Lindinet 20 sort of. Instructions for installing Lindinet. Arterial thrombosis and thromboembolism

Latin name: Lindynette
ATX code: G03AA10
Dyucha speech: Etinilestradiol
Virobnik: Gedeon Richter, Ugorshchina
Wash your permits from pharmacies: For the recipe

Lindinet 20 should be used as a contraceptive for oral contraception with a low amount of hormones.

Indication before zastosuvannya

Lindinet 20 tablets are used as a contraceptive method, as well as for regulating impaired menstrual function.

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In one tablet of hormonal contraceptive there are two main components, which are represented by etinilestradiol and gestodene, their mass fraction is equal to 0.02 mg and 0.075 mg in vivo.

Dodatkovo and speeches:

• Povidon
• magnesium stearate
• Starch from corn
• Silicon dioxide in colloid form
• lactose monohydrate
• Sodium calcium is eaten.

Jubilant authorities

The antiseptic drug based on ethinylestradiol and gestodene inhibits the synthesis of gonadotropic hormones by the pituitary gland, which improves the maturation of follicles.

Estrogen storage tablets are represented by etinilestadiol, which is one of the synthetic analogues of the hormone estradiol, which is viable in the human body, taking an active part in the regulation of menstrual function together with progesterone.

Gestodene is another component of the antiseptic drug, which is similar to 19-nortestosterone, due to the strength of the injection of veins, it completely reverses both the natural hormone - progesterone, and the synthetic analogue of yoga - levonorgestrel. Calling on those who are active in the progestogenic storage of Lindinet, douse the temple, zasosuyut yoga in low doses. Zavdyaki tsommu not poserіgaєtsya іstotnogo infusion on perebіg metabolism of fats and carbohydrates, do not show yogo androgenic power.

The action of the contraceptive method is connected with the work of both central and peripheral mechanisms, which galvanize the process of maturation of follicles, thereby reducing the acceptability of the endometrial uterine ball to the blastocyst itself. With this, the viscosity of the vision (and the cervical mucus itself) rises, that the current lowering of the current conception is reduced.

If you drink Lindinet 20 postyno (as a description of the drug), it is possible to test an effective contraceptive - normalization of MC, a decrease in the risk of development of some gynecological ailments, including oncological ones.

Etinilestradiol is practically completely absorbed by mucosal HCTs. After 1-2 days after taking the tablets (with the instructions), it is possible to increase the concentration in the blood. The indicator of bioavailability is 60%. Link with albumins - 98.5%.

As a result of aromatic hydroxylation, the formation of methylated and hydroxylated metabolites occurs. The process of vision will take place with the participation of the nirk system and the intestines, the hour of vision will become 24 years. With this stable rye ethinilestradiol is registered for 3-4 doba.

Gestodene so easily goes through the process of absorption in the mucosal-intestinal tract, the most obvious indications of the presence of speech in the blood can be reached after 60 minutes. Bioavailability of gestagenic storage liquid is 99%.

The amount of gestodene in the blood decreases steadily, the period of product refilling becomes 24 years. Stable rіven gestodene is observed in the other half of the MC.

Release form

Hormonal needles are round, light cream colored, placed in a blister pack of 21 pcs. The middle packs can be 1 or 3 blisters. packaging with instructions.

Lindinet 20: instruction from zastosuvannya

Price from 381 to 2059 rubles.

The administration of the hormonal preparation Lindenet may be carried out every day at one hour to ensure its contraceptive effect. Lindinet 30 is also accepted, the instruction from the application is similar.

As a hormonal preparation, vikoristovuetsya first, pershu pill is taken from 1 MC to 5 MC. It is necessary to take Lindinet 20 for 21 days, after which a seven-day administration of a hormonal drug is given, the same days menstruation begins. The intake of hormones from the new blister pack is started for 8 days. irrespective of the fact that the bleeding ended in the first place.

Switching from another COC

It is necessary to take Lindinet 20 tablet for the next step after the woman has taken the rest of the COC drink from the blister. The cob of the first menstruation will pass like a dream.

Switching from mini-drinks, hormonal injections, intrauterine systems or implants

The beginning of hormonal therapy may take place any day of the MC, if you take a mini-drank. In case of early implantation - on the day of removal, injection of hormones - on the day of the previous injection.

In times of transition from monopreparations, it is necessary to zastosovuvat bar'ernі contraceptives come in, so that the woman did not take the prolongation of the first cycle to the reception.

After abortion on early terms (1 trimester)

Hormonal therapy with anti-inflammatory pills should be started on the same day after the operation. Let the woman follow the standard scheme, beware of many necessities, that which is not suitable in this way. After abortion, triple hormone therapy is indicated.

After an abortion on lower terms (2 trimesters)

Take the first Lindinet tablet 20 days after 28 days. (one month) without any additional contraceptive approaches. If you are taking an antiseptic drug, take it according to the designated term, with a duration of 7 deb. sled zabіgati vagіtnostі dodatkovo.

Well, before taking contraceptives, the woman has little unprotected sexual contact, start taking hormonal pills, after switching off the possible vaccinity, or, in a different way, drink a Lindinet 20 tablet first without middle on the first day of the MC (if it gets better menstrual cycle).

Scheme of taking when skipping pills

If you missed the pills, if you don’t need to take them, drink the missed Lindinet 20 pill, as if you guessed about it.

If you don’t overtake in taking pills for 12 years, then the contraceptive effect works, you don’t have to come in later. All advances are taken as usual, the pass to the drug is not added to the contraceptive action.

Even though the woman had a chance to miss a black contraceptive, and the hourly interval is over 12 years, hormonal pills are less effective. The woman can drink a little ball, as if she missed it, the steps are taken for the standard scheme. Dodatkovo zastosovuyutsya bar'ernі methodi zapobіgannya protyag 7 days. From that moment, if there was a bypass.

Even though there was a small amount of missing pills, and less than 7 pieces were left in the package, most likely the woman did not interrupt the intake of hormonal pills. Missing pills on the third day of protizaplidnoe therapy does not significantly reduce the effectiveness.

If you take ci contraceptives without interruption, there will be no monthly ones, but it may be possible that there is a prolific bleeding after an hour of drinking from a new blister. As soon as two months of uninterrupted intake of pigs (including the cycle, if there is a re-passage) there is no menstrual bleeding, varto ob'yazkovo turn off the vagity when taking Lindinet 20. If you work further, consult your doctor nekologom, vіn zaproponuє kіlka variantіv vіrishennya problem.

How robiti, how did vomit start, diarrhea

However, when taking the pills, there is a risk of vomiting or diarrhea, and since the moment the drug has been taken, it has not been more than 3-4 years, it is possible to equalize the missed pill, increasing the progression of the current pregnancy. So robiti - live quietly when you come in yourself, what if you missed a walk. If a woman does not want to change the regimen for taking a contraceptive, take a Lindinet 20 tablet from a new blister.

How to set menstruation

As if a hormonal drug is stagnating for a long time, you need to spend a month, take hormonal pills without a seven-day break. You can start menstruation for a few days, right up to the end of the cycle from another blister. It doesn’t turn off the possibility of bleeding bloody visions that are smeared, but bursting bleeding (such a reaction to the body is considered normal). After the end of the seven-day break, you can drink Lindinet 20 as soon as possible. To work, if necessary, to complete the intake of Lindinet, take care of your gynecologist.

Stasis with vagity and GV

Hormonal pills are not prescribed during the hour of pregnancy. If you need to choose a contraceptive for an hour of lactation, varto complete the breastfeeding.

Contraindication

Do not follow hormonal intake when:

• Overworld susceptibility to warehouse contraceptives
• Pathologies causing impaired functioning of the liver
• Pathological neoplasms in the liver
• Slightness to thrombosis, as well as thromboembolism
• Serious CVS pathologies (including myocardial infarction)
• Anemia sickle cell type
• The presence of estrogen-deposited newborns
• Uterine bleeding of unknown origin
• Blood diabetes that occurs on aphids microangiopathies
• Zhovtyanitsa idiopathic
• Manifest herpes
• Vagity
• Otosclerotic changes
• Vіtsі ponad 35 roіv (oskіlki zvіkom іstotno dvіschuєє ymovіrіnіnіє razviti poіchnyh efektіv).

Come in later

With special care, the following should be shown for the manifestation of such pathological conditions and illness:

• Severe migraine headaches
• Oncoprocesses in dairy plants
• Parts of an epileptic attack
• Pathology of the functioning of the mikhur (including zhovchno-stone ailments)
• AT movement
• Immobilization
• Depressive camp
• Interval period following a serious surgical intervention
• Blood diabetes
• Zhovtyanitsa cholestatic type
• Various forms of liver failure.

If the patient is over 35 years of age and if she is not allowed to smoke, please consult with a doctor about the possibility of switching to Lindinet 30. It is important to indicate that the woman has such a quantity of hormones that are taken, without intermediary instilling on the contraceptive active effect. Already after 40 years, varto tried to pick up other contraceptives.

Crossing medical vzaєmodії

Depending on the instructions to Lindient 20 and 30 hepatic microsomal enzyme inducers, antibacterial drugs significantly reduce the level of estrogen in the blood, which improves the progression of pregnancy. What can be taken into account during this period? So, ymovіrnіst dosit great. The stretch of the last period of rejoicing and the stretch of the coming 7 days. after this, it is necessary to go to the stop of additional contraceptive approaches.

Inhibitors of hepatic enzymes, with their own strength, help to increase the concentration of estrogen components in the blood.

Drugs that promote the motility of the intestinal tract, reduce the absorption of components of hormonal pills.

Ascorbic acid improves the process of sulphation of estrogen components and increases their bioavailability.

Hormonal influences on the processes of metabolism of cyclosporine and theophylline in the body, which can cause an untransmitted reaction from the side of various organs and systems.

It is not possible to drink preparations with zvіroboyu, oskolki pіd hіlіkuvannya can start ryasna menstruation (bleeding).

Patients with diabetes mellitus should be advised to take dosing of hypoglycemic drugs.

Varto signify that the same cross-modalities are to blame for this tendency, as Lindinet 30 anti-inflammatory tablets are taken.

Side effects

For an hour to receive anti-falling piguls, a possible development of non-negligible reactions:

• CCC: thromboembolism or thrombosis on aphids of advanced pharynx, a sharp striae of AT
• SHKT: nudity is strong and vomit until you vomit, development of hepatocellular adenoma, it can be blamed on hepatitis
• State system: reduced state tension, early menstruation, impaired secretion of vaginal vision
• Endocrine system: changes in the vagina, a little strain in the breasts
• CNS: emotional instability, shyness to depressive states (during the trial of hormonal therapy), occasional headaches, malaise, increased stiffness, migraine (even severe headache).

You can also watch out for: sickness in the lower part of the abdomen, chloasmia (if you are sick, turn off the trip to sleep), intolerance to contact lenses, bloating, show allergies, symptoms of impaired tolerance to glucose. Such a reaction may develop in the aftermath of a trivial intake of hormones.

Overdose

If a woman has taken an increased dose of the drug, symptoms may develop: nausea and vomit, headache. Overdose can be strong monthly.

