Laktionet - instructions for use, reviews, counterparts and forms of release (75 μg birth control pills) of a contraceptive drug in women, including during pregnancy, after childbirth and breast-feeding. Composition and side effects

In this article, you can read the instructions for using the drug Laktionet. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Lactineth 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. Analogs of Lactineth in the presence of existing structural analogues. Use for contraception in women, including during pregnancy, after childbirth and breast-feeding. Composition of the preparation.

Laktionet - gestagen-containing contraceptive for oral administration, the active ingredient of which is desogestrel. Like other hormonal contraceptives, which contain only progestogen as an active ingredient, Lactitone can be taken by women during breast-feeding, as well as in contraindications to estrogens or unwillingness to use estrogen-containing contraceptives.

Unlike other gestagen contraceptives, the contraceptive effect of Lactitone is explained by the inhibition of the ovulation process, which is confirmed by the absence of the ovulatory follicle in ultrasound examination and the absence of an increase in the values ​​of the luteotropic hormone (LTG) and Progesterone in the blood in the middle of the menstrual cycle. At the same time, desogestrel, as well as other progestogens, has the property of increasing the viscosity of the mucus of the cervix, preventing the progress of spermatozoa.

Perl index (the indicator reflecting the onset of pregnancy in 100 women during the year of contraception) is 0.4, which is comparable with the use of combined hormonal contraceptives for oral use.The use of the drug Lactitete leads to a decrease in the content of estradiol in the blood plasma to values ​​corresponding to the early follicular phase.

Progestogens affect carbohydrate and lipid metabolism.

Composition

Desogestrel (active metabolite Etonogestrel) + auxiliary substances.

Pharmacokinetics

When taken orally, Lactitone is absorbed quickly. Etonogestrel in 95.5-99% binds to blood plasma proteins, mainly with albumin and to a lesser extent with sex hormone binding globulin (GSHG). Desogestrel by hydroxylation and dehydrogenation is metabolized into the active metabolite ethonogestrel. Ethonogestrel is metabolized by the formation of sulfate and glucuronide conjugates. Etonogestrel and its metabolites are excreted by the kidneys and through the intestine (in a ratio of 1.5: 1) in the form of free steroids and conjugates.

In lactating mothers, etonogestrel is excreted in breast milk in a ratio of milk / serum 0.37-0.55. Thus, with an approximate milk consumption of the mother in the amount of 150 mg / kg of body weight per day, the newborn can receive 0.01-0.05 μg of etonogestrel / kg per day.

Indications

• contraception.

Forms of release

The tablets covered with a cover of 75 mkg.

Instructions for use and dosing regimen

In the absence of prior application of hormonal contraceptives (during the last month), the taking of tablets starts from the 1st day of the menstrual cycle, 1 tablet per day, if possible at the same time of day, following in the direction indicated on the package, so that the interval between taking two Tablets were 24 hours, if necessary with a small amount of liquid. This drug does not require a break in admission. Each next package should be started immediately after the end of the previous one.

The first drug intake

Women who did not take oral contraceptives in the previous month

The first tablet should be taken from the 1st day of the menstrual cycle (menstruation). In this case, no additional methods of contraception are required.

You can start taking tablets from the 2nd-5th day of menstruation, but in this case, additional contraceptive methods should be used in the first cycle in the first 7 days of taking the tablets.

Women who switch from another combined oral contraceptive (PDA) to Lactitet

If possible, the day after the last tablet of the previous PDA. In this case, no additional methods of contraception are required.

Women who switch from mono-component preparations containing only progestogen (mini-pili, injections, implants or intrauterine contraceptives that release progestogen)

When switching from minipilli, the drug can be taken any day, in case of injections, on the day that the next injection should be done, in the case of an implant, on the day after it is removed.

In all of these cases, the use of barrier methods of contraception is recommended for the first 7 days.

Admission after abortion in 1 trimester of pregnancy

After abortion in the first trimester of pregnancy, it is recommended to start taking the drug immediately after the abortion, and in this case there is no need for additional methods of contraception.

Taking the drug after childbirth or after the termination of pregnancy in the 2nd trimester

Reception of the drug is not earlier than 21-28 days after the termination of pregnancy in the 2nd trimester or after childbirth. If the drug is supposed to start later, then it is necessary to use the barrier method of contraception during the first 7 days.In addition, if unprotected sex has occurred before starting the use of the drug, pregnancy should be excluded or the beginning of the drug on the first day of the next menstruation (during the restoration of the menstrual cycle) be postponed.

Missed (forgotten) tablets

The effectiveness of the contraceptive is reduced if more than 36 hours have passed between two tablets. If the break does not exceed 12 hours, the contraceptive effect does not decrease, and the use of an additional contraceptive method is not required. The intake of the remaining tablets is continued according to the usual schedule.

In the case of a more than 12-hour break, the contraceptive effect may decrease. To achieve effective blocking of the hypothalamic-pituitary-ovarian system, it is necessary to take the drug daily for 7 days. Thus, with a break of more than 12 hours, the drug is continued in normal mode, however, additional (barrier) methods of contraception must be used in the next 7 days. If the intake of the tablet was missed during the first week of the drug and in the previous 7 days there was an unprotected sexual intercourse, it is impossible to exclude the possibility of pregnancy.

Measures taken in case of vomiting

If within 3-4 hours after taking the pill vomiting develops, then the tablet is not fully absorbed. In this case, you should do the same as in the case of missed tablets. The necessary tablet (the necessary pills) should be replenished from another package.

Observation

Despite the regular intake of tablets, there may be irregular menstruation. If menstruation occurs very often and irregularly, another method of contraception should be considered. If the disorder persists, it is necessary to eliminate the organic cause.

