Microginon
Microginon: 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. For violations of liver function
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Microgynon
ATX code: G03AA07
Active ingredient: ethinylestradiol + levonorgestrel (ethinylestradiol + levonorgestrel)
Producer: Bayer Pharma AG (Germany), Alvogen IPCo Sarl (Luxembourg)
Description and photo update: 2019-13-08
Prices in pharmacies: from 280 rubles.
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Mikroginon is a monophasic oral contraceptive drug.
Release form and composition
The dosage form of Mikroginon is coated tablets (21 pcs. In blisters, 1 or 3 blisters in a cardboard box).
The composition of 1 tablet contains active ingredients:
- Ethinylestradiol - 0.03 mg;
- Levonorgestrel - 0.15 mg.
Additional components: magnesium stearate - 0.1 mg, lactose - 32.97 mg, corn starch - 18 mg, talc - 1.65 mg, polyvidone 25,000 - 2.1 mg.
Shell composition: yellow dye iron oxide (E172) - 0.027 mg, sucrose - 19.371 mg, talc - 4.198 mg, polyvidone 700,000 - 0.189 mg, polyethylene glycol 6000 - 2.148 mg, titanium dioxide (E171) - 0.274 mg, calcium carbonate - 8.606 mg, mountain glycolic wax - 0.05 mg, 85% glycerol - 0.137 mg.
Pharmacological properties
Pharmacodynamics
Microginon is a low-dose, monophasic oral contraceptive. It is a combined estrogen-progestin agent.
The contraceptive effect of the drug is due to three mechanisms that complement each other:
- suppression of the ovulation process at the level of the hypothalamic-pituitary system;
- a change in the rheological properties of cervical mucus, as a result of which it becomes impermeable to sperm;
- a change in the inner layer of the wall of the uterus (endometrium), making it impossible for the implantation of a fertilized egg.
Taking Mikroginon normalizes the female menstrual cycle. Menstruation becomes less painful, the intensity of bleeding decreases, and hence the risk of iron deficiency anemia.
Pharmacokinetics
Levonorgestrel is absorbed quickly and completely in the gastrointestinal tract. The maximum plasma concentration (3-4 ng / ml) is observed approximately one hour after taking the tablets. Bioavailability is almost complete. About 64% of levonorgestrel binds to SHBG (sex hormone binding globulin) and about 35% to serum albumin. Only 1.3% of levonorgestrel is free in serum. The apparent volume of distribution is 184 liters.
Levonorgestrel is completely metabolized. Removal is two-phase. The terminal phase half-life is about 20-23 hours. Levonorgestrel metabolites are excreted in bile and urine in a 1: 1 ratio.
Ethinylestradiol is also rapidly and completely absorbed in the digestive tract. The maximum plasma concentration (95 pg / ml) is reached in about 1–2 hours. The bioavailability of ethinyl estradiol is about 45%, since it undergoes the effect of "primary passage" through the liver (in different patients, this indicator varies from 20 to 65%). The connection with plasma proteins is almost complete (98%). Basically, ethinyl estradiol binds to albumin. It also induces the synthesis of SHBG. Vd (apparent volume of distribution) - 2.8-8.6 l / kg.
Ethinylestradiol is metabolized in the liver and small intestine mucosa mainly by aromatic hydroxylation. Removal is two-phase. The half-life of the first phase is about 1 hour, the second is from 10 to 20 hours. It is excreted only as metabolites by the liver and kidneys in a ratio of 6: 4 with a half-life of about 24 hours.
Indications for use
According to the instructions, Mikroginon is prescribed to prevent unwanted pregnancy.
