Cilest. 21 tablets
CILEST is a low-dose combined oral hormonal contraceptive used to prevent pregnancy.
Each tablet contains two types of female hormones - norgestimate and ethinyl estradiol. CILEST prevents the release of an egg from your ovaries so you can not get pregnant. Furthermore, CILEST makes mucus (mucus) in your vagina more dense, making it difficult to penetrate the sperm into the uterus. The contraceptive effect begins after the first tablet approved.
2. What you need to know before taking CILEST
Do not take CILEST:
if you are allergic to norgestimate, ethinyl estradiol or any of the other ingredients of this medicine (listed in section 6).
You should not use CILEST tablets if you have, have had or develop any of the following:
a blood clot in a blood vessel of the leg (thrombosis), the lungs (pulmonary embolism) or other organs, or inflammation of the veins (thrombophlebitis);
heart attack or stroke;
disease, which may be an indication of a heart attack in the future (eg, angina pectoris, which causes severe chest pain) or stroke (for example, spent a "mini stroke" without consequences or transient ischemic attack (TIA);
migraine with aura (ie. focal neurological symptoms);
disease in your family, which affects the clotting of your blood;
damaged heart valve with complications;
consistently high blood pressure (160/100 mmHg or more);
diabetes, affect the blood vessels;
disease that increases the risk of blood clots (thrombosis), as major surgery, any surgery on your legs, severe trauma or prolonged bed rest in bed;
severe liver disease if liver function have not recovered to the normal range;
liver tumors (benign or malignant);
diagnosed or suspected cancer of the breast or genital organs;
abnormal increase of the inner layer of the uterus (endometrial hyperplasia);
unexplained bleeding from the vagina;
jaundice associated with pregnancy or previous use of hormonal contraceptives.
CILEST Do not take if you are:
pregnant or think you may be pregnant;
Tell your doctor, pharmacist or nurse before you start taking CILEST tablets and let them know if any of the following apply to you because he / she must clarify whether you take oral contraceptives and may impose more frequent examinations during the use of CILEST tablets.
Check with your doctor if any of the following applies to you or the following conditions occur or worsen:
If you suffer from valvular heart disease (uncomplicated) or cardiac arrhythmias;
If you suffer from vasculitis (superficial phlebitis);
If you suffer from varicose veins;
if your parents or one of your brothers / sisters have a history of blood clots, heart attack or stroke;
if you are a smoker (especially if you are older than 35 years);
if you have diabetes;
if you are overweight;
if you have high blood pressure (> 140/90) or your blood pressure rises;
If you suffer from migraine;
if you suffer from epilepsy;
if you, your parents or brothers / sisters have a history of high levels of lipids (cholesterol, triglycerides) in the blood;
if you have problems with your liver or gallbladder disease;
If you suffer from Crohn's disease or ulcerative colitis (chronic inflammatory bowel disease);
if you have or have had chloasma (yellowish-brown areas of skin pigmentation in pregnancy, especially in the face). If this happens, avoid exposure to sunlight and UV rays;
if you have a bleeding disorder (such as protein C deficiency).
If any of these conditions occur or worsen during use of CILEST, you should seek advice of physician.
Stop using CILEST tablets immediately and contact a doctor if you develop any of the following symptoms of angioedema:
swelling of the face, tongue or throat;
difficulty in swallowing;
hives or difficulty breathing.
CILEST tablets and venous and arterial clots
The case of formation of blood clots are rare and may occur regardless of the use of combined oral contraceptives. Yet the risk is greater in women taking combined oral contraceptive. The risk of developing thrombosis is higher during pregnancy than in the use of combined oral contraceptives.
If a vein in the leg is formed clot (deep vein thrombosis or DVT) and move to the bloodstream to the lungs, it can cause chest pain, shortness of breath, and in rare cases can lead to permanent disability or even cause death . This is called "pulmonary embolism" and is very rare.
The way CILEST influences the risk of thromboembolism as compared to other oral contraceptives, is not known.
The risk of clots in a vein in users combined oral contraceptives increases:
with increasing age;
if someone in your immediate family ever had a blood clot in the leg, lung (pulmonary embolism) or other authority;
if you are overweight;
if you have had surgery if you have severe trauma or prolonged bed rest in bed. Tell your doctor that you are taking CILEST tablets as you may need to stop using birth control pills. In elective surgery is recommended to stop taking oral contraceptives for at least four weeks before surgery and not recovering taken two weeks after the end of the recovery period.
