins and arteries (including history; including PE, DVT, cerebrovascular disorders );
- conditions preceding thrombosis (including a history; for example, or related to violation cerebral circulation attacks of focal or cerebral disorders);
- occurring with vascular complications;
- severe and/or multiple factors that increase the risk of t rhombosis of veins or arteries ;
- severe forms liver diseases (including history; taking the drug is allowed only if the liver test results are normal);
- liver tumors ;
- caused by hormonal imbalance malignant diseases of the mammary glands or reproductive organs (as well as suspicion of them);
- vaginal bleeding unspecified etiology;
- established or assumed pregnancy ;
- hypersensitivity to substances contained in the tablets.
Side effects of Janine
The most common side effects of taking estrogen-progestin contraceptives for oral use are:
- an increase in the size and tension of the mammary glands, their soreness, as well as the appearance of discharge from them;
- bloody discharge from the genital tract of varying intensity (can be spotting or have the character of breakthrough bleeding);
- headaches (migraine attacks are also possible);
- mood lability;
- change libido ;
- deterioration of tolerance to contact lenses;
- visual impairment;
- abdominal pain;
- nausea ;
- skin rashes;
- vomit;
- changes in the nature of vaginal discharge;
- nodular (nodous) or multiforme ;
- cholestatic jaundice ;
- generalized itching;
- weight fluctuations;
- fluid retention;
- allergic reactions.
Sometimes side effects of Zhanine are expressed in the form of an increase in plasma concentration triglycerides , increased fatigue, decreased tolerance to carbohydrates, chloasma (the risk of focal hyperpigmentation is especially high in women who have chloasma appeared during pregnancy).
Like other combined hormonal contraceptives for oral use, Janine may cause thrombosis or .
Contraceptive pills Janine, instructions for use (Method and dosage)
Zhanine tablets are intended for regular use; violation of the standard regimen of use provokes intermenstrual bleeding , and also reduces the contraceptive and therapeutic effectiveness of the drug.
According to the instructions for use, Janine is taken daily with water in the order indicated on the package. One cycle consists of 21 days of taking the pills and 7 days of a break, during which (usually on the 2nd or 3rd day) the woman begins menstrual bleeding . Sometimes withdrawal bleeding does not stop until you start taking pills from a new package.
How to take Janine tablets for the first time?
If the woman did not use contraception in the previous month hormonal drugs , then they start drinking pills from day 1 menstrual cycle (on the first day of bleeding). If use is started from days 2 to 5 of the cycle, within a week after taking the first tablet, you should use barrier contraceptives .
How to take the drug correctly when switching from other contraceptives?
When switching from others combined hormonal drugs Taking the pills begins the next day after the last tablet with the active substances of the previous drug is taken.
The appointment must begin no later than:
- the next day after the standard one-week break (if the woman used a drug containing 21 tablets);
- the next day after taking the last pill - “placebo” (if package No. 28 is used).
When switching from progestogen drug (implant, injectable contraceptives) tablets are started to be taken without interruption:
- on any day, if the transition is made from a mini-pill;
- from the day when the next injection was planned, if the transition is made from contraceptives in injections;
- on the day of implant removal.
In all of the above cases, in the first week of taking Janine tablets, you should use barrier contraceptives .
Rules for admission after childbirth or abortion
After termination of pregnancy in the first 13 weeks, the drug can be started immediately. Additional contraception is not needed.
After termination of pregnancy between 14 and 27 weeks, and also if the pregnancy ends in childbirth, taking the pills begins for 21-28 days. If the first pill is taken later, in the first week of taking the drug you should use.
If sexual relations took place between taking the drug and childbirth/abortion, before taking Zhanine you should exclude the possibility of pregnancy or wait until your first period.
How to take pills if you miss them?
The missed pill should be taken as soon as possible, the next one from the package should be taken at the usual time. A delay of less than 12 hours does not reduce the contraceptive effect of the drug.
The breaks between taking tablets should not be more than 7 days, since it is within 7 days of continuous use of the drug that adequate suppression of the functional activity of the system is achieved hypothalamus-pituitary-ovaries .
If the delay exceeds 12 hours in the first 14 days of taking the drug, the next pill is taken immediately when remembered (even if this involves taking 2 pills at the same time). In the next 7 days you should use barrier contraceptives .
The greater the number of tablets missed and the closer the missed period is to the standard weekly break, the higher the woman’s risk of becoming pregnant.
If a delay of more than 12 hours occurred from days 15 to 21 of taking the drug, the next pill must be taken immediately when remembered (even if this involves taking 2 pills at the same time).
In the future, the reception is continued as usual and at the same time. In the next 7 days after missing, you should use barrier contraceptives. In addition, you will need to start taking pills from a new package immediately when the previous one ends, i.e. without taking a seven-day break.
Typically, withdrawal bleeding in this case does not begin until the second pack is completed. However, the possibility of spotting and even breakthrough bleeding cannot be ruled out.
The absence of withdrawal bleeding after missing pills during the seven-day period free from taking Janine is a reason to assume pregnancy.
Vomiting within three to four hours after taking the pills reduces the absorption of the active substances of the drug. In this case, you must follow the recommendations when skipping pills.
If a woman does not plan to change her usual dosage regimen, it is recommended to take additional pills from the next package if necessary.
To delay the onset of cyclic bleeding, the drug is continued to be taken continuously using a new package. You can take pills from a new pack for as long as the woman wants (until the pack runs out). At this time, spotting and breakthrough bleeding are possible.
Reception from the next pack begins after a week's break.
How long can I take Janine? If the drug is well tolerated, it can be used for as long as the need for contraception remains.
Janine and endometriosis
The exact cause of the occurrence has not been established, it is only known that an important role in the development of the pathological process is played by hormonal imbalance . The effectiveness of the drug in endometriosis due to its mechanism of action.
In the second phase of the cycle after ovulation, there is intense preparation of the organs of the reproductive system for pregnancy, one of the manifestations of which is the growth of the uterine mucosa.
Janine prevents the release of the egg from the ovary (that is, ovulation), and, therefore, reduces the severity of post-ovulation changes endometrium of the uterus .
Why are tablets prescribed for endometriosis?