Symptomatic therapy is recommended. What work - turn to the doctor (wine to please the drug) and drink the prescribed drugs. If there is a sign of a significant increase in the burning camp, then bleeding will occur. Consider that there is no specific antidote.

Wash away the savings and the term of appurtenance

Hormonal pills are kept for an average temperature that does not exceed 30 C. The term for contraceptive applicability is 3rd grade.

Analogues

Bayer Pharma, Nimechchina

Price from 500 to 2142 rubles.

Logest behind a warehouse similar to Lindinet 20 є low-dose contraceptive method. Take yoga just like that, I may have similar contraindications, maybe I’ll go with Lindinet as a side effect. Patches have 1 (21 tab.) or 3 (63 tab.) blister. packaging.

Pros:

• The tablets work effectively (block the current ovulation)
• MC regulator
• Vykoristovuetsya for the treatment of some hormone-dependent gynecological diseases.

Cons:

• High price
• High rizik rosette side
• It is not assigned, as a woman for over 35 years.

Lindinet 20 is a combination monophasic oral contraceptive.

Release form and warehouse

Lindinet 20 - tablets: round, double-sided, covered with a shell of a light yellow color (21 pieces in a blister, 1 or 3 blisters are packed in a cardboard box).

Fluent speeches (in 1 tablet):

• Gestodene - 75 mcg;
• Etinilestradiol - 20 mcg.

Additional components: magnesium stearate, corn starch, silicon dioxide, sodium calcium edatate, povidone, lactose monohydrate.

Warehouse of husk: calcium carbonate, titanium dioxide, macrogol 6000, povidone, talc, sucrose, barvnik quinolinic yellow (D+S yellow No. 10) (E104).

Indication before zastosuvannya

Lindinet 20 is approved for contraception.

Contraindication

Absolute:

• Venous thromboembolism in history;
• Venous or arterial thrombosis / thromboembolism (including legenous artery embolism, stroke, myocardial infarction, thrombosis of the deep veins of the hominus), including in history;
• Evidence of any history of thrombosis (zocrema, transient ischemic attack, angina pectoris);
• Severe and / or multiple risk factors for the development of venous / arterial thrombosis (such as arterial hypertension with arterial pressure equal or more than 160/100 mm Hg, atrial fibrillation, aggravated damage to the valvular apparatus of the heart, disease sudin coronary;
• pancreatitis, which is accompanied by severe hypertriglyceridemia (including history);
• Presence in this hour or in the anamnesis of cholestatic zhovtyanitsy (including with anterior vagity), severe liver disease and hepatitis (until the moment of normalization of functional and laboratory indications and a stretch of 3 months after the end of the day);
• Swelling of the liver (including the history of illness);
• Zhovtyanitsya with glucocorticosteroids;
• Zhovchnokam'yana ailment, incl. in history;
• Dyslipidemia;
• Blood diabetes, which is accompanied by angiopathies;
• Syndromes Gilbert, Dubina-Johnson, Rotor;
• Severe scurvy, otosclerosis or some progress with glucocorticosteroids or with anterior vaginess;
• Migraine, which is characterized by moderate neurological symptoms, in the anamnesis among them;
• Vaginal bleeding of unclear movement;
• Hormone-storing evils of newly formed organs and milk diseases or suspicion of them;
• Surgical intervention from trivial immobilization;
• Vagіtnіst chi pіdozra on her;
• lactation period;
• Intensive smoking (more than 15 cigarettes per doba) for 35 years;
• Contraindication. Increased sensitivity to drug components.

Special care should be taken in such situations:

• Vik older than 35 years;
• Slightness to thrombosis (damage to cerebral circulation or myocardial infarction in someone from close relatives in a young person);
• Chicken;
• Obesity (mass body index over 30 kg/m2);
• Spadkovy angioedema;
• Dyslipoproteinemia;
• Illness (including vaginal herpes, chloasma, porphyria, chorea minor), which in the past vinicles or worsened under an hour of anterior vagity or as a result of an anterior intake of statin hormones;
• Illness of the liver (like acute, and chronic);
• Hemolytic-uremic syndrome;
• Valves in the heart;
• Arterial hypertension;
• Atrial fibrillation;
• epilepsy;
• migraine;
• Severe injury;
• surgical insertion on the lower ends;
• Great surgical intervention;
• Trival immobilization;
• Varicose veins and superficial thrombophlebitis;
• Blood diabetes without judgmental disorders;
• Kron's disease;
• sickle cell anemia;
• Hypertriglyceridemia (including family history);
• Ulcerative colitis;
• Systemic vermilion vulgaris;
• Severe depression, including history;
• The half-life period (21 days after the half-life for women who are not fit, the period after the completion of lactation for mothers-year-olds);
• Changes in biochemical indications (protein C or S deficiency, hyperhomocysteinemia, antithrombin III deficiency, activated protein C resistance, antiphospholipid antibodies, including canine anticoagulant, antibodies to cardiolipin).

Method of stoking and dosing

Lindinet 20 take 1 tablet per doby for 21 days, but at the same hour doby. Let's wait for a 7-day break, for an hour I'm afraid of bleeding of the eye. On the next day after taking the next tablet, interrupt (on the 8th day after taking the remaining pill from the package, or after 4 days after taking the first pill, on the same day of the next day) taking the drug again.

The first tablet should be taken from day 1 to day 5 of the menstrual cycle.

When switching from the next combined oral contraceptive, take the first Lindinet tablet on the 20th day after the last tablet of the second contraceptive, tobto. the first day of bleeding is visible.

Suggestions about the transition from medical care, to avoid progestogen only: if you have a mini-drank, you can start taking Lindinet 20 at any day of the cycle; yakshcho tse implant - the coming day after yogo removal; yakscho tse іn'єktsії - ahead of the rest of the in'єktsії. In all of these episodes, it is recommended to use additional methods of contraception for the first seven days.

After an abortion in the first trimester of pregnancy, it is possible to start taking Lindinet 20 immediately after the operation, but additional methods of prevention are not needed.

After an abortion in another trimester, and after a gradual change, the drug is needed for 21-28 days, for the first 7 days, it is necessary to additionally stop the contraceptive method. If on the cob of contraception, if there is an article of contact, then it is recommended to take Lindinet 20 before the first menstruation, or turn off the pregnancy.

At the time of the admission of the devil's reception:

• Even if less than 12 years have passed, it is not necessary to use additional methods of contraception, and the effects of the drug are not reduced. I missed a pill, next I took it as soon as possible, I gave it at the next hour;
• If the clav interval is more than 12 years, do not repeat the missed dose. Lindinet 20 continue to take an emergency regimen, and for the next 7 days to try an additional method of contraception. As with cioma, less than 7 tablets were left in the package, I do not need to break the work. Bleeding in this case does not occur until the completion of another package, but there may be bleeding or bleeding that is smeared. If bleeding does not occur after the completion of another package, it is necessary to turn off the vagity.

In case of developing vomiting and / or diarrhea for 3-4 years, after taking pills, it is possible to reduce the contraceptive effect of the drug, it is recommended to work the same way, as if you had a missed dose.

With the help of Lindinet 20, you can speed up the onset of menstruation. For which change should be interrupted while taking the drug. The shorter this interval, the more time it takes to eliminate spotty or bleeding bleeding when taking another package.

To stop the current menstruation, it is necessary to continue taking Lindinet 20 from a new package without disturbing the 7-day break. It is possible to delay menstruation for as long as necessary, as much as necessary, right up to the last pill from another package. In this case, it is possible to smear or bleed heavily. Regular intake of the drug can be resumed after a significant 7-day interruption.

Pobichna diya

Possible side effects that may affect Lindinet 20:

• Cardiovascular system: arterial hypertension; rarely - venous and arterial thromboembolism (including thromboembolism of the legenous artery, deep vein thrombosis of the lower veins, stroke, myocardial infarction); more rarely - venous or arterial thromboembolism of the nirk, mesenteric, retinal, hepatic arteries and veins;
• Organic sensitivity: loss of hearing due to otosclerosis;
• Others: porphyria, hemolytic-uremic syndrome, rarely - acute reactive systemic red dog; more rarely - Sidenham's chorea (pass after administration of the drug).

Other side effects are less severe, but more often blamed. The dosage of the drug taken in different cases is due to the virishuvati likar individually for the skin patient with the improvement of corystosis and rhysics:

• State system: more, increased and strained milk ulcers, development of inflammatory processes of the pihvi, galactorrhea, candidiasis, acyclic bleeding / bloody vision from the pihvi, change in the mucus of the pihvi, amenorrhea after the administration of the drug;
• Herbal system: Crohn's ailment, nudota, vomit, virazkovy colitis, epigastric pain, liver adenoma, hepatitis, cholelithiasis, vyniknennya or aggravated zhovtyanitsa and / or vermin, induced by cholestasis;
• Central nervous system: headache, migraine, depression, mood lability;
• Speech exchange: hyperglycemia, decreased tolerance to carbohydrates; increase in the level of thyroid-stimulating hormone; zbіlshennya masi tіla; stippling of rіdini in the body;
• Organ sensitivity: hearing loss, when wearing contact lenses - increased sensitivity of the horn;
• Dermatological reactions: increased hair loss, swelling or exudative erythema, chloasma, hanging;
• Other: allergic reactions.

especially vkazіvki

Before the recognition of Lindinet 20, a woman may undergo a general medical examination (laboratory examination, control of arterial pressure, examination of a special and family history) and gynecological examination (including cytological analysis of a cervical smear, obstruction of the pelvic organs and milk them zaloz). Similar obstezhennja to carry out skin 6 months for the whole period of taking the drug.

The skin of the woman can be left behind, so the drug does not protect against diseases that are transmitted by the state route, incl. VIL-infections.

After acute viral hepatitis, the drug can be taken only after the normalization of liver function, and not earlier than after 6 months.

The study of Lindinet 20 injection on the degree of psychophysical reactions and building up to the concentration of respect was not carried out.

Medical interaction

Adverse drug effects reduce the contraceptive efficacy of Lindinet 20: ampicillin, tetracycline, barbiturate, rifampicin, carbamazepine, primidone, phenytoin, phenylbutazone, felbamate, topiramate, oxcarbazepine, griseofulvin, g idantoine. In addition, when taking a similar combination, menstruation disruption and bleeding are frequent. As a matter of fact, the intake of these drugs is necessary, the entire period of their one-hour intake and the duration of 7 days after the completion of the next treatment, the use of supplementary non-hormonal methods of contraception, and in the case of rifampicin, the duration of 4 days after wow.

Sulfation of etinilestradiol is one of the most intoxicating speeches of Lindinet 20 - it is found at the intestinal wall. All preparations, as well as sulphation at the intestinal wall (including ascorbic acid), competitively sulphate ethinilestradiol, which enhances its biological availability.

Liver enzyme inhibitors (e.g., fluconazole and itraconazole) increase plasma concentrations of ethinilestradiol.

Therapeutic measures that promote the motility of the mucosal intestinal tract, reduce the absorption of the intoxicating speeches of Lindinet 20 and the same time in plasma.

