Lindineth 20 after. Taking OK "Lindinet" during menstruation. Delay or acceleration of the menstrual cycle

Content

Among modern means contraception, it is worth noting the Lindinet 20 birth control pills. The drug contains minimal doses of hormones, so it practically does not cause side effects. Refers to monophasic agents. In addition to its direct purpose, it helps normalize the menstrual cycle, reduce the severity of premenstrual syndrome and relieve pain during menstruation. The tablets are used according to the scheme described in the instructions.

Composition of Lindinet 20

According to the composition of hormones, Lindinet 20 is classified as a monophasic oral contraceptive. It contains two main active ingredients:

Ethinyl estradiol(0.02 mg). This is an artificial analogue of the hormone estradiol, which takes part in the regulation of the menstrual cycle. The estrogenic component of the drug.
Gestodene (0.075 mg). A derivative of 19-nortestosterone, which is superior in activity to both artificial gestagens and progesterone produced by the corpus luteum.

Due to its high activity, gestodene is contained in the drug in a small dosage, which prevents the development of undesirable effects. Otherwise, Lindinet 20 would have side effects, for example, in the form of disturbances in lipid and carbohydrate metabolism.

Difference between Lindinet 20 and Lindinet 30

The difference between drugs designated 20 and 30 is the different dosage of hormones.

Important! A drug with a lower hormone content is prescribed mainly to young, nulliparous women.

Ethinyl estradiol dosages:

0.03 mg under the designation 30;
0.02 mg under designation 20.

In this regard, the drug with a lower dosage is most often prescribed to young girls who have not yet given birth. Its analogue is recommended for patients who have crossed the 30-year mark.

Indications for use

The main indication for use is the prevention of unwanted pregnancy. This drug belongs to the group of oral contraceptives. Lindinet 20 hormones contain estrogen (in the form of ethinyl estradiol) and progesterone (gestodene). They have a triple effect on the reproductive system:

inhibit the ovulation process;
increase the viscosity of mucus in the cervix, thereby preventing sperm from moving towards the egg;
affect the mucous membrane of the uterus, making it impossible for a fertilized egg to attach to it.

Pills are prescribed not only as a contraceptive. They are also used to correct hormonal imbalances.

Lindinet 20 for endometriosis

Endometriosis is a disease in which tissue similar in functionality and structure to the endometrium grows outside the uterus. The condition normalizes without specific treatment in about a third of cases. This occurs as a result of the immune system, which recognizes excess tissue and destroys it.

In most cases, endometriosis requires treatment. Doctors often prescribe contraceptives (Lindinet 20 is one of them) to normalize hormonal levels in the body.

The treatment regimen is as follows:

A six-month course of oral contraceptive is prescribed.
If there are positive dynamics, it is extended for another 3-6 months.

After using the contraceptive, the patient should experience no menstrual pain. With continued treatment, the lesions of endometriosis decrease in size.

Lindinet 20 for menopause

After menopause, a woman still has a small chance of becoming pregnant. Since most women do not plan to have children at this age, the issue of contraception should be given attention.

Important! According to researchers, oral contraception during menopause reduces the likelihood of developing diseases thyroid gland And of cardio-vascular system, and also prevents the leaching of calcium from the body.

Before you start taking hormonal medications during perimenopause, you should consult your doctor. He will prescribe diagnostic measures to obtain a complete picture of the condition.

Contraindications for Lindinet 20

Like any other drug, Lindinet 20 birth control pills have a number of contraindications. Conditions in which their use is prohibited or not recommended.

Intolerance to the drugs included in the drug.
Threat of thrombosis development.
Uncorrectable moderate to severe hypertension.
Migraine.
The presence of a major surgical intervention with a long recovery period.
Diabetes.
Pancreatitis.
Liver pathologies (hepatitis, cholestatic jaundice).
Dyslipidemia.
Taking drugs containing steroids, which led to the development of jaundice.
Cholelithiasis.
Liver tumors.
Otosclerosis.
Hormone-dependent malignant tumors of the genital organs, mammary glands (including the likelihood of their development).
Tobacco smoking in patients over 35 years of age.
Pregnancy, breastfeeding.

After giving birth, patients are not advised to use birth control pills for 21 days. If the patient is breastfeeding, she should refrain from taking them during breastfeeding.

How to take Lindinet 20

The order and method of using Lindinet 20 depends on the menstrual cycle. When a patient just starts taking the drug, she needs to wait until the first day of her period.

The drug is taken in the order indicated on the blister. If you miss a Lindinet 20 tablet, you are advised to continue taking it as directed. Upon completion of the 21-day course, stop taking the drug for 7 days. During this period, your period should begin.

After the 7-day break, continue taking the same regimen, regardless of whether your periods have stopped.

How to take Lindinet 20 for the first time

The first dose takes place between the 1st and 5th day of menstruation. If the discharge has stopped, you should not be afraid. Next, you need to continue taking the drug for 21 days.

When you can not use protection with Lindinet 20

The main purpose is contraception. Correct use does not require the use of additional contraceptives. If diarrhea or vomiting is observed 3-4 hours after administration, this may lead to a decrease in contraceptive effect. In such a situation, it is recommended to take the next dose as soon as possible. In order not to violate the schedule in the blister, you should take a tablet from a new pack.

After childbirth, the drug is resumed on days 21-28. In the first week of use it is recommended to use additional methods contraception.

What to do if you missed a Lindinet 20 tablet

If you miss Lindinet 20, you need to replenish the dose as soon as possible. If the interval does not exceed 12 hours, the effect of treatment will continue. However, if the absence is more than 12 hours, it is recommended to use additional contraception. The instructions for taking missed Lindinet 20 tablets indicate that the next dose is taken at the usual time.

Cancel Lindinet 20

The drug is taken 1 tablet per day for 21 days. Upon completion of this course, menstruation or withdrawal bleeding begins. On the next day after the seventh day, the drug is resumed. Thus, bleeding is the body’s reaction to the withdrawal of Lindinet 20.

Pregnancy while taking Lindinet 20

Lindinet 20, shown in the photo, is considered a highly effective contraceptive. The Pearl index (an indicator of the number of pregnancies occurring in 100 patients taking the drug within one year) reaches 0.05.

Is it possible to get pregnant while taking Lindinet 20?

Full activity occurs by the 14th day of taking the drug. Therefore, for the first two weeks it is necessary to use barrier methods of contraception.

Pregnancy after Lindinet 20

If the drug has been used for several years, it will take about 12 months for the reproductive system to fully recover. Patients planning pregnancy are advised to:

complete the course completely;
start taking folic acid;
after 3 months, plan sexual intercourse in accordance with the ovulation schedule.

Important! After long-term use of the drug, complete restoration of the reproductive system may take up to 12 months.

The use of contraceptives is stopped with the complete completion of the course. If hormone treatment lasts no more than six months, a woman can become pregnant immediately after discontinuation.

Side effects of Lindinet 20

All side effects are divided into several groups according to frequency of occurrence. The drug should be discontinued immediately if:

otosclerosis;
porphyria;
arterial hypertension;
hemolytic-uremic syndrome.

Symptoms such as stroke, heart attack, thrombosis are rare.

The most commonly observed side effects are:

bloody issues;
inflammation of the vaginal walls;
painful sensations, enlarged mammary glands;
nausea, vomiting, diarrhea;
ulcerative colitis;
hepatitis;
erythema nodosum, rash, hair loss;
headache;
depressive states;
weight gain;
decreased hearing, corneal sensitivity;
allergic reactions.

If such symptoms are detected in the first month of taking Lindinet 20, you should consult a doctor and evaluate the advisability of using this contraceptive.