In rare instances, the blood clot could be formed in the artery (arterial thrombosis), for example in the heart (heart attack) or the brain (stroke). In very rare cases, a blood clot can form in the liver, gut, kidney or eye.
The risk of blood clots in the arteries when taking the combined oral contraceptives increases:
with increasing age;
if you smoke. You are strictly advised to stop smoking when taking CILEST, especially if you are older than 35 years;
if you have elevated levels of fat in the blood (cholesterol or triglycerides);
if you are overweight;
if you have high blood pressure;
if you have heart problems (valvular disorders or abnormal heart rhythm called atrial fibrillation);
if someone in your immediate family ever had a heart attack or stroke.
If you suspect thrombosis or thromboembolism, immediately contact a doctor and stop using the contraceptive pill. Symptoms of venous or arterial thrombosis can include:
sudden swelling, redness or pain in the leg;
sudden severe pain in the chest that can unfold or to the left arm;
sudden shortness of breath;
sudden fit of coughing;
unusual, severe, prolonged headache or worsening of migraine;
any sudden vision changes (such as partial or complete loss of vision, blurred vision or double vision);
difficult or slurred speech;
seizures, which may be associated with seizures;
weak or strong belief that suddenly appear on one side or one part of the body;
acute abdominal pain.
Pill and cancer
The risk of breast cancer is generally increases with age. The risk of breast cancer is somewhat higher with the use of oral contraceptives. Compared with the risk of breast cancer at some time in life, the increased risk associated with use of oral contraceptives is low. Excess risk of breast cancer decreases gradually over a period of 10 years after the use of oral contraceptives. Diagnosing breast cancer in women taking oral contraceptives, it is at a more advanced stage than in women not using any.
In rare cases benign liver tumors and even more rarely, malignant liver tumors in women taking oral contraceptives. Tumors can cause life-threatening internal bleeding. If you experience sudden, severe abdominal pain, contact your doctor.
Prolonged use of oral contraceptives more frequently reported the occurrence of cancer of the cervix. This is not always due to the use of oral contraceptives may be associated with sexual behavior and other factors.
Bleeding between cycles
In the first few months after starting treatment with CILEST, you can get unexpected bleeding (outside the pause of 7 days). If bleeding continues for more than the first few months or starts after several months, your doctor should check whether there is something wrong.
If you take the tablets correctly, you do not vomit or have had severe diarrhea and have not taken any other medicines, it is very unlikely that you are pregnant. However, if your menstrual period is absent for two consecutive months, must be examined by a gynecologist to take a pregnancy test before you continue to take CILEST. If you forget to take your tablets, ask a health professional before the first absent menstrual cycle.
Blood levels of certain nutrients such as folic acid may be lower in women using oral contraceptives. This can be important for women who become pregnant shortly after discontinuation of oral contraceptives.
During pregnancy and during use of oral contraceptives may occur or worsen these conditions, but their relationship to the use of birth control pills is not confirmed:
jaundice and / or pruritus associated with biliary obstruction (cholestasis);
porphyria (increased secretion of pigment in the blood);
Systemic lupus erythematosus - type of connective tissue disease;
haemolytic uraemic syndrome - a disease of the blood, which damages the kidneys;
gestational herpes (a rare skin disease that occurs during pregnancy);
otosclerosis (a type of hearing loss).
Women who use oral contraceptives should undergo regular medical examinations. The frequency of inspections depends on the contraceptive potential risk impact of a condition or disease.
Like other contraceptives do not protect against CILEST HTV infection (AIDS) or other diseases transmitted sexually.
Other medicines and CILEST
Some other medicines may affect the efficacy of CILEST CILEST or may affect the effectiveness of other drugs.
Tell your doctor or pharmacist if you are taking, have recently taken or take any other medicines.
This is especially important if they include:
drugs against seizures (e. barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, topiramate and lamotrigine);
(Phos) aprepitant (medicine to treat nausea);
antifungals (e. griseofulvin, itraconazole, ketoconazole, voriconazole and fluconazole);
some antiretroviral drugs for the treatment of HTV / AIDS (ritonavir); some HTV protease inhibitors (e. atazanavir, indinavir, nelfinavir, ritonavir, ritonavir boosted protease inhibitors), some non-nucleoside reverse transcriptase inhibitors (e. etravirine, nevirapine);
drugs, prevention of high levels of blood fats (atorvastatin, rosuvastatin, clofibric acid);
medicines for pain relief (paracetamol, morphine, etorisoksib);
bosentan (medicine for the treatment of pulmonary hypertension);
modafinil (a drug for the treatment of excessive sleepiness);
ciclosporin (medicine to suppress the immune system to prevent graft rejection after transplantation);
omeprazole (a drug for the treatment of gastritis and acids);
rifabutin, rifampicin (medicines to treat tuberculosis);
prednisolone (anti-inflammatory drug);
theophylline (a drug for the treatment of asthma);
selegiline (a drug for the treatment of Parkinson's disease);
tizanidine (a medicine for the treatment of multiple sclerosis [MS]).