In accordance with the instructions, the effect of the drug Janine is aimed at relieving pain, normalizing the disturbed cycle, reducing the intensity of bleeding, that is, eliminating the symptoms that are the main (although not the only) ones when endometriosis .
The release of blood during menstruation is normally due to the fact that the mucous membrane formed in the second half of the cycle is rejected, and the blood vessels are damaged. Since Janine suppresses ovulation, then endometrium does not grow so actively, therefore, the tissues around do not become inflamed and do not compress the nerve trunks.
Moreover, like any hormonal agent , the drug allows you to normalize the cycle, making it strictly periodic.
How to take for endometriosis?
Janine is effective both in genital and extragenital (outside the genital organs) endometriosis . The components of the drug exhibit high activity in the body, which allows them to be used in the lowest possible dose.
Several regimens for the use of the drug Janine have been developed for endometriosis . At the same time, the doctor must select treatment individually for each woman.
In some cases, it is considered advisable to drink pills in accordance with the contraceptive regimen: one per day, from the first day of the cycle. After three cycles “ 21 days of admission + 7 days of break “The patient should undergo blood clotting tests and monitor the condition of the lesions endometriosis , and also evaluate the functional state of the liver using a biochemical blood test.
It is also possible to take the drug according to a prolonged regimen, according to which the pills should be taken continuously for 63 or 84 days in a row, and then take a week's break.
In addition to the direct effect of the active components of the drug on tissues and organs, with this treatment regimen the drug reduces the amount menstrual bleeding (instead of 3-4, one usually passes), which also has a beneficial effect on the patient’s condition.
Reviews from doctors about Janine endometriosis indicate the high effectiveness of the drug. Their statements are also confirmed by the results of numerous studies and practical experience: according to statistics, the use of the drug can achieve positive results in approximately 85% of cases.
In addition, experts note that Janine is well absorbed in the body (its bioavailability is 90%) and rarely provokes side effects.
Overdose
Symptoms of overdose are nausea, vomiting, spotting from the genital tract or bleeding of varying degrees of intensity.
Therapy is symptomatic. The drug does not have an antidote.
Interaction
Simultaneous use of birth control pills Janine with drugs that induce microsomal enzymes of liver cells (including barbiturates , hydantoins , and probably Felbamate ), provokes an increase in clearance dienogest And ethinyl estradiol , which may cause a decrease in the contraceptive effect.
As a rule, the maximum activity of liver enzymes is observed 2-3 weeks after the start of treatment with these drugs, however, it can be observed over the next 4 weeks after completion of the course.
Against the background of the use of Janine in combination with drugs ampicillin and tetracycline series concentration decreases ethinyl estradiol .
It should be remembered that women who take any of the above remedies for a short course should additionally use barrier contraceptives throughout the entire treatment period and for 7 days after its completion.
If a woman is undergoing treatment Rifampicin , then the need to use additional contraceptive measures continues for a full 4 weeks after its completion. If concomitant therapy is started at the end of taking a package of hormonal tablets, the next one should be started without taking the usual break.
Terms of sale
On prescription.
Storage conditions
Store out of reach of children at a temperature of no more than 25°C.
Best before date
36 months.
special instructions
The use of the drug Zhanine is contraindicated before the onset of menarche and after the attack.
In some cases, the use sex hormone preparations may cause the development tumors in the liver . Increase in size liver , severe abdominal pain, as well as signs intraperitoneal bleeding must be taken into account when making a differential diagnosis.
Taking the drug Janine may be accompanied by irregular bleeding (both in the form of spotting and breakthrough bleeding), especially in the first months of therapy. In this regard, assessment of irregular bleeding should be carried out only after an adaptation period of approximately 3 cycles.
If such bleeding recurs or occurs after previous regular cycles, a non-hormonal cause should be sought. Diagnosis is carried out in order to exclude the presence of a malignant neoplasm in the patient or pregnancy . In some cases, diagnostic curettage may be required.
Janine does not protect against STDs and HIV infection.
Analogues
The products are produced by different companies and have a significant difference in price; Silhouette is about half the price of its counterpart.
Which is better: Claira or Janine?
The basis of the drug Claira make up dienogest And estradiol valerate (a substance that is a precursor of the substance produced by the human body 17β-estradiol ). Each package contains 5 types of tablets, which differ in the composition of the active ingredients and their concentration.
Mechanism of action Clairs due to the ability of its active components to suppress ovulation and change the properties of cervical mucus. In addition, the drug reduces pain and intensity of bleeding during menstruation , hinders development iron deficiency anemia , reduces the risk of developing ovarian cancer and endometrial cancer .
Which is better: Janine or Diana 35?
It is a combination (2 mg) and ethinyl estradiol (35 mcg). If Janine is prescribed primarily to prevent pregnancy in women with endometriosis , then the use of Diane-35 is advisable for contraception in women with severe symptoms androgenization .
Janine or Visanne - which is better?
In the composition of the drug Byzanne 2 mg is present as the active ingredient micronized dienogest . The drug is intended for the treatment endometriosis. To achieve a therapeutic effect, the tablets are taken for six months.
The main indication for the use of the drug Zhanine is contraception (in particular contraception in women with endometriosis ).
According to doctors and patients who were treated with both drugs, treatment endometriosis Janine is not always as effective as treatment using Visanne. In addition, the latter is often better tolerated and causes fewer side effects.
When wondering which drug to choose, you should remember that each woman’s body is individual, in addition, in each specific case, the indications for use may differ. In this regard, a specialist must prescribe this or that remedy.
Use with alcohol
In the instructions for the drug, the manufacturer does not give any recommendations regarding the possibility of using Janine tablets with alcoholic beverages.
However, please remember that:
- the reaction of different organisms to the same dose of alcohol may differ;
- hormonal drugs are an additional burden for liver , which is responsible for the breakdown of ethyl alcohol (i.e., with an overdose of alcohol, the consequences can be quite serious both for the liver and for the body as a whole);
- with increased activity of liver enzymes due to an overdose of alcohol, the breakdown and elimination of substances contained in the drug are significantly accelerated (i.e., the contraceptive effect may be reduced);
- An overdose of alcohol, accompanied by vomiting, leads to the fact that the active substances of the tablets do not have time to be absorbed from the gastrointestinal tract, and as a result, the effectiveness of the drug decreases.