Drug interactions

A number of drugs reduce the contraceptive activity of hormones. Among them:

Ampicillin;
Tetracycline;
Rifampicin;
Primidone;
Carbamazepine;
Phenylbutazone;
Phenytoin;
Griseofulvin;
Topiramate;
Oxcarbazepine.

Any drug that stimulates the gastrointestinal tract will lead to a decrease in the concentration of active substances in the blood. The same effect is observed with the simultaneous use of infusions and other products based on St. John's wort.

Is it possible to drink alcohol with Lindinet 20

From a pharmacological point of view, contraceptives are compatible with alcohol. However, the presence of alcohol in the liver affects the pharmacokinetics of the drug and increases the likelihood of side effects.

Terms and conditions of storage

Tablets are stored at a temperature not exceeding 25 ° C in a place inaccessible to children. Shelf life: 3 years.

Analogues of Lindinet 20

Analogues of Lindinet 20 differ in the composition and dosage of hormones. The most common names are shown below.

Lindinet 20 or Logest: which is better

Birth control pills Logest contains the same dosage of hormones: 0.075 mg gestodene and 0.02 mg ethinyl estradiol. You need to choose a specific remedy with your doctor.

Lindinet 20 or Yarina: which is better

Yarina is a contraceptive containing 0.03 mg of ethinyl estradiol and 3 mg of drospirenone. The latter is also an analogue of natural progesterone.

Latin name: Lindynette
ATX code: G03AA10
Active substance: Ethinyl estradiol
Manufacturer: Gedeon Richter, Hungary
Conditions for dispensing from a pharmacy: On prescription

Lindinet 20 is one of the low-hormone oral contraceptives.

Indications for use

Lindinet 20 tablets are taken for contraceptive purposes, as well as to regulate impaired menstrual function.

Compound

One hormonal contraceptive tablet contains two main components, which are ethinyl estradiol and gestodene, their mass fraction is 0.02 mg and 0.075 mg, respectively.

Additionally there are the following substances:

Povidone
Magnesium stearate
Corn starch
Silicon dioxide in colloidal form
Lactose monohydrate
Sodium calcium edetate.

Medicinal properties

A contraceptive based on ethinyl estradiol and gestodene inhibits the process of synthesis of gonadotropic hormones by the pituitary gland, which helps slow down the maturation of follicles.

The estrogen component of birth control pills is represented by ethinyl estadiol, which is one of the synthetic analogues produced in human body the hormone estradiol, which is actively involved in the regulation of menstrual function together with progesterone.

Gestodene is the second component of the contraceptive; it is classified as a derivative of 19-nortestosterone; in terms of its potency, it is significantly superior to both the natural hormone, progesterone, and its synthetic analogue, levonorgestrel. Due to the fact that the activity of this gestagenic component of Lindinet is quite high, it is used in low doses. Due to this, there is no significant effect on the metabolism of fats and carbohydrates, and its androgenic properties do not appear.

The action of the contraceptive is associated with the work of both central and peripheral mechanisms that inhibit the process of follicle maturation, thereby reducing the susceptibility of the endometrial uterine layer to the blastocyst itself. At the same time, the viscosity of the discharge (namely cervical mucus) increases, which significantly reduces the likelihood of conception.

If you drink Lindinet 20 constantly (as the description for the drug indicates), you can observe the therapeutic effect of the contraceptive - the circulatory cycle is normalized, and the risk of developing certain gynecological ailments, including cancer, is reduced.

Ethinyl estradiol is almost in full absorbed by the mucous membranes of the gastrointestinal tract. 1-2 after taking the tablets (according to the instructions), its highest concentration in the blood is observed. The bioavailability rate is 60%. Communication with albumin is 98.5%.

As a result of aromatic hydroxylation, the formation of methylated and hydroxylated metabolites occurs. The elimination process takes place with the participation of the renal system and intestines, the half-life is 24 hours. In this case, a stable level of ethinyl estradiol is recorded on days 3-4.

Gestodene also quickly undergoes the process of absorption in the gastrointestinal tract; the highest levels of this substance in the blood are achieved after 60 minutes. The bioavailability of the gestagenic component of the drug reaches 99%.

The amount of gestodene in the blood decreases slowly, the half-life of metabolic products is 24 hours. A stable level of gestodene is observed in the 2nd half of the MC.

Release form

Hormonal pills are round, light cream in color, placed in blister packs of 21 pcs. There may be 1 or 3 blisters inside the pack. packaging with instructions.

Lindinet 20: instructions for use

Price from 381 to 2059 rubles.

The use of the hormonal drug Lindenet should be done every day at the same time to ensure their contraceptive effect. It is worth noting that Lindinet 30 is also accepted, the instructions for use are similar.

If a hormonal drug is used for the first time, then the first tablet is taken from 1 MC to 5 MC. It is necessary to take Lindinet 20 for 21 days, after which a seven-day withdrawal of the hormonal drug is provided, it is on these days that menstruation begins. Taking hormones from a new blister pack starts at 8 days. regardless of whether the withdrawal bleeding has completed or not.

Switching from another COC

The Lindinet 20 tablet will need to be taken the next day after the woman took the last COC pill from the blister. The beginning of the first menstruation proceeds as usual.

Switching from mini-pills, hormonal injectables, intrauterine systems, or implants

Hormone therapy can be started on any day of the MC if you have taken the mini-pill. When using earlier implants - on the day of removal, injection of hormones - on the day of the intended injection.

In case of switching from single drugs, it will be necessary to use barrier contraceptive measures so that the woman does not become pregnant during the first cycle of use.

After an early abortion (1st trimester)

Hormonal therapy with birth control pills should begin on the same day of surgery. Let the woman drink them according to the standard regimen; there is no need to use protection, since in this case you will not get pregnant. After an abortion, long-term hormone therapy is indicated.

After an abortion in later stages (2nd trimester)

The first Lindinet 20 tablet should be taken after 28 days. (one month) without using any additional contraceptive measures. If you take the contraceptive drug later than the specified period, for 7 days. You should additionally protect yourself from pregnancy.

If a woman had unprotected sexual intercourse before taking contraceptives, she should start using hormonal pills after excluding possible pregnancy or do it differently - take the Lindinet 20 tablet for the first time directly on the first day of the MC (when your own menstrual cycle begins).

Regimen for skipping pills

If you missed taking the tablets, there is no need to stop taking them; take the missed Lindinet 20 tablet as soon as you remember.

If gaps in taking pills do not exceed 12 hours, then the contraceptive effect works; barrier protection measures are not used. All subsequent tablets are taken as usual; skipping the drug does not affect the contraceptive effect.

If a woman happens to miss another dose of contraception, and the time interval exceeds 12 hours, hormonal pills are not as effective. The woman must take the pill she missed; subsequent ones are taken according to the standard regimen. Additionally, barrier methods of protection are used for 7 days. from the moment when there was a pass.

If a pill was missed and there are less than 7 pills left in the package, it is best that the woman does not take a break from taking hormonal pills. Skipping pills during the third week of contraceptive therapy does not significantly reduce its effectiveness.

It is worth considering that if you take these contraceptives continuously, you will not have periods, but breakthrough vaginal bleeding may occur while using tablets from a new blister. If after two months of continuous use of pills (including a cycle when there was a skip) menstrual-like bleeding does not occur, you should definitely rule out pregnancy while taking Lindinet 20. What to do next, consult a gynecologist, he will offer several options for solving the problem.

What to do if vomiting or diarrhea starts

If you experience vomiting or diarrhea while taking pills, and more than 3-4 hours have passed since taking the drug, this can be compared to skipping a pill, and the likelihood of pregnancy increases. What to do - take the same measures as in the case of a missed pill. If a woman does not want to change her contraceptive regimen, take Lindinet 20 tablet from a new blister.

