Brand Name Choices
No generic medication is available for Mercilon (Desogestrel/Ethinyl Estradiol)
What Mercilon is and what it is used for
Mercilon is a combined oral contraceptive pill (‘the Pill’). You take it to prevent pregnancy. This low-dose contraceptive contains two types of female sex hormones, oestrogen and progestogen. These hormones prevent an egg being released from your ovaries so you can’t get pregnant. Mercilon also makes the fluid (mucus) in your cervix thicker which makes it more difficult for sperm to enter the womb. Mercilon is a 21-day pill – you take one each day for 21 days, followed by 7 days when you take no pills. The benefits of taking the Pill include:
• it is one of the most reliable reversible methods of contraception if used correctly
• it doesn’t interrupt sex
• it usually makes your periods regular, lighter and less painful
• it may help with pre-menstrual symptoms. Mercilon will not protect you against sexually transmitted infections, such as Chlamydia or HIV. Only condoms can help to do this.
How to take Mercilon
3.1 How to take it To prevent pregnancy, always take this medicine exactly as described in this leaflet or as your doctor, family planning nurse or pharmacist has told you. Check with your doctor, family planning nurse or pharmacist if you are not sure. Take Mercilon every day for 21 days. Mercilon comes in strips of 21 pills, each marked with a day of the week.
• Take your pill at the same time every day.
• Start by taking a pill marked with the correct day of the week.
• Follow the direction of the arrows on the strip. Take one pill each day, until you have finished all 21 pills.
• Swallow each pill whole, with water if necessary. Do not chew the pill. Then have seven pill-free days. After you have taken all 21 pills in the strip, you have seven days when you take no pills. So if you take the last pill of one pack on a Friday, you will take the first pill of your next pack on the Saturday of the following week. Within a few days of taking the last pill from the strip, you should have a withdrawal bleed like a period. This bleed may not have finished when it is time to start your next strip of pills. You don’t need to use extra contraception during these seven pill-free days – as long as you have taken your pills correctly and start the next strip of pills on time As long as you take Mercilon correctly, you will always start each new strip on the same day of the week. 3.2 Starting Mercilon As a new user or starting the Pill again after a break Either take your first Mercilon pill on the first day of your next period. By starting in this way, you will have contraceptive protection with your first pill. Or if your period has already begun start taking Mercilon on day 5 (counting the first day of your period as day 1) whether or not your bleeding has stopped. You must also use extra contraception, such as condoms, until you have taken the first seven pills correctly. Changing to Mercilon from another contraceptive Pill
• If you are currently on a 21-day Pill: start taking Mercilon the next day after the end of the previous strip. You will have contraceptive protection with your first pill but you will not have a bleed until after you finish your first strip of Mercilon.
• If you are currently on a 28-day Pill: start taking Mercilon the day after your last active pill. You will have contraceptive protection with your first pill. You will not have a bleed until after you finish your first strip of Mercilon.
• Or if you are taking a progestogen-only Pill (mini-Pill or POP): start Mercilon on the first day of bleeding, even if you have already taken the POP for that day. You will have contraceptive cover straight away. If you don’t usually have any bleeding while you are taking a progestogen-only Pill, you can stop taking it any day and start Mercilon the next day. You will need to use extra contraception, such as a condom, for seven days. Changing to Mercilon from a progestogen-only injection, implant of progestogen releasing intrauterine device (IUD) Start taking Mercilon when your next injection is due or on the day that your implant or IUD is removed. Make sure you also use an additional contraceptive method, such as a condom, for the first 7 days that you are taking Mercilon. Starting Mercilon after a miscarriage or abortion If you have had a miscarriage or an abortion, your doctor may tell you to start taking Mercilon straight away. This means that you will have contraceptive protection with your first pill. Contraception after having a baby If you have just had a baby, ask your doctor for advice about contraception. If you are not breast-feeding:
• you can start taking Mercilon three weeks after the birth or,
• you can start taking Mercilon more than three weeks after the birth but you need to use extra contraception, such as a condom until you have taken the first seven pills correctly.