According to doctors, you should wait at least 3 hours between taking pills and alcoholic drinks.
During pregnancy
In the course of epidemiological studies, it was found that Janine does not increase the risk of teratogenic effects in a child whose mother took birth control pills before pregnancy or, unknowingly, in the first weeks.
However, during pregnancy, taking the drug is contraindicated.
Since combined hormonal drugs are characterized by the ability to suppress lactation and affect the composition of breast milk, nursing women are advised to refrain from taking them.
If you are planning a child, you should stop using birth control pills. Doctors advise trying to get pregnant from the beginning of a new cycle. Pregnancy usually occurs fairly quickly after taking the pills.
pharmachologic effect
Low-dose monophasic oral combined estrogen-progestogen contraceptive drug.
The contraceptive effect of Janine is carried out through complementary mechanisms, the most important of which include suppression of ovulation and a change in the viscosity of cervical mucus, as a result of which it becomes impermeable to sperm.
When used correctly, the Pearl index (an indicator reflecting the number of pregnancies in 100 women taking a contraceptive during the year) is less than 1. If pills are missed or used incorrectly, the Pearl index may increase.
The gestagenic component of Janine - dienogest - has antiandrogenic activity, which is confirmed by the results of a number of clinical studies. In addition, dienogest improves the blood lipid profile (increases the amount of high-density lipoproteins).
In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstruation is less common, the intensity and duration of bleeding decreases, resulting in a reduced risk of developing iron deficiency anemia. In addition, there is evidence of a reduced risk of endometrial and ovarian cancer.
Pharmacokinetics
Dienogest
Suction
After oral administration, dienogest is quickly and completely absorbed from the gastrointestinal tract. Cmax is reached after 2.5 hours and is 51 ng/ml. Bioavailability is approximately 96%.
Distribution
Dienogest binds to serum albumin and does not bind to sex steroid binding globulin (SGBS) and corticoid binding globulin (CBG). About 10% of the total concentration in the blood serum is found in free form; about 90% are nonspecifically associated with serum albumin. Induction of SHPS synthesis by ethinyl estradiol does not affect the binding of dienogest to serum protein.
The pharmacokinetics of dienogest is not affected by the level of SHPS in the blood serum. As a result of daily administration of the drug, the level of dienogest in the serum increases approximately 1.5 times.
Metabolism
Dienogest is almost completely metabolized. Serum clearance after a single dose is approximately 3.6 L/h.
Removal
T1/2 is about 8.5-10.8 hours. A small part of dienogest is excreted by the kidneys unchanged. Metabolites are excreted in urine and bile in a ratio of about 3:1 with T1/2 equal to 14.4 hours.
Ethinyl estradiol
Suction
After oral administration, ethinyl estradiol is rapidly and completely absorbed. Cmax in blood serum is reached after 1.5-4 hours and is 67 pg/ml. During absorption and "first pass" through the liver, ethinyl estradiol is metabolized, resulting in its oral bioavailability averaging about 44%.
Distribution
Ethinyl estradiol is almost completely (approximately 98%), although nonspecifically, bound to albumin. Ethinyl estradiol induces the synthesis of SHBG. The apparent V d of ethinyl estradiol is 2.8-8.6 l/kg.
C ss is achieved during the second half of the treatment cycle.
Metabolism
Ethinyl estradiol undergoes presystemic conjugation, both in the mucous membrane of the small intestine and in the liver. The main route of metabolism is aromatic hydroxylation. The clearance rate from blood plasma is 2.3-7 ml/min/kg.
Removal
The decrease in the concentration of ethinyl estradiol in the blood serum is biphasic; the first phase is characterized by T1/2 of the first phase - about 1 hour, T1/2 of the second phase - 10-20 hours. It is not excreted unchanged from the body. Ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6 with T1/2 of about 24 hours.
Indications
- contraception.
Dosage regimen
The pills should be taken orally in the order indicated on the package, every day at approximately the same time, with a small amount of water. Zhanine ® should be taken 1 tablet/day continuously for 21 days. Each subsequent package begins after a 7-day break, during which withdrawal bleeding (menstrual-like bleeding) is observed. It usually begins on the 2-3rd day after taking the last pill and may not end until you start taking a new package.
Start of taking Janine
At not taking any hormonal contraceptives in the previous month Taking Janine starts on the 1st day of the menstrual cycle (i.e. on the 1st day of menstrual bleeding). It is possible to start taking it on the 2-5th day of the menstrual cycle, but in this case it is recommended to use a barrier method of contraception during the first 7 days of taking the tablets from the first package.
At transition from combined oral contraceptives, vaginal ring, transdermal patch Taking Janine should begin the day after taking the last active tablet from the previous package, but in no case later than the next day after the usual 7-day break in taking (for drugs containing 21 tablets) or after taking the last inactive tablet ( for preparations containing 28 tablets per package). When switching from a vaginal ring or transdermal patch, it is preferable to start taking Janine on the day the ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.
At switching from contraceptives containing only gestagens ("mini-pills", injection forms, implant) or from a gestagen-releasing intrauterine contraceptive (Mirena) a woman can switch from taking the “mini-pill” to Janine ® on any day (without a break), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from an injectable contraceptive - on the day when the next injection is due. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill.
After abortion in the first trimester of pregnancy the woman can start taking the drug immediately. In this case, the woman does not need additional methods of contraception.
After childbirth or abortion in the second trimester of pregnancy It is recommended to start taking the drug on the 21-28th day after childbirth or abortion in the second trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill. However, if a woman has already been sexually active, pregnancy should be excluded before taking Zhanine or she must wait until her first menstruation.
Taking missed pills
If you are late in taking the pills less than 12 hours, contraceptive protection is not reduced. A woman should take the missed pill as soon as possible, and the next pill should be taken at the usual time.
If the delay in taking the pills was more than 12 hours, contraceptive protection may be reduced.
In this case, you can be guided by the following two basic rules:
- taking the drug should never be interrupted for more than 7 days;
— to achieve adequate suppression of the hypothalamic-pituitary-ovarian system, 7 days of continuous use of the pill are required.