How to postpone your period

If, with long-term use of a hormonal drug, there is a need to delay menstruation, take hormonal pills without the usual seven-day break. You can delay menstruation for any number of days, up to the end of the pills from the second blister. You should not exclude the possibility of spotting or breakthrough bleeding (this reaction of the body is considered normal). After the end of the seven-day break, you can drink Lindinet 20 as usual. What to do if you need to stop taking Lindinet, consult your gynecologist.

Use during pregnancy and pregnancy

Hormonal pills are not prescribed during pregnancy. If there is a need to use a contraceptive during lactation, you should stop breastfeeding.

Contraindications

You should not take this hormonal drug if:

Excessive sensitivity to the components of the contraceptive
Pathologies caused by impaired liver function
Pathological neoplasms in the liver
Tendency to thrombus formation, as well as thromboembolism
Serious pathologies of the cardiovascular system (including myocardial infarction)
Sickle cell anemia
Presence of estrogen-dependent neoplasms
Uterine bleeding of unknown origin
Diabetes mellitus, which occurs against the background of microangiopathy
Idiopathic jaundice
Manifestations of herpes
Pregnancy
Otosclerotic changes
Over 35 years of age (since with age the likelihood of developing side effects increases significantly).

Precautionary measures

Particular caution should be exercised in the presence of such pathological conditions and diseases:

Severe migraine-like headaches
Oncological process in the mammary glands
Frequent epileptic seizures
Pathologies of the functioning of the gallbladder (including cholelithiasis)
Increased blood pressure
Immobilization
Depressive state
Recovery period after major surgery
Diabetes
Cholestatic jaundice
Various forms of liver failure.

If the patient is over 35 years old and smokes, it is worth consulting with a specialist about the possibility of switching to Lindinet 30. It is worth noting that the woman’s age and the amount of hormones taken directly affects the contraceptive effect. After 40 years, it is worth choosing other means of contraception.

Cross-drug interactions

In accordance with the instructions for Lindient 20 and 30 inducers of liver microsomal enzymes, antibacterial drugs significantly reduce the level of estrogen in the blood, which increases the likelihood of pregnancy. Is it possible to get pregnant during this period? Yes, the probability is quite high. During the entire treatment period and over the next 7 days. upon its cessation, it is necessary to resort to the use of additional contraceptive measures.

Liver enzyme inhibitors, in turn, help increase the concentration of estrogen components in the blood.

Drugs that increase gastrointestinal motility reduce the absorption of components of hormonal pills.

Ascorbic acid slows down the process of sulfation of estrogen components and increases their bioavailability.

The hormonal agent affects the metabolic processes of cyclosporine and theophylline in the body, which can cause an unexpected reaction from various organs and systems.

You should not drink preparations with St. John's wort, as heavy menstruation (bleeding) may begin during herbal treatment.

Patients with diabetes mellitus should adjust the dosage of hypoglycemic drugs taken.

It is worth noting that the same cross-interactions occur if Lindinet 30 birth control pills are taken.

Side effects

While taking birth control pills, unwanted reactions may develop:

CVS: very rarely, thromboembolism or thrombosis may develop against the background of increased blood clotting, a sharp increase in blood pressure
Gastrointestinal tract: severe nausea and vomiting, development of hepatocellular adenoma, possible hepatitis
Reproductive system: decreased libido, heavy periods, impaired secretion of vaginal discharge
Endocrine system: weight change, feeling of tightness in the chest
Central nervous system: emotional instability, tendency to depression (during long-term hormonal therapy), frequent headaches, lethargy, increased fatigue, migraine (very severe headache).

You may also experience: pain in the lower abdomen, the occurrence of chloasma (if you are prone to it, you should avoid prolonged exposure to the sun), intolerance to contact lenses, swelling, allergies, symptoms of impaired glucose tolerance. This reaction can develop as a result of long-term use of hormones.

Overdose

If a woman has taken increased dosages of the drug, the following symptoms may be observed: nausea and vomiting, headache. An overdose may result in heavy periods.

Symptomatic therapy is recommended. What to do - consult a doctor (he will advise you to discontinue the drug) and take the prescribed medications. After this, there is a significant improvement in the general condition and cessation of bleeding. It is worth noting that there is no specific antidote.

Storage conditions and shelf life

Hormonal pills are stored at an average temperature not exceeding 30 C. The shelf life of the contraceptive is 3 years.

Analogues

Bayer Pharma, Germany

Price from 500 to 2142 rub.

Logest is similar in composition to Lindinet 20 and is a low-dose contraceptive. It is taken in the same way, it has similar contraindications, it can cause similar effects to Lindinet side effect. A pack contains 1 (21 tablets) or 3 (63 tablets) blister sheets. packaging.

Pros:

The pills work effectively (block the onset of ovulation)
Regulates MC
Used to treat some hormone-dependent gynecological diseases.

Minuses:

High price
High risk of side effects
Not prescribed if the woman is over 35 years old.

Registration Certificate Holder:
GEDEON RICHTER Plc.

ATX code for LINDYNET 20

G03AA10 (Gestodene and estrogen)

Analogues of the drug according to ATC codes:

Before using LINDINET 20 you should consult your doctor. These instructions for use are for informational purposes only. To get more complete information Please refer to the manufacturer's instructions.

Clinical and pharmacological group

23.032 (Monophasic oral contraceptive)

Release form, composition and packaging

Light yellow film-coated tablets, round, biconvex, unprinted on both sides; at the break of white or almost white with light yellow edging.

Excipients: sodium calcium edetate, magnesium stearate, colloidal silicon dioxide, povidone, corn starch, lactose monohydrate.

Shell composition: quinoline yellow dye (D+S yellow No. 10) (E104), povidone, titanium dioxide, macrogol 6000, talc, sucrose.

21 pcs. - blisters (1) - cardboard packs. 21 pcs. - blisters (3) - cardboard packs.

pharmachologic effect

Monophasic oral contraceptive. Inhibits the secretion of gonadotropic hormones of the pituitary gland. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is ethinyl estradiol, a synthetic analogue of the follicular hormone estradiol, which participates together with the corpus luteum hormone in the regulation of the menstrual cycle. The gestagenic component is gestodene, a derivative of 19-nortestosterone, which is superior in strength and selectivity to not only the natural corpus luteum hormone progesterone, but also other synthetic gestagens (for example, levonorgestrel). Due to its high activity, gestodene is used in low dosages, in which it does not exhibit androgenic properties and has virtually no effect on lipid and carbohydrate metabolism.

Along with the indicated central and peripheral mechanisms that prevent the maturation of an egg capable of fertilization, the contraceptive effect is due to a decrease in the susceptibility of the endometrium to the blastocyst, as well as an increase in the viscosity of the mucus located in the cervix, which makes it relatively impenetrable for sperm. In addition to the contraceptive effect, the drug, when taken regularly, also has a therapeutic effect, normalizing the menstrual cycle and helping to prevent the development of a number of gynecological diseases, incl. tumor nature.

Pharmacokinetics

Gestoden

Suction

After oral administration, it is quickly and completely absorbed from the gastrointestinal tract. After a single dose, Cmax is observed after 1 hour and is 2-4 ng/ml. Bioavailability is about 99%.

Distribution

Gestodene binds to albumin and sex hormone binding globulin (SHBG). 1-2% is found in plasma in free form, 50-75% specifically binds to SHBG. An increase in the level of SHBG in the blood caused by ethinyl estradiol affects the level of gestodene: the fraction associated with SHBG increases and the fraction associated with albumin decreases. Average Vd - 0.7-1.4 l/kg. The pharmacokinetics of gestodene depends on the level of SHBG. The concentration of SHBG in blood plasma under the influence of estradiol increases 3 times. When taken daily, the concentration of gestodene in the blood plasma increases 3-4 times and in the second half of the cycle reaches a state of saturation.