The preparations of St. John's wort reduce the concentration of active speeches to the preparation, which can lead to the appearance of bleeding and induce vaginess. Therefore, this combination is not recommended.

Ritonavir reduces the total concentration of etinilestradiol by 41%, therefore, it is recommended to use additional non-hormonal methods of contraception or take an oral contraceptive with a higher concentration of etin ilestradiol.

Lindinet 20 may reduce carbohydrate tolerance, increase the need for oral antidiabetic patients or insulin.

Analogues

Numbers that can be seen to one pharmaceutical group, like avenging different active speech (MPN), are called one in one name, but they are victorious for the glee of one and the same diseases themselves.

• - Dragee

Indication for zastosuvannya. Lindinet 20

Contraception.

Dispensing form for Lindinet 20

the buns are covered with shell; packaging contour komіrkova 21 carton pack 1;
the buns are covered with shell; packaging contour komіrkova 21 carton pack 3;

Pharmacodynamics of Lindinet 20

Ignore the secretion of gonadotropic hormones in the pituitary gland, galvanic maturation of follicles and the transition to the ovulation process. Increases the viscosity of the cervical mucus, which facilitates the penetration of spermatozoa into the uterus.

Pharmacokinetics of Lindinet 20

Gestodene

Shvidko is practically 100% absorbable from HCT (bioavailability is close to 99%). After 1 year after a single injection, the concentration becomes 2-4 ng / ml. Links with albumin and globulin, which links with state hormones (SHBG). 1–2% is used in the form of a free steroid, 50–75% binds specifically to SHBG. An increase in the level of SHBG in the blood, caused by etinilestradiol, is added to the level of gestodene: an increase in the fraction due to SHBG and a decrease in the fraction due to albumins. The average dose was given to gestodene 07-14 l/kg. Biotransformation is required similarly to other steroids. Average clearance: 0.8-1.0 ml / min / kg. Riven in blood syrovatts decreases biphasically. In the final phase T1 / 2 - 12-20 years. Seen less in the form of metabolites: 60% - from the section, 40% - from the feces. T1 / 2 metabolites is close to 1 day.

Etinilestradiol

Shvidko and practically povnіstyu vmktuєtsya іz SHKT. The average value of Cmax in blood sputum is 30-80 pg / ml, it is reached in 1-2 years after taking it. Bioavailability through presystemic conjugation and primary metabolism is close to 60%. In fact, it also non-specifically binds to albumin (about 98.5%) and induces an increase in the level of SHBG in blood serum. The average total was 5–18 l/kg. Mainly, aromatic hydroxide is due to the adoption of hydroxyl and methylated metabolites, which are present in the forms of free metabolites or in the forms of conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma is close to 5–13 ml/min/kg. Concentration in blood syrovats decreases biphasically. T1 / 2 of the other phase - close to 16–24 years. Etinilestradiol is seen less in the form of metabolites, from the section and in the ratio 2:3. T1 / 2 metabolites - close to 1 day. A stable concentration (20% higher, lower after a single dose) is restored up to 3-4 days.

Vykoristannya drug Lindinet 20 pіd hour vagіtnostі

The drug is contraindicated for the hour of vaginess. If it is necessary to administer the drug during lactation, there should be a change in the nutritional status of breastfeeding (active speech of the drug in a small number is seen with breast milk).

Contraindications prior to injection of Lindinet 20

- increased sensitivity to the components of the drug;

Illness, which is accompanied by pronounced damage to the functions of the liver;

Swelling of the liver (including history);

Thrombosis and thromboembolism (including history);

Myocardial infarction (including history);

Heart failure; cerebrovascular damage (including history);

become, scho to overcome thrombosis (including transient ischemic attacks, angina pectoris);

coagulopathy;

sickle cell anemia;

Estrogen-deposited swellings, incl. swelling of the milk follicle or endometrium (including history);

Blood diabetes, complications of microangiopathies;

Uterine bleeding of unclear etiology;

Idiopathic zhovtyanitsa and sverbіzh pіd an hour before the pregnancy;

Presence in history of herpes;

Otosclerosis will become worse due to an hour of early pregnancy;

Vagity.

With care:

Breast cancer;

Chorea vaginal (previous recognition may be worsened by interruption of chorea vaginal);

Blood diabetes;

epilepsy;

Illness of zhovchnoy michur, especially zhovchnokam'yana twig (including in the anamnesis);

Pechinkov's insufficiency;

Arterial hypertension;

Immobilization;

Great surgical presentations;

cholestatic zhovtyanitsya (including vagіtnyh in anamnesis);

Depression (including history);

Migraine.

Lindinet 20

From the side of the cardiovascular system: rarely - thromboembolism, thrombosis (including the vessels of the veins of the eye), arterial occlusion advancement.

From the side of the herbal system: sometimes - nudota, vomiting, hepatitis, hepatocellular adenoma.

On the side of the state system: other - intermenstrual blood vision, changes in vaginal secretion, changes in libido.

On the side of the endocrine system: sometimes - it is obvious that there are tensions in the milk glands, a change in the mass of the body.

From the side of the central nervous system: emotional lability, depression, confusion, headache, migraine, weakness, volatility.

Others: possible pain in the lower abdomen, chloasma, discomfort when wearing contact lenses, sodium and sodium retention in the body, allergic reactions, impaired glucose tolerance.

Changes in laboratory indications: in case of oral antiparasitic signs and symptoms of laboratory indications (functional indications of the liver, nirok, supramental ulcers, thyroid ulcer, indications of blood clotting and fibrinolytic factors, levels of lipoprotein and transport proteins їнів) can be changed.

Dosing method for Lindinet 20

In the middle, not roaring, drinking down with a sufficient amount of water, independently from the outside.

Take 1 tab. per day (if possible, at the same hour to finish) for 21 days, after which there is a 7-day break, at which time there is menstrual-like bleeding through the injection. After a 7-day interruption, regardless of the fact that the bleeding has ended, or only start, continue taking the drug from the offensive packaging. At this time, the rhythm is restored, which is easily observed: 3 days - taking pills, 1 day - a break. Start taking the drug from a new skin pack on the same day of the week.

First drug intake: Lindinet should be taken on the first day of the menstrual cycle. The cob is allowed to be taken on the 2nd-5th day of the menstrual cycle, but in this case it is recommended to use additional methods of contraception.

Switching the drug from another oral contraceptive. When switching from a contraceptive with ethinilestradiol 20 mcg in place, the switch is switched to the normal regimen after a 7-day interval. When switching from tablets to take 30 mcg of ethinilestadiol, it is recommended to switch off the 7-day interval, and then take it for a better regimen.

Switching to taking the drug with drugs that use less progestogen (“min-drank”, in’єktsії, implants): from “min-drank” you can switch to taking the drug Lindinet at any day of the cycle. It is possible to switch from the implant to the next day with Lindinet after the implant has been removed; for injections - one day before the injection. In these cases, in the first 7 days, it is necessary to stop additional methods of contraception.

Taking the drug Lindinet after an abortion in the 1st trimester of pregnancy: after an abortion at the same time, you can change the drug, in which case there is no need for an additional method of contraception.

Taking the drug Lindinet after a fall or after an abortion in the second trimester of pregnancy: taking the drug can be started after 21-28 days after the fall of the mind, as the woman is not fit to breastfeed, or an abortion in the second trimester of pregnancy. In these cases, in the first 7 days, it is necessary to stop additional methods of contraception. As soon as there is a mild sexual contact, or after an abortion, before taking the drug, turn off the vaginess or kidney before the first menstruation.

Overdose in taking pills: if I took a pill, I missed it - I missed a pill and take it again. If the interval becomes less than 12 years, the effectiveness of the drug will not decrease, and in this case there is no need to stop the supplementary method of contraception. Take other tablets at the right time. If the interval becomes longer than 12 years, the effectiveness of the drug may decrease. In this case, the woman is guilty of taking the missed pill, and in the future the pills are to be taken in the normal mode, in case of 7 days in the attack, it is necessary to stop additional methods of contraception. Yakscho in the package was lost less than 7 tab. taking the drug from the offensive package begins without interruption. In this case, there is no menstrual-like bleeding after taking the drug until the end of the drug taken from another package, but bleeding can occur if smeared or else. There is usually no menstrual-like bleeding after the ingestion of the drug after completion of the ingestion from another package, even before continuing with the ingested drug, the next vagity.

Come on, you get used to vomit and diarrhea: for 3-4 years after taking the drug, vomit and/or diarrhea begin, possibly reducing the contraceptive effect. In this case, the need for children is zgidno with the item "Pass for taking pills." If the patient does not want to change the regimen, the missed tablets must be taken from the new package.

Changing the date of the cob of menstruation: є mozhlivіst prikoryuvat the cob of menstruation by way of fast interruption in taking the drug. The shortest break in taking the drug, it is more effective, which does not cause menstrual-like bleeding, but more or less bleeding, which smears, is indicated for an hour to the drug taken from the offensive packaging. To stop menstruation, the drug should be continued from a new package without a 7-day interruption. Menstruation can be trimmed as long as necessary: ​​until the end, I will take the rest of the walk from another package. With a stoppage of menstruation, there may be bleeding or bleeding, which is smeared. Regular intake of Lindinetu can be renewed after a significant 7-day break.

Overdose with Lindinet 20

Severe symptoms after taking high doses of the antiseptic drug have not been described.

Symptoms: nausea, vomit, in young girls - small vaginal bleeding.

Likuvannya: more symptomatic. There is no specific antidote.

Lindinet 20 with other drugs.

Rifampicin (advancing clearance), as well as barbiturates, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine, may cause severe uterine bleeding or decrease contraceptive efficacy.

Contraceptive efficacy decreases with the use of ampicillin, tetracycline (mechanism of contraction). Before the next hour of taking with the listed drugs, as well as for 7 days after the completion of the course of taking them, it is necessary to stop other non-hormonal (condom, spermicidal gels) methods of contraception. When vikoristanny rifampicin by additional methods of contraception, it was followed up for 4 days after completion of yoga intake. Be-yaké LZ, which increases the motility of the SHKT, lowers the level of the drug in the blood.

LZ (for example, ascorbic acid), which are sulphated in the intestinal walls, competitively sulphate etinilestradiol and improve its biological availability. Liver enzyme inhibitors (e.g., itraconazole, fluconazole), increase plasma concentration of ethinilestradiol.

Etinilestradiol, by inhibiting liver enzymes or by accelerating conjugation (eg, glucuronidation), may interfere with the metabolism of other drugs, increasing or decreasing blood concentrations (e.g., cyclosporine, theophylline).

The congestion of preparations with St. John's wort (including tea) reduces the concentration of the drug in the blood, which can lead to bleeding, vaginess (cause of St. John's wort on liver enzymes, as it takes 2 more days after the completion of the course of taking St. John's wort). Ritonavir reduces the AUC of ethinilestradiol by 41%. At the same time, ritonavir should be administered with a higher dose of etinilestradiol (Lindinet 30) or non-hormonal methods of contraception should be administered.