• If you have had sex since the birth there is a chance that you could be pregnant, you should therefore use another form of contraception, such as a condom. In this case, take your first Mercilon pill on the first day of your next period. 3.3 A missed pill If you miss a pill, follow these instructions: If you have missed any of the pills in a strip, and you do not bleed in the first pill-free break, you may be pregnant. Contact your doctor or family planning clinic, or do a pregnancy test yourself. If you start a new strip of pills late, or make your “week off” longer than seven days, you may not be protected from pregnancy. If you had sex in the last seven days, ask your doctor, family planning nurse or pharmacist for advice. You may need to consider emergency contraception. You should also use extra contraception, such as a condom, for seven days. 3.4 A lost pill If you lose a pill, Either take the last pill of the strip in place of the lost pill. Then take all the other pills on their proper days. Your cycle will be one day shorter than normal, but your contraceptive protection won’t be affected. After your seven pill-free days you will have a new starting day, one day earlier than before. Or if you do not want to change the starting day of your cycle, take a pill from a spare strip. Then take all the other pills from your current strip as usual. You can then keep the opened spare strip in case you lose any more pills. 3.5 If you are sick or have diarrhoea If you are sick (vomit) or have very bad diarrhoea your body may not get its usual dose of hormones from that pill. If you vomit within 3 to 4 hours after taking your pill, this is like missing a pill. You must follow the advice for missed pills – see section 3.3, A missed pill. If you have severe diarrhoea for more than 12 hours after taking Mercilon follow the instructions for if you are more than 12 hours late – see section 3.3, A missed pill. →Talk to your doctor if your stomach upset carries on or gets worse. He or she may recommend another form of contraception. 3.6 Missed a period – could you be pregnant? Occasionally, you may miss a withdrawal bleed. This could mean that you are pregnant, but that is very unlikely if you have taken your pills correctly. Start your next strip at the normal time. If you think that you might have put yourself at risk of pregnancy (for example, by missing pills or taking other medicines), or if you miss a second bleed, you should do a pregnancy test. You can buy these from the chemist or get a free test at your family planning clinic or doctors surgery. If you are pregnant, stop taking Mercilon and see your doctor. 3.7 Taking more than one pill should not cause harm It is unlikely that taking more than one pill will do you any harm, but you may feel sick, vomit or have some vaginal bleeding. Talk to your doctor if you have any of these symptoms. 3.8 You can delay a period If you want to delay having a period, finish the strip of pills you are taking. Start the next strip the next day without a break. Take this strip the usual way. After the second strip, leave seven pillfree days as usual, then start your next strip of pills in the normal way. When you use the second strip, you may have some unexpected bleeding or spotting on the days that you take the pill, but don’t worry. 3.9 When you want to get pregnant If you are planning a baby, it’s best to use another method of contraception after stopping Mercilon until you have had a proper period. Your doctor or midwife relies on the date of your last natural period before you get pregnant to tell you when your baby is due. However, it will not cause you or the baby any harm if you get pregnant straight away
Possible side effects
Like all medicines, Mercilon can cause side effects, although not everybody gets them. If you get any side effect, particularly if severe and persistent, or have any change to your health that you think may be due to Mercilon, please talk to your doctor. An increased risk of blood clots in your veins (venous thromboembolism (VTE)) or blood clots in your arteries (arterial thromboembolism (ATE)) is present for all women taking combined hormonal contraceptives. For more detailed information on the different risks from taking combined hormonal contraceptives please see section 2 “What you need to know before you use Mercilon”. 4.1 Serious side effects – see a doctor straight away Signs of deep vein thrombosis include;
• swelling of one leg or along a vein in the leg or foot especially when accompanied by:
• pain or tenderness in the leg which may be felt only when standing or walking;
• increased warmth in the affected leg;
• change in colour of the skin on the leg e.g. turning pale, red or blue. Signs of a pulmonary embolism:
• sudden unexplained breathlessness or rapid breathing;
• sudden cough without an obvious cause, which may bring up blood;
• sharp chest pain which may increase with deep breathing;
• severe light headedness or dizziness;
• rapid or irregular heartbeat;
• severe pain in your stomach. If you are unsure, talk to a doctor as some of these symptoms such as coughing or being short of breath may be mistaken for a milder condition such as a respiratory tract infection (e.g. a ‘common cold’). Signs of retinal vein thrombosis (blood clot in the eye):
• Symptoms most commonly occur in one eye:
• immediate loss of vision or
• painless blurring of vision which can progress to loss of vision. Signs of heart attack:
• chest pain, discomfort, pressure, heaviness;
• sensation of squeezing or fullness in the chest, arm or below the breastbone;