Metabolism and excretion

Gestodene is biotransformed in the liver. The average plasma clearance is 0.8-1 ml/min/kg. The level of gestodene in the blood serum decreases in two phases. T1/2 in the β-phase is 12-20 hours. Gestodene is excreted only in the form of metabolites, 60% in urine, 40% in feces. T1/2 of metabolites - about 1 day.

Ethinyl estradiol

Suction

After oral administration, ethinyl estradiol is absorbed quickly and almost completely. The average Cmax in the blood serum is reached 1-2 hours after administration and is 30-80 pg/ml. Absolute bioavailability due to presystemic conjugation and primary metabolism is about 60%.

Distribution

Completely (about 98.5%), but nonspecifically binds to albumin and induces an increase in the level of SHBG in the blood serum. Average Vd - 5-18 l/kg.

Css is established by the 3-4th day of taking the drug, and it is 20% higher than after a single dose.

Metabolism

It undergoes aromatic hydroxylation to form hydroxylated and methylated metabolites, which are present in the form of free metabolites or in the form of conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma is about 5-13 ml.

Removal

Serum concentration decreases in two phases. T1/2 in the β-phase is about 16-24 hours. Ethinyl estradiol is excreted only in the form of metabolites, in a 2:3 ratio with urine and bile. T1/2 of metabolites - about 1 day.

LINDYNET 20: DOSAGE

Prescribe 1 tablet/day for 21 days, if possible at the same time of day. After taking the last tablet from the package, take a 7-day break, during which withdrawal bleeding occurs. The next day after a 7-day break (i.e., 4 weeks after taking the first tablet, on the same day of the week), the drug is resumed.

The first tablet of Lindinet 20 should be taken from the 1st to the 5th day of the menstrual cycle.

When switching to Lindinet 20 from another combined oral contraceptive, the first Lindinet 20 tablet should be taken after taking the last tablet from the package of another oral hormonal contraceptive, on the first day of withdrawal bleeding.

When switching to taking Lindinet 20 from drugs containing only progestogen (mini-pill, injections, implant), when taking a “mini-pill”, taking Lindinet 20 can be started on any day of the cycle, switching from using the implant to taking Lindinet 20 is possible the day after removal of the implant, when using injections - on the eve of the last injection. In these cases, additional methods of contraception should be used in the first 7 days.

After an abortion in the first trimester of pregnancy, you can start taking Lindinet 20 immediately after surgery. In this case, there is no need to use additional methods of contraception.

After childbirth or after an abortion in the second trimester of pregnancy, taking the drug can be started on days 21-28. In these cases, additional methods of contraception must be used in the first 7 days. If you start taking the drug later, an additional barrier method of contraception should be used in the first 7 days. If sexual intercourse took place before starting contraception, pregnancy should be ruled out before starting the drug or the start of use should be delayed until the first menstruation.

If you miss a pill, take the missed pill as quickly as possible. If the dosage interval does not reduce the effect of the drug, in which case there is no need to use an additional method of contraception. The remaining tablets should be taken at the usual time. If the interval is more than 12 hours, the contraceptive effect of the drug may be reduced. In such cases, you should not make up for the missed dose, continue taking the drug as usual, but in the next 7 days you must use an additional method of contraception. If at the same time there are less than 7 tablets left in the package, taking the drug from the next package should be started without interruption. In this case, withdrawal bleeding does not occur until the end of taking the drug from the second package, but spotting or breakthrough bleeding may occur.

If withdrawal bleeding does not occur after completing the drug from the second package, then pregnancy should be excluded before continuing to take the drug.

If vomiting and/or diarrhea begins within 3-4 hours after taking the drug, the contraceptive effect may be reduced. In such cases, you should follow the instructions for skipping pills. If the patient does not want to deviate from her usual contraceptive regimen, the missed pills should be taken from another package.

To speed up the onset of menstruation, you should reduce the break in taking the drug. The shorter the break, the more likely it is that breakthrough or spotting bleeding will occur while taking tablets from the next package (similar to cases with delayed menstruation).

To delay the onset of menstruation, the drug must be continued from a new package without a 7-day break. Menstruation can be delayed as long as necessary until the end of taking the last tablet from the second pack. When menstruation is delayed, breakthrough or spotting bleeding may occur. Regular use of Lindinet 20 can be resumed after the usual 7-day break.

Overdose

No severe symptoms have been described after taking the drug in high doses.

Symptoms: nausea, vomiting, in girls - bleeding from the vagina.

Treatment: symptomatic therapy is prescribed; there is no specific antidote.

Drug interactions

The contraceptive activity of Lindinet 20 is reduced when taken simultaneously with ampicillin, tetracycline, rifampicin, barbiturates, primidone, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine. The contraceptive effect of oral contraceptives is reduced when these combinations are used, breakthrough bleeding and menstrual irregularities become more frequent. While taking Lindinet 20 with the above drugs, as well as for 7 days after completing the course of taking them, it is necessary to use additional non-hormonal (condom, spermicidal gels) methods of contraception. When using rifampicin, additional methods of contraception should be used for 4 weeks after completion of the course of taking it.

When used simultaneously with Lindinet 20, any drugs that increase gastrointestinal motility reduce the absorption of active substances and their level in the blood plasma.

Sulfation of ethinyl estradiol occurs in the intestinal wall. Drugs that are also subject to sulfation in the intestinal wall (including ascorbic acid) competitively inhibit the sulfation of ethinyl estradiol and thereby increase the bioavailability of ethinyl estradiol.

Inducers of microsomal liver enzymes reduce the level of ethinyl estradiol in the blood plasma (rifampicin, barbiturates, phenylbutazone, phenytoin, griseofulvin, hydantoin, felbamate, rifabutin, oscarbazepine).

Liver enzyme inhibitors (itraconazole, fluconazole) increase the level of ethinyl estradiol in the blood plasma.

Some antibiotics (ampicillin, tetracycline), by interfering with the intrahepatic circulation of estrogens, reduce the level of ethinyl estradiol in plasma.

Ethinyl estradiol, by inhibiting liver enzymes or accelerating conjugation (primarily glucuronidation), can affect the metabolism of other drugs (including cyclosporine, theophylline); The concentration of these drugs in the blood plasma may increase or decrease.

When Lindinet 20 is used simultaneously with St. John's wort preparations (including infusion), the concentration of active substances in the blood decreases, which can lead to breakthrough bleeding and pregnancy. The reason for this is the inducing effect of St. John's wort on liver enzymes, which continues for another 2 weeks after completing the course of taking St. John's wort. It is not recommended to prescribe this combination of drugs.

Ritonavir reduces the AUC of ethinyl estradiol by 41%. In this regard, during the use of ritonavir, a hormonal contraceptive with a higher ethinyl estradiol content should be used or additional non-hormonal methods of contraception should be used.

It may be necessary to adjust the dosage regimen when using hypoglycemic agents, because oral contraceptives may decrease carbohydrate tolerance and increase the need for insulin or oral antidiabetic agents.

Pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation.

The components of the drug are excreted in breast milk in small quantities.

When used during lactation, milk production may decrease.

LINDYNET 20: SIDE EFFECTS

Side effects requiring discontinuation of the drug

From the cardiovascular system: arterial hypertension; rarely - arterial and venous thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism); very rarely - arterial or venous thromboembolism of the hepatic, mesenteric, renal, retinal arteries and veins.