Contraindications
Absolute:
- Migraine, accompanied by focal neurological symptoms (indications in the anamnesis);
- Conditions preceding thrombosis, including transient ischemic attacks, angina pectoris (indications in history or present at present);
- Thrombosis (venous and arterial) and thromboembolism, including cerebrovascular disorders, deep vein thrombosis, myocardial infarction, pulmonary thromboembolism (indications in history or present);
- Uncontrolled arterial hypertension;
- Diabetes mellitus, occurring in combination with vascular complications;
- Vaginal bleeding, the etiology of which is unclear;
- Severe or multiple risk factors for thrombosis (venous or arterial), including cardiac arrhythmias, valvular heart disease, coronary artery disease or cerebrovascular disease;
- Pancreatitis, occurring in combination with severe hypertriglyceridemia (indications in history or current presence);
- Major injuries, major surgical interventions, prolonged immobilization, leg surgery;
- Revealed malignant hormone-dependent diseases (including lesions of the mammary glands or genitals), as well as if they are suspected;
- Benign or malignant liver tumors (indications in history or current presence);
- Severe liver disease and liver failure (after normalization of liver tests, Mikroginon can be resumed);
- Pregnancy (confirmed or suspected) and the period of breastfeeding;
- Hypersensitivity to drug components.
Relative (caution is required when prescribing Mikroginon):
- Arterial hypertension;
- Crohn's disease (granulomatous enteritis);
- Thrombophlebitis of superficial veins (inflammation of a vein with its thrombosis);
- Diabetes;
- Severe fat metabolism disorders (hyperlipidemia, obesity);
- Migraine;
- Hemolytic uremic syndrome;
- Otosclerosis with impaired hearing, pruritus, or idiopathic jaundice during a previous pregnancy;
- Congenital hyperbilirubinemia - an increase in the amount of bilirubin in the blood serum (Gilbert, Rotor and Dubin-Johnson syndromes);
- Liebman-Sachs disease;
- Sickle cell anemia.
Instructions for the use of Mikroginon: method and dosage
Microginon tablets are taken orally with a small amount of water, preferably at the same time.
Dosage regimen - 1 tablet daily, following the order indicated on the package, for 21 days. After taking the last dragee from the blister, you must take a break for 7 days. Typically, withdrawal bleeding occurs at this time.
If in the previous month the woman did not use hormonal contraceptives, it is preferable to start taking Mikroginon on the first day of the menstrual cycle. In cases where the start of therapy coincides with days 2-5 of the menstrual cycle, it is recommended to use additional barrier methods of contraception for 7 days.
When making the transition from other combined oral contraceptive drugs, Mikroginon begins to be taken the next day after taking the last active tablet from the previous package. The deadline for starting therapy: for drugs containing 21 tablets - the next day after the usual seven-day break; preparations containing 28 pills per package - the next day after taking the last pills containing inactive components.
Features of the transition from other contraceptive drugs (with the use of additional barrier methods of contraception during the first 7 days of therapy):
- Implant, intrauterine contraceptive with gestagen: on the day of its removal;
- Mini-drank: without a break any day;
- Injection form of the drug: on the day the next injection was scheduled.
In cases of prescribing therapy after an abortion carried out in the first trimester of pregnancy, Mikroginon can be started immediately (additional contraceptive protection is not required).
If a woman is prescribed a drug after childbirth or an abortion performed in the second trimester of pregnancy, it is recommended to start taking Mikroginon on days 21-28. In cases where the drug is started later, it is recommended to additionally use protective contraceptive measures for 7 days. If, before the start of taking Mikroginon, a woman has already had a sex life, it is required to exclude pregnancy, or wait for the first menstruation.
The contraceptive effect of the drug does not decrease when the daily dose of Mikroginon is missed for up to 12 hours. In this case, it is necessary to take pills as soon as possible, then return to the usual dosing regimen.
If the pass is more than 12 hours, the following guidelines should be followed:
- Do not interrupt taking Mikroginon for more than 7 days;
- Conduct continuous therapy for 7 days to adequately suppress the hypothalamic-pituitary-ovarian regulation.
If you skip the daily dose of Mikroginon during the first week of taking the drug, the pills must be taken even if this leads to taking two pills at the same time. Next, you need to adhere to the usual scheme of taking Mikroginon, but over the next 7 days, barrier contraceptive measures should be used. If sexual intercourse took place within a week before skipping the pills, the possibility of pregnancy should be taken into account.
