Lindinet 20
Lindinet 20: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Lindynette 20
ATX code: G03AA10
Active ingredient: ethinylestradiol + gestodene (ethinylestradiol + gestodene)
Producer: Gedeon Richter (Hungary)
Description and photo update: 2019-13-08
Prices in pharmacies: from 468 rubles.
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Lindinet 20 is a monophasic oral contraceptive.
Release form and composition
Dosage form Lindinet 20 - coated tablets: round, biconvex, light yellow, under the membrane, the structure is almost white or white (21 pieces in blisters, in a cardboard box 1 or 3 blisters).
Content of active ingredients in 1 tablet Lindinet 20:
- Ethinylestradiol - 0.02 mg;
- Gestodene - 0.075 mg.
Auxiliary components: corn starch, magnesium stearate, sodium calcium edetate, colloidal silicon dioxide, lactose monohydrate, povidone.
Shell composition: povidone, titanium dioxide, macrogol 6000, calcium carbonate, quinoline yellow dye (D + S yellow No. 10) (E104), sucrose, talc.
Pharmacological properties
Pharmacodynamics
Lindinet 20 is a combined drug that inhibits the pituitary secretion of gonadotropic hormones.
Ethinyl estradiol is an estrogenic component of Lindinet 20. It is a synthetic analogue of estradiol, which is involved in the regulation of the menstrual cycle together with the corpus luteum hormone.
Gestodene is a gestagen component of the drug. It is a derivative of 19-nortestosterone and is superior in selectivity and potency to progesterone (a natural hormone of the corpus luteum) and modern synthetic progestogens (for example, levonorgestrel). Due to its high activity, gestodene is used in low dosages, at which it practically does not affect carbohydrate and lipid metabolism and does not exhibit androgenic properties.
The contraceptive effect of Lindinet 20 is due to central and peripheral mechanisms that prevent the maturation of the egg, as well as a decrease in the susceptibility of the inner layer of the uterus to the blastocyst and an increase in the viscosity of the cervical fluid, which makes it practically impenetrable for sperm.
In addition to the contraceptive effect, Lindinet 20, with regular use, has a therapeutic effect, normalizing the female menstrual cycle and preventing some gynecological diseases, including those of tumor origin.
Pharmacokinetics
Ethinylestradiol is almost completely and rapidly absorbed in the digestive tract. After 1–2 hours, its maximum plasma concentration (30–80 pg / ml) is reached. Ethinylestradiol undergoes presystemic conjugation and primary metabolism in the liver, so its absolute bioavailability is only about 60%. Approximately 98.5% binds to plasma proteins (albumin). The average volume of distribution is 5-18 l / kg.
Ethinylestradiol is metabolized primarily by aromatic hydroxylation. As a result of metabolism, methylated and hydroxylated metabolites are formed, which are partly in conjugated and partly in free form (sulfates and glucuronides). Plasma clearance is 5–13 ml / min / kg. It is excreted in the urine and bile in two stages exclusively in the form of metabolites with a half-life of 24 hours. A stable concentration of ethinyl estradiol is established on days 3-4, while its level is 20% higher than the concentration after taking a single dose.
Gestodene is also rapidly absorbed in the gastrointestinal tract. The maximum plasma concentration (2-4 ng / ml) is reached after 1 hour. Bioavailability of gestodene is approximately 99%. It binds 50-75% to SHBG (sex hormone binding globulin) and albumin. Only 1–2% of gestodene is in a free state. The apparent volume of distribution is 0.7-1.4 l / kg.
The metabolism of gestodene corresponds to the metabolism of other steroids. Plasma clearance is 0.8–1 ml / min / kg. The level of gestodene in the blood decreases in stages. In the second phase, the half-life is 12–20 hours. It is excreted only in the form of metabolites: 40% - with feces, 60% - with urine. The half-life of metabolites is about 24 hours. A stable concentration of gestodene is achieved in the second half of the cycle.
