mph Bangladesh


Ethinyl estradiol with Norethisterone

(eth' in il) (es tra dye' ol) with (Nor-reth-ist-er-rone)

 

P  - Contraindicated in pregnancy

L  - Caution when used during lactation

(Formulation may not be available in Bangladesh market.)

Brand/Product Info


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Gen. MedInfo

Why is this medication prescribed?

This is combined oral hormonal contraceptive medication used to prevent pregnancy (Ethinyl estradiol 35mcg + Norethisterone 1mg tablets).

Ethinylestradiol/Norethisterone contains two hormones that are similar to the hormones oestrogen and progesterone that are produced by the body. Ethinylestradiol/Norethisterone is used to prevent women from becoming pregnant. It works by preventing the release of eggs from the ovary and changes the lining of the uterus which makes it difficult for an egg to develop. It also increases the thickness of vaginal fluid which can stop a sperm from reaching an egg.

Ethinylestradiol/Norethisterone may increase the chances of developing blood clots, breast cancer or cervical cancer. However, it may provide some protection against ovarian and endometrial cancer. You and your prescriber will need to weigh up the benefits and risks of taking Ethinylestradiol/Norethisterone before you start to take it.

Hormonal contraceptives will only prevent a pregnancy if they are taken regularly. It is important you take this medicine at the same time each day. If you want immediate contraceptive cover then start to take Ethinylestradiol/Norethisterone on the first day of your menstrual period. If you do not start taking Ethinylestradiol/Norethisterone on the first day of your menstrual period you will need to take extra contraceptive precautions for at least seven days until Ethinylestradiol/Norethisterone starts to work. For more information about starting Ethinylestradiol/Norethisterone and if you need to take extra contraceptive precautions ask your prescriber, family planning nurse or read the patient information leaflet that comes with your medicine.

Once you have started to take Ethinylestradiol/Norethisterone, you should take it once a day for 21 days. After this you should not take any more tablets for the next seven days. Start a new strip of Ethinylestradiol/Norethisterone immediately after the seven day tablet-free break. During this break you will usually have a withdrawal bleed. If you do not have a withdrawal bleed during the tablet-free break and you have taken all your pills properly, you are very unlikely to be pregnant. However, if you miss a withdrawal bleed and you have not taken your tablets properly or if you miss two withdrawal bleeds in a row you should immediately contact your prescriber or family planning nurse. This is because there is a possibility that you could be pregnant and Ethinylestradiol/Norethisterone may harm a baby if taken during pregnancy.

In certain situations the effectiveness of Ethinylestradiol/Norethisterone may be reduced and you will need to take extra contraceptive precautions. These situations include: missing a dose by more than 12 hours; taking other medicines that interact with Ethinylestradiol/Norethisterone; having diarrhoea or an upset stomach or any medical condition which interferes with the absorption of your medicine. If any of these situations occur during the last seven days of your strip you should not have a tablet-free break between strips of tablets. Start taking the next strip of tablets without a break.

As there is no gap between strips you will not have a withdrawal bleed at the end of the first strip. But you may have some menstrual bleeding while you are taking the second strip and you should have a withdrawal bleed once you finish the second strip. For more information about situations when the effectiveness of Ethinylestradiol/Norethisterone may be reduced and when to take additional contraceptive precautions ask your prescriber, family planning nurse or read the patient information leaflet that comes with your medicine.

Other information about Ethinylestradiol/Norethisterone:

if you have a history of irregular menstrual cycles or amenorrhoea you may not have any periods when you stop taking Ethinylestradiol/Norethisterone. For more information speak to your prescriber or family planning nurse

Do not share your medicine with other people. It may not be suitable for them and may harm them.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber. Using this medication does not protect you or your partner against sexually transmitted diseases (e.g., HIV, gonorrhea).