• fullness, indigestion or choking feeling;
• upper body discomfort radiating to the back, jaw, throat, arm and stomach;
• sweating, nausea, vomiting or dizziness;
• extreme weakness, anxiety, or shortness of breath;
• rapid or irregular heartbeats. Signs of a stroke:
• sudden weakness or numbness of the face, arm or leg, especially on one side of the body;
• sudden confusion, trouble speaking or understanding;
• sudden trouble seeing in one or both eyes;
• sudden trouble walking, dizziness, loss of balance or coordination;
• sudden, severe or prolonged headache with no known cause;
• loss of consciousness or fainting with or without seizure. Sometimes the symptoms of stroke can be brief with an almost immediate and full recovery, but you should still seek urgent medical attention as you may be at risk of another stroke. Signs of blood clots blocking other blood vessels:
• swelling and slight blue discolouration of an extremity;
• severe pain in your stomach (acute abdomen). Signs of a severe allergic reaction to Mercilon
• swelling of the face, lips, mouth, tongue or throat. Signs of breast cancer include:
• dimpling of the skin;
• changes in the nipple;
• any lumps you can see or feel. Signs of cancer of the cervix include:
• vaginal discharge that smells and contains blood;
• Unusual vaginal bleeding;
• pelvic pain;
• painful sex. Signs of severe liver problems include:
• severe pain in your upper abdomen;
• yellow skin or eyes (jaundice). →If you think you may have any of these, see a doctor straight away. You may need to stop taking Mercilon. 4.2 Possible side effects
Common (may affect up to 1 in 10 people):
• Putting on weight;
• Breast problems, such as painful or tender breasts;
• Depression or mood changes;
• Stomach problems, such as nausea; abdominal pain;
Uncommon (may affect up to 1 in 100 people):
• Migraine (see a doctor as soon as possible if this is your first migraine or it’s worse than usual, or if the headache is severe, unusual or long lasting);
• Fluid retention (swollen hands, ankles or feet – a sign of fluid retention);
• Decreased sexual desire;
• Skin problems, such as rash or hives;
• Breast enlargement;
Rare (may affect up to 1 in 1000 people)
• Changes in vaginal secretions–Irregular vaginal bleeding
•see section 4.3, Bleeding between periods should not last long;
• Breasts producing a milky fluid from the nipples;
• Hypersensitivity reactions;
• Discomfort of the eyes if you wear contact lenses;
• Erythema nodosum (bruise-like swelling to the shins);
• Erythema multiforme (this is a skin condition);
• Decreased weight;
• Increased sexual desire;
• Harmful blood clots in a vein or artery for example: o in a leg or foot (i.e. DVT); o in a lung (i.e. PE); o heart attack; o stroke; o mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic attack (TIA); o blood clots in the liver, stomach/intestine, kidneys or eye. The chance of having a blood clot may be higher if you have any other conditions that increase this risk. (See section 2 for more information on the conditions that increase risk for blood clots and the symptoms of a blood clot.)
• Severe allergic reaction to Mercilon
• Breast cancer
• Cancer of the cervix
• Severe liver problems
• High blood pressure
• Gall stones
• Chorea (a problem with the nervous system causing jerky movements that you can’t control)
• Worsening of systemic lupus erythematosus (SLE; when your immune system attacks your body causing, for example, joint ache and tiredness)
• Stomach and intestine problems such as pancreatitis; Crohn’s disease; ulcerative colitis
• Worsening of otosclerosis (a hearing problem)
• Problems with blood sugar
• Worsening of a rare condition called porphyria
• Worsening of skin problems, such as brown patches on your face or body (chloasma) blister-like rash, (herpes gestationis) →Tell your doctor, pharmacist or family planning nurse if you are worried about any side effects which you think may be due to Mercilon. Also tell them if any existing conditions get worse while you are taking Mercilon. 4.3 Bleeding between periods should not last long A few women have a little unexpected bleeding or spotting while they are taking Mercilon, especially during the first few months. Normally, this bleeding is nothing to worry about and will stop after a day or two. Keep taking Mercilon as usual; the problem should disappear after the first few strips. You may also have unexpected bleeding if you are not taking your pills regularly, so try to take your pill at the same time every day. Also, unexpected bleeding can sometimes be caused by other medicines. →Make an appointment to see your doctor if you get breakthrough bleeding or spotting that:
• carries on for more than the first few months
• starts after you’ve been taking Mercilon for a while
• carries on even after you’ve stopped taking Mercilon.
Reporting of side effects If you get any side effects, talk to your doctor, family planning nurse or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine. United Kingdom: Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store Malta: ADR Reporting at: www.medicinesauthority.gov.mt/adrportal.
How to Store Mercilon
Keep this medicine out of the sight and reach of children. Do not use Mercilon after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. Store Mercilon below 25°C but not in the fridge. Store it in the original package, in order to protect from light and moisture. 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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