Indications for use
The use of Lindinet 20 is indicated for oral contraception.
Contraindications
- Multiple and / or severe risk factors for arterial or venous thrombosis (including atrial fibrillation, complicated lesions of the valvular apparatus of the heart, moderate or severe arterial hypertension (blood pressure (BP) 160/100 mm Hg or more), coronary artery or cerebral vascular disease brain);
- Angina pectoris, transient ischemic attack and other precursors of thrombosis, including history;
- History of venous thromboembolism;
- Prolonged immobilization after surgery;
- Migraine with focal neurological symptoms, including a history;
- Arterial or venous thromboembolism or thrombosis (deep vein thrombosis of the leg, myocardial infarction, pulmonary embolism, stroke), including history;
- Pancreatitis (including history) against the background of severe hypertriglyceridemia;
- Liver tumors, including history;
- Hyperlipidemia;
- Jaundice with the use of glucocorticoids (GCS);
- Severe liver disease, cholestatic jaundice (including during pregnancy), hepatitis (including history) - until the restoration of laboratory and functional parameters and after their normalization within 3 months;
- Diabetes mellitus complicated by angiopathy;
- Gallstone disease, including history;
- Rotor syndrome, Dabin-Johnson syndrome, Gilbert's syndrome;
- Severe itching;
- Otosclerosis and its progression while taking GCS or during a previous pregnancy;
- Vaginal bleeding of unknown origin;
- Hormone-dependent malignant neoplasms of the genitals and mammary glands, or if they are suspected;
- Smoking over the age of 35 (over 15 cigarettes per day);
- Breastfeeding period;
- Pregnancy or suspicion of it;
- Hypersensitivity to drug components.
Caution should be exercised when prescribing Lindinet to 20 women with risk factors that increase the likelihood of developing arterial or venous thrombosis or thromboembolism: age over 35 years, hereditary predisposition to thrombosis (myocardial infarction, thrombosis or cerebrovascular accident in close relatives at a young age), smoking, hemolytic uremic syndrome, liver diseases, hereditary angioedema, chloasma, herpes of pregnant women, porphyria, Sydenham's chorea, chorea minor and other diseases that have arisen or worsened during the previous use of sex hormones or during pregnancy, obesity with a body weight index of more than 30 kg per m 2, valvular heart disease, arterial hypertension, atrial fibrillation, dyslipoproteinemia, migraine, epilepsy, severe trauma, prolonged immobilization, major surgery, surgery on the lower extremities, sickle cell anemia, superficial thrombophlebitis and varicose veins (without diabetes mellitus disorders), the postpartum period, ulcerative colitis, severe depression (including history), Crohn's disease, chronic and acute liver diseases, systemic lupus erythematosus, hypertriglyceridemia (including family history), abnormalities in biochemical parameters (lupus anticoagulant, hyperhomocysteinemia, resistance, activated deficiency of antithrombin III, protein S or C, antiphospholipid antibodies, including antibodies to cardiolipin).
Instructions for use of Lindinet 20: method and dosage
Lindinet 20 tablets are taken orally, regardless of food intake, always at the same time of day.
The first tablet from the blister must be taken from the 1st to the 5th day of menstrual bleeding. The use of Lindinet 20 involves taking 1 tablet per day for 21 days, followed by a seven-day break, during which withdrawal bleeding occurs. Taking pills from the next blister begins on the first day after a 7-day break at the same time as in the previous cycle.
To switch from another oral combined contraceptive, the first Lindinet 20 tablet is taken the next day after the end of the previous package, on the first day of withdrawal bleeding.
When taking mini-pills, the transition to Lindinet 20 can be started on any day of the cycle, with the previous use of the implant - the next day after its removal, with injections - on the eve of the next injection. The transition from monopreparations must be accompanied by the use of additional barrier methods of contraception during the first 7 days.
