Jess - instructions for use, analogues, reviews of hormonal contraceptive pills for contraception in women. Consequences of pregnancy and lactation. Side effects (bleeding, headache) and drug withdrawal

In this article, you can read the instructions for using the drug Jess. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Jess in their practice. 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 Jess in the presence of existing structural analogues.Use of hormonal contraceptive pills for contraception in women, including during pregnancy and lactation. Side effects (bleeding, headache), withdrawal and use in children and adolescents.

Jess - monophasic oral contraceptive with antimineralocorticoid and antiandrogenic properties.

The contraceptive effect of combined oral contraceptives is based on the interaction of various factors, the most important of which are suppression of ovulation and a change in the properties of the cervical secret, as a result of which it becomes impermeable to spermatozoa.

When used correctly, Perl's index (the number of pregnancies per 100 women per year) is less than 1. When missing tablets or improperly used, the Pearl index may increase.

AT composition of the preparation include ethinyl estradiol (in the form of betadecase clathrate) and drospirenone.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, less painful menstruation is observed less often, the intensity of bleeding decreases, which reduces the risk of anemia.In addition, according to epidemiological studies, the use of combined oral contraceptives reduces the risk of developing endometrial cancer and ovarian cancer.

Drospirenone, contained in the preparation of Jess, has an antimineralocorticoid action. Prevents weight gain and the appearance of edema associated with estrogen-induced fluid retention, which ensures very good tolerability of the drug. Drospirenone has a positive effect on premenstrual syndrome (PMS). Clinical efficacy of Jess in alleviating the symptoms of severe PMS such as severe psychoemotional disorders, breast engorgement, headache, muscle and joint pain, weight gain and other symptoms associated with the menstrual cycle is shown.

Drospirenone also has anti-androgenic activity and helps to reduce acne, fat content of the skin and hair. This action of drospirenone is similar to the action of natural progesterone, produced by the body.

Drospirenone does not have androgenic, estrogenic, glucocorticoid and antiglucocorticoid activity.All this in combination with antimineralocorticoid and antiandrogenic action provides drospirenone biochemical and pharmacological profile, similar to natural progesterone.

In combination with ethinyl estradiol, drospirenone shows a beneficial effect on the lipid profile, characterized by an increase in HDL.

Pharmacokinetics

Drospirenone

When ingested drospirenone quickly and almost completely absorbed. In unmodified form, drospirenone is excreted only in trace amounts. Metabolites of drospirenone are excreted with feces and urine in a ratio of approximately 1.2: 1.4.

Ethinylestradiol

After ingestion, ethinylestradiol is rapidly and completely absorbed. Concomitant ingestion reduces the bioavailability of ethinylestradiol in about 25% of those surveyed, while in other subjects no similar changes were noted. Ethinyl estradiol is not practically excreted unchanged. Metabolites of ethinyl estradiol are excreted in urine and bile in a ratio of 4: 6.

Indications

• contraception;
• treatment of a moderate form of acne (acne vulgaris);
• treatment of severe premenstrual syndrome.

Forms of release

Tablets (28 tablets per package).

Jess Plus - tablets, film-coated 3 mg + 0.03 mg + 0.451 mg (contains addition Calcium levomefolinate).

Instructions for use and reception scheme

Tablets should be taken in the order indicated on the package, every day at approximately the same time, with a small amount of water. Tablets are taken without interruption in admission. You should take 1 tablet a day consecutively for 28 days. Each subsequent package should be started the day after the last tablet from the previous package was taken.

Bleeding cancellation, as a rule, begins on the 2-3rd day after the start of taking inactive tablets and may not yet be completed before the start of the next package.

Initiation of the drug

In the absence of taking any hormonal contraceptives in the previous month

The drug is taken 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 tablets from the first package.

When switching from other combined oral contraceptives, vaginal rings or contraceptive patches

It is preferable to start taking the drug the next day after taking the last active tablet from the previous package, but in no case later than the day after the usual 7-day break (for preparations containing 21 tablets) or after taking the last inactive tablet (for preparations containing 28 tablets in a package). The preparation of Jess should be started on the day of removal of the vaginal ring or plaster, but no later than the day when a new ring is to be inserted or a new adhesive is stuck.

When switching from contraceptives containing only gestagens ("mini-pili", injectable forms, implant), or with the progestogen-releasing progestogen (Mirena)

A woman can switch from taking a mini-drink to Jace any day (without interruption), from an implant or an intrauterine contraceptive with gestagen - on the day of removal, from an injection contraceptive - the day the next injection is to be made. In all cases, it is necessary to use an additional barrier method of contraception during the first 7days of taking the tablets.