Accordingly, if the delay in taking active pills was more than 12 hours (the interval from the moment of taking the last active pill was more than 36 hours), the following can be recommended:
First week of taking the drug
It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this means taking two pills at the same time). The next pill is taken at the usual time. Additionally, a barrier method of contraception (for example, a condom) should be used for the next 7 days. If sexual intercourse took place within a week before missing the pills, the possibility of pregnancy must be taken into account. The more tablets are missed, and the closer they are to a break in taking active substances, the greater the likelihood of pregnancy.
Second week of taking the drug
It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this means taking two pills at the same time). The next pill is taken at the usual time. Provided that the woman took the pill correctly during the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as if you miss two or more pills, you must additionally use barrier methods of contraception (for example, a condom) for 7 days.
Third week of taking the drug
The risk of pregnancy increases due to the upcoming break in taking the pill. A woman must strictly adhere to one of the following two options. Moreover, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods.
1. It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this requires taking two pills at the same time). The next pill is taken at the usual time, until the pills from the current package run out. The next pack should be started immediately without interruption. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the pill.
2. A woman can also stop taking pills from the current package. She should then take a break for 7 days, including the day she missed the pills, and then start taking a new pack.
If a woman misses taking a pill and then does not have withdrawal bleeding during a break in taking it, pregnancy must be ruled out.
If a woman had vomiting or diarrhea within up to 4 hours after taking active tablets, absorption may not be complete and additional contraceptive measures should be taken. In these cases, you should follow the recommendations when skipping pills.
Changing the start day of the menstrual cycle
To delay the onset of menstruation, a woman should continue taking pills from the new package of Janine immediately after taking all the pills from the previous one, without interruption in taking. The pills from this new package can be taken for as long as the woman wishes (until the package runs out). While taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. You should resume taking Janine from a new package after the usual 7-day break.
To postpone the start of menstruation to another day of the week, a woman should shorten the next break from taking the pills by as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding and will continue to have spotting and breakthrough bleeding while taking the second package (the same as in the case when she would like to delay the onset of menstruation).
Additional information for special categories of patients
Children and teenagers the drug Zhanine ® is indicated only after the onset of menarche.
After menopause the drug Zhanine ® is not indicated.
The drug Zhanine ® is contraindicated women with severe liver disease until liver function tests return to normal.
Zhanine ® has not been specifically studied in patients with impaired renal function. Available data do not suggest changes in treatment in these patients.
Side effect
When taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. While taking the drug Zhanine ® , women experienced other undesirable effects listed in the table below. Within each group, allocated depending on the frequency of the undesirable effect, undesirable effects are presented in order of decreasing severity.
Determination of the frequency of adverse reactions: often (≥1/100 and<1/10), нечасто (≥1/1000 и <1/100), редко (≥1/10 000 и <1/1000). Для дополнительных побочных реакций, выявленных только в процессе постмаркетинговых наблюдений и для которых оценку частоты провести не представляется возможным, указано - частота неизвестна.
Often (≥1/100 and<1/10) | Infrequently (≥1/1000 and<1/100) | Rarely (≥1/10,000 and<1/1000) | Frequency unknown |
Infections and infection | |||
Vaginitis/vulvovaginitis Vaginal candidiasis or other vulvovaginal infections | Salpingoophoritis (adnexitis) Urinary tract infections Cystitis Mastitis Cervicitis Fungal infections Candidiasis Herpetic lesions of the oral cavity Flu Bronchitis Sinusitis Upper respiratory tract infections Viral infections | ||
Benign, malignant and unspecified tumors (including cysts and polyps) | |||
Uterine fibroids Breast lipoma | |||
Blood and lymphatic system | |||
Anemia | |||
Endocrine system | |||
Virilization | |||
Metabolism | |||
Increased appetite | Anorexia | ||
Psychiatric disorders | |||
Decreased mood | Depression Mental disorders Insomnia Sleep disorders Aggression | Mood changes Decreased libido Increase libido |
|
Nervous system | |||
Headache | Dizziness Migraine | Ischemic stroke Cerebrovascular disorders Dystonia | |
Sense organs | |||
Dryness of the mucous membrane of the eyes Irritation of the mucous membrane of the eyes Oscillopsia Sudden hearing loss Noise in ears Dizziness Hearing impairment | Intolerance to contact lenses (unpleasant sensations when wearing them) | ||
The cardiovascular system | |||
Arterial hypertension Arterial hypotension | Cardiovascular disorders Tachycardia, including increased heart rate Pulmonary artery thrombosis/thromboembolism Thrombophlebitis Diastolic hypertension Orthostatic circulatory dystonia Tides Phlebeurysm Vein pathology Pain in the veins | ||
Respiratory system | |||
Bronchial asthma Hyperventilation | |||
Digestive system | |||
Abdominal pain, including upper and lower abdominal pain, discomfort/bloating Nausea Vomit Diarrhea | Gastritis Enteritis Dyspepsia | ||
Dermatological reactions | |||
Acne Alopecia Rash, including macular rash Itching, including generalized itching | Atopic dermatitis/neurodermatitis Eczema Psoriasis Hyperhidrosis Chloasma Pigmentation disorder/hyperpigmentation Seborrhea Dandruff Hirsutism Pathological changes in the skin Orange peel Spider veins | Erythema multiforme | |
Allergic reactions | |||
Manifestations of allergic reactions, including allergic dermatitis | Hives Erythema nodosum |
||
Musculoskeletal system | |||
Back pain Feeling of discomfort in muscles and bones Myalgia Pain in the limbs | |||
Reproductive system and mammary glands | |||
Pain in the mammary glands, feeling of discomfort, engorgement of the mammary glands | Abnormal withdrawal bleeding, including menorrhagia, hypomenorrhea, oligomenorrhea, and amenorrhea Intermenstrual bleeding, including vaginal bleeding and metrorrhagia Increased size of the mammary glands, swelling and feeling of fullness of the mammary glands Breast swelling Dysmenorrhea Genital tract/vaginal discharge Ovarian cysts Pain in the pelvic area | Cervical dysplasia Uterine cysts Pain in the area of the uterus Breast cysts Fibrocystic mastopathy Dipareunia Galactorrhea Menstrual irregularities | Discharge from the mammary glands |
General symptoms | |||
Fatigue Asthenia Bad feeling | Chest pain Peripheral edema Flu-like symptoms Inflammation Temperature increase Irritability | Fluid retention | |
Survey results | |||
Changes in body weight (weight gain, loss, and fluctuations) | Increased TG levels in the blood Hypercholesterolemia | ||
Congenital and genetic disorders | |||
Detection of additional breasts/polymastia |
In women receiving combined oral contraceptives The following undesirable effects have been reported: venous thromboembolic complications, arterial thromboembolic complications, cerebrovascular complications, arterial hypertension, hypertriglyceridemia, changes in glucose tolerance or effects on insulin resistance of peripheral tissues, liver tumors (benign or malignant), liver dysfunction, chloasma.