The more pills were missed, and the closer this period is to a break in taking active substances, the higher the likelihood of pregnancy.
If you skip the daily dose of Mikroginon during the second week of taking the drug, the pills must be taken even if this leads to taking two pills at the same time. Next, you need to adhere to the usual scheme of taking Mikroginon without the use of additional protective measures. If in the previous 7 days the woman also missed taking the drug, there is a need to use additional contraception.
If you skip taking Mikroginon during the third week of therapy, the risk of lowering the reliability of the drug is inevitable, which is associated with the upcoming interruption in taking it. In this case, you can stick to one of two schemes:
- The last missed tablet should be taken as soon as possible (it is possible to take two tablets at the same time). In the future, the therapy is continued according to the usual scheme and, having finished the package, they begin to take from the next one without interruption. Withdrawal bleeding is likely to occur after the end of the second pack, however, while taking pills, there is a possibility of spotting and breakthrough bleeding;
- Dragee intake from the current package is stopped for 7 days (taking into account the day of skipping), after which the therapy is continued throughout the full cycle of 21 pills from the new package.
If a single dose was missed, and then during the seven-day break, withdrawal bleeding did not occur, pregnancy must be excluded.
Dyspeptic disorders in the form of vomiting and diarrhea that develop within an interval of up to 4 hours after taking active pills can lead to impaired absorption of the active substances of Mikroginon, so a woman should take additional protective measures (it is necessary to follow the recommendations for skipping a single dose of the drug).
Taking Mikroginon tablets from a new package without interruption leads to a delay in the onset of menstruation (the development of spotting or breakthrough uterine bleeding is possible). By shortening the time between taking pills from the packages, you can postpone the day of the onset of menstruation.
Side effects
During the use of Mikroginon, the following disorders may develop:
- Soreness, enlargement, tension of the mammary glands, discharge from the mammary glands;
- Spotting spotting and breakthrough uterine bleeding;
- Change in libido;
- Allergic reactions;
- Headache;
- Changes / decreased mood;
- Visual impairment, poor tolerance of contact lenses;
- Change in body weight;
- Changes in vaginal secretion;
- Migraine;
- Abdominal pain, nausea, vomiting;
- Fluid retention;
- Skin rash, erythema multiforme, erythema nodosum, generalized pruritus;
- Cholestatic jaundice.
In rare cases, the development of increased fatigue and dyspeptic disorders in the form of diarrhea is possible. Chloasma can sometimes occur, especially if there is a history of chloasma in pregnant women.
In some cases, thromboembolism and thrombosis may develop.
Overdose
In case of an overdose of Mikroginon, the following symptoms may occur: vomiting, nausea, uterine bleeding, or spotting spotting.
Treatment is symptomatic. There is no specific antidote.
special instructions
When planning a surgical intervention, it is recommended to stop taking Mikroginon at least a month before it. You can resume therapy 14 days after the end of immobilization.
Additionally, it is necessary to use barrier contraceptive methods:
- While taking medications that affect microsomal enzymes, and within 28 days after their cancellation;
- While taking antibiotic drugs (ampicillins, tetracyclines) and within 7 days after their cancellation.
If the time of using the barrier contraceptive method ends later than the tablets in the package, you should go to the next package of Mikroginon without the usual seven-day break in taking the tablets.
When prescribing the drug, it is necessary to take into account the risk factors, assessing the ratio of the potential benefit to the existing threat (with an increase, increase or the first manifestations of any of these risk factors / conditions, you should consult a specialist).
There is information about an increase in the incidence of arterial and venous thrombosis and thromboembolism. Seek medical attention if symptoms such as: swelling and / or unilateral leg pain, sudden severe chest pain radiating to the left arm or not, sudden attacks of coughing, sudden shortness of breath, any unusual, severe, long-lasting headache, diplopia, sudden partial or complete loss of vision, dizziness, slurred speech or aphasia, loss of consciousness with or without a seizure, movement disorders, acute abdominal symptoms, weakness or significant loss of sensation that suddenly develops on one side or in one part body.