From the senses: hearing loss caused by otosclerosis.

Other: hemolytic-uremic syndrome, porphyria; rarely - exacerbation of reactive systemic lupus erythematosus; very rarely - Sydenham's chorea (passing after discontinuation of the drug).

Other side effects are more common but less severe. The advisability of continuing to use the drug is decided individually after consultation with a doctor, based on the benefit/risk ratio.

From the reproductive system: acyclic bleeding/bloody discharge from the vagina, amenorrhea after discontinuation of the drug, changes in the state of vaginal mucus, the development of inflammatory processes in the vagina, candidiasis, tension, pain, enlarged mammary glands, galactorrhea.

From the outside digestive system: epigastric pain, nausea, vomiting, Crohn's disease, ulcerative colitis, the occurrence or exacerbation of jaundice and/or itching associated with cholestasis, cholelithiasis, hepatitis, liver adenoma.

Dermatological reactions: erythema nodosum, exudative erythema, rash, chloasma, increased hair loss.

From the central nervous system: headache, migraine, mood lability, depression.

From the senses: hearing loss, increased sensitivity of the cornea (when wearing contact lenses).

From the metabolic side: fluid retention in the body, change (increase) in body weight, decreased tolerance to carbohydrates, hyperglycemia, increased TG levels.

Other: allergic reactions.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 30°C. Shelf life - 3 years.

Indications

contraception.

Contraindications

the presence of severe and/or multiple risk factors for venous or arterial thrombosis (incl.
complicated lesions of the heart valve apparatus,
atrial fibrillation,
diseases of the cerebral vessels or coronary arteries,
arterial hypertension severe or moderate with blood pressure ≥ 160/100 mmHg);
presence or indication in history of precursors of thrombosis (incl.
transient ischemic attack,
angina);
migraine with focal neurological symptoms,
incl.
in the anamnesis;
venous or arterial thrombosis/thromboembolism (incl.
myocardial infarction,
stroke,
deep vein thrombosis of the leg,
pulmonary embolism) currently or in history;
a history of venous thromboembolism;
surgery with prolonged immobilization;
diabetes(with angiopathy);
pancreatitis (incl.
in the anamnesis),
accompanied by severe hypertriglyceridemia;
dyslipidemia;
severe liver diseases,
cholestatic jaundice (incl.
during pregnancy),
hepatitis,
incl.
history (before normalization of functional and laboratory parameters and within 3 months after their normalization);
jaundice when taking GCS;
gallstone disease currently or in history;
Gilbert's syndrome,
Dubin-Johnson syndrome,
Rotor syndrome;
liver tumors (incl.
in the anamnesis);
severe itching
otosclerosis or its progression during a previous pregnancy or taking corticosteroids;
hormone-dependent malignant neoplasms of the genital organs and mammary glands (incl.
if you suspect them);
vaginal bleeding of unknown etiology;
smoking over the age of 35 (more than 15 cigarettes per day);
pregnancy or suspicion of it;
lactation period;
hypersensitivity to the components of the drug.

The drug should be prescribed with caution in conditions that increase the risk of developing venous or arterial thrombosis/thromboembolism: age over 35 years, smoking, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate family), hemolytic-uremic syndrome, hereditary angioedema, liver diseases, diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (including porphyria, herpes of pregnant women, minor chorea / Sydenham disease /, Sydenham chorea, chloasma) , obesity (body mass index more than 30 kg/m2), dyslipoproteinemia, arterial hypertension, migraine, epilepsy, valvular heart disease, atrial fibrillation, prolonged immobilization, extensive surgery, surgery on the lower extremities, severe trauma, varicose veins veins and superficial thrombophlebitis, the postpartum period (non-lactating women /21 days after childbirth/; nursing women after completion of the lactation period), the presence of severe depression (including a history), changes in biochemical parameters (activated protein C resistance, hyperhomocysteinemia , antithrombin III deficiency, protein C or S deficiency, antiphospholipid antibodies, including antibodies to cardiolipin, lupus anticoagulant), diabetes mellitus not complicated by vascular disorders, SLE, Crohn's disease, ulcerative colitis, sickle cell anemia, hypertriglyceridemia ( including family history), acute and chronic diseases liver.

special instructions

Before starting to use the drug, it is necessary to conduct a general medical examination (detailed family and personal history, blood pressure measurement, laboratory tests) and gynecological examination (including examination of the mammary glands, pelvic organs, cytological analysis of a cervical smear). Such examinations during the period of taking the drug are carried out regularly, every 6 months.

The drug is a reliable contraceptive: the Pearl index (an indicator of the number of pregnancies that occurred during the use of a contraceptive method in 100 women over 1 year) with correct use is about 0.05. Due to the fact that the contraceptive effect of the drug from the start of administration is fully manifested by the 14th day, in the first 2 weeks of taking the drug, it is recommended to additionally use non-hormonal methods of contraception.

In each case, before prescribing hormonal contraceptives, the benefits or possible negative effects of their use are individually assessed. This issue must be discussed with the patient, who, after receiving the necessary information, will make the final decision on the preference for hormonal or any other method of contraception.

The woman's health condition must be carefully monitored. If any of the following conditions/diseases appear or worsen while taking the drug, you must stop taking the drug and switch to another, non-hormonal method of contraception:

diseases of the hemostatic system;
conditions/diseases,
predisposing to the development of cardiovascular disease,
renal failure;
epilepsy;
migraine;
the risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;
diabetes,
not complicated by vascular disorders;
severe depression (if depression is associated with impaired tryptophan metabolism,
then vitamin B6 can be used for correction purposes);
sickle cell anemia,
in some cases (for example,
infections,
hypoxia) estrogen-containing drugs in this pathology can provoke thromboembolism;
the appearance of abnormalities in laboratory tests assessing liver function.

Thromboembolic diseases

Epidemiological studies have shown that there is a connection between taking oral hormonal contraceptives and an increased risk of developing arterial and venous thromboembolic diseases (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism). An increased risk of venous thromboembolic diseases has been proven, but it is significantly less than during pregnancy (60 cases per 100 thousand pregnancies). When using oral contraceptives, arterial or venous thromboembolism of the hepatic, mesenteric, renal or retinal vessels is very rarely observed.

The risk of arterial or venous thromboembolic disease increases:

with age;
when smoking (heavy smoking and age over 35 years are risk factors);
if there is a family history of thromboembolic diseases (for example,
from parents,
brother or sister).
If a genetic predisposition is suspected,
It is necessary to consult a specialist before using the drug;
for obesity (body mass index more than 30 kg/m2);
with dislipoproteinemia;
with arterial hypertension;
for diseases of the heart valves,
complicated by hemodynamic disorders;
with atrial fibrillation;
for diabetes mellitus,
complicated by vascular lesions;
with prolonged immobilization,
after major surgery,
after surgery on the lower extremities,
after a serious injury.

In these cases, it is assumed to temporarily stop using the drug (no later than 4 weeks before surgery, and resume no earlier than 2 weeks after remobilization).

Women after childbirth have an increased risk of venous thromboembolic disease.

It should be taken into account that diabetes mellitus, systemic lupus erythematosus, hemolytic-uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia increase the risk of developing venous thromboembolic diseases.

It should be taken into account that resistance to activated protein C, hyperhomocysteinemia, protein C and S deficiency, antithrombin III deficiency, and the presence of antiphospholipid antibodies increase the risk of developing arterial or venous thromboembolic diseases.