After abortion in 1 trimester of pregnancy

A woman can start taking the drug immediately. If this condition is met, the woman does not need additional contraceptive measures.

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 2nd 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 tablets. However, if a woman has already lived a sexual life, pregnancy should be excluded before the beginning of Jess's reception or it is necessary to wait for the first menstruation.

Acceptance of missed tablets

Skipping inactive tablets can be ignored. Nevertheless, they should be thrown away, so as not to accidentally prolong the period of taking inactive tablets. The following recommendations apply only to the omission of active tablets.

If the delay in taking the drug is less than 12 hours, the contraceptive protection is not reduced. A woman should take the missed tablet as soon as possible, and the next take at the usual time.

If the delay in taking the tablets is more than 12 hours, the contraceptive protection can be reduced.The more pills are missed and the closer the skipping of tablets to the phase of taking inactive tablets, the higher the probability of pregnancy.

In this case, you can follow the following two basic rules:

1. taking the drug should never be interrupted for more than 4 days;

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

Accordingly, if the delay in taking active tablets is more than 12 hours (the interval from the time of taking the last active tablet is more than 36 hours), you can recommend the following:

From the 1st to the 7th day

A woman should take the last missed pill right away, as soon as she remembers it, even if it means taking two pills at the same time. The following tablets she continues to take at the usual time. In addition, during the next 7 days, the barrier method of contraception (for example, a condom) needs to be additionally used. If sexual intercourse has occurred within 7 days before passing the pill, you should consider the possibility of pregnancy.

From the 8th to the 14th day

A woman should take the last missed pill right away, as soon as she remembers it, even if it means taking two pills at the same time.The following tablets she continues to take at the usual time.

Provided that the woman took the tablets correctly for 7 days preceding the first missed tablet, there is no need for additional contraceptive measures. Otherwise, as well as when two or more tablets are missed, barrier methods of contraception (for example, a condom) should be used additionally within 7 days.

From the 15th to the 24th day

The risk of a decrease in reliability is inevitable due to the approaching phase of taking inactive tablets. A woman should strictly adhere to one of the following two options. If, during the 7 days preceding the first missed tablet, all the pills were taken correctly, there is no need to use additional contraceptive methods. Otherwise it is necessary to use the first of the following schemes and additionally use the barrier method of contraception (for example, a condom) for 7 days.

1. The woman should take the last missed tablet as soon as possible, as soon as she remembers (even if it means taking two tablets at the same time).The following tablets are taken at the usual time, until the active tablets in the package run out. Four inactive tablets should be discarded and immediately begin taking the tablets from the next package. Bleeding cancellation is unlikely until the active pills in the second package run out, but there may be spotting and breakthrough bleeding during taking the tablets.

2. A woman can also interrupt the taking of tablets from the current package. Then she should take a break no more than 4 days, including the days of skipping the tablets, and then start taking the drug from the new package.

If a woman misses active pills and no withdrawal bleeding occurs while taking inactive tablets, it is necessary to exclude pregnancy.

Recommendations for gastrointestinal disorders

In severe gastrointestinal disorders, absorption may be incomplete, therefore additional contraceptive measures should be taken.

If vomiting occurs within 4 hours after taking an active pill, recommendations should be followed when skipping tablets. If a woman does not want to change her usual schedule of taking and transfer the onset of menstruation on another day of the week, an additional active pill should be taken from another package.

How to change menstrual cycles or how to delay the onset of menstruation

To delay the onset of menstruation, a woman should continue taking the tablets from the next package of Jess, skipping the inactive tablets from the current package. Thus, the cycle can be extended, if desired, for any period, until the active tablets from the second package run out. Against the background of taking the drug from the second package, a woman may have spotting or breakthrough uterine bleeding. Regular reception of Jess is then resumed after the end of the phase of taking inactive tablets.

To postpone the onset of menstruation on another day of the week, the woman should shorten the next phase of taking inactive tablets for the desired number of days. The shorter the interval, the higher the risk that it will not have withdrawal bleeding, and thereafter will be spotting and breakthrough bleeding during the second package.

Additional information for specific patient categories

Children and adolescents Jace drug is shown only after the onset of menarche.

After the onset of menopause, Jess is not shown.