Caution against drug administration Lindinet 20

Illness of the circulatory system. Oral antiseptics can reduce the risk of myocardial infarction. Risk of myocardial infarction and thromboembolic conditions of various localizations of growth in women her history of VTS, age older than 35–40 years). It is necessary to insure women over 35 years of age and rich curts. In women, the older woman who took the drug had a three-hour increase in the arterial pressure. An increase in the arterial pressure is often observed when drugs are taken with high doses of hormones.

It is necessary to take care of the drug before ingestion of the drug, as the woman is afraid of: congenital susceptibility to thromboembolic disease, obesity (mass body index more than 30 kg/m2), impaired fat metabolism (dyslipoproteinemia), arterial hypertension hypertension, disease of the valves of the heart, fibrillation of trivalo immobilization, severe surgeries, operations on the legs, severe injuries (in case of a risk of thromboembolic disease in the postoperative period, it is necessary to take the drug 4 days before the planned operation and take it through 2 days after activation of the patient).

When taking the drug, it should be administered negligently when symptoms of thromboembolism appear: pain in the chest, which may irradiate to the left arm, unbearably severe pain in the legs, swelling of the legs, hospitable pain with inhalation or cough, hemoptysis.

Pukhlini. In some cases, the incidence of cervical cancer in the middle women was noted, for a long time they took oral anti-inflammatory drugs (no causal and inherited association with the drug was not brought). Imovirnist to develop cervical cancer due to sexual behavior and other factors (human papilloma virus). The studies did not lead to a causal link between breast cancer and taking drugs: in women who took oral antiparasitic infections, the illness was manifested at a greater early stage, and in women who did not take drugs. There were occasional reports about the development of benign liver swelling in women, for a long time they take hormonal antiseptic diseases, with a development of intracranial bleeding.

Other pathological conditions. Taking the drug should be administered when there is a loss of vision (new or partial), exophthalmia, diplopia, or when there is a swollen papilla of the optic nerve, or damage to the vessels of the network. Behind the data, there is a significant risk of the elimination of gallstones from the age of growth among women, if they take oral antiseptic drugs or preparations to avenge estrogen. The rest of the investigations showed that the risk of the adoption of gallstone disease is less in case of congestion of preparations with a small dose of hormones. With the onset of migraine, worsening of migraine, or with the appearance of a post-mortem or with repeated, non-severe headache, take the drug immediately. When taking the drug Lindinet, it is necessary to treat it negatively with the appearance of a generalized scurvy or with the appearance of an epileptic attack.

Injecting the drug into the exchange of carbohydrates and lipids. Women who take oral antibiotics may be at risk of reduced tolerance to carbohydrates. In some women, an increase in the level of triglycerides in the blood was revealed during the ingestion of oral antiseptic infection. In women with relapsing hyperlipidemia who take the drug with estrogen, a marked increase in plasma triglycerides was observed, which could lead to the development of pancreatitis. In case of congestion of oral antiproliferative infections, especially in the first 3 months, irregular bleeding may occur, which can be smeared or purulent. If bleeding occurs three times a day, or if it appears after regular cycles have formed, the reason is non-hormonal, and it is necessary to conduct a routine gynecological examination in order to uncover vagity or evil dentures. If a non-hormonal cause can be excluded and intermenstrual bleeding continues for more than 4 months, then switch to another drug. In some cases, menstrual-like bleeding through the administration of the drug for a 7-day interval does not appear. If the regimen of the drug taken was broken before the day of bleeding, or if bleeding the day after taking another package, it is necessary to turn off the blood pressure before continuing the course of the drug taken. Before the cob of zastosuvannya protizaplіdnyh pills next zіbrati reports of the family and special anamnesis and to conduct a medical and gynecological examination. Qi follow-up repeat skin 6 months. At physical examination, AT should be checked, follow-up of milk ulcers, palpation of the abdomen, conduct gynecological follow-up of cytological follow-up of the smear, as well as laboratory follow-up of indications (functional indicators of the liver, nirok, supramental ulcers, shield visible burrows, indications of pharynx and fibrin). transport proteins). It is necessary for a woman to be ahead of her, so that the drug does not protect against infection, which are transmitted by the state route, zocrema from SNIDu. In case of acute or chronic impaired liver function, you should take the drug until the value of liver enzymes is restored. If liver function is impaired, the metabolism of steroid hormones may be impaired. For those women who develop depression when taking anti-inflammatory drugs, dose the drug and switch to another method of contraception to clarify the relationship between the development of depression and taking the drug. It is necessary to be more careful for the presence of depression in the anamnesis, and in case of confirmed depression, complete the course of taking an oral antiseptic drug. With chronic oral antifungal infections, the concentration of folic acid in the blood may decrease. There may be less clinical significance in the case of current vaccinia in a short term after the completion of the course of oral antiseptic treatment.

With diarrhea, intestinal motility increases and the intake of the drug decreases.

stock

speeches, scho dіyut: gestodene, etinilestradiol;

1 tablet contains gestodene 0.075 mg and ethinilestradiol 0.02 mg

Additional speeches: sodium calcium edatate, magnesium stearate, silicon dioxide, povidone, corn starch, lactose, quinoline yellow (E 104), titanium dioxide (E 171), macrogol 6000, talc, calcium carbonate, sucrose.

Pharmaceutical form

The buns are covered with shell.

Pharmacological group

Hormonal contraceptives for systemic contraception. Gestodene and estrogen (fixed combinations). ATC code G03A A10.

Indication

Oral contraception.

Contraindication

• Vagіtnіst chi pіdozra on her;
• genital bleeding of unclear etiology;
• presence or history of arterial or venous thromboembolic disease (for example, deep vein thrombophlebitis, legenous artery thromboembolism, cerebrovascular disease, myocardial infarction);
• the presence of a risk of arterial or venous thromboembolism (impaired blood circulation, heart failure, transient arrhythmia);
• presence of prodromal symptoms of thrombosis in history (transient cerebral ischemic attack, angina pectoris);
• heart-vascular damage (pathology of the valve (-iv) of the heart, arrhythmias);
• severe arterial hypertension;
• manifestation of benign chi malignant swelling and severe disease of the liver
• presence in the anamnesis of malignant tufts of the uterus and milk infections;
• diagnosis of malignant swelling of the endometrium or other estrogen deposits of the newborn
• vascular ophthalmopathy;
• herpes vaginal history
• sickle cell anemia
• hyperlipidemia;
• diabetic angiopathy;
• migraine with moderate neurological symptoms;
• pancreatitis in history, as a result of cases of severe hypertriglyceridemia;
• presence in the anamnesis of cholestatic zhovtyanitsa at the hour of vagity or vagina
• progression of otosclerosis under an hour of posterior vaginess;
• Dubin-Johnson syndrome; Rotor syndrome;
• increased sensitivity to any component of the drug.

Method of stosuvannya that dose

Take the drug for a period of 21 days, 1 tablet per day (if possible, at the same hour). Let's break the 7-day break. Under the hour of the 7-day break, menstrual-like bleeding occurs after taking the drug. Bleeding begins on the 2nd or 3rd day after taking the remaining pills and may not end until the cob of taking the pills from the offensive package.

On the next day after the 7-day break, start by taking tablets from the offensive package, to take 21 tablets.

First dose of the drug.

Taking Lindinet 20 times a day from the first day of the menstrual cycle.

Taking pills can be taken from the 2nd to the 5th day of menstruation, however, in this case, it is necessary to take supplementary non-hormonal contraceptives for the first seven days of taking the pills for an hour of the first cycle.

Switching to Lindinet 20 with another oral contraceptive.

The first tablet of Lindinet 20 should be taken after taking the remaining tablet from the front pack of the second oral hormonal anti-inflammatory drug on the first day of menstrual bleeding, and not later than the next day after interrupting taking the tablets (or taking placebo) from the front packaging of oral contraceptives.

Switching to the Lindinet 20 drug, which should be replaced with less progestogen (mini-drank), injectable, implant or intrauterine system.

From the “mini-drank” you can switch to taking the drug Lindinet 20 every day of the cycle. From the implant, you can switch to Lindinet 20 on the day of removal of the implant or the intrauterine system; іz rozchinu for іn'єktsiy - at the day, if it is necessary to rob chergovu іn'єktsiyu, zamіst іn'єktsiy.

In these cases, in the first 7 days, it is necessary to stop additional methods of contraception.

Taking Lindinet 20 days after abortion in the first trimester of pregnancy.

After an abortion, you can start taking the drug immediately, at this time there is no need to stop an additional method of contraception.

Taking Lindinet 20 days later or after an abortion in another trimester of pregnancy.

Information about the congestion of the drug during lactation is described in the section "Congestion in the period of pregnancy and breastfeeding".

Women, who do not like breastfeeding, can start taking the drug in 21-28 days after a half-life or abortion in another trimester of pregnancy. If a woman fails to take pills later in 21-28 days after a half-life or abortion, then in the first 7 days it is necessary to stop additional methods of contraception.

As if after a gradual or abortion, there was a state of contact, before taking the drug, turn off the pregnancy or stop the first menstruation.

Permission to accept.

Although the delay in taking the pill does not change for 12 years, the antiseptic drug does not decrease. I missed a pill and needed to take it right away, as it was. I'll take a pill from the package next to take it at the usual hour. If you delay taking the pill for 12 years, contraception may decrease. In such a time, it is necessary to care about two basic rules:

1. A break in taking pills can never be more than 7 days.

2. Adequate application of the hypothalamus-hypophysis-ovaries system to uninterrupted ingestion of the drug for 7 days.

Vidpovіdno to tsgogo in everyday life should be cherished by the recommendations below:

1st week

The woman is guilty of taking the last missed pill as a last resort, so I should have to take two pills at the same time. After all, continue to take the pills at the appointed hour. In addition, for the next 7 days, it is necessary to use a bare method of contraception, for example, a condom. As in the previous 7 days, an article act was passed, next to secure the possibility of current pregnancy. The more pills were missed and the closer the re-admission to the 7-day interruption in taking the drug, the greater the risk of pregnancy.

2nd week

The woman is guilty of taking the last missed pill as a last resort, so I should have to take two pills at the same time. After all, continue to take the pills at the appointed hour. If the woman took the pills correctly for 7 days before the pass, there is no need to overcome the additional anti-inflammatory drugs. In the other case, or if more than one tablet is missed, it is recommended to additionally overcome the bar'er method of contraception for 7 days.

3rd day

Imovirnist decrease in the contraceptive effect is significant after a possible 7-day break in the drug intake. However, for the administration of the scheme for taking pills, it is possible to reduce the contraceptive intake. If you do not take one of the lower options, then you do not need to overcome the need to win additional contraceptives for knowing the correct intake of pills for 7 days before the pass. However, it is not so, it is recommended to try the first of the suggested further options and to try supplementary methods of contraception for the next 7 days.

1. The woman is guilty of taking the last missed tablet, as a matter of course, so that she should take two tablets at the same time. After all, continue to take the pills at the appointed hour. Taking pills from a new package should be taken as soon as possible after the end of the previous one, so it is not guilty to interrupt the intake of the drug. It is small, that menstrual-like bleeding will start before the end of taking pills from another package, although you can watch out for bloody vision that you smear, otherwise bleeding is probable.