In women with hereditary angioedema, exogenous estrogens may exacerbate symptoms.
The occurrence or worsening of conditions for which the relationship with the use of combined oral contraceptives has not been clearly proven: jaundice and/or itching associated with cholestasis, formation of gallstones, porphyria, systemic lupus erythematosus; hemolytic-uremic syndrome, Sydenham's chorea, herpes of pregnancy, otosclerosis with hearing impairment, Crohn's disease, ulcerative colitis, cervical cancer.
In women using combined oral contraceptives, there is a very small increase in the incidence of breast cancer. Because Breast cancer rarely occurs in women under 40 years of age, and given the overall risk of breast cancer, the additional number of cases is very small. The relationship with the use of combined oral contraceptives is not known.
Contraindications for use
Janine ® should not be used if you have any of the conditions/diseases listed below. If any of these conditions develop for the first time while taking it, the drug should be discontinued immediately.
- presence of thrombosis (venous and arterial) currently or in history (for example, deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders);
- the presence or history of conditions preceding thrombosis (for example, transient ischemic attacks, angina pectoris);
— diabetes mellitus with vascular complications;
- current or history of migraine with focal neurological symptoms;
- the presence of severe or multiple risk factors for venous or arterial thrombosis (including complicated lesions of the valvular apparatus of the heart, atrial fibrillation, diseases of the cerebral vessels or coronary arteries of the heart, uncontrolled arterial hypertension, serious surgery with prolonged immobilization, smoking at an older age 35 years);
- liver failure and severe liver diseases (until normalization of liver tests);
- current or history of pancreatitis with severe hypertriglyceridemia;
- current or history of benign or malignant liver tumors;
- identified or suspected hormone-dependent malignant diseases of the genital organs or mammary glands;
- vaginal bleeding of unknown origin;
— pregnancy or suspicion of it;
- period of breastfeeding;
- hypersensitivity to the components of the drug.
Carefully
The potential risks and expected benefits of using combined oral contraceptives should be carefully weighed in each individual case in the presence of the following diseases/conditions and risk factors:
- risk factors for the development of thrombosis and thromboembolism (smoking, obesity, dyslipoproteinemia, arterial hypertension, migraine, valvular heart disease, prolonged immobilization, major surgical interventions, extensive trauma, hereditary predisposition to thrombosis/thrombosis, myocardial infarction or cerebrovascular accident at a young age any of the immediate relatives/);
- other diseases in which peripheral circulatory disorders may occur (diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease, UC, sickle cell anemia, phlebitis of the superficial veins);
- hereditary angioedema;
- hypertriglyceridemia;
- liver diseases;
- diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (for example, jaundice, cholestasis, gallbladder disease, otosclerosis with hearing impairment, porphyria, herpes pregnant, Sydenham's chorea);
- postpartum period.
Use during pregnancy and breastfeeding
Zhanine ® is not prescribed during pregnancy and breastfeeding.
If pregnancy is detected while taking Janine, the drug should be discontinued immediately. However, extensive epidemiological studies have not shown an increased risk of developmental defects in children born to women who received sex hormones before pregnancy, or teratogenic effects when sex hormones were inadvertently taken in early pregnancy.
Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is contraindicated during lactation. Small amounts of sex steroids and/or their metabolites may be excreted in milk.
Overdose
No serious adverse events have been reported following overdose.
Symptoms: nausea, vomiting, spotting or metrorrhagia.
Treatment: carry out symptomatic therapy. There is no specific antidote.
Drug interactions
Interaction of oral contraceptives with other drugs may lead to breakthrough bleeding and/or decreased contraceptive reliability.
The following types of interactions have been reported in the literature.
Effect on hepatic metabolism
The use of drugs that induce microsomal liver enzymes can lead to an increase in the clearance of sex hormones. Such drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin; There are also suggestions for oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort.
HIV protease inhibitors (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and combinations thereof also have the potential to affect hepatic metabolism.
Effect on enterohepatic circulation
According to individual studies, some antibiotics (for example, penicillins and tetracyclines) may reduce the enterohepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol.
While taking any of the above medications, a woman should additionally use a barrier method of contraception (for example, a condom).
Substances affecting the metabolism of combined hormonal contraceptives (enzyme inhibitors)
Dienogest is a substrate of cytochrome P450 (CYP)3A4. Known CYP3A4 inhibitors, such as azole antifungals (eg, ketoconazole), cimetidine, verapamil, macrolides (eg, erythromycin), diltiazem, antidepressants, and grapefruit juice, may increase plasma levels of dienogest.
While taking medications that affect microsomal enzymes, and for 28 days after their discontinuation, you should additionally use a barrier method of contraception.
While taking antibiotics (with the exception of rifampicin and griseofulvin) and for 7 days after their discontinuation, you should additionally use a barrier method of contraception. If the period of use of the barrier method of protection ends later than the pill in the package, you need to move on to the next package of Janine without the usual break in taking the pill.
Oral combination contraceptives may affect the metabolism of other drugs, resulting in increased (eg cyclosporine) or decreased (eg lamotrigine) plasma and tissue concentrations.
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life - 3 years.
Use for liver dysfunction
If liver dysfunction occurs, temporary discontinuation of Zhanine may be required until laboratory parameters normalize. If cholestatic jaundice or cholestatic itching develops (first occurring during pregnancy or previous use of sex hormones), Zhanine ® should be discontinued.
Use for renal impairment
Taking Zhanine may affect biochemical indicators of kidney function.
