Zhanin - instructions for use, reviews, analogs and forms of release (tablets and pills) of the contraceptive drug. Side effects (bleeding, pain) and pregnancy on the background of taking the medicine
In this article, you can read the instructions for using the contraceptive drug Janine. Comments of visitors of the site - consumers of this medicine, as well as opinions of doctors of specialists on the use of Zhanin in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Zhanin with available structural analogues. Use for contraception in healthy women. Side effects (bleeding, pain), as well as with pregnancy on the background of taking the drug.
Janine - low-dose monophasic oral combined estrogen-gestagen contraceptive drug.
The contraceptive effect of Jeanine is carried out by means of complementary mechanisms, the most important of which are suppression of ovulation and a change in the viscosity of cervical mucus, as a result of which it becomes impenetrable to spermatozoa.
When properly applied, the Perl index (the indicator reflecting the number of pregnancies in 100 women taking the contraceptive during the year) is less than 1. When missing tablets or improperly applied, the Pearl index may increase.
The gestagenic component of Jeanine - dienogest - has anti-androgenic activity, which is confirmed by the results of several clinical studies. In addition, dienogest improves the lipid profile of the blood (increases the number of high-density lipoproteins).
In women taking combined oral contraceptives, the menstrual cycle becomes more regular, less painful menstruation is observed, the intensity and duration of bleeding is reduced, resulting in a reduced risk of developing iron deficiency anemia.In addition, there is evidence of a reduced risk of developing endometrial cancer and ovarian cancer.
Pharmacokinetics
After ingestion, dienogest is quickly and completely absorbed from the digestive tract. Dienogest is almost completely metabolized. An insignificant part of the dienogest is excreted by the kidneys in the unmodified state. Metabolites are excreted in urine and bile in a ratio of about 3: 1.
After ingestion, ethinylestradiol is rapidly and completely absorbed. Unchanged from the body is not excreted. Metabolites of ethinyl estradiol are excreted in urine and bile in a ratio of 4: 6.
Indications for admission
- contraception.
Forms of release
Dragee 2 mg + 30 μg (in the form of tablets are not available).
Instructions for use and dosing regimen
Dragee should be taken orally in the order given on the package, every day at about the same time, with a small amount of water. Zhanin should take 1 tablet a day continuously for 21 days. The admission of each next package begins after a 7-day break, during which withdrawal bleeding (menstrual-like bleeding) is observed. It usually starts on the 2nd-3rd day after the last dragee has been taken and may not end before the start of the new package.
The beginning of reception of Zhanin
In the absence of taking any hormonal contraceptives in the previous month, the intake of Janine begins on the 1st day of the menstrual cycle (ie, on the 1st day of menstrual bleeding). It is allowed to start taking the menstrual cycle on the 2nd-5th day, but in this case it is recommended to use the barrier method of contraception during the first 7 days of taking the pills from the first package.
When switching from combined oral contraceptives, vaginal rings, transdermal patches, the administration of Jeanine should be started the day after the last active pills were taken from the previous package, but, in no case, no later than the next day after the usual 7-day break in admission (for preparations , containing 21 dragees) or after taking the last inactive dragee (for preparations containing 28 dragees in a package). When moving from the vaginal ring, the transdermal patch, it is preferable to start taking Jeanine on the day of removal of the ring or patch, but no later than the day when a new ring is to be inserted or a new patch is stuck.
When switching from contraceptives containing only gestagens ("mini-pili", injectable forms,implant) or with a gestagen releasing intrauterine contraceptive (Mirena), a woman can switch from a mini-drink to Jeanine any day (without interruption), from an implant or an intrauterine contraceptive with gestagen - on the day of removal, from an injection contraceptive - per day , when the next injection is to be made. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.
After an abortion in the first trimester of pregnancy, a 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 2nd 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 the reception is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman already had a sex life, pregnancy should be excluded before taking Jeanine or it is necessary to wait for the first menstruation.
Acceptance of missed pills
If the delay in taking the dragee is less than 12 hours, the contraceptive protection does not decrease.Missed pills woman should take as soon as possible, the next dragee is taken at the usual time.
If the delay in taking the dragee is more than 12 hours, the contraceptive protection may be reduced.
In this case, you can follow the following two basic rules:
- 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 reception of the dragees are required.