Tactics with amenorrhea that occurs during the use of the drug depends on whether the pill was taken according to the instructions or not, a pregnancy test may be required.

If pregnancy occurs, the drug should be discontinued.

It must be remembered that taking Laktionet does not protect against infection with HIV and other sexually transmitted diseases.

Side effect

• irregular menstruation;
• acyclic spotting (more rare or more frequent bleeding);
• prolonged menstruation;
• acne;
• nausea, vomiting;
• mood changes;
• decreased libido;
• tenderness of the mammary glands;
• violation of the menstrual cycle;
• headache;
• increase in body weight;
• alopecia;
• fatigue;
• discomfort when wearing contact lenses;
• vaginitis;
• dysmenorrhea;
• ovarian cysts;
• redness of the skin;
• rash;
• hives;
• erythema nodosum;
• cholestatic jaundice;
• itching;
• cholelithiasis;
• chorea;
• herpes pregnant;
• otosclerosis;
• deafness;
• development of hemolytic-uremic syndrome.

Contraindications

• presence at present or in an anamnesis of venous thromboembolism (including deep vein thrombosis of the lower extremities, thromboembolism of the pulmonary artery);
• severe liver disease at present or in the anamnesis (before the normalization of liver function indicators);
• hepatic insufficiency at present or in the anamnesis;
• established or suspected malignant hormone-dependent tumors (including breast cancer);
• liver cancer;
• bleeding from the vagina of an unclear etiology;
• established or suspected pregnancy;
• lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
• prolonged immobilization, incl. associated with surgery or disease (risk of venous thromboembolism);
• hypersensitivity to desogestrel or other components of the drug.

Carefully:

• resistant hypertension, developing on the background of taking the drug, incl. with ineffectiveness of antihypertensive therapy;
• Chlamydia, especially in the presence of chloasma during pregnancy in history;
• diabetes mellitus (due to the possible effect of progestogens on the sensitivity of peripheral receptors to insulin and on glucose tolerance);
• porphyria;
• systemic lupus erythematosus;
• herpes (during pregnancy in the anamnesis).

Application in pregnancy and lactation

The drug is contraindicated for use in pregnancy. In pre-clinical studies, when a very high dose of progestogen was administered, masculinization of the female fetus was observed.

In epidemiological studies, there was no increased risk of a teratogenic effect and congenital developmental defects among children whose mothers took oral hormonal contraceptives prior to pregnancy or unintentionally - in the early stages of pregnancy.

Like other preparations containing only progestogen, Lactineth does not affect the quality and quantity of mother's milk,but a small amount of the metabolite of desogestrel (etonogestrel) is excreted in the mother's milk and is approximately 0.01-0.05 μg / kg per day (with the amount of breast milk consumed 150 ml / kg per day). The results of a 7-month follow-up showed no increased risks for breastfed infants when assessing their growth, psychomotor and physical development.

Nevertheless, careful monitoring of the development and growth of the infant during breastfeeding is necessary if the woman uses Laktionet for the purpose of contraception.

special instructions

In the presence of any condition or risk factor, the physician should correlate the intended use and potential risk with the use of the drug Lactinet individually for each woman before the onset of hormonal contraception. In case of occurrence of any undesirable effect or risk factor it is necessary immediately to put the attending physician in a notification for the decision of a question on expediency of the further reception of a preparation.

Patients with diabetes should be monitored carefully during the first months of using Lactanet.

Reception Laktioneta reduces the content of estradiol in the blood to a value corresponding to the early follicular phase.

The protective effect of traditional only progestogen-containing contraceptives in terms of preventing ectopic pregnancy is not as pronounced as in combined oral contraceptives, which is associated with relatively often occurring when taking progestagen-containing preparations by ovulation. Despite the fact that Lactitete usually inhibits ovulation, the possibility of an ectopic pregnancy should be borne in mind when a differential diagnosis occurs when a woman develops amenorrhea or abdominal pain.

Sometimes there may be a chloasma, especially in women with a history of pregnant women with chloasma. Women with a tendency to chloasma should avoid sunlight and ultraviolet irradiation during the intake of Lactainet.

Patients with lactose intolerance should bear in mind that 1 tablet contains 67.445 mg of lactose monohydrate. Patients with rare hereditary diseases, such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption, should not take the drug.

Impact on the ability to drive vehicles and manage mechanisms

The drug does not affect the ability to drive vehicles or other working mechanisms.

Drug Interactions

Simultaneous use of inducers of microsomal liver enzymes can cause breakthrough bleeding and a decrease in the contraceptive effect of the drug. These drugs are derivatives of hydantoin (including phenytoin), rifabutin, barbiturates, primidone, Carbamazepine and rifampicin, as well as oxcarbazepine, topiramate, felbamate and griseofulvin. Specialized studies for the interaction of desogestrel with other drugs have not been conducted. The maximum induction of microsomal liver enzymes is achieved no earlier than 2-3 weeks after the start of the application of the corresponding inducer and lasts up to 4 weeks after its cancellation.

Women taking medications that induce microsomal enzymes of the liver should be recommended temporary additional use of barrier or other nonhormonal methods of contraception.

Antibiotics (eg, ampicillin and tetracycline) reduce the effectiveness of oral contraceptives.

With the simultaneous use of the above drugs with desogestrel, the use of the barrier method of contraception throughout the course of treatment and for 7 days (for rifampicin - 28 days) after the end of therapy is recommended.

In the treatment of Activated carbon absorption of steroids, and, consequently, and contraceptive effectiveness, may decrease. In this case, follow the recommendations given in the section "Dosage regimen" for the missed intake of the drug.

Analogues of the drug Laktionet

Structural analogs for the active substance:

• Charozette.

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