Use in elderly patients
Not applicable.
special instructions
Before starting or resuming the use of the drug Zhanine ®, it is necessary to familiarize yourself with the woman’s life history, family history, conduct a thorough general medical examination (including measurement of blood pressure, heart rate, determination of body mass index) and gynecological examination, including examination of the mammary glands and cytological examination of scrapings from the cervix (test Papanicolaou test), exclude pregnancy. The scope of additional studies and the frequency of follow-up examinations are determined individually. Typically, follow-up examinations should be carried out at least once a year.
A woman should be informed that Janine ® does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
If any of the conditions, diseases and risk factors listed below currently exist, the potential risks and expected benefits of combined oral contraceptives should be carefully weighed on an individual basis and discussed with the woman before she decides to start taking drug. If risk factors become more severe, intensify, or when risk factors first appear, it may be necessary to discontinue the drug.
Diseases of the cardiovascular system
The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism (deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular diseases) when taking combined oral contraceptives. These diseases are rare.
The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients suggest that this increased risk is predominantly present during the first 3 months.
The overall risk of VTE in patients taking low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола), в 2-3 раза выше, чем у небеременных пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах. ВТЭ может привести к летальному исходу (в 1-2% случаев).
Venous thromboembolism (VTE), manifested as deep vein thrombosis or pulmonary embolism, can occur with the use of any combined oral contraceptives.
It is extremely rare that when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing or walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.
Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, incl. with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; sense of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may be misinterpreted as symptoms of other more or less severe events (eg, respiratory tract infection).
Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. Symptoms of a stroke: sudden weakness or loss of sensation in the face, arm or leg, especially on one side of the body, sudden confusion, problems with speech and comprehension; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the extremities, acute abdomen.
Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.
Arterial thromboembolism can be fatal.
The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases:
- with age;
- in smokers (with an increase in the number of cigarettes or an increase in age, the risk increases, especially in women over 35 years of age);
- for obesity (body mass index more than 30 kg/m2);
- if there is a family history (for example, venous or arterial thromboembolism ever occurred in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
- with prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of planned surgery, at least four weeks before it) and not resume use for two weeks after the end of immobilization;
- with dislipoproteinemia;
- for arterial hypertension;
- for migraine;
- for diseases of the heart valves;
- with atrial fibrillation.
The possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial. The increased risk of thromboembolism in the postpartum period should be taken into account.
Peripheral circulatory disorders may also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis) and sickle cell anemia.
An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.
Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).
When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (< 50 мкг этинилэстрадиола).
Tumors
The most significant risk factor for developing cervical cancer is persistent papilloma viral infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. However, the connection with the use of combined oral contraceptives has not been proven. Controversy remains regarding the extent to which these findings are related to screening for cervical pathology or to sexual behavior (lower use of barrier methods of contraception).
A meta-analysis of 54 epidemiological studies found that there is a slightly increased relative risk of breast cancer diagnosed in women who used combined oral contraceptives. The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. Its connection with the use of combined oral contraceptives has not been proven. The observed increased risk may also be a consequence of earlier diagnosis of breast cancer in women using combined oral contraceptives. Women who have ever used combined oral contraceptives are diagnosed with earlier stages of breast cancer than women who have never used them.
In rare cases, during the use of combined oral contraceptives, the development of liver tumors has been observed, which in some cases led to life-threatening intra-abdominal bleeding. If severe abdominal pain, liver enlargement, or signs of intra-abdominal bleeding occur, this should be taken into account when making a differential diagnosis.
Other states
Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.
Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant increases have rarely been reported. However, if a persistent, clinically significant increase in blood pressure develops while taking combined oral contraceptives, these drugs should be discontinued and treatment of hypertension should be initiated. Taking combined oral contraceptives can be continued if normal blood pressure values are achieved with antihypertensive therapy.
The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their association with combined oral contraceptives has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described during the use of combined oral contraceptives.
In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.
Acute or chronic liver dysfunction may require discontinuation of combined oral contraceptives until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives.
Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (less than 50 mcg ethinyl estradiol). However, women with diabetes mellitus should be carefully monitored while taking combined oral contraceptives.
Chloasma can sometimes develop, especially in women with a history of pregnancy chloasma. Women prone to chloasma should avoid prolonged exposure to the sun and ultraviolet radiation while taking combined oral contraceptives.
The effectiveness of combined oral contraceptives may be reduced if pills are missed, vomiting and diarrhea occur, or as a result of drug interactions.
Effect on the menstrual cycle
While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular bleeding should be assessed only after an adaptation period of approximately three cycles. If irregular bleeding recurs or develops after previous regular cycles, careful evaluation should be performed to rule out malignancy or pregnancy.
Some women may not develop withdrawal bleeding during a break from taking the tablets. If combined oral contraceptives are taken as directed, the woman is unlikely to be pregnant. However, if combined oral contraceptives have not been taken regularly before or if there are no consecutive withdrawal bleeds, pregnancy should be ruled out before continuing to take the drug.
Impact on laboratory test performance
Taking combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma transport protein levels, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond normal values.
Preclinical safety data
Preclinical data from routine repeated-dose toxicity, genotoxicity, carcinogenicity and reproductive toxicity studies do not indicate a particular risk to humans. However, it should be remembered that sex steroids can promote the growth of certain hormone-dependent tissues and tumors.
Impact on the ability to drive vehicles and operate machinery
Zhanine's chemical composition is a single-phase and low-dose drug.
The medicine affects the ovulation process and suppresses it. The use of Janine changes the consistency of the cervical fluid and interferes with the advancement of sperm. This effect is possible due to the action of substances in the composition of the drug: dienogest And ethinyl estradiol. The instructions must be carefully studied before use.
The drug is available in tablet form.
Janine's instructions
The full text of the instructions can be found below. This is the instruction that you will find in the package of Janine if you buy it at the pharmacy. In the article we will describe the most important points of the instructions in a simpler and more understandable language.
How to use Janine
You can start taking Janine from the very beginning of the menstrual cycle. If you start taking it a few days after the onset of your period, then you will need to use additional means.
There are some features when using this tool:
- When changing combined contraceptives, Janine should be taken immediately after finishing taking the other drug. Or you can do it after a standard break.
- After the mini-pill, you can immediately switch to this medicine. You should switch from intrauterine contraceptives after removing the product. It is also recommended to use additional protective equipment for several days.