2. You can also take pills from the in-line packaging. In another case, the break in taking the drug may be 7 days, including the days of missing pills; taking pills from the next pack.

If a woman missed taking pills and if she does not have menstrual-like bleeding, stop taking the drug for an hour, then look at her vaginess.

Come in, scho get used to the hour of vomiting.

For 3-4 years after taking the drug, blubbering begins, which means that the speech, that is, did not get wet from the pills. In such a case, the next step is clear to the point “Passing a pill”. If the patient does not want to be taken, missed pills must be taken from the supplementary package.

Zatrimka chi to speed up the menstrual cycle.

To stop menstruation, taking the tablets should be continued from a new package without interrupting the drug intake. Menstruation can be delayed as long as necessary until the end of taking the remaining pill from another package. With a stoppage of menstruation, there may be bleeding or bleeding, which is smeared. Regular intake of Lindinet 20 can be resumed after a significant 7-day break.

With the method of accelerating the onset of menstrual bleeding, the 7-th day of the break in the drug intake will soon last for a few days. If there is a lesser break in the drug intake, then it is better, that menstrual-like bleeding does not occur, but more or less severe bleeding occurs at the hour of taking the offensive packaging.

Side reactions

During the first period of drug ingestion, 10-30% of women may develop such side effects: strain of milk ulcers, increased self-esteem, bleeding, smearing. Qi side effects sound slightly pronounced and pass through 2-4 cycles.

Other possible side reactions.

In women, if they take oral contraceptives, vaginitis may occur, flushing of the chest, changes in mood, headaches, tedium, vomiting, acne, changes in the menstrual cycle, tension of milk ailments, changes in body mass and libido.

The stagnation of oral contraceptives is associated with the development of such states:

• arterial and venous thrombotic and thromboembolic complications, including myocardial infarction, stroke, vein thrombosis and legenous artery embolism;
• intraepithelial neoplasia of the cervix and cervical cancer;
• breast cancer;
• benign liver swelling (focal vascular hyperplasia).

Infections and invasions: vulvovaginal candidiasis.

Good, evil and unspecified new creations (including brushes and polyps): breast cancer, hepatocellular carcinoma, liver adenoma.

From the side of the blood and lymphatic system: hemolytic uremic syndrome.

From the side of the immune system: anaphylactic reactions, kropiv'yanka, angioedema, severe allergic reactions with impaired respiratory and circulatory symptoms, exacerbation of the systemic red dog, exacerbation of porphyria.

Ruined eating and exchange of speeches: nausea, decreased or increased appetite, bloating, decreased glucose tolerance, hyperlipidemia, hypertriglyceridemia, ischemic colitis, inflammation of the intestines (Crohn's disease, Virazkovy colitis).

Psychic damage: change your mood, depression, lowered libido, drativity, nervousness.

From the side of the nervous system: migraine, headache, constipation, acute chorea, optic nerve neuritis*, stroke (LLT).

* Neuritis of the ophthalmic nerve can lead to a partial or repetitive morbidity.

From the side of the organ zor: intolerance to contact lenses, thrombosis of the artery of the lining of the eye.

From the side of the organs of hearing and equal: otosclerosis.

From the side of the heart: myocardial infarction.

From the side of the cardiovascular system: arterial hypertension, thrombosis, embolism

From the side of the grass path: nausea, vomiting, pain in the abdomen, pancreatitis.

From the side of the liver and the living paths: ailment of zhovchnoy michur, zhovchnokam'yana ailment**, hepatocellular ushkodzhennya (including hepatitis and impaired liver function).

** The use of combined oral contraceptives can help to overcome an acute disease of mush and speed up the development of ailments in women, since they did not have symptoms of disease earlier.

On the side of the shkіri and pіdshkіrnoї kіtkovini: acne, chloasma (melasma LLT), hirsutism, alopecia, erythema vulgaris, erythema multiforme.

From the side of the reproductive system and milk infections: profuse bleeding, seeing that smear between menstruation, used in milk ulcers, engorgement of milk ulcers.

Laboratory indications: decrease in weight loss, decrease in folate levels.

Serious and other unfortunate occurrences are described in the section “Features of stagnation”.

Overdose

After taking large doses of Lindinet, 20 important symptoms were not observed. Signs of overdose: nausea, vomit, in young girls - small vaginal bleeding. The drug does not have a specific antidote, it is symptomatic treatment.

Congestion during pregnancy or breastfeeding

Vagity. Before the cob I will receive Lindinet 20 slid to turn off the vaginess.

As if the pregnancy occurred during the period of drug intake, it is necessary to take oral contraceptives in a negligent manner.

Great epidemiological studies have not shown any increased risk of congenital vadose development in newborns, as they were born in women, as they took oral contraceptives to vagity, nor teratogenic disease (zocrema, heart disease and anom alіy rozvitku kіntsіvok) in women, if oral contraceptives were not taken on early terms. vagity.

Anniversary of the breast. The stagnation of hormonal antiparasitic effects during the first hour of breastfeeding is not recommended;

Children

The drug should be administered to children.

Features

Illness of the circulatory system.

Oral antiseptics can reduce the risk of myocardial infarction. Risk of myocardial infarction is common in chickens and may have other risk factors, such as hypertension, hypercholesterolemia, obesity and diabetes.

Chicken significantly increases the risk of cardiovascular complications, which can be blamed on oral contraceptives. This risk increases with age, for women age 35 years and quiet, who smoke a lot, the risk of cardiovascular complications increases significantly. Women who are taking oral anti-infective drugs are recommended to take it in the form of a chicken.

Lindinet 20 is a sign of protection for women, as they may be at risk of cardiovascular disease.

The use of oral contraceptives increases the risk of developing cerebrovascular diseases (ischemic and hemorrhagic stroke) and venous thromboembolic disorders.

It was reported about the increase in arterial pressure (AT) in women who took oral contraceptives. The rise of the arterial pressure was often observed in women of the older century, and also for the trivial stagnation.

Otrimanі data to confirm that the frequency of the development of arterial hypertension increases in stale amounts of estrogen.

For these women, who had previously been diagnosed with an arterial pressure movement, or were diagnosed with an illness, which were accompanied by an arterial movement, or suffered an illness, they should recommend a different method of contraception. As if, unimportantly, a woman with arterial hypertension needs to take oral antiseptic drugs, she needs suvory control and, as a result, a significant increase in arterial pressure is indicated, the drug should be taken.

In most women, the arterial pressure after the application of the drug turns to normal, and later on, the risk of arterial hypertension is not typical.

Venous and arterial thrombosis and thromboembolism.

The use of combined oral contraceptives is associated with the development of risk of venous and arterial thrombotic and thromboembolic conditions. For a skin-specific estrogen/progestogen combination, a dosing regimen should be prescribed to compensate for the minimum amount of estrogen and progestogen and simultaneously provide a low rate of failure and meet the needs of the patient.

Venous thrombosis and thromboembolism.

The use of any combination of oral contraceptives (COCs) causes the development of risk of venous thromboembolic disease (VTZ).

Additional risk for the development of venous thromboembolic disease increases in women who have not yet taken such drugs. Tsey rizik is richly smaller, lower rizik VTZ vagіtnih. Out of 100,000 cases, approximately 60 suffer from VTZ and 1-2% of all cases of VTZ have a lethal end.

The incidence of VTZ in women who take 50 mcg and less of ethinilestradiol in combination with levonorgestrel is approximately 20 per 100,000 women per day. The incidence of VTZ in women who take gestodene in the combination becomes approximately 30-40 cases per 100,000 women per river.

Risk of thromboembolism (arterial and / or venous) growth:

• with vіkom;
• in case of chickens (superior chickens and age, especially older than 35 years old, additional risk factors);
• with a tight family history (for example, an illness of a father or a brother, sister in a young age). Since it is congenital susceptibility to thromboembolic disease, it is necessary to take care of the drug before ingesting the drug
• with obesity (mass body index more than 30 kg/m2);
• with impaired fat metabolism (dyslipoproteinemia)
• with arterial hypertension;
• with migraine
• with congestion of the valves of the heart
• with fleeting arrhythmias (atrial fibrillation)
• in case of triple immobilization, major operations, operations on the lower limbs, severe injuries. At the same time, due to the risk of thromboembolic disease growth in the post-operative period, it is recommended to take the drug 4 days before the operation and start taking it 2 days after the remobilization of the disease.

Oskіlki period without delay after a gradual association with the development of a risk of thromboembolism, taking Lindinet 20 weeks later, no earlier than on the 28th day after the stagnation, or an abortion in another trimester of pregnancy.

Arterial thrombosis and thromboembolism.

Lindinet 20 increases the risk of developing arterial thrombotic and thromboembolic conditions. Descriptions of complications include myocardial infarction and cerebrovascular damage (ischemic and hemorrhagic stroke, transient ischemic attack). Risk of development of arterial thrombotic and thromboembolic complications in women, as it may cause additional risk factors.

Carefully recognize Lindinet 20 women, as they may be risk factors for the development of thrombotic and thromboembolic conditions.

Women who suffer from migraine and take CCP (especially in times of migraine with aura), may develop a risk of developing a stroke.

The drug should not be taken seriously when such signs of thromboembolism appear: pain in the chest, irradiation in the left arm, abnormally strong pain in the legs, swollen legs, prickly pain when breathing in or coughing, bloody vision from the bronchi .

Biochemical indicators that indicate susceptibility to thromboembolic disease: resistance to activated protein C (APC), hyperhomocysteinemia, deficiency of antithrombin III, protein C and protein S, the presence of antiphospholipid antibodies (antikardiolip іnovі, lupus-anticoagulants).

Pukhlini.

In some studies, it was reported about the increased incidence of cervical cancer in women, although they took oral antiproliferative drugs, but the results are ambiguous. Imovirnist the development of cervical cancer to fall due to sexual behavior and other officials (for example, due to the papilloma virus).

It was revealed the incidence of breast cancer in women who were taking oral antiparasitic infections, were clinically indicated at a more early stage, lower in women who did not take these drugs.

There were occasional reports about the development of benign liver swelling in women, as it is a trivaly hour to take hormonal anti-inflammatory diseases.

A link has been established between the appearance of benign liver fluff and the use of oral contraceptives, although such benign fluff is rare. With the expansion of these puffs, intracranial bleeding is likely to occur, which can lead to death.

In women, as if it were common to take oral antiproliferative drugs, they soon became aware of the development of a malignant swelling of the liver.

Patients who may have a history of cholestatic zhovtyanitsya or swollen during the period of pregnancy, as well as patients who have previously taken combined oral contraceptives, risk for the development of this disease. If such patients take Lindinet 20, they need to be closely monitored, and if the pathological state is reversed, the drug should be taken.

Others become.

In case of stagnation of oral antiparasitic diseases, thrombosis of the vessels of the veins of the eye can sometimes be established. Taking the drug should be administered in the event of an injury (full or partial), exophthalmia, diplopia, or with a swollen nipple of the pore nerve, or damage to the vessels of the network and undergo additional medical obstezhennia.

Behind the data, there is a significant risk of the elimination of gallstones with a century of growth in women, if they take oral antibiotics or preparations to ward off estrogen. New studies have shown that there is a risk of stone disease in the presence of drugs with a small dose of hormones.