Read the Patient Information Leaflet provided with the manufacturers’ packaging before you start using this product and each time you get a refill. The leaflet contains very important information on when to take your pills and what to do if you miss a dose. If you have any questions, consult your doctor.

What special precautions should I follow?

Ethinylestradiol/Norethisterone is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

  • are allergic or sensitive to or have had a reaction to any of the ingredients in the medicine
  • are currently having investigations for breast cancer, cancer of the genitals or any cancer that is sensitive to oestrogen
  • are immobile for a long period of time
  • are obese
  • are pregnant
  • have a condition that became worse during pregnancy
  • have had a heart attack
  • have had certain problems during pregnancy such as jaundice, rashes or itching
  • have multiple sclerosis
  • have or have had angina
  • have or have had asthma
  • have or have had breast cancer, cancer of the genitals or any cancer that is sensitive to oestrogen
  • have or have had breast problems
  • have or have had cerebrovascular problems
  • have or have had chloasma
  • have or have had depression
  • have or have had diabetes
  • have or have had epilepsy
  • have or have had gallstones
  • have or have had heart and circulation problems
  • have or have had high blood pressure
  • have or have had kidney problems
  • have or have had liver problems such as livertumours or jaundice
  • have or have had metabolic problems
  • have or have had migraine or severe headaches
  • have or have had otosclerosis
  • have or have had porphyria
  • have or have had tetany
  • have or have had thrombophlebitis
  • have or have had uterine problems such as fibroids
  • have or have had varicose veins or are currently having injections to treat varicose veins
  • have recently had or are about to have surgery
  • have risk factors for developing thromboembolic problems such as having a personal or family history of thromboembolic problems
  • have risk factors for heartdisease such as if you have high levels of cholesterol in the blood, have had toxaemia of pregnancy, are over 35 years of age or if you smoke
  • have sickle cell anaemia
  • have vaginal bleeding and the cause of the bleeding is not known
  • wear contact lenses

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to determine whether or not the medicine is suitable and whether it must be prescribed with extra care
  • to check that this medicine is not having any undesired effects

Over time it is possible that Ethinylestradiol/Norethisterone can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Ethinylestradiol/Norethisterone has become unsuitable, it is important that the prescriber is contacted immediately.

Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Ethinylestradiol/Norethisterone:

  • there are no specific foods that you must exclude from your diet when taking Ethinylestradiol/Norethisterone

Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

Like all medicines Ethinylestradiol/Norethisterone can cause side effects. You should see how this medicine affects you and then judge if you are safe to drive or operate machinery. If you are in any doubt, talk to your prescriber.

Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Ethinylestradiol/Norethisterone:

  • do not take this medicine during pregnancy
  • this medicine may harm your baby if taken during pregnancy
  • if you become pregnant, or think you have become pregnant while taking Ethinylestradiol/Norethisterone, you must contact your prescriber

This medicine is not suitable during pregnancy. Your prescriber will only start your treatment with this medicine once they are certain that you are not pregnant. If you are planning to become pregnant you should discuss with your prescriber or family planning nurse when it is best to stop Ethinylestradiol/Norethisterone.

Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Ethinylestradiol/Norethisterone:

  • women who are breast-feeding must not take this medicine

Before you have your baby you should discuss breast-feeding with your doctor or midwife. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed.

Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following types of medicine may interact with Ethinylestradiol/Norethisterone:

  • antiarthritics
  • antibiotics
  • antiepileptics
  • sedatives

If you are taking Ethinylestradiol/Norethisterone and one of the above types of medicines, make sure your prescriber knows about it.

Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins.

Make sure you tell your prescriber the names of all the complementary preparations and vitamins that you are taking or are planning to take.

Your prescriber can then decide whether it is appropriate for you to take combinations that are known to interact.

In the case of Ethinylestradiol/Norethisterone:

  • this medicineinteracts with St. John's Wort

If you have been prescribed Ethinylestradiol/Norethisterone you should only take something on the above list on the specific advice of your prescriber.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor might order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

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