- You can immediately start using the medicine after an abortion in the first trimester.
- This method of contraception can be used from 21 days after childbirth or abortion. If a woman has already been sexually active after giving birth, it is recommended to exclude pregnancy.
Janine drinks clean water. The drug is used every day at a certain time. One tablet is taken.
After a seven-day break, you should start a new course. As a rule, after the end of the course, menstruation begins.
Side effects
The use of Janine may be accompanied by some side effects.
This contraceptive may cause irregular periods or spotting or bloody discharge. This can be especially true in the first months of using medications.
Taking Janine may be accompanied by some negative effects:
- High blood pressure may occur.
- Cerebrovascular complications.
- Liver dysfunction.
- In the presence of hereditary angioedema, there may be an exacerbation of symptoms.
- Complications may occur with the following diseases: herpes, ulcerative colitis, jaundice, otosclerosis, jaundice.
- Vaginitis, increased appetite, decreased mood, cystitis, cervicitis, insomnia, allergic reaction, migraines and headaches may appear.
Janine with endometriosis
Janine is a drug that is often used in the treatment of endometriosis.
Women of reproductive age are more susceptible to this disease. The disease is characterized by the fact that endometrial cells spread beyond the endometrial layer of the uterus. This causes bleeding, which causes inflammation in the surrounding tissues.
The process is accompanied by severe pain, enlargement of the uterus, and infertility may occur.
The disease manifests itself as menstrual irregularities. Instead of blood, a smear with a brownish tint appears.
Sometimes the first symptoms of the disease appear as the initial stage of pregnancy. Fever, chills, weakness and nausea occur.
There are many ways to treat endometriosis and one of them is Janine.
There are some reasons that can cause infertility with this disease:
- The occurrence of hormonal disorders when the egg does not fully mature.
- Immune system disorders.
- The resulting inflammatory process affects the proliferation of connective tissue and the development of adhesive processes.
The longer a woman suffers from endometriosis, the greater the likelihood of infertility. Therefore, it is so important to start treatment as early as possible.
Janine is a monophasic and low-dose estrogen. Its effect is based on the elimination of all symptoms of the disease. After its use, severe pain in the pelvic area disappears, menstrual function normalizes, and heavy bleeding stops.
However, this drug does not change the lipid composition of the blood, does not contribute to severe weight gain and does not damage the liver.
It is believed that Janine does not stop the disease completely, but effectively fights pain and other symptoms.
Only the attending physician can prescribe Janine for endometriosis. After the examination, the required dosage and a certain course of treatment are prescribed.
What should I do if I missed Janine’s appointment?
If it has been since you missed your appointment less than 12 hours, then the effect of contraception is not reduced. The missed pill should be taken immediately, and the next medicine should be taken at the usual time.
If it's passed more than 12 hours after skipping, the contraceptive function decreases.
At the same time, it is important not to interrupt the course of treatment for more than a week and for the full effect of the drug you need at least seven days of continuous use of the drug.
If after taking it has already passed more than 30 hours, then the following is performed:
- you need to take the missed pill immediately
- the next tablet is taken at the usual time
- it is additionally recommended to use a barrier method of contraception for seven days
If your period does not appear when you skip a dose of Zhanine, then pregnancy should be ruled out.
What can be treated with Janine?
Janine is endowed with antiandrogenic activity. In addition, this drug improves blood lipid composition.
When using it, the following positive effects can occur:
- The menstrual cycle is regular and painless.
- Painful menstruation disappears.
- The duration of bleeding is reduced.
- The risk of iron deficiency anemia is reduced.
- The risk of developing ovarian and endometrial cancer is reduced.
- Endometriosis is being treated.
- Sometimes prescribed by a doctor for uterine fibroids.
In cases where it is necessary to undergo a course of treatment for a hormone-dependent pathology (endometriosis, uterine fibroids) and at the same time provide protection against unwanted pregnancy, doctors prescribe COCs containing estradiol and a special gestagen - dienogest. Such hormonal drugs include Silhouette. To understand the differences and similarities, it is worth familiarizing yourself with some of their main characteristics. Thanks to a comparative analysis, every woman will be able to understand which drug to choose Janine or Silhouette, and will determine which is better suited for the treatment of certain gynecological diseases.
Indications for use
If we compare both drugs according to indications, then in the annotation to Janine only one point is indicated - contraception. But the indications for the drug Silhouette are much wider. It is prescribed for the treatment of acne in women in the absence of the expected therapeutic effect during local therapy and the need to provide contraceptive action.
Composition and release form
At first glance, the packaging with the drugs is almost the same, but there is still a significant difference - Janine is available in the form of dragees, and Silhouette is available in the form of tablets. The composition of both COCs is almost identical, the main components are estradiol, dienogest in a dosage of 0.03 mg and 2 mg, respectively. Dragees additionally include gelatin, sucrose, and dextrose; these components are not present in tablets. In addition, each Silhouette tablet is marked “G53”. It is worth noting that each package of both COCs may contain 21 or 63 tablets. or others
Therapeutic effect
Since the drugs have an identical composition of active components, their effect on the body is completely the same. Under the influence of estrogen and gestagen, an artificial hormonal background is formed, in which the work of the ovaries is inhibited (ovulation does not occur), the density of the produced cervical mucus increases, which prevents pregnancy.
The gestagen component (dienogest) is characterized by antiandrogenic activity, which makes it possible to effectively treat acne, mild forms of hirsutism, and alopecia that arise against the background of hormonal imbalance. It is worth noting that other COCs (Jess, Bonade) are characterized by the same effect.
Many women taking these drugs note an improvement in the condition of the skin (reduction in its oiliness), the disappearance of seborrhea and a positive effect on the condition of the nail plate. This effect is not achieved immediately; you will need to take hormones for at least three months.
When taking these therapeutic contraceptives for endometriosis, normalization of the menstrual cycle is observed, the severity of painful manifestations during menstruation decreases, and the intensity of bleeding decreases. This reduces the likelihood of developing anemia, as well as the occurrence of cancer processes in the endometrial layer of the uterus and ovaries.