When carrying out an abortion in the first trimester of pregnancy, pills should be taken immediately after the operation without the use of additional contraceptive measures.
After an abortion in the second trimester of pregnancy or after childbirth, the use of Lindinet 20 begins 21-28 days later without the use of additional methods of contraception. If the drug is started later, then during the first 7 days it is necessary to use an additional method of contraception.
If the woman had sexual intercourse before the start of contraception, the use of the drug should be started after the exclusion of pregnancy or with the onset of menstrual bleeding.
If you skip taking the next dose of Lindinet 20 at the set time, if the delay is less than 12 hours (the contraceptive effect of the drug has not been violated), the pill should be taken as soon as you remember, and the next pills - at the usual time. If the delay exceeds 12 hours, then you should not take the missed pill, but continue taking the drug according to the scheme, using additional methods of contraception for the next 7 days. If the missed dose occurred less than 7 days before the end of the package, you must start taking the tablets from the next blister without interruption. In this case, withdrawal bleeding will occur after the completion of the second blister, but spotting or breakthrough bleeding may occur before the break. In the absence of menstrual bleeding after taking all the tablets from the second blister,continuation of oral contraception is possible only after excluding pregnancy.
If a woman starts vomiting and / or diarrhea within the first 3-4 hours after taking the next pill, which disrupted the absorption process and reduced the clinical effect of Lindinet 20, then in this case there are two options for further therapy. One of them is to take the next tablet according to the scheme at the set time and take further measures in accordance with the recommendations related to the skipping of the drug. The second option is that a woman can take a similar pill from another blister without deviating from her usual contraceptive regimen.
If it is necessary to accelerate the onset of menstruation, it is recommended to shorten the break in taking Lindinet 20. It should be borne in mind that the shorter the break, the greater the risk of spotting or breakthrough bleeding during the period of taking pills from the next blister (similar to cases of delayed menstruation).
If it is necessary to postpone the next menstruation for a later period, taking the tablets should be continued from a new package without a seven-day break. You can delay the onset of menstruation for the desired period, up to the end of the tablets from the second package. During the period of the planned delay in menstrual bleeding, breakthrough or spotting bleeding may occur. After a seven-day break, you should continue to take Lindinet 20 regularly.
Side effects
The use of Lindinet 20 should be canceled if the following side effects develop:
- Sense organs: hearing loss caused by otosclerosis;
- Cardiovascular system: arterial hypertension; rarely - myocardial infarction, deep vein thrombosis of the lower extremities, stroke, pulmonary embolism and other venous and arterial thromboembolism; very rarely - venous or arterial thromboembolism of the renal, hepatic, retinal, mesenteric arteries and veins;
- Others: porphyria, hemolytic uremic syndrome; rarely - exacerbation of reactive systemic lupus erythematosus; very rarely - Sydenham's chorea (disappears after stopping the drug).
In addition, the action of Lindinet 20 can potentiate the development of other less severe side effects, but more often occurring:
- Reproductive system: spotting or acyclic vaginal bleeding, candidiasis, amenorrhea (after withdrawal), changes in the state of vaginal mucus, the development of inflammatory processes in the vagina, galactorrhea, breast enlargement, tension and pain;
- Nervous system: headache, mood lability, migraine, depression;
- Metabolism: hyperglycemia, increased body weight, fluid retention in the body, decreased tolerance to carbohydrates, increased thyroglobulin concentration;
- Digestive system: nausea, epigastric pain, vomiting, ulcerative colitis, Crohn's disease, hepatitis, cholelithiasis, liver adenoma, exacerbation or appearance of itching associated with cholestasis and / or jaundice;
- Sensory organs: in women with contact lenses - increased sensitivity of the cornea, hearing loss;
- Dermatological reactions: rash, erythema nodosum, increased hair loss, exudative erythema, chloasma;
- Others: the development of allergic reactions.
The decision on the advisability of further taking the drug is made after consultation with the doctor individually, by balancing the benefits and risks of contraception.
