(Ethinyl Estradiol/Norethindrone Acetate)
Brand Name Choices
No generic medication is available for Loestrin (Ethinyl Estradiol/Norethindrone Acetate)
What Loestrin is and what it is used for
The name of your medicine is Loestrin tablets. Loestrin contains two types of medicine:
• Norethisterone acetate – this is a hormone known as a ‘progestogen’
• Ethinylestradiol – this is a hormone known as an ‘estrogen’. These hormones are similar to those produced naturally by your body during pregnancy. What Loestrin is used for Loestrin is a contraceptive pill used to stop you becoming pregnant.
• It is called a ‘combined contraceptive pill’
• This is because it contains two types of medicine.How Loestrin works The hormones in your pill help stop you from getting pregnant in the following ways:
• Stopping eggs being released for fertilisation
• Thickening the fluid present in the neck of the womb. This makes it more difficult for sperm to enter the womb
• The lining of the womb does not thicken enough for a fertilised egg to become embedded in it.
How to take Loestrin
Always take this medicine exactly as your doctor has told you. Check with your doctor or
pharmacist if you are not sure.
Taking this medicine
• Take this medicine by mouth
• Swallow the tablets whole with a drink of water
• Do not crush or chew your tablets. How much to take The recommended dose is one Loestrin tablet taken once a day.
• Take the tablet at about the same time of day, for 21 days in a row
• The packet of tablets is marked with the day of the week when you should take each tablet. This will help you remember to take one tablet for these 21 days
• If you are not sure whether you have taken your tablet, look at the day on the pack to see. Once you have taken all 21 tablets, stop taking Loestrin for 7 days
• A few days after you have taken the last tablet, you should have a period
• You do not need to use any additional contraceptive protection during the 7 days’ break, provided all of the tablets have been taken correctly. After the 7 days’ break, start the next pack of Loestrin
• Start on the same day of the week that you started your previous pack
• Start taking Loestrin on that day, whether or not you are still bleeding. Starting your first course of Loestrin
• You can start Loestrin anytime in your menstrual cycle if you are sure you are not pregnant
• If you start Loestrin on the first day of your period you will be protected from pregnancy immediately
• You can also start Loestrin up to, and including, the fifth day of your period and you will be protected from pregnancy immediately
• If you start Loestrin at any other time in your menstrual cycle you will need to use additional contraception, such as condoms, for the first seven days of taking Loestrin. However, you can switch from another hormonal contraceptive, such as a different combined oral contraceptive (COC) or a progestogen-only pill (POP), at any time in your menstrual cycle and additional contraception is not required. Speak to your doctor or pharmacist if you are not sure what type of contraceptive you were using. Taking Loestrin after having a baby You can start taking Loestrin 21 days after the delivery:
• if you are not breast-feeding
• if you do not have any complications
• if you are able to get up and move around without any problems
• By starting this way you will have contraceptive protection straight away. If you start taking Loestrin more than 21 days after the delivery:
• You should use an additional method of contraception, such as a condom
• Keep doing this until you start to take Loestrin, and for 7 days after you start. 1.3.1 Package Leaflet 9 Taking Loestrin after a miscarriage or an abortion After a miscarriage or abortion, Loestrin can normally be started straight away. If you have a stomach upset Being sick (vomiting) and/or having diarrhoea may stop Loestrin from working properly. If you have a stomach upset, you should:
• Keep taking Loestrin as usual
• Use another method of contraception, such as a condom
• Keep doing this during the upset and for 7 days after recovery. If the 7 days goes past when the pack has run out, you should:
• Start the next pack, the next day, without taking the 7 days’ break. If you do not get a period after finishing the second pack, talk to your doctor straight away before starting your next pack. If you have no bleeding or irregular bleeding with Loestrin Ask your doctor for advice before you start a new course of Loestrin if you have no bleeding at all in the 7 days after a course of tablets. Your doctor may want to check you, to see if you are pregnant. If bleeding occurs during the 21 days in which you are taking Loestrin, do not stop taking the tablets. The bleeding should stop in a day or two. However, if the bleeding is troublesome, very heavy, lasts a long time or keeps happening, talk to your doctor. If bleeding does occur while taking Loestrin, it is usually only in the first 2 or 3 months, while your body is adjusting itself to Loestrin. If you take more Loestrin than you should If you take more Loestrin than you should, talk to a doctor straight away. If you forget to take Loestrin or start a pack late Missing tablets or starting the pack late may make Loestrin less effective. The chance of pregnancy after missing tablets depends on when tablets are missed and how many tablets are missed. A Loestrin tablet is late when you have forgotten to take it at the usual time. A tablet has been missed when it is more than 24 hours since the time you should have taken it. If you miss one Loestrin tablet anywhere in your pack or start the new pack one day late, you will still have contraceptive cover. However, missing two or more Loestrin tablets or starting the pack two or more days late (more than 48 hours late) may affect your contraceptive cover. As soon as you realise you have missed any Loestrin tablets, take the last tablet you missed immediately. In particular, during the seven day pill free break your ovaries are not getting any effects from Loestrin. If you make this pill free break longer by forgetting two or more Loestrin tablets, your ovaries might release an egg and there is a real risk of becoming pregnant. Follow the advice below. If you are not sure what to do, continue to take Loestrin and use additional contraception, such as condoms, and seek advice as soon as possible. 1.3.1 Package Leaflet 10 If you have missed one Loestrin tablet, anywhere in the pack:
• Take the last tablet you missed now even if it means taking two tablets in one day
• Continue taking the rest of the pack as usual
• No additional contraception needed
• Take your 7 day break as normal If you have missed two or more Loestrin tablets (more than 48 hours late), anywhere in the pack:
• Take the last tablet you missed now even if it means taking two tablets in one day
• Leave any earlier missed tablets
• Continue taking the rest of the pack as usual and use an extra method of contraception for the next seven days
• You may need emergency contraception – see below
• You may need to start the next pack of Loestrin without a break – see below. Emergency contraception If you have had unprotected sex in the previous seven days and you have missed two or more Loestrin tablets (more than 48 hours late) in the first week of a pack, you may need emergency contraception. Get advice from your contraception clinic, family doctor, or a pharmacist about this. Starting the next pack of Loestrin after missing two or more tablets (more than 48 hours late) If seven or more tablets are left in the pack after the last missed tablet:
• Finish the pack
• Have the usual seven-day break. If less than seven tablets are left in the pack after the missed tablet:
• Finish the pack and begin new one the next day (this means missing out the break) If you stop taking Loestrin To make sure you have contraceptive protection, it is important that you take Loestrin as directed by your doctor. If you stop taking Loestrin, this will result in the loss of contraceptive protection and the risk of pregnancy. If you wish to become pregnant, you should contact your doctor about stopping the tablets. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
1.3.1 Package Leaflet 11
Stop taking Loestrin and see a doctor straight away if you notice any of the following
serious side effects. You may have a serious blood clot (thrombosis) and may need
urgent medical treatment:
• The very first attack of migraine that you have ever had (usually sight problems followed by a throbbing headache and feeling sick)
• Any bad headaches which are worse than normal or more often than normal
• Migraines you already have which get worse
• Pain, tingling or feeling numb in any part of the body
• Chest or stomach pain
• Painful breathing, feeling breathless or unexplained cough
• Speech problems
• Feeling dizzy or faint
• Sudden sight problems
• Swelling of the veins (phlebitis) or limbs. Your doctor may stop you taking Loestrin:
• if you develop a yellowing of the skin and the whites of your eyes (jaundice)
• if your blood pressure goes up
• if you get a condition listed in the section ‘Warnings and precautions’ or you have one of these listed conditions and it gets worse.
The following side effects have also been reported:
• Allergy-type rash
• Infection of the vagina (thrush)
• Being less able to tolerate sugar and starches (carbohydrates)
• Low mood (depression)
• Rise in blood pressure
• Stomach upset, bloating or cramps, feeling sick (nausea) or being sick (vomiting)
• Water retention or changes in body weight
• Yellowing of the skin or whites of the eyes (jaundice)
• Brown patches on the face or body
• Painful breasts or increase in breast size or leaking from breasts
• Reduced breast milk after birth
• Missed periods during and after treatment
• Breakthrough bleeding or spotting, heavier or lighter bleeding
• Changes in the cervix (neck of the uterus or womb)
• Temporary infertility after stopping the tablet
• Loss of interest in sex
• Changes to the shape of your cornea (a part of the eye). This can cause irritation or discomfort when wearing contact lenses. If you wear contact lenses and this happens, see an optician.
Other side effects reported but not thought to be connected with oral contraceptive treatment:
• Changes in appetite
• Blood problem (porphyria) 1.3.1 Package Leaflet 12
• Feeling tired, nervous or dizzy
• Inflamed vagina
• Pre-menstrual like syndrome
• Cloudy lenses in the eye (cataracts)
• Bad diarrhoea
• Increased hair growth or hair loss
• Acne, serious skin rashes or itching
• Back pain
• Kidney problems or pain when passing water (cystitis-like syndrome)
• Missed periods for some time after stopping the pill
• Liver problem (Budd Chiari syndrome). This causes pain and swelling in the right side of the stomach area, yellowing of the skin and whites of the eyes, feeling sick, fever, vomiting blood and swelling of the legs.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
How to Store Loestrin
Keep this medicine out of the sight and reach of children. Store in the original packaging below 30ºC. Do not use this medicine after the expiry date, which is stated on the carton and blister foil. The expiry date refers to the last day of that month. Do not use this medicine if you notice that the pack or any of the tablets are damaged. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment
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