When assessing the benefit/risk ratio of taking the drug, it should be taken into account that targeted treatment of this condition reduces the risk of thromboembolism. Symptoms of thromboembolism are:

sudden chest pain
which radiates to the left hand;
sudden shortness of breath;
any unusually severe headache,
ongoing for a long time or appearing for the first time,
especially when combined with sudden complete or partial loss of vision or diplopia,
aphasia,
dizziness,
collapse,
focal epilepsy,
weakness or severe numbness of half the body,
motor disorders,
severe unilateral pain in the calf muscle,
acute stomach.

Tumor diseases

Some studies have reported an increased incidence of cervical cancer in women who took hormonal contraceptives for a long time, but the results of the studies are inconsistent. Sexual behavior, infection with the human papillomavirus and other factors play a significant role in the development of cervical cancer.

A meta-analysis of 54 epidemiological studies found that there is a relative increase in the risk of breast cancer among women taking oral hormonal contraceptives, but the higher detection rate of breast cancer may have been associated with more regular medical screening. Breast cancer is rare among women under 40, whether they take hormonal birth control or not, and increases with age. Taking pills can be considered one of many risk factors. However, the woman should be made aware of the possible risk of developing breast cancer based on an assessment of the benefit-risk ratio (protection against ovarian and endometrial cancer).

There are few reports of the development of benign or malignant liver tumors in women taking hormonal contraceptives for a long time. This should be kept in mind when differentially assessing abdominal pain, which may be associated with an increase in liver size or intraperitoneal bleeding.

Chloasma can develop in women with a history of this disease during pregnancy. Those women who are at risk of developing chloasma should avoid contact with sun rays or ultraviolet radiation while taking Lindinet 20.

Efficiency

The effectiveness of the drug may be reduced in the following cases: missed pills, vomiting and diarrhea, simultaneous use of other drugs that reduce the effectiveness of birth control pills.

If the patient is simultaneously taking another drug that may reduce the effectiveness of birth control pills, additional methods of contraception should be used.

The effectiveness of the drug may decrease if, after several months of their use, irregular, spotting or breakthrough bleeding appears, in such cases it is advisable to continue taking the tablets until they run out in the next package. If at the end of the second cycle menstrual-like bleeding does not begin or acyclic bleeding does not stop, stop taking the pills and resume it only after pregnancy has been ruled out.

Changes in laboratory parameters

Under the influence of oral contraceptive pills - due to the estrogen component - the level of some laboratory parameters (functional indicators of the liver, kidneys, adrenal glands, thyroid gland, hemostasis indicators, levels of lipoproteins and transport proteins) may change.

Additional Information

After suffering an acute viral hepatitis the drug should be taken after normalization of liver function (not earlier than 6 months).

For diarrhea or intestinal disorders, vomiting, the contraceptive effect may be reduced. While continuing to take the drug, it is necessary to use additional non-hormonal methods of contraception.

Women who smoke have an increased risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk depends on age (especially in women over 35 years of age) and on the number of cigarettes smoked.

The woman should be warned that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Impact on the ability to drive vehicles and operate machinery

No studies have been conducted to study the effect of Lindinet 20 on the abilities necessary to drive a car and operate machinery.

Use for renal impairment

Use for liver dysfunction

Contraindicated in case of liver dysfunction.

Lindinet 20 is a monophasic drug: all tablets in the package contain the same dose of hormones. One Lindinet 20 tablet contains 20 mcg (0.02 mg) of ethinyl estradiol and 75 mcg of gestodene.

One cardboard package contains 1 or 3 blisters (plates). One blister contains 21 tablets, the dose is designed for three weeks.

ATTENTION: The drug has contraindications. Do not start using this drug without first consulting your doctor.

Analogues

The drug Logest contains the same dose of hormones as Lindinet 20.

Advantages of Lindinet 20

Lindinet 20 is the latest generation contraceptive. Lindinet 20 tablets contain very low doses of hormones, and therefore side effects are almost never observed when taking these tablets.

Taking Lindinet 20 for 3 months or more restores the regular menstrual cycle (if it is disrupted), reduces the manifestations of premenstrual syndrome (PMS) and. Regular use of Lindinet 20 significantly reduces the risk of developing mastopathy, ovarian cancer, uterine cancer, and other women's diseases.

Rules for taking Lindinet 20

If you are just starting to take Lindinet 20, then you should take the first tablet from the blister from the 1st to the 5th day of menstruation. As a result of taking the first tablets from the package, your period may stop. This is not scary and is due to the effect of hormones on the body. During the first 14 days of taking the tablets, it is recommended to use additional funds contraception.

It is advisable to take the tablets at approximately the same hour every day.

It is advisable to take the tablets in the order indicated on the blister. But, if by mistake you start taking the tablets in the wrong order, then nothing bad will happen, since all Lindinet 20 tablets contain the same dose of hormones.

After you have taken 21 tablets, you should take a 7-day break, during which you do not need to take any tablets. During this week's break, you may get your period.

During the 7-day break, you do not need to use additional contraception. This only applies if you start taking the pills again after the week-long break.

You should start taking the first tablet from the next blister on the 8th day after a seven-day break. It doesn’t matter whether your period has already started or ended.

When will the contraceptive effect of Lindinet 20 occur?

The reliable contraceptive effect of Lindinet 20 occurs after 14 days of taking the tablets. In the first 2 weeks of taking the first package of Lindinet 20, you must use additional contraception.

Do I need to use protection during a week-long break from Lindinet 20?

If you took the previous package of Lindinet 20 according to the rules and without omissions, then during the 7-day break you do not need to use additional contraception. Additional contraception is also not required at the beginning of the next pack.

How to switch to Lindinet 20 from other OK?

If the previous OC package contained 28 tablets, then the first Lindinet 20 tablet should be taken the next day after the end of the tablets from the previous package.

If the package of the previous OCs contained 21 tablets, then you can start taking the tablets the day after the end of the previous OCs, or on the 8th day after a 7-day break.

Additional contraception must be used for 14 days after starting Lindinet 20.

How to switch to Lindinet 20 from a vaginal ring or hormonal patch?

The first Lindinet 20 tablet should be taken on the day of removal of the vaginal ring or removal. You can also start taking birth control pills on the same day as the new patch or insert the vaginal ring again.

How to switch to Lindinet 20 from an intrauterine device (IUD)?

The first Lindinet 20 tablet should be taken on the day of removal intrauterine device. It is recommended to use additional contraception for another week after starting birth control pills to avoid unwanted pregnancy.

How to start taking Lindinet 20 after an abortion?

If you had an abortion early(up to 12 weeks of pregnancy), then the first Lindinet 20 tablet can be taken on the day of the abortion. If you want to start taking Lindinet 20 birth control pills not on the first day after an abortion, and you have already had unprotected sex, then you can start taking the pills only when you are sure that you are not pregnant.

If the abortion was performed at a pregnancy stage of more than 12 weeks, then the first Lindinet 20 tablet should be taken 21-28 days after the abortion procedure. To do this, you must be sure that you have not become pregnant again within the past month. If taking the pills is started later than the recommended period, then it is recommended to use additional contraception for another week after starting to take the pills.

How to start taking Lindinet 20 after childbirth?

You can start taking Lindinet 20 tablets 21-28 days after giving birth. If you had unprotected sex before starting to take birth control pills, you should not start taking Lindinet 20 until you are sure that you are not pregnant. If treatment is started later than the specified period (21-28 days), it is recommended to use additional contraception for 7 days after starting to take the pills.

Can I take Lindinet 20 if I am breastfeeding?

What to do if you miss a Lindinet 20 tablet?

If the delay in taking Novinet was less than 12 hours (that is, less than 36 hours have passed since taking the previous pill), then the contraceptive effect of the drug remains. Take the missed pill as quickly as possible. There is no need to use additional contraception.