With the appearance of a more severe attack of migraine, with the appearance of a fast or with a repeated unbearably severe headache, the drug should be prescribed.

The intake of Lindinet 20 tablets should be taken in a negligent manner with the appearance of a stinger or with the appearance of an epileptic attack.

Influx on the exchange of carbohydrates and lipids.

Women taking Lindinet 20 may be at risk of reduced tolerance to carbohydrates. For this reason, women with uterine diabetes should take Lindinet 20 , guilty of perebuvat under a retelny look.

In some women with chronic oral antiparasitic infections, an increase in the level of triglycerides in the blood was revealed. A number of progestogens reduce the level of high fat lipoproteins (HPLL). In connection with the fact that estrogen increases the level of HDL cholesterol in blood plasma, injecting the drug Lindinet 20 into the exchange of lipids to deposit both equal to estrogen and progestogen and to the dose of the form of progestogen.

It is necessary to establish a strict control over women with hyperlipidemia, who, regardless of the price, have taken anti-inflammatory drugs.

In women who had mild relapsing hyperlipidemia and took the drug with estrogen, there was a sharp increase in triglycerides in blood plasma, which could lead to pancreatitis.

Disruption of the menstrual cycle.

If Lindinet 20 is blocked, especially in the first three months, irregular bleeding may occur. If such bleeding is to last a three-hour period, or they appear after regular cycles have been formed, the cause of them, as a rule, is non-hormonal; it is necessary to conduct a general gynecological examination to exclude the vaccinity of the evil wombs. Since the non-hormonal cause is excluded, the next step is to switch to another drug.

In other periods, menstrual-like bleeding does not occur after taking the drug for a 7-day period. If the regimen of the drug was disrupted before the day of bleeding, or if the bleeding was daily after taking the remaining pill from another package, then until the continuation of the drug intake, the patient should turn off the vagity.

Become one that requires special care.

Medical review.

Before using the drug Lindinet 20 on the cob, it is necessary to take a report of the family history and undergo a thorough medical and gynecological examination. Qi follow-up should be repeated regularly. During the physical examination, the arterial pressure was reduced, the lactiferous ulcers were extended, palpation was alive, gynecological obstruction was carried out after the follow-up of the cytological smear, as well as laboratory examinations.

It is necessary for a woman to be ahead of her, so that the drug does not protect against infections, that it is spread by the stateway, the cream against SNIDu.

liver function.

In acute cases of chronically impaired liver function, the drug should be ingested until normalization of liver enzymes. If the activity of hepatic enzymes is impaired, the metabolism of steroid hormones may be impaired.

Affective discord.

For women who experience depression while receiving antidepressant drugs, take the drug dotally and switch to another method of contraception until the cause of the depressive state is identified. Women, who had previously suffered depression, should be guilty of rehab under remote control, and in case of depression, they should take oral anti-infective drugs.

Riveven folate.

With chronic oral antifungal infections, folic acid levels in the blood may decrease. It may be clinically significant only once, if it is not long after the completion of the course of oral anti-seizure therapy, it is possible to conceive.

Chloasma.

The appearance of chloasma is especially often observed in women, as they may have a history of chloasma of the vagina. Women, yakі skhilnі to chloasma, sіd unikati perebuvannya on sontsі, as well as dії ultraviolet vipromіuvannya pіd іn hour priyom PDA.

Krіm zaznachenyh stanіv, I need to give special respect to the stan of the woman for the manifestations of the upcoming illnesses: otosclerosis, rozsіyany sclerosis, epilepsy, chorea mala, porphyria, which intermittent, tetanіchі stani, nirkov deficiency, obesity, systemic chervoniy vovchak, uterine myoma.

Under the influence of oral anti-infective agents number of previous laboratory tests(indicators of the function of the liver, nirok, nadirkovyh zoloza, thyroid zloza, zdannya blood and fibrinolytic factors, lipoproteins and transport proteins) may change. Uncertainty on the spot, the show-offs are overflowing at the borders of the norm.

Patients with rare sluggish forms of galactose intolerance, lactase deficiency or glucose-galactase malabsorption syndrome should not take the drug.

Patients with rare, subclinical forms of fructose intolerance, sucrose-isomaltase deficiency, or glucose-galactase malabsorption syndrome should not take the drug.

Zdatn_st vplivat on swidk_st reaction when keruvannya by motor transport by other mechanisms

No other mechanisms have been carried out to investigate how much the drug can be injected into the car.

Interactions with other medical procedures and other types of interactions

Interactions between etinilestradiol and single-hourly stasis drugs can lead to an increase or decrease in plasma levels of ethinilestradiol.

A decrease in plasma levels of etinilestradiol can lead to an increase in the amount of bleeding and disruption of the menstrual cycle, and may also lead to a decrease in the contraceptive effect of Lindinet 20. Therefore, in times of one-hour ingestion of etinilestradiol and the drug iv, to reduce plasma levels of ethinilestradiol as an adjunct to taking a contraceptive method (e.g. , condoms, spermicides). As it is necessary to administer the drug intake in order to avoid such active speech, it is necessary to look at the possibility of using hormonal contraceptives as the main method of contraception.

If you are taking medications that reduce the concentration of ethinilestradiol in the blood, it is recommended to use supplementary non-hormonal methods of contraception for at least 7 days. If you are taking medicinal preparations that will lead to the induction of microsomal liver enzymes and cause a decrease in the concentration of etinilestradiol in blood serum, it is recommended to use additional non-hormonal methods of contraception protyag om more than a tribal period. In some cases, the fallow dose, trivality and consistency of administration of the drug cause the induction of enzymes, may pass later, the first lower induction of enzymes in the liver will begin to stick.

Active speech agents that may reduce the concentration of etinilestradiol in the blood serum:

• whether the speech is active, as it reduces the hour of transit by the shlunkovo-intestinal tract and, henceforth, reduces the intake;
• speech, which induce microsomal liver enzymes, e.g. rifampicin, rifabutin, barbiturate, primidone, phenylbutazone, phenytoin, dexamethasone, griseofulvin, topiramate, deacid inhibitors and proteases, modafinil, carbamazepine, oxcarbazepine;
• hypericum perforatum(zvіrobіy) i ritonavir
• antibiotics (for example, ampicillin and other penicillins, tetracycline), stink shards reduce hepatic-intestinal estrogen recycling.

Active speech, which may increase the concentration of etinilestradiol in the blood serum:

• atorvastatin;
• drugs, yakі also sulphated in the walls of the intestinal tract, for example, ascorbic acid (vitamin C) and paracetamol;
• speech, which inhibit cytochrome P450 3A4 isoenzyme, for example, indinavir, fluconazole, troleandomycin.

Troleandomycin may reduce the risk of intrahepatic cholestasis in concomitant use of oral contraceptives.

Vzaєmodії, pov'yazanі іz vmoktuvannyam drug. With diarrhea, intestinal motility increases and hormone absorption decreases. Whether it be a drug that shortens the time of the presence of a hormonal drug in the colon, lowers the level of the hormone in the blood.

Impact on the metabolism of other drugs.

Etinilestradiol may interfere with the metabolism of other drugs by blocking liver enzymes or by speeding up conjugation (used to the liver). Blood levels may increase (eg, cyclosporine, theophylline, corticosteroids) or decrease (eg, lamotrigine, levothyroxine, valproate) through other drugs.

In the case of an one-hour insufficiency of ritonavir and oral antiseptic use, the drug should be considered with a higher dose of etinilestradiol or vicoristotherapy with a non-hormonal method of contraception.

Pharmacological authorities

Pharmacological. Combinations of oral anti-inflammatory drugs and blocking of gonadotropins. The primary action of these preparations is directed to ovulation galvanization. The drug is used to change the cervical mucus, which makes it easier for sperm to pass through the empty uterus and into the endometrium, thereby changing the possibility of implantation. All tse priyaє zabіgannyu vagіtnostі.

Oral antiparasitic infections, the crime of zapobigannya vaginosti, may have a low positive power.

Irritating menstrual cycle. The menstrual cycle becomes regular. The amount of blood loss is reduced during the hour of menstruation and the amount of blood loss is reduced. The frequency of dysmenorrhea decreases.

Wash away the savings

Store at a temperature not higher than 25 C in the original packaging for protection from light and water.

Take care of the place inaccessible to children.

Package

21 tablets, coated with a shell, in blister, 1 or 3 blisters at a time with a cardboard case to store the blister from a cardboard package.

Lindinet 20 (etinilestradiol + gestodene) - monophasic tableting of combinations (estrogen + progestogen) antiseptic drug. Virobnik is a Ukrainian pharmaceutical company Gedeon Richter. The date of entering the light market is 2004. The drug is valued for its safety, safe contraception and effective control of the menstrual cycle. Lіpndinet 20 may be tolerable, does not affect the indications of arterial pressure and the concentration of aldosterone, which is especially important for women in pre-menopausal and menopausal periods. Lindinet 20 is an excellent choice for women of the middle reproductive age (from 22 to 35 years of age), as it requires trival, reliable and safe contraception, as well as for girls, as well as for women who have hormonal anti-parasitic diseases. Irrespective of the low number of intoxicating speeches, the drug is superb in controlling the menstrual cycle and is guaranteed to reduce the characteristic pain in the lower abdomen. Lindinet 20 is the optimal choice in mild depression, if the woman develops undesirable effects, due to a high dose of the estrogenic or progestin component. Lindinet 20 should store the minimum dose of etinilestradiol and gestagen (gestodene) in its warehouse, which will ensure the drop in plasma estrogen concentrations. Gestodene inclusions in the drug at a dose that does not have clinically significant glucocorticoid activity, but has a stable body mass.

This confirms the results of the preparation, demonstrates the presence of a significant increase in the woman's body mass. Gestodene is one of the most intense and highly addictive progestins present in the pharmaceutical market today. Zavdyaki high activity, chiu speech vicory at low concentrations, in which it does not contribute to the exchange of fats and carbohydrates and does not show androgenic power. Antizaplide cream, the drug may also have a therapeutic effect, changing the development of a whole series of diseases of the gynecological profile, incl. puffy etiology.

Before the cob of cob Lindinetu 20, a woman can undergo a medical examination, which includes the collection of family and special anamnestic data, the elimination of arterial pressure, laboratory analysis, as well as gynecological obstezhennia. Nadal podіbne obstezhennya, for the reason that the woman takes oral contraceptives, may be carried out from the periodicity 1 time per test. To the beginning of antiseptic therapy with vicarious hormonal contraceptives, skin women are aware of all possible risks and potential risks, if the drug is taken at once from a woman, a decision is made about the choice of that other method contraception. As soon as the cob of the drug was taken, the woman developed or became ill with the circulatory system, cardiovascular disease, epilepsy, circulatory diabetes, depression, then antiseptic therapy should be taken.