Side effect

The following most common adverse reactions are reported in women who use Jes as indicated by "Contraception" and "Contraception and treatment of a moderate form of acne vulgaris": nausea, mammary gland pain, irregular uterine bleeding, bleeding from the genital tract, unspecified genesis. These adverse reactions occurred in more than 3% of women. In patients using Jess as indicated by "Contraception and treatment of severe premenstrual syndrome", the following most common adverse reactions (more than 10% of women) were reported: nausea, mammary gland pain, irregular uterine bleeding.

Severe adverse reactions are arterial and venous thromboembolism.

Also note:

• migraine (headache);
• mood swings, depression / depressed mood;
• decrease or absence of libido;
• venous or arterial thromboembolism;
• nausea;
• pain in the mammary glands;
• irregular uterine bleeding;
• bleeding from the genital tract, unspecified genesis.

The following are adverse reactions with a very rare incidence, which are believed to be associated with the administration of drugs from the group of oral combination drugs.

Tumors

• the frequency of diagnosing breast cancer in women taking combined oral contraceptives is slightly increased. Due to the fact that breast cancer is rarely seen in women under 40, the increase in the number of diagnoses of breast cancer in women taking combined oral contraceptives is insignificant in relation to the overall risk of this disease;
• liver tumors (benign and malignant).

Other states

• erythema nodosum;
• hypertension;
• conditions developing or worsening during the administration of combined oral contraceptives, but their relationship has not been proven: jaundice and / or pruritus associated with cholestasis, gallstones, porphyria, systemic lupus erythematosus, hemolytic uremic syndrome, Sydenham's chorea, hearing loss associated with otosclerosis;
• in women with hereditary angioedema, estrogen use may cause or aggravate its symptoms;
• impaired liver function;
• changes in glucose tolerance or effects on insulin resistance;
• Crohn's disease, nonspecific ulcerative colitis;
• Chloasma;
• Hypersensitivity (including symptoms such as rash, hives).

Contraindications

The Jace drug should not be used in the presence of any of the conditions listed below. If any of these conditions develop for the first time against the background of the drug, the drug should be immediately withdrawn:

• thromboses (venous and arterial) and thromboembolism at present or in the anamnesis (including deep vein thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular disorders;
• conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at present or in the anamnesis;
• Migraine with focal neurologic symptoms at present or in the anamnesis;
• diabetes mellitus with vascular complications;
• multiple or expressed risk factors for venous or arterial thrombosis (including complicated heart valve disease, atrial fibrillation, cerebrovascular or coronary artery disease, uncontrolled arterial hypertension, serious surgery with prolonged immobilization, smoking over the age of 35) ;
• Pancreatitis with severe hypertriglyceridemia at present or in the anamnesis;
• hepatic insufficiency and severe liver disease (until liver tests are normalized);
• liver tumors (benign or malignant) at present or in the anamnesis;
• severe renal failure, acute renal failure;
• adrenal insufficiency;
• identified hormone-dependent malignant diseases (including genitals or mammary glands) or suspected of them;
• vaginal bleeding of unknown origin;
• pregnancy or suspected of it;
• the period of breastfeeding;
• hypersensitivity to any of the components of the preparation Jess.

Application in pregnancy and lactation

Jess is not prescribed during pregnancy and during breastfeeding.

If pregnancy is detected during the administration of the drug Jess, the drug should be immediately canceled. However, extensive epidemiological studies have not revealed any increased risk of developmental defects in children born to women who have received sex steroids (including combined oral contraceptives) prior to pregnancy or teratogenicity,when sex steroids were taken inadvertently in the early stages of pregnancy.

Existing data on the results of taking Jess during pregnancy are limited, which does not allow us to draw any conclusions about the effect of the drug on the course of pregnancy, the health of the newborn and the fetus. There are no significant epidemiological data on the Jess drug at present.

Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is not recommended until the end of breastfeeding. A small amount of sex steroids and / or their metabolites can be excreted in breast milk.

special instructions

If any of the conditions / risk factors listed below are currently available, the potential risk and expected benefit of using combined oral contraceptives in each individual case should be weighed carefully and discussed with the woman before she decides to start taking the drug. In case of weighting, strengthening or the first manifestation of any of these conditions or risk factors, a woman should consult her doctor,who can decide whether to cancel the drug.

Diseases of the cardiovascular system

The results of epidemiological studies indicate the existence of a relationship between the use of combined oral contraceptives and an increase in the incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disease) with combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is maximal in the first year of taking such drugs. An increased risk is present after the initial use of oral contraceptives or the resumption of the use of the same or different combined oral contraceptives (after a break between doses of 4 weeks or more). Data from a large prospective study with 3 groups of patients show that this increased risk is present mainly during the first 3 months.