Accordingly, if the delay in the intake of active dragees was more than 12 hours (the interval from the moment of reception of the last active dragee is more than 36 hours), one can recommend the following:
The first week of taking the drug
It is necessary to take the last missed pills as soon as possible, as soon as a woman remembers this (even if you need to take two pills at the same time). The next dragee is taken at the usual time. In addition, 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 skipping the dragees, the probability of pregnancy should be taken into account.The more pills are missed, and the closer they are to the break in the intake of active substances, the greater the probability of pregnancy.
The second week of taking the drug
It is necessary to take the last missed pills as soon as possible, as soon as a woman remembers this (even if you need to take two pills at the same time). The next dragee is taken at the usual time. Provided that the woman took the dragee correctly for 7 days preceding the first missed pellet, there is no need to use additional contraceptive measures. Otherwise, as well as when two or more pills are missed, barrier methods of contraception (for example, a condom) should be used additionally within 7 days.
The third week of taking the drug
The risk of pregnancy is increased because of the upcoming interruption in taking pills. A woman should strictly adhere to one of the following two options. If, during the 7 days preceding the first missed pellet, all pills were taken correctly, there is no need to use additional contraceptive methods.
- It is necessary to take the last missed pills as soon as possible, as soon as a woman remembers this (even if you need to take two pills at the same time).The next dragee is taken at the usual time, until the dragee runs out of the current packaging. The next package should be started immediately without interruption. Withdrawal bleeding is unlikely until the end of the second pack, but may occur spotting and breakthrough bleeding during the tablet-taking.
- A woman can also interrupt the taking of a dragee from the current package. Then, she should take a break for 7 days, including the day of skipping the dragees and then start taking a new package.
If a woman missed taking the pills, and then during a break in admission she does not have a withdrawal bleeding, it is necessary to exclude pregnancy.
Recommendations in case of vomiting and diarrhea
If a woman has vomiting or diarrhea within up to 4 hours after taking active dragees, absorption may not be complete and additional contraceptive measures should be taken. In these cases, you should focus on recommendations when skipping the dragee.
Changing the day of the beginning of the menstrual cycle
To delay the onset of menstruation, a woman should continue taking the pills from a new package of Jeanine immediately after all the pills are taken from the previous one, without taking a break.Dragee from this new package can be taken for as long as the woman wishes (until the packaging is finished). Against the background of taking the drug from the second package, a woman may have spotting or breakthrough uterine bleeding. Renew the reception of Jeanine from the new package follows the usual 7-day break.
To postpone the day of the onset of menstruation on the next day of the week, the woman should shorten the nearest break in taking the dragees for as many days as she wants. The shorter the interval, the higher the risk that it will not have withdrawal bleeding, and thereafter will be spotting spot bleeding and breakthrough bleeding during the second package (just like when it wants to delay the onset of menstruation).
Additional information for specific patient categories
For children and adolescents, the drug Jeanine is shown only after the onset of menarche.
After the onset of menopause, the preparation Jeanine is not shown.
The drug Jeanine is contraindicated in women with severe liver disease, until the liver function indicators are normalized.
Side effects
- vaginitis;
- salpingoophoritis (adnexitis);
- urinary tract infections;
- cystitis;
- mastitis;
- cervicitis;
- fungal infections;
- candidiasis;
- herpetic damage to the oral cavity;
- viral infections;
- uterine myoma;
- anorexia;
- anemia;
- gastritis;
- enteritis;
- dyspepsia;
- eczema;
- psoriasis;
- hyperhidrosis;
- myalgia;
- pain in the limbs;
- dysplasia of the cervix;
- cysts of the uterine appendages;
- pain in the appendages of the uterus;
- pain in the chest;
- peripheral edema;
- influenza-like symptoms;
- fatigue;
- asthenia;
- bad feeling;
- headache;
- dizziness;
- migraine.
Contraindications
Janine should not be used in the presence of any of the conditions / diseases listed below. If any of these conditions develop for the first time against the background of its administration, the drug should be immediately withdrawn.
- presence of thromboses (venous and arterial) at present or in the anamnesis (for example, deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders);
- presence at present or in anamnesis of conditions preceding thrombosis (eg, transient ischemic attacks, angina pectoris);
- diabetes mellitus with vascular complications;
- present or previous history of migraine with focal neurological symptoms;
- presence of severe or multiple risk factors for venous or arterial thrombosis (including complicated heart valve disease, atrial fibrillation, cerebral vascular disease or coronary arteries of the heart, uncontrolled hypertension, serious surgical intervention with prolonged immobilization, smoking over the age of 35 years);
- liver failure and severe liver disease (before normalization of liver tests);
- presence at present or in anamnesis of pancreatitis with severe hypertriglyceridemia;
- the presence, at present or in the anamnesis, of benign or malignant liver tumors;
- identified hormone-dependent malignant diseases of genital organs or mammary glands or suspected of them;
- vaginal bleeding of unknown origin;
- pregnancy or suspected of it;
- the period of breastfeeding;
- hypersensitivity to the components of the drug.