Overdose
Taking large doses of Lindinet 20 does not lead to severe overdose symptoms. Nausea and vomiting are common, and young girls have mild vaginal bleeding.
There is no specific antidote. The appointment of symptomatic therapy is recommended.
special instructions
The use of Lindinet 20 should be started after consulting a doctor and conducting a general medical and gynecological examination, including an examination of the pelvic organs, mammary glands, cytological analysis of a cervical smear. The examination is recommended every 6 months during the period of taking the tablets.
Taking into account the clinical condition of the woman and the risk factors for the development of side effects, the advantage or disadvantage of oral contraception is assessed and a decision is made regarding its use. The doctor should inform about the possible aggravation of the existing pathologies, the undesirable actions of Lindinet 20 and the need to seek advice if the state of health worsens.
It is necessary to abolish hormonal contraception if any of the following diseases or conditions appear or worsen: diseases and conditions predisposing to the development of cardiovascular and renal failure, epilepsy, pathologies of the hemostatic system, the risk of developing estrogen-dependent gynecological diseases or estrogen-dependent tumors, migraine, diabetes mellitus without vascular disorders, severe depression, sickle cell anemia, abnormal liver function tests.
Lindinet 20 has a reliable contraceptive effect after 2 weeks of admission, therefore, in order to exclude possible pregnancy during the first 2 weeks, it is recommended to use additional barrier methods of contraception.
Against the background of the use of oral hormonal contraception, the likelihood of venous and arterial thromboembolic diseases increases, the possible (very rare) development of arterial or venous thromboembolism of the hepatic, renal, mesenteric or retinal vessels should be taken into account.
Factors contributing to an increased risk of developing arterial or venous thromboembolic diseases include genetic predisposition, heavy smoking, obesity, and the presence of dyslipoproteinemia, arterial hypertension, heart valve disease with hemodynamic disorders, atrial fibrillation, diabetes mellitus with vascular lesions. The risk increases with the woman's age, with prolonged immobilization caused by major surgical intervention, including on the lower limbs, or after severe trauma. For planned operations, Lindinet 20 should be canceled 4 weeks before the operation and resumed 2 weeks after remobilization.
Regular medical supervision requires the use of Lindinet 20 in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia and in women after childbirth.
The risk of developing arterial or venous thromboembolic diseases increases hyperhomocysteinemia, resistance to activated protein C, deficiency of proteins C and S, the presence of antiphospholipid antibodies, and antithrombin III deficiency.
Taking Lindinet 20 can be regarded as one of the many factors affecting the development of cervical or breast cancer. Increased registration of these pathologies in women taking hormonal contraceptives may be associated with regular medical supervision and medical examinations.
After prolonged oral hormonal contraception, the possible development of benign or malignant liver tumors should be considered in the differential diagnostic assessment of abdominal pain, which may be associated with intraperitoneal bleeding or an increase in liver size.
Women who are prone to chloasma are advised to avoid exposure to direct sunlight or ultraviolet radiation.
The contraceptive effect of Lindinet 20 is reduced if the next dose is missed, with vomiting or diarrhea, while taking medications that affect its effectiveness. To avoid conception, a woman should use additional barrier contraceptives as recommended.
The appearance of irregular spotting or breakthrough bleeding and the absence of menstrual bleeding during the seven-day break can be a consequence of pregnancy. Therefore, before starting to take pills from the next blister, you must consult your doctor and resume therapy after excluding pregnancy.
The estrogenic component of the drug can affect laboratory parameters of the level of transport proteins and lipoproteins, functional parameters of the kidneys, liver, thyroid gland, adrenal glands, hemostasis indicators.
The use of Lindinet 20 after acute viral hepatitis is indicated not earlier than 6 months after the normalization of liver function.
Women who smoke are at increased risk of developing vascular diseases, especially after 35 years (the degree of risk depends on the age and the number of cigarettes smoked per day).