If you are more than 12 hours late, the effectiveness of the pills is reduced. Your actions in this case depend on the number of the missed pill:

1 to 7 tablets: Take the missed tablet as soon as possible, even if you have to take 2 tablets at the same time. Use additional contraception (for example) for the next week to avoid unwanted pregnancy.
8 to 14 tablets: Take the missed tablet as soon as possible, even if you have to take 2 tablets at the same time. If you have not missed any appointments in the past week, you may not need to use additional contraception. Otherwise, it is recommended to take additional protection for another week after release to avoid unwanted pregnancy.
15 to 21 tablets: Take the missed Lindinet 20 tablet as soon as you remember, even if this means taking 2 tablets at the same time. Then continue taking the tablets as usual, and when you finish the pack, immediately start the next one. This way you skip the week between packs. If you took all Lindinet 20 tablets on time during the previous 7 days before the missed period, then there is no need for additional contraception. Otherwise, it is recommended to use additional contraception for 7 days after the missed date.

What should I do if I missed several Lindinet 20 tablets?

If you miss 2 Lindinet 20 tablets in a row, pay attention to which tablets you missed. If these are tablets for 1 or 2 weeks of use (from 1 to 14), then take 2 tablets as soon as you remember about the omission and 2 more tablets the next day. Then take one tablet per day as usual until the pack runs out. Use additional contraception for another 7 days after resuming taking the pills.

If you missed two tablets in a row in the 3rd week of taking it (from 15 to 21), then there are two options: 1. continue taking Lindinet 20, one tablet per day until the package runs out and then, without taking a 7-day break , start new packaging. At the same time, use additional contraception for another 7 days after the missed period.
2. throw away the current (unfinished) package and start taking a new package with the first tablet (one tablet per day, as usual). In this case, you need to use additional contraception for another 7 days after the missed date.

If you miss 3 Lindinet 20 tablets in a row, throw away the current pack of tablets and start a new pack with the first tablet. Use additional contraception for another 7 days. You will have an increased risk of pregnancy, so if your period does not come during the next break, contact your gynecologist.

If you are not sure what to do in your situation, use additional contraception until you talk to your doctor. In any case, if you miss two or more tablets, be sure to use additional protection (using condoms) for at least 7 days.

1-2 days after missing the pills, you may experience spotting or breakthrough bleeding, similar to your period. This is not dangerous and is associated with missing Lindinet 20. Continue taking the tablets according to the instructions and the discharge will stop.

How to delay menstruation with Lindinet 20?

If you need to delay your period, then after finishing one package of Lindinet 20, start a new blister the next day without taking a 7-day break. In this case, menstruation will be delayed by 2-4 weeks, but slight spotting may appear approximately in the middle of the next package.

Please note: you can postpone your periods only if you took Lindinet 20 at least one month before the postponed menstruation.

Bloody discharge when taking Lindinet 20

What reduces the contraceptive effect of Lindinet 20?

The contraceptive effect of Lindinet 20 can be reduced by vomiting, diarrhea, taking large doses of alcohol, or taking certain medications. Read more about this here:

What to do if you don’t have your period during a seven-day break from taking Lindinet 20?

What should I do if I become pregnant while taking Lindinet 20?

Taking Lindinet 20 before surgery

Taking Lindinet 20 should be stopped 4 weeks before the upcoming surgery. If the operation is urgent, tell your doctor that you are taking birth control pills.

2 weeks after you can walk independently after surgery, you can start taking Lindinet 20.

How often should you visit a gynecologist while taking Lindinet 20?

Once a year, even if nothing bothers you.

In this article you can find instructions for use medicinal product Lindinet 20 and 30. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Lindinet in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Lindinet analogues in the presence of existing structural analogues. Use of hormonal contraceptives for contraception in women, including during pregnancy and breastfeeding. Side effects(bleeding, pain).

Lindinet- monophasic oral contraceptive. Inhibits the secretion of gonadotropic hormones of the pituitary gland. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is ethinyl estradiol, a synthetic analogue of the follicular hormone estradiol, which participates together with the corpus luteum hormone in the regulation of the menstrual cycle. The gestagenic component is gestodene, a derivative of 19-nortestosterone, which is superior in strength and selectivity to not only the natural corpus luteum hormone progesterone, but also other synthetic gestagens (for example, levonorgestrel). Due to its high activity, gestodene is used in low dosages, in which it does not exhibit androgenic properties and has virtually no effect on lipid and carbohydrate metabolism.

The difference between Lindinet 20 and Lindinet 30

The main difference between both drugs lies in the different amounts of the component ethinyl estradiol; one type of drug contains 30 mcg, the other 20 mcg. Hence various names nevertheless similar drugs. Both drugs also contain gestodene in the amount of 75 mcg.

Pharmacokinetics

Gestoden

After oral administration, it is quickly and completely absorbed from the gastrointestinal tract. Bioavailability is about 99%. Gestodene is biotransformed in the liver. It is excreted only in the form of metabolites, 60% in urine, 40% in feces.

Ethinyl estradiol

After oral administration, ethinyl estradiol is absorbed quickly and almost completely. Ethinyl estradiol is excreted only in the form of metabolites, in a 2:3 ratio with urine and bile.

Indications

contraception.

Release forms

Film-coated tablets.

Instructions for use and dosage regimen

Prescribe 1 tablet per day for 21 days, if possible at the same time of day. After taking the last tablet from the package, take a 7-day break, during which withdrawal bleeding occurs. The next day after a 7-day break (i.e., 4 weeks after taking the first tablet, on the same day of the week), the drug is resumed.

The first tablet of Lindinet should be taken from the 1st to the 5th day of the menstrual cycle.

When switching to Lindinet from another combined oral contraceptive, the first Lindinet tablet should be taken after taking the last tablet from the package of another oral hormonal contraceptive, on the first day of withdrawal bleeding.

When switching to taking Lindinet from drugs containing only progestogen ("mini-pill", injections, implant), when taking the "mini-pill", taking Lindinet can be started on any day of the cycle; you can switch from using the implant to taking Lindinet on the day after removal of the implant, when using injections - the day before the last injection. In these cases, additional methods of contraception should be used in the first 7 days.

After an abortion in the 1st trimester of pregnancy, you can start taking Lindinet immediately after surgery. In this case, there is no need to use additional methods of contraception.

After childbirth or after an abortion in the 2nd trimester of pregnancy, taking the drug can be started on days 21-28. In these cases, additional methods of contraception must be used in the first 7 days. If you start taking the drug later, an additional barrier method of contraception should be used in the first 7 days. If sexual intercourse took place before starting contraception, pregnancy should be ruled out before starting the drug or the start of use should be delayed until the first menstruation.

If you miss a pill, take the missed pill as quickly as possible. If the interval in taking the pills is less than 12 hours, then the contraceptive effect of the drug is not reduced, and in this case there is no need to use an additional method of contraception. The remaining tablets should be taken at the usual time. If the interval is more than 12 hours, the contraceptive effect of the drug may be reduced. In such cases, you should not make up for the missed dose, continue taking the drug as usual, but in the next 7 days you must use an additional method of contraception. If there are less than 7 tablets left in the package, taking the drug from the next package should be started without interruption. In this case, withdrawal bleeding does not occur until the end of taking the drug from the second package, but spotting or breakthrough bleeding may occur.

If withdrawal bleeding does not occur after completing the drug from the second package, then pregnancy should be excluded before continuing to take the drug.

Side effect

Side effects requiring discontinuation of the drug:

arterial hypertension;
arterial and venous thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism);
arterial or venous thromboembolism of the hepatic, mesenteric, renal, retinal arteries and veins;
hearing loss due to otosclerosis;
hemolytic-uremic syndrome;
porphyria;
exacerbation of reactive systemic lupus erythematosus;
Sydenham's chorea (passing after discontinuation of the drug).