Features of application
Like all COCs, dragees and tablets are taken for endometriosis as follows: 1 r. per day in a dosage of 1 tablet. or 1 dr. The regimen for using the drugs is the same - 21 days of taking tablets or dragees, followed by a seven-day break.
The transition from other hormonal drugs is carried out according to a similar scheme described in the annotation. If you miss a contraceptive, you must follow the recommendations given in the instructions, which are the same for both COCs.
It is worth noting that during the treatment of endometriosis or fibroids, continuous use of tablets or dragees may be prescribed for 3 months. Thanks to such long-term use of hormones, the expected therapeutic effect will be achieved.
Contraindications for use
The list of contraindications for drugs prescribed for endometriosis is the same. Contraceptives are not prescribed for:
- Pregnancy, GW
- Hypersensitivity to the components of dragees or tablets
- Liver pathologies
- Thrombosis or a tendency to develop them
- Migraine-like headaches
- Diabetes mellitus complicated by vascular pathologies
- Diseases of the pancreas, including pancreatitis
- Surgical interventions with a long period of immobilization
- Detection of hormone-dependent oncological processes in the internal genital organs
- Vaginal bleeding of unknown origin.
Adverse reactions and overdose
If we compare COCs according to the list of adverse reactions, they are the same. It is also worth taking into account the individual characteristics of the body; specific reactions to both Janine and Silhouette are allowed, although these drugs are characterized by good tolerability in endometriosis.
Quite often there are:
- Headache
- Exacerbations of existing cardiovascular pathologies
- Painful sensations in the chest area
- Mood swings
- Increased appetite.
If serious side symptoms develop, hormonal treatment will need to be discontinued. Check with your doctor which is better than Zhanine and Silhouette. Perhaps the gynecologist will advise you to switch to Jess. This COC is a microdosed hormonal drug and is suitable for nulliparous women.
When using the standard dosage of each COC, overdose is unlikely. But when taking an increased dose of hormones, the occurrence of attacks of nausea and the urge to vomit, the occurrence of breakthrough bleeding or spotting, cannot be ruled out. It is recommended to carry out symptomatic therapy.
Best before date
Hormonal tablets from Bayer are allowed to be taken for 3 years from the date of manufacture, but the shelf life of tablets from the Hungarian manufacturer is shorter and is only 2 years.
Manufacturer
If you have to choose Janine or Silhouette, you should pay attention to the country of origin. The first drug is manufactured by Bayer, Germany. The production of the second COC is carried out by Gedeon Richter, Hungary.
Some women consider Janine to be a higher quality drug compared to Silhouette, but this opinion is erroneous; each of the hormonal contraceptives is made from high-quality synthetic components.
Price
The huge difference between hormonal drugs is their cost. The price for a package of Janine (21 dr.) varies from 900 to 1164 rubles. And the cost of Silhouette tablets is almost half as much and is equal to 557 – 670 rubles. Which drug to buy, consult your doctor, but it is worth considering that the price does not in any way characterize its effectiveness.
It must be remembered that taking any COC with antiandrogenic action should only be started after consulting a doctor. If you have endometriosis, you will need to take contraceptives for a long time, since hormones do not get rid of the cause of the developed pathology, but only relieve the characteristic symptoms.
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- I’m taking it on the 13th day, menstruation does not end (not spotting, but moderate menstrual flow), daily headaches, nausea, dizziness, severe decrease in libido, loss of strength! Today I spent the whole day in bed, I didn’t have the strength to get up! And tomorrow there will be no one to look after the child, so what to do?
Zhanine's tablets helped me with several diseases, although I started taking this drug for menstrual irregularities. And in the end, I also got rid of the annoying acne on my face that had tormented me since I was 15 years old. Now I no longer take Janine, since there is no such need, but I will say that the drug is definitely excellent. Zhanine's tablets helped me with several diseases, although I started taking this drug for menstrual irregularities. And in the end, I also got rid of the annoying acne on my face that had tormented me since I was 15 years old.
Now I no longer take Janine, since there is no such need, but I will say that the drug is definitely excellent.
I thought that Zhanine would clear up acne completely, but it turned out that I still needed treatment at the same time, I took Differin with Metrogyl. But at least then new ones don’t appear, and that’s good.
I have been taking it for 5 years, on the recommendation of a doctor. I feel good. Before the appointment, I was often worried about problems in the female part. My friend, on the recommendation of a doctor, took them for two months, took a break for the third and became pregnant. (It didn't work before)
Good for getting rid of acne. The first month I was treated with Metrogyl to remove the acne that was already there, and then I completely forgot about acne. However, I don’t see any side effects yet.
I take Janine along with Lavita vitamins. Sometimes I drink wine or champagne, there were no consequences. I didn’t get pregnant, and that’s the most important thing for me!)
I was always afraid of hormones and hoped that I would never have to take them! But during the examination they discovered a cyst. For treatment, I was prescribed Janine. Among the side effects: for the first month I smeared a little blood without interruption, but not a lot, I felt tired, my breasts became enlarged and hurt. The second month nothing... I was always afraid of hormones and hoped that I would never have to take them! But during the examination they discovered a cyst. For treatment, I was prescribed Janine. Among the side effects: for the first month I smeared a little blood without interruption, but not a lot, I felt tired, my breasts became enlarged and hurt. The second month nothing smeared. The condition is normal, the oiliness of the skin and hair began to decrease, the breasts are swollen and do not hurt, they have become great)) the pimples on the back and chest and face have disappeared!!! I don’t feel PMS anymore!!! I didn’t notice any changes in libido. I feel better with Janine than without him!!! And I’ll say one more thing, girls. I am now 30 years old and I have been suffering from acne since I was 15, no matter what I treated or applied!! If I had known earlier that hormonal supplements would help so much, I would have started taking them right away without delay! So many scars could have been avoided! I wouldn’t hide from everyone for fifteen years! Now, in three months, the skin has become smooth and absolutely clean, only the old scars spoil the appearance (((The weight has not changed and cellulite has not appeared! Everything is super and my only regret is that I was not advised to drink it earlier!!! And by the way, the cyst turned out to be endometrioid and it doesn’t resolve on its own and Janine won’t help either. I’ll have to do a laparoscopy. But it’s okay, we’ll survive! But in the summer I’ll flaunt my tanned, clean back)))