Pharmacology

Monophasic oral contraceptive. Ignore the secretion of gonadotropic hormones in the pituitary gland. The contraceptive effect of the drug is due to the use of kilkom mechanisms. The estrogen component of the drug is etinilestradiol, a synthetic analogue of the follicular hormone estradiol, which takes part together with the hormone of the stomach in the regulation of the menstrual cycle. The gestagenic component is gestodene - similar to 19-nortestosterone, which overrides the strength and selectivity of not only the natural hormone of the stomach, progesterone, but also other synthetic progestogens (for example, levonorgestrel). Signs of high activity of gestodene vicorate in low doses, in some veins they do not show androgenic power and practically do not affect lipid and carbohydrate metabolism.

A number of designated central and peripheral mechanisms that shift the maturation of the ovum to the ovary, the contraceptive effect of delusions of decreased acceptability of the endometrium to the blastocyst, as well as an increase in the viscosity of the mucus, which is known walk in the cervix of the uterus, to work її visibly impassable for. Krim contraceptive effect of the drug with regular use of may and lіkuvalnu diyu, normalizing the menstrual cycle and concomitantly preventing the development of low gynecological diseases, incl. Fluffy nature.

Pharmacokinetics

Gestodene

Vsmoktuvannya

If I receive an internal swede and povnistyu get wet from the SHKT. After a single dose, C max is indicated after 1 year and becomes 2-4 ng / ml. Bioavailability - close to 99%.

Rozpodil

Gestodene binds to albumin and globulin, which binds to state hormones (SHBG). 1-2% occur in plasma in the free form, 50-75% bind specifically to SHBG. An increase in the level of SHBG in the blood, caused by etinilestradiol, is added to the level of gestodene: an increase in the fraction associated with SHBG, and a decrease in the fraction associated with albumins. Average V d - 0.7-1.4 l / kg. Pharmacokinetics of gestodene lie in the form of GZNG. The concentration of SHBG in the blood plasma under the influence of estradiol increases by 3 times. With proper administration, the concentration of gestodene in plasma increases by 3-4 times and in the other half of the cycle it reaches the maximum.

Metabolism and vision

Gestodene is biotransformed in the liver. The average plasma clearance should be 0.8-1 ml/min/kg. The riven of gestodene in blood syrovatts decreases biphasically. T 1/2 in β-phase - 12-20 years. Gestodene is less likely to be excreted in the form of metabolites, 60% - from the section, 40% - from the feces. T 1/2 metabolites - about 1 day.

Etinilestradiol

Vsmoktuvannya

After administering etinilestradiol, it is wetted quickly and practically completely. The average Cmax in blood syrovatt reaches 1-2 years after admission and becomes 30-80 pg / ml. Absolute bioavailability through presystemic conjugation and primary metabolism is close to 60%.

Rozpodil

Mostly (about 98.5%), but non-specifically associated with albumin and inducing an increase in the level of SHBG in blood circulatory system. Average V d - 5-18 l / kg.

C ss is restored up to 3-4 days after taking the drug and won by 20% more, lower after a single dose.

Metabolism

Aromatic hydroxylation is due to the adoption of hydroxylated and methylated metabolites, which are present in the forms of the free metabolites or in the forms of the conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma becomes close to 5-13 ml.

Vivedennya

Concentration in blood syrovats decreases biphasically. T 1/2 in β-phase - close to 16-24 years. Etinilestradiol is seen only in the form of metabolites, in the ratio of 2:3 in the section and in the liver. T 1/2 metabolites - about 1 day.

Release form

Pigulki, covered with a shell of a light yellow color, round, double-sided, offending sides without writing; on the evils of a white or white color with a light yellow edging.

additional speech: sodium calcium edatate - 0.065 mg, magnesium stearate - 0.2 mg, silicon dioxide coloid - 0.275 mg, povidone - 1.7 mg, corn starch - 15.5 mg, lactose monohydrate - 37.165 mg.

Warehouse of the husk: barvnik quinolinovy ​​zhovtii (D+S zhovtiy No. 10) (E104) - 0.00135 mg, povidone - 0.171 mg, titanium dioxide - 0.46465 mg, macrogol 6000 - 2.23 mg, calcium - 8.24 mg, talc - 8.24 mg. - 19.66 mg.

21 pcs. - blisters (1) - packs of cardboard.
21 pcs. - blisters (3) - packs of cardboard.

Dosing

Assign 1 tab./doby for 21 days, if possible, at the same time doby. After taking the rest of the pill from the package, there will be a 7-day break, when there is bleeding in the eye. Break the next day after the 7th day (that is, after 4 days after taking the first pill, on the same day of the next day) to take the drug.

Taking the first tablet Lindinet 20 should be started from the 1st to the 5th day of the menstrual cycle.

When switching to Lindinet 20 from the last combined oral contraceptive, the first tablet of Lindinet 20 should be taken after taking the remaining pill from the package of the second oral hormonal contraceptive, on the first day of bleeding.

If you switch to Lindinet 20 with drugs that only gestagen can be used ("mini-drank", in'excise', implant), if you take "mini-drank" with Lindinet 20, you can start on any day of the cycle, go from stopping the implant on the Lindinet 20 preparation can be taken the next day after the removal of the implant; In these cases, in the first 7 days, it was necessary to stop additional methods of contraception.

After an abortion in the 1st trimester of pregnancy, you can consider taking the drug Lindinet 20 immediately after the operation. In this case, there is no need to establish additional methods of contraception.

After a gradual decrease or after an abortion in the second trimester of pregnancy, the drug can be taken at 21-28 days of pregnancy. In these cases, during the first 7 days, it is necessary to stop additional methods of contraception. If the first cob takes the drug in the first 7 days, then stop using an additional barrier method of contraception. In case of contraceptive exposure, before the cob of contraception, before the cob of the drug, turn off the pregnancy or turn off the cob before the first menstruation.

If you miss a pill, you missed a pill and you need to take it again. If the interval for taking pills becomes less than 12 years, then the antiseptic effect of the drug does not decrease, and in this case there is no need to stop the supplementary method of contraception. Other tablets should be taken at the usual hour. Even if the interval becomes longer than 12 years, the antiseptic effect of the drug may be reduced. In such cases, it is not necessary to repeat the missed dose, continue taking the drug in the normal mode, however, at the onset of 7 days, it is necessary to stop the supplementary method of contraception. As a result, less than 7 tabs were lost in the package. taking the drug from the offensive package should be started without interruption. In this case, bleeding is not observed until the completion of the received drug from another package, but bleeding may appear, which is smeared or else.

If bleeding does not occur after completion of taking the drug from another package, before continuing with the received drug, turn off the vagity.

For a period of 3-4 years after taking the drug, vomiting and/or diarrhea can begin, and the contraceptive effect may decrease. In such situations, it should be appropriate to take the pills when skipping the pills. If the patient does not use the normal contraceptive regimen, missed pills should be taken from the other packaging.

To speed up the onset of menstruation, change the interruption of the drug taken. If the break is shorter, then it is more likely to be caused by bleeding or spotting bleeding at the hour of taking pills from the offensive packaging (similar to falling out of the stuttering of menstruation).

To stop the cob of menstruation, the drug should be continued from a new package without a 7-day interruption. Menstruation can be delayed for as long as necessary until the end of taking the remaining pill from another package. With a stoppage of menstruation, there may be bleeding or bleeding, which is smeared. Regular intake of Lindinet 20 can be resumed after a significant 7-day break.

Overdose

No severe symptoms have been described following administration of the drug at high doses.

Symptoms: boredom, vomit, in girls - bloody visions of piss.

Prescribe symptomatic therapy, no specific antidote.

Interaction

The contraceptive activity of Lindinet 20 is reduced by one-hour administration of ampicillin, tetracycline, rifampicin, barbiturates, primidone, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, approx. The antiseptic effect of oral contraceptives decreases with the congestion of these combinations, frequent bleeding and disrupted menstruation. For an hour taking Lindinet 20 with other drugs, as well as for 7 days after the completion of the course, it is necessary to take additional non-hormonal (condom, spermicidal gel) methods of contraception. If rifampicin is blocked, additional methods of contraception should be stopped for 4 days after the completion of yoga intake.

In the case of one-hour exposure to Lindinet 20, there may be a drug that increases the motility of the CT, reduces the absorption of active speech and blood plasma.

Sulfation of etinilestradiol occurs at the intestinal wall. Preparations that also provide sulphation in the intestinal walls (including ascorbic acid), competitively sulphate etinilestradiol and thereby enhance the biological availability of etinilestradiol.

Inducers of microsomal liver enzymes reduce plasma levels of ethinilestradiol (rifampicin, barbiturate, phenylbutazone, phenytoin, griseofulvin, topiramate, hydantoin, felbamate, rifabutin, oscarbazepine).

Liver enzyme inhibitors (traconazole, fluconazole) increase ethinilestradiol levels in blood plasma.

Active antibiotics (ampicillin, tetracycline), interfering with intrahepatic circulation of estrogen, reduce plasma levels of ethinilestradiol.

Etinilestradiol by way of inhibition of liver enzymes or accelerated conjugation (usamped glucuronidation) may affect the metabolism of other drugs (zocrema cyclosporine, theophylline); Plasma concentrations of these drugs may either increase or decrease.

With one-hour exposure to Lindinet 20 with St. John's wort (including nastya), the concentration of active speech in the blood decreases, which can lead to the appearance of bleeding, vaginess. The reason for this is inducing St. John's wort on liver enzymes, as it is three days after the completion of the course of taking St. John's wort. It is not recommended to use a combination of drugs.

Ritonavir reduces the AUC of ethinilestradiol by 41%. In conjunction with cym pid hour of zastosuvannya ritonavir should zastosovuvaty hormonal contraceptive with a higher dose of etinilestradiol or additionally zastosovuvat non-hormonal methods of contraception.

You may need to correct the dosing regimen for an hour of stagnation of hypoglycemic diseases, tk. oral antidiabetic regimens may reduce carbohydrate tolerance, increase insulin requirements and oral antidiabetic regimens.

Pobichna diya

Side effects that may affect the drug

Cardiovascular system: arterial hypertension; rarely - arterial and venous thromboembolism (including myocardial infarction, stroke, thrombosis of the deep veins of the lower limbs, thromboembolism of the legenous artery); more rarely - arterial or venous thromboembolism of the hepatic, mesenteric, nirk, retinal arteries and veins.

Sensitive to the side of the organs: loss of hearing, mindful of otosclerosis.

Others: hemolytic-uremic syndrome, porphyria; rіdko - zagostrennya reactive systemic red dog; more rarely - Sidenham's chorea (should be taken after administration of the drug).

Other side effects are more frequent, but less severe. Dotsilnist prodovzhennya zastosuvannya drug vyrishuєtsya іndivіdіdually pіslya konsultії s zіkarem, vhodyachiyі іz svіvіdnoshennya measles / rizik.

On the side of the state system: acyclic bleeding / bloody vision from the pihvi, amenorrhea after the administration of the drug, changes in the mucus of the pihvi, the development of inflammation of the pihvi, candidiasis, tension, baldness, increased milk infections, galactorrhea.

On the side of the herbal system: pain in epigastrium, nudota, vomit, Crohn's ailment, virazkovy colitis, viniknennya or aggravated zhovtyanitsa and/or sverblyka, associated with cholestasis, cholelithiasis, hepatitis, liver adenoma.