Application in pregnancy and lactation
Janine is not prescribed during pregnancy and during breastfeeding.
If the pregnancy is detected during the reception of Jeanine, the drug should be immediately canceled. However, extensive epidemiological studies have not revealed an increased risk of developmental defects in children born to women who received sex hormones before pregnancy or teratogenicity when sex hormones were mistaken for early pregnancy.
Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is contraindicated in lactation. A small amount of sex steroids and / or their metabolites can be excreted with milk.
special instructions
Before starting or resuming the use of the drug, it is necessary to familiarize yourself with the history of life, the family history of the woman, to conduct a thorough medical examination (including measurement of blood pressure, heart rate, body mass index) and gynecological examination, including breast examination and cytology of cervical scraping Pap test), to exclude pregnancy.The volume of additional studies and the frequency of follow-up visits are determined individually. Usually, follow-up examinations should be conducted at least once a year.
A woman should be informed that Janine does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
In women with hypertriglyceridemia (or the presence of this condition in a family history), an increased risk of developing pancreatitis while taking combined oral contraceptives.
Although a small increase in blood pressure has been reported in many women taking combined oral contraceptives, clinically relevant increases have been rare. Nevertheless, if a persistent, clinically significant increase in blood pressure develops during the intake of combined oral contraceptives, these drugs should be discontinued and the treatment of hypertension should begin. Reception of combined oral contraceptives can be continued if normal blood pressure values are achieved with the help of antihypertensive therapy.
Although combined oral contraceptives may affect 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 μg ethinylestradiol). Nevertheless, women with diabetes should be carefully observed during the intake of combined oral contraceptives.
The effectiveness of combined oral contraceptive drugs can be reduced by missing dragees, with vomiting and diarrhea, or as a result of drug interactions.
Effects on the menstrual cycle
On the background of taking combined oral contraceptives, irregular bleeding (spotting bleeding or breakthrough bleeding) can 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, a thorough examination should be conducted to exclude malignant neoplasms or pregnancy.
Some women during the break in taking a dragee may not develop withdrawal bleeding. If combined oral contraceptives are taken as directed, it is unlikely that a woman is pregnant. However, if previously combined oral contraceptives were not taken regularly or if there are no consecutive two bleeding cancellations, pregnancy should be excluded before continuing with the drug.
Impact on laboratory test scores
Admission of combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal, transport protein levels in the plasma, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond the limits of normal values.
Impact on the ability to drive vehicles and manage mechanisms
Not found.
Drug Interactions
The interaction of oral contraceptives with other drugs can lead to breakthrough bleeding and / or a decrease in contraceptive reliability.
According to separate studies, some antibiotics (for example, penicillins and tetracycline) can reduce the intestinal hepatic circulation of estrogens, thereby lowering the concentration of ethinylestradiol.
During the intake of any of the above medicines, a woman should additionally use the barrier method of contraception (for example, a condom).
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, can increase plasma dienogest levels.
During the reception of antibiotics (with the exception of rifampicin and griseofulvin) and within 7 days after their withdrawal, the barrier method of contraception should be used additionally. If the period of use of the barrier method of protection ends later than the dragee in the package, you need to go to the next packing of Zhanin without the usual break in taking the pills.
Oral combined contraceptives may affect the metabolism of other drugs, leading to an increase (eg, cyclosporine) or a decrease (for example, lamotrigine) in their concentrations in plasma and tissues.
Analogues of the drug Jeanine
Structural analogs for the active substance:
- Silhouettes
Similar medicines:
Other medicines:
- Evra - instructions for use, reviews, analogs and form of contraceptive patch of a contraceptive in adults and during pregnancy (consequences of use)
- Glycine - instructions for use, reviews, analogs and formulations (100 mg tablets, fort fortification 600 mg) for the treatment of stroke, neurosis, encephalopathy in adults, children (including newborns) and pregnancy
- Botox - instructions for use, analogs, testimonials and release forms (injections in the form of lyophilizate) anti-wrinkle and cramps of the lips, forehead and other parts of the face.Pros and cons of drug administration in adults, as well as in pregnancy