Other side effects (less severe):

acyclic bleeding/bloody discharge from the vagina;
amenorrhea after drug withdrawal;
change in the state of vaginal mucus;
development of inflammatory processes in the vagina;
candidiasis;
tension, pain, enlarged mammary glands;
galactorrhea;
epigastric pain;
nausea, vomiting;
Crohn's disease;
ulcerative colitis;
the occurrence or exacerbation of jaundice and/or itching associated with cholestasis;
liver adenoma;
erythema nodosum;
exudative erythema;
rash;
chloasma;
increased hair loss;
headache;
migraine;
mood lability;
depression;
hearing loss;
increased sensitivity of the cornea (when wearing contact lenses);
fluid retention in the body;
change (increase) in body weight;
decreased tolerance to carbohydrates;
hyperglycemia;
allergic reactions.

Contraindications

the presence of severe and/or multiple risk factors for venous or arterial thrombosis (including complicated lesions of the heart valve apparatus, atrial fibrillation, cerebral or coronary artery disease, severe or moderate arterial hypertension with blood pressure ≥ 160/100 mm Hg .st.);
presence or indication in history of precursors of thrombosis (including transient ischemic attack, angina pectoris);
migraine with focal neurological symptoms, incl. in the anamnesis;
venous or arterial thrombosis/thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the leg, pulmonary embolism) currently or in history;
a history of venous thromboembolism;
surgery with prolonged immobilization;
diabetes mellitus (with angiopathy);
pancreatitis (including a history), accompanied by severe hypertriglyceridemia;
dyslipidemia;
severe liver diseases, cholestatic jaundice (including during pregnancy), hepatitis, incl. history (before normalization of functional and laboratory parameters and within 3 months after their normalization);
jaundice when taking GCS;
gallstone disease currently or in history;
Gilbert's syndrome, Dubin-Johnson syndrome, Rotor syndrome;
liver tumors (including history);
severe itching, otosclerosis or its progression during a previous pregnancy or taking corticosteroids;
hormone-dependent malignant neoplasms of the genital organs and mammary glands (including if they are suspected);
vaginal bleeding of unknown etiology;
smoking over the age of 35 (more than 15 cigarettes per day);
pregnancy or suspicion of it;
lactation period;
hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation.

The components of the drug are excreted in breast milk in small quantities.

When used during lactation, milk production may decrease.

special instructions

The drug is a reliable contraceptive: the Pearl index (an indicator of the number of pregnancies occurring during the use of a contraceptive method in 100 women over 1 year) when used correctly is about 0.05. Due to the fact that the contraceptive effect of the drug from the start of administration is fully manifested by the 14th day, in the first 2 weeks of taking the drug, it is recommended to additionally use non-hormonal methods of contraception.

diseases of the hemostatic system;
conditions/diseases predisposing to the development of cardiovascular and renal failure;
epilepsy;
migraine;
the risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;
diabetes mellitus not complicated by vascular disorders;
severe depression (if depression is associated with impaired tryptophan metabolism, then vitamin B6 can be used for correction);
sickle cell anemia, because in some cases (for example, infections, hypoxia), estrogen-containing drugs for this pathology can provoke thromboembolism;
the appearance of abnormalities in laboratory tests assessing liver function.

Thromboembolic diseases

The risk of arterial or venous thromboembolic disease increases:

with age;
when smoking (heavy smoking and age over 35 years are risk factors);
if there is a family history of thromboembolic diseases (for example, parents, brother or sister). If a genetic predisposition is suspected, it is necessary to consult a specialist before using the drug;
for obesity (body mass index more than 30 kg/m2);
with dislipoproteinemia;
with arterial hypertension;
for diseases of the heart valves complicated by hemodynamic disorders;
with atrial fibrillation;
with diabetes mellitus complicated by vascular lesions;
with prolonged immobilization, after major surgery, after surgery on the lower extremities, after severe trauma.

In these cases, it is assumed to temporarily stop using the drug (no later than 4 weeks before surgery, and resume no earlier than 2 weeks after remobilization).

Women after childbirth have an increased risk of venous thromboembolic disease.

It should be taken into account that resistance to activated protein C, hyperhomocysteinemia, protein C and S deficiency, antithrombin 3 deficiency, and the presence of antiphospholipid antibodies increase the risk of developing arterial or venous thromboembolic diseases.

sudden chest pain that radiates to the left arm;
sudden shortness of breath;
any unusually severe headache that continues for a long time or appears for the first time, especially when combined with sudden complete or partial loss of vision or diplopia, aphasia, dizziness, collapse, focal epilepsy, weakness or severe numbness of half the body, movement disorders, severe unilateral pain in the calf muscle, acute abdomen.

Tumor diseases

Chloasma

Chloasma can develop in women with a history of this disease during pregnancy. Those women who are at risk of developing chloasma should avoid contact with sunlight or ultraviolet radiation while taking Lindinet.

Efficiency

The effectiveness of the drug may be reduced in the following cases: missed pills, vomiting and diarrhea, simultaneous use of other drugs that reduce the effectiveness of birth control pills.

If the patient is simultaneously taking another drug that may reduce the effectiveness of birth control pills, additional methods of contraception should be used.

Changes in laboratory parameters

Additional Information

After acute viral hepatitis, the drug should be taken after normalization of liver function (no earlier than 6 months).

With diarrhea or intestinal disorders, vomiting, the contraceptive effect may be reduced. While continuing to take the drug, it is necessary to use additional non-hormonal methods of contraception.

The woman should be warned that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Impact on the ability to drive vehicles and operate machinery

No studies have been conducted to study the effect of Lindinet on the abilities necessary to drive a car or operate machinery.

Drug interactions

The contraceptive activity of Lindinet is reduced when taken simultaneously with ampicillin, tetracycline, rifampicin, barbiturates, primidone, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine. The contraceptive effect of oral contraceptives is reduced when these combinations are used, breakthrough bleeding and menstrual irregularities become more frequent. While taking Lindinet with the above drugs, as well as for 7 days after completing the course of taking them, it is necessary to use additional non-hormonal (condom, spermicidal gels) methods of contraception. When using rifampicin, additional methods of contraception should be used for 4 weeks after completion of the course of taking it.

When used simultaneously with Lindinet, any drug that increases gastrointestinal motility reduces the absorption of active substances and their level in the blood plasma.

Inducers of microsomal liver enzymes reduce the level of ethinyl estradiol in the blood plasma (rifampicin, barbiturates, phenylbutazone, phenytoin, griseofulvin, topiramate, hydantoin, felbamate, rifabutin, oscarbazepine). Liver enzyme inhibitors (itraconazole, fluconazole) increase the level of ethinyl estradiol in the blood plasma.

Some antibiotics (ampicillin, tetracycline), by interfering with the intrahepatic circulation of estrogens, reduce the level of ethinyl estradiol in plasma.

When Lindinet is used simultaneously with St. John's wort preparations (including infusion), the concentration of active substances in the blood decreases, which can lead to breakthrough bleeding and pregnancy. The reason for this is the inducing effect of St. John's wort on liver enzymes, which continues for another 2 weeks after completing the course of taking St. John's wort. It is not recommended to prescribe this combination of drugs.

Ritonavir reduces the AUC of ethinyl estradiol by 41%. In this regard, while using ritonavir, a hormonal contraceptive with a higher ethinyl estradiol content (Lindinet 30) should be used or additional non-hormonal methods of contraception should be used.

Analogues of the drug Lindinet

Structural analogues according to active substance:

Logest;
Mirelle;
Femoden.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.