Dermatological reactions: exudative erythema, exudative erythema, hanging, chloasma, increased hair loss.

From the side of the central nervous system: headache, migraine, mood lability, depression.

On the side of the organs of sensitivity: decreased hearing, increased sensitivity of the horn (when wearing contact lenses).

Damage from the side of the exchange of speech: stippling of the radii in the body, change (improvement) of body mass, decrease in tolerance to carbohydrates, hyperglycemia, increase in the level of TG.

Other: allergic reactions.

Indication

Contraception.

Contraindication

• the presence of severe and / or multiple factors in the risk of venous or arterial thrombosis (including aggravated damage to the valvular apparatus of the heart, atrial fibrillation, ailment of the vessels of the brain or coronary arteries, arterial hypertension, severe or middle stage severity of AT 0 ≥0 .st. );
• presence or history of evidence of thrombosis (including ischemic transient attack, angina pectoris);
• migraine with moderate neurological symptoms, incl. in history;
• venous or arterial thrombosis / thromboembolism (including myocardial infarction, stroke, thrombosis of the deep veins of the hominus, embolism of the legenous artery) or in history;
• the presence of venous thromboembolism in history;
• surgical intervention from trivial immobilization;
• blood diabetes (with angiopathies);
• pancreatitis (including history), which is accompanied by severe hypertriglyceridemia;
• dyslipidemia;
• severe liver disease, cholestatic zhovtyanitsya (including with vagity), hepatitis, incl. in anamnesis (before normalization of functional and laboratory indications and for a period of 3 months after normalization);
• zhovtyanitsya when taking corticosteroids;
• zhovchnokam'yana ailment in Denmark, or in the anamnesis;
• Gilbert's syndrome; Dubin-Johnson syndrome; Rotor syndrome;
• swelling of the liver (including history);
• strong sverbіzh, otosclerosis or yogo progress with anterior vaginess or taking corticosteroids;
• hormone-depleted evils of newly formed organs and milk diseases (including in case of suspicion of them);
• vaginal bleeding of unclear etiology;
• hens for women older than 35 years (over 15 cigarettes per day);
• vagіtnіst chi pіdozra on ї;
• lactation period;
• Increased sensitivity to drug components.

For the sake of protection, the drug should be used in countries that increase the risk of development of venous or arterial thrombosis/thromboembolism: older than 35 years of age, smoking, downturn to thrombosis (thrombosis, myocardial infarction, or damage to cerebral circulation in young omu vіtsi someone else) hemolytic-uremіchny syndrome, recessive angioedema, liver disease, disease, which in the past vinicles or worsened with pregnancy or on aphids in front of the intake of state hormones (including porphyria, vaginal herpes, chorea / Sidenham's disease) , obese (IMT over 30 kg/ m 2 ), dyslipoproteinemia, arterial hypertension, migraine, epilepsy, valvular heart disease, atrial fibrillation, trival immobilization, wide surgical intervention, surgical intervention on the lower limbs, surgical intervention at the lower kіntsіvkakh lebіt, p_slyapological period (when women do not like / 21 days after sloping); women who come after the completion of the lactation period), the presence of an important depression, (including in the anamnesis), changes in biochemical signs (resistance of activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein deficiency C or S, antiphospholipid antibodies, in t h.antibody to cardiolipin, canine anticoagulant), sucrose diabetes, no complication of vascular disorders, VKV, Crohn's ailment, virazkovy colitis, sickle cell anemia, hypertriglyceridemia (including those with a family history), hospital that chronic.

Features

Congestion with vagity and breastfeeding

The drug is contraindicated until zastosuvannya with pregnancy and during lactation.

In a small number of components, the drug is seen in breast milk.

When zastosuvanni pіd hour of lactation, the appearance of milk may change.

Zastosuvannya with impaired liver function

Contraindications for impaired liver function.

Zastosuvannya when the function of nirok is damaged

The drug is not recommended for use in case of nirok diseases.

especially vkazіvki

Before the cob infusion of the drug, it is necessary to carry out general medical (reporting family and special anamnesis, mimicking arterial pressure, laboratory follow-up) and gynecological obstruction (including obstruction of milk ulcers, pelvic organs, cytological analysis of cervical smear). If necessary, take the drug regularly, skin for 6 months.

The drug is a supernatant contraceptive: Pearl index (indicator of the number of vaginesses, which is the first hour of contraception in 100 women for a period of 1 year), with the correct intake, it becomes close to 0.05. At the same time, if the contraceptive effect of the drug on the cob is generally manifested until the 14th day, then in the first 2nd period of the drug it is recommended to stop the non-hormonal methods of contraception.

In skin cases, before the recognition of hormonal contraceptives, the possible negative effects of their use are individually assessed. It is necessary to discuss the food with the patient, so after taking the necessary information, take the rest of the decision about the choice of hormonal or other method of contraception.

The health status of a woman needs to be closely controlled. If it is necessary to take the drug for an hour, or it will worsen, whether it is from overexposure / sickness, it is necessary to take the drug and switch to another, non-hormonal method of contraception:

• disease of the system and hemostasis;
• become / ill, which lead to the development of heart-vascular, nirkovo insufficiency;
• epilepsy;
• migraine;
• risk of development of estrogen-deposited swelling or estrogen-deposited gynecological diseases;
• bloody diabetes, not aggravated by court injuries;
• severe depression (because depression is due to impaired tryptophan metabolism, then vitamin B6 can be blocked with a correction method);
• sickle cell anemia, because in other cases (for example, infections, hypoxia) preparations that prevent estrogen, with this pathology, they can cause thromboembolic manifestations;
• appearance of symptoms in laboratory tests to assess the function of the liver.

Thromboembolic disease

Epidemiological investigations have been carried out on the occurrence of oral hormonal anti-inflammatory diseases and increased risk of developing arterial and venous thromboembolic diseases (including myocardial infarction, stroke, thrombosis of the deep veins of the lower veins, thromboembolism of the legenev's arch). There was an increase in the risk of venous thromboembolic disease, and also less, lower with vacancy (60 cases per 100,000 vacancies). In case of congestion of oral anti-inflammatory drugs, arterial or venous thromboembolism of the hepatic, mesenteric, nirk, or vessels of the sitkivka is rarely suspected.

Risk of occurrence of arterial or venous thromboembolic disease progresses:

• with vіkom;
• with chickens (intensive chickens and age older than 35 years are considered to be factors of risk);
• when there is a family history of thromboembolic disease (for example, in fathers, brothers and sisters). If you suspect a genetic disorder, it is necessary to consult a doctor before taking the drug;
• with obesity (IMT over 30 kg/m2);
• with dyslipoproteinemia;
• with arterial hypertension;
• with diseased heart valves, worsening hemodynamic disorders;
• with atrial fibrillation;
• with circulatory diabetes, aggravated by judicial injuries;
• in case of triple immobilization, after a great operative intervention, after an operative intervention on the lower limbs, after a serious injury.

In these cases, timchasovy zastosuvannya zastosuvannya drug (not later than 4 days before surgery, and later - not earlier than 2 days after remobilization).

In women, after a gradual increase in the risk of venous thromboembolic disease.

It is possible to treat sciatica, sciatica diabetes, systemic urticaria, hemolytic-uremic syndrome, Crohn's ailment, nonspecific viral colitis, sickle cell anemia, increase the risk of developing venous thromboembolic disease.

Increased resistance to activated protein, hyperhomocysteinemia, protein C and S deficiency, antithrombin III deficiency, presence of antiphospholipid antibodies, increased risk of arterial or venous thromboembolic disease b.

Assessing the risk of measles/risk to the drug taken, the next step is to ensure that the goal of treatment is to reduce the risk of thromboembolism. Thromboembolism symptoms є:

• rapt bіl at the breasts, shcho іrradiyuє at the lion's hand;
• rapt's butt;
• whether it be an unspeakably strong head beat, which is three times a long time, or it appears earlier, especially when there is a rupture or a partial second dawn, or a diplopia, aphasia, confusion, collapse, focal epilepsy єyu, weakly or to the pronounced names of the half of the body, with ruddy damage, strong m'yazi, symptomatic complex "hostry lives".

Puhlinni ill

In some cases, it was reported about the frequent occurrence of cervical cancer in women, for a long time they took hormonal anti-inflammatory drugs, but the results were superb. In the development of cervical cancer, sexual behavior, infection with human papilloma virus and other factors play a significant role.

A meta-analysis of 54 epidemiological studies showing that there is no risk of developing breast cancer in the middle of women, if they take oral hormonal anti-seizure drugs, a higher risk of developing breast cancer could be due to more regular medical treatment. Breast cancer rarely develops in the middle of women up to 40 years of age, regardless of the fact that they take hormonal anti-parasitic stinks, and it increases over time. Taking pills may be considered as one of the risk factors. Tim is not less, the woman is guilty, but she was informed about the possibility of a risk for the development of breast cancer, depending on the assessment of the risk of corystasis and risk (protection against ovarian cancer and endometrium).

Innumerable reports about the development of benign or malignant swelling of the liver in women, as a matter of fact, they take hormonal anti-proliferative diseases for a long time. The mother should be monitored for UVA in case of differential diagnostic assessment of pain in the abdomen, which may be due to an increase in the size of the liver or intracranial bleeding.

Chloasma can develop in women who may have a history of illness in case of vaginess. For women who may develop chloasma at risk, it is necessary to avoid contact with sleepy exchanges or ultraviolet light exposures for an hour to receive Lindinet 20.

Efficiency

The effectiveness of the drug may decrease in such cases: missed pills, vomiting and diarrhea, overnight ingestion of other drugs, which reduce the effectiveness of anti-inflammatory pills.

If the patient takes an hourly other drug, which may reduce the effectiveness of anti-inflammatory pills, then stop additional methods of contraception.

The effectiveness of the drug may be reduced, even after a few months of congestion are irregular, spotty or continual bleeding, in such cases continue taking the tablets until the end of the pack. If, like in another cycle, menstrual-like bleeding does not start, or acyclic bloody visions do not occur, take pills and remember it only after the pregnancy is turned off.

Change of laboratory indicators

When taking oral antiseptic tablets - in conjunction with the estrogen component - the level of certain laboratory parameters (functional indicators of the liver, nirok, supra-nural ulcers, thyroid ulcer, indicators of hemostasis, lipoprotein and transport proteins) can be changed. їнів).

additional information

After acute viral hepatitis, the drug should be taken after normalization of liver function (not earlier than after 6 months).

With diarrhea and intestinal disorders, vomiting, the contraceptive effect may decrease. Without taking the drug, it is necessary to use additional non-hormonal methods of contraception.

Women who scorch, may increase the risk of the development of vessel diseases with serious consequences (myocardial infarction, stroke). Keep risk for a lifetime (especially for women over 35 years of age) and for the number of cigarettes you smoke.

Keep ahead of the woman, so that the drug does not protect against VIL-infection (SNID) and other illnesses that are transmitted by the state route.

Inflowing into the building to the maintenance of vehicles and control of mechanisms

There was no follow-up of the injection of the drug Lindinet 20 on the wheels, necessary for caring by car and vibrating mechanisms.