The likelihood of developing thrombosis (venous and / or arterial) and thromboembolism increases in smokers, with age, in women with dyslipoproteinemia, migraine, heart valve disease, arterial hypertension, atrial fibrillation, obesity (with a body mass index of more than 30 kg / m 2), as well as with prolonged immobilization and after major surgical interventions, any operations on the legs or extensive injuries. Also, the risk increases if there is a family history of venous or arterial thromboembolism that has ever occurred in parents or close relatives at a relatively young age. With a hereditary predisposition, a woman must be examined by an appropriate specialist before starting to take Mikroginon.
In the postpartum period, the increased risk of thromboembolism must be considered.
Against the background of diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel diseases (granulomatous enteritis or ulcerative colitis) and sickle cell anemia, circulatory disorders may also develop.
Migraine (with an increase in frequency and severity) during the period of use of Mikroginon may be the reason for discontinuation of therapy.
There is evidence of an increased risk of cervical cancer with prolonged use of the drug. It was also found that the use of combined contraceptives slightly increases the risk of developing breast cancer.
In rare cases, the appearance of liver tumors was observed during therapy. With an increase in the liver, the appearance of severe pain in the abdominal region or symptoms of intra-abdominal bleeding, during the differential diagnosis, it is necessary to take into account the use of Mikroginon.
During the use of the drug, you also need to take into account the likelihood of developing the following disorders:
- Pancreatitis (usually against the background of abnormally elevated levels of lipids and / or lipoproteins in the blood (hypertriglyceridemia) or with a family history of this condition);
- Formation of stones in the gallbladder;
- Increased blood pressure (rarely observed). With a persistent, clinically significant increase in blood pressure, it is necessary to cancel Mikroginon and begin therapy for arterial hypertension. Taking the drug can be resumed after normalization of values;
- Jaundice and / or pruritus associated with cholestatic syndrome;
- Systemic lupus erythematosus;
- Porphyrin disease;
- Chorea;
- Liver dysfunction (acute or chronic) (in this case, it may be necessary to cancel therapy (until the indicators return to normal));
- Hemolytic uremic syndrome;
- Hearing loss associated with otosclerosis;
- Herpes during pregnancy;
- Granulomatous enteritis and ulcerative colitis.
Against the background of diabetes mellitus, women should be under medical supervision while taking Mikroginon.
If you have a tendency to chloasma during therapy, you should avoid exposure to ultraviolet radiation and prolonged exposure to the sun.
The use of Mikroginon can affect the results of certain laboratory studies, including indicators of the function of the thyroid gland, kidneys, adrenal glands, liver, as well as indicators of carbohydrate metabolism, the level of transport proteins in plasma, and parameters of fibrinolysis and coagulation. As a rule, such changes do not go beyond the normal range.
During the use of Mikroginon, irregular bleeding may occur, especially during the first months of admission. Therefore, any irregular bleeding should be assessed only after an adaptation period (about 3 cycles).
If irregular bleeding occurs after previous regular cycles, or if there are prolonged irregular cycles, a thorough examination is necessary to exclude pregnancy or malignant neoplasms.
During a break in taking Mikroginon, in some cases, withdrawal bleeding may not develop. If the drug is taken in accordance with the recommendations, pregnancy is unlikely.
Before taking the drug, a woman is recommended to undergo a thorough examination (general medical and gynecological), including a cytological examination of cervical mucus and an examination of the mammary glands, as well as to exclude pregnancy and the presence of disorders of the blood coagulation system.
With prolonged use of Mikroginon, repeated examinations should be carried out every six months.
It should be borne in mind that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Application during pregnancy and lactation
Mikroginon is not indicated for use during pregnancy and breastfeeding.
If you become pregnant while taking the drug, it should be canceled immediately. Studies have not revealed any increased risk of developmental defects in infants born to women who took Mikroginon before pregnancy. Also, no teratogenic effect of the drug was revealed when it was used inadvertently in the early stages of pregnancy.
Combined oral contraceptives can change the composition of breast milk and reduce