The overall risk of VTE in patients,(<50 mcg ethinylestradiol) are 2-3 times higher than in non-pregnant patients who do not take combined oral contraceptives, however, this risk remains lower compared to the risk of VTE during pregnancy and childbirth. VTE may be life threatening or fatal (in 1-2% of cases).

VTE, manifested as deep vein thrombosis, or pulmonary embolism, can occur when using any combination oral contraceptives.

Very rarely, when combined oral contraceptives are used, thrombosis of other blood vessels arises, for example, liver, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus on the relationship between the onset of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along the vein on the leg, pain or discomfort in the leg only in the vertical position or walking, local fever in the affected leg, redness or discoloration of the skin on the leg.

Symptoms of thromboembolism of the pulmonary artery (PE) are as follows: shortness of breath or rapid breathing; sudden cough, incl. with hemoptysis; acute pain in the chest, which can increase with a deep breath; sense of anxiety; severe dizziness; rapid or irregular heartbeat. Some of these symptoms (eg, dyspnea, cough) are nonspecific and may be misinterpreted as symptoms of other more or less severe events (eg, respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion or myocardial infarction. Symptoms of stroke: sudden weakness or loss of sensitivity of the face, hands or feet, especially on one side of the body, sudden confusion, problems with speech and understanding; sudden one- or two-sided loss of vision; sudden gait disturbance, dizziness, loss of balance or coordination of movements; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, puffiness and weak blueing of the extremities, sharp abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of constriction or raspiraniya in the chest, in the hand or behind the breastbone; discomfort with irradiation in the back, cheekbone, larynx, hand, stomach; cold sweats, nausea, vomiting or dizziness, severe weakness, anxiety, or shortness of breath; rapid or irregular heartbeat.

Arterial thromboembolism can be life threatening or fatal.

The risk of developing thrombosis (venous and / or arterial) and thromboembolism increases:

• with age;
• smokers (with the increase in the number of cigarettes or an increase in the age of the risk increases, especially in women older than 35 years);
• with obesity (body mass index more than 30 kg / m2);
• in the presence of a family history (for example, venous or arterial thromboembolism ever at close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, a woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
• with prolonged immobilization, serious surgical intervention, any foot surgery or extensive trauma.In these situations, it is desirable to discontinue the use of combined oral contraceptives (in case the intended operation of at least four weeks prior to it) and not to resume reception within two weeks after immobilization;
• with dyslipoproteinemia;
• with arterial hypertension;
• with migraine;
• with diseases of the valvular heart;
• with atrial fibrillation.

The increase in frequency and severity of migraine during use of combined oral contraceptives (which may be preceded by cerebrovascular disorders) can be grounds for immediate discontinuation of these drugs.

By biochemical parameters indicating the inherited or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, lack of antithrombin III, protein C deficiency, protein deficit S, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

When assessing the risk-benefit ratio, it should be borne in mind that adequate treatment of the relevant condition can reduce the risk of thrombosis associated with it.It should also be taken into account that the risk of thrombosis and thromboembolism in pregnancy is higher than when taking low-dose oral contraceptives (<50 mcg ethinyl estradiol).

Tumors

The most significant risk factor for developing cervical cancer is persistent papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. The connection with the use of combined oral contraceptives has not been proven. There are contradictions as to the extent to which these findings are associated with screening for cervical pathology or with peculiarities of sexual behavior (more rare use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies has shown that there is a slightly increased relative risk of developing breast cancer diagnosed in women taking combined oral contraceptives now (relative risk 1.24). The increased risk gradually disappears within 10 years after discontinuation of these medications.Due to the fact that breast cancer is rarely seen in women under 40 years of age, the increase in the number of diagnoses of breast cancer in women taking combined oral contraceptives now or recently, is insignificant in relation to the overall risk of this disease. The observed increase in risk may be the result of an earlier diagnosis of breast cancer in women using combined oral contraceptives, the biological effect of oral contraceptives, or a combination of both. Women who use combined oral contraceptives have clinically less advanced breast cancer than women who have never used them.

In rare cases, against the background of combined oral contraceptives, the development of benign, and extremely rare, malignant liver tumors, which in some cases led to life-threatening intraabdominal hemorrhage. In the event of severe pain in the abdominal region, enlarged liver, or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis.