Lindinet 20 does not protect against sexually transmitted infections, including HIV infection (AIDS).
The effect of the drug on the patient's ability to drive vehicles and mechanisms has not been established.
Application during pregnancy and lactation
Lindinet 20 is contraindicated in pregnant and lactating women.
The components of the drug are secreted in small amounts in breast milk.
Taking an oral contraceptive while breastfeeding may decrease milk production.
With impaired renal function
Lindinet 20 is not recommended for use in patients with kidney disease.
For violations of liver function
According to the instructions, Lindinet 20 is contraindicated in patients with impaired liver function.
Drug interactions
- Inducers of microsomal liver enzymes (rifampicin, phenylbutazone, barbiturates, griseofulvin, phenytoin, hydantoin, topiramate, rifabutin, felbamate, oxcarbazepine), antibiotics (ampicillin, tetracycline): help to reduce the content of ethinylestradiol in the blood plasma;
- Liver enzyme inhibitors (fluconazole, itraconazole): increase the concentration of ethinyl estradiol in blood plasma;
- Means that increase the motility of the gastrointestinal tract: reduce the absorption of active substances and their concentration in the blood plasma when combined with Lindinet 20;
- Ascorbic acid and other agents that undergo sulfation in the intestinal wall: competitively slow down the sulfation of ethinyl estradiol and increase its bioavailability.
The simultaneous administration of ritonavir, tetracycline, ampicillin, rifampicin, primidone, barbiturates, phenylbutazone, carbamazepine, phenytoin, topiramate, griseofulvin, oxcarbazepine, felbamate leads to a decrease in the contraceptive effectiveness of the drug. Therefore, during the period of admission and for 7 days (when combined with rifampicin - 4 weeks) after therapy with these drugs, a woman should use additional barrier methods of contraception.
The drug affects the metabolism of cyclosporine and theophylline.
The simultaneous administration of St. John's wort preparations is not recommended, since the risk of breakthrough bleeding increases.
Patients with diabetes mellitus may need to adjust the dose of hypoglycemic agents.
Analogs
Analogs of Lindinet 20 are: Lindinet 30, Logest, Model Tin, Femoden, Angeleta, Vidora, Gestarella, Daila, Naadin, Novinet.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C in a dark, dry place.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Lindinet 20
According to reviews, Lindinet 20 does an excellent job with its main task - protection from unwanted pregnancy. Women note that the menstrual cycle becomes more regular, critical days pass easier, pains in the lower abdomen disappear. In some patients, the condition of hair and skin improves, and their mood improves. Another advantage of the drug is its relative cheapness (especially compared to some more expensive analogues). Also, the drug helps to restore hormonal levels after gynecological operations.
Despite the large share of positive reviews, Lindinet 20 also receives negative evaluations, most often due to individual intolerance to the drug. Contraceptive pills are not suitable for all women and can cause side effects, sometimes very serious (weight gain, swelling, nausea, vomiting, pain in the stomach, decreased libido, etc.). Of the disadvantages of the drug, some women also mention that the days of the week are not marked on the package.
Doctors categorically forbid patients to prescribe Lindinet 20 on their own, as well as change the dosage of the drug (for example, switch to Lindinet 30). If side effects appear or worsen, it is recommended to seek the advice of a specialist.
Price for Lindinet 20 in pharmacies
The price for Lindinet 20 No. 21 (one blister in a cardboard box) is 396–473 rubles.
Lindinet 20 No. 63 (three blisters in a carton box) can be purchased for 863-1120 rubles.
Lindinet 20: prices in online pharmacies
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Drug name Price Pharmacy |
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Lindinet 20 20 mcg + 75 mcg film-coated tablets 21 pcs. 468 r Buy |
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Lindinet 20 tablets p.o. 21 pcs. RUB 608 Buy |
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Lindinet 20 20 mcg + 75 mcg film-coated tablets 63 pcs. 1229 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