The use of activated charcoal or colesevelam may weaken the effect of contraceptive drugs.
You should also tell your doctor if you take herbal products containing St. John's wort (Hypericum perforatum), as it weakens the effect of contraceptive drugs.
CILEST with food and drink
Do not drink grapefruit juice while taking CILEST.
Pregnancy, lactation and fertility
If you are pregnant or breast-feeding, you may be pregnant or planning to become pregnant, ask your doctor or pharmacist before taking this medicine.
CILEST not use during pregnancy. If you become pregnant, stop using contraceptives and contact your doctor. Tell your doctor if you have used CILEST tablets during pregnancy.
It is possible to use CILEST during breastfeeding have an effect on the baby. Therefore you should not use CILEST during breastfeeding unless your doctor prescribes it explicitly. Nursing mothers should monitor the volume of milk as CILEST may reduce its quantity.
Driving and using machines
There are no known effects.
CILEST contains lactose monohydrate.
If your doctor has told you that you have an intolerance to some sugars, contact your doctor before taking CILEST.
3. How to take CILEST
Always take this medicine exactly as prescribed by your doctor or pharmacist. If you are not sure, ask your doctor or pharmacist.
The contraceptive effect begins after the first tablet approved. Each calendar pack contains 21 tablets.
First treatment cycle. Start taking the drug in the first day of your menstrual cycle. Return to taking one tablet a day (tablets should be taken in sequential order to be able to keep track of whether you take a tablet every day). The tablets should be taken at approximately the same time each day, for example evening.
When taken all the tablets from the container, is paused 7 days, during which menstruation usually occurs. Even in the absence of menstruation after the 7 day period without treatment, you must start a new cycle of treatment with new 21 tablets.
Second and subsequent cycles of therapy. Start the next treatment cycle / calendar pack on the same day of the week, as in the previous cycle. If after the second treatment cycle menstruation missing, contact your doctor.
Delay the menstrual cycle. After taking all the tablets from the pack, start a new pack for the required number of days. Then do the 7-day break, followed by a new pack of 21 tablets with a new starting day.
Breakthrough bleeding. In the event of breakthrough bleeding or spotting treatment should continue. This bleeding often disappear after a few cycles. If breakthrough bleeding persists, contact a doctor / health professional.
What should I do in case of vomiting or severe diarrhea? If vomiting occurs within 3 hours after taking the pill or in case of severe diarrhea lasting more than 24 hours, the effectiveness of contraception may not be adequate and you should use an additional non-hormonal method of contraception (eg condoms) for 7 days after recovery. If vomiting or diarrhea persist, you should contact your doctor or other healthcare professional.
If you take more than the amount of CILEST
If you take more than you should or if CILEST as a child accidentally swallows the medicine, call your doctor at a hospital in the center for emergency medical care or call. 112, to assess risks and to get instructions on how to take .
If you forget to take CILEST
Do not take a double dose to make up a single dose.
If you miss to take your tablet with less than 12 hours, contraceptive protection is not reduced. Take the missed tablet as soon as you remember and take further tablets at the usual time.
If you miss to take your tablet with more than 12 hours, contraceptive protection may be reduced. The more tablets you miss, the greater is the risk of reduced contraceptive effect. The risk of pregnancy is especially great if you miss a tablet at the beginning or end of a calendar pack. Therefore, we must do the following:
Missed more than 1 tablet calendar pack:
Check with your doctor.
1 tablet missed in week 1:
Take the missed tablet as soon as you remember, even if this means taking two tablets at the same time. Take the next tablet at the usual time and be sure to use an additional method of contraception (other than hormonal contraception such as a condom) for the next 7 days. If you had sexual intercourse in the past week, you may be pregnant and you should immediately contact your doctor.
1 tablet missed in week 2
Take the missed tablet as soon as you remember, even if this means taking two tablets at the same time. Take the next tablet at the usual time. If you take the tablets correctly in the 7 days preceding the forgotten tablet, contraceptive
effect of the tablets has not decreased and not having to use an additional contraceptive method.