Tumors can endanger life or lead to death.

Other states

Clinical studies have shown no effect of drospirenone on potassium concentration in blood serum in patients with mild and moderate renal insufficiency. There is a theoretical risk of developing hyperkalemia in patients with impaired renal function with an initial concentration of potassium on IGN, concurrently taking medications leading to a delay in potassium in the body. Nevertheless, in women with an increased risk of developing hyperkalemia, it is recommended to determine the concentration of potassium in the plasma during the first cycle of taking Jess.

Women with hypertriglyceridemia (or having this condition in a family history) may have 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.

The following conditions have been reported to develop or worsen, both during pregnancy and when taking combined oral contraceptives, but their association with combined oral contraceptives has not been proven: jaundice and / or pruritus associated with cholestasis; formation of stones in the gallbladder; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea; herpes pregnant; hearing loss associated with otosclerosis. Also, cases of Crohn's disease and ulcerative colitis are described in combination with combined oral contraceptives.

In women with hereditary forms of angioedema, exogenous estrogens can cause or worsen symptoms of angioedema.

Acute or chronic liver dysfunction may require the cancellation of combined oral contraceptives until the liver function returns to normal.Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous reception of sex hormones, requires discontinuation of combined oral contraceptives.

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 (<50 μg ethinyl estradiol). Nevertheless, women with diabetes should be carefully observed during the intake of combined oral contraceptives.

Sometimes chloasma can develop, especially in women with a history of pregnancy chloasma. Women with a tendency to chloasma when taking combined oral contraceptives should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

Laboratory Tests

The use of combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal, transport protein levels in plasma,parameters of carbohydrate metabolism, parameters of coagulation and fibrinolysis. Changes usually do not go beyond the limits of normal values.

Drospirenone increases the activity of plasma renin and aldosterone, which is associated with its antimineralocorticoid effect.

Medical examinations

Before starting or resuming the use of JEs, you need to familiarize yourself with the history of life, the family history of the woman, conduct a thorough general medical (including measurement of blood pressure, heart rate, body mass index) and gynecological examination (including breast examination and cytology of cervical mucus), and 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 warned that combined oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Decreased efficiency

The effectiveness of combined oral contraceptive drugs can be reduced by missing tablets, with vomiting and diarrhea, or as a result of drug interactions.

Insufficient control of 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 may not develop withdrawal bleeding during a break in taking pills. 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 the ability to drive vehicles and manage mechanisms

Not found.

Drug Interactions

The interaction of oral contraceptives with other drugs (enzyme inducers, some antibiotics) can lead to breakthrough bleeding and / or a decrease in contraceptive reliability. Women taking these drugs should temporarily use barrier methods of contraception in addition to the Jas drug, or choose another method of contraception.

The use of drugs that induce microsomal enzymes of the liver can lead to an increase in the clearance of sex hormones. These drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin; There are also suggestions for oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John's Wort.

HIV protease inhibitors (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and their combinations also have the potential to affect hepatic metabolism.

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 administration of drugs that affect microsomal enzymes, and within 28 days after their withdrawal, the barrier method of contraception should be used additionally.

During the administration of antibiotics (such as ampicillins and tetracyclines) 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 dragees in the package, you need to move on to the next Jess pack without an ordinary break in taking the pills.

The major metabolites of drospirenone are formed in the plasma without the involvement of the cytochrome P450 system. Therefore, the effect of inhibitors of the cytochrome P450 system on the metabolism of drospirenone is unlikely.

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.

Based on in vitro interaction studies, as well as in vivo studies in female volunteers taking omeprazole, Simvastatin and midazolam as markers, it can be concluded that the effect of drospirenone at a dose of 3 mg on the metabolism of other drug substances is unlikely.

There is a theoretical possibility of increasing the serum potassium level in women receiving Jess at the same time as other drugs that can increase the serum potassium level. These drugs include ACE inhibitors, angiotensin 2 receptor antagonists, some anti-inflammatory drugs, potassium-sparing diuretics and aldosterone antagonists. However, in studies evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference between serum potassium concentration in comparison with placebo. Nevertheless, in women taking drugs that can increase the serum potassium level, it is recommended to determine the serum potassium concentration during the first cycle of the Jess preparation.

To identify possible interactions, you should read the instructions for the use of appropriate medications.

Analogs of the hormonal drug Jess

Structural analogs for the active substance:

• Daillah;
• Dimia;
• Midian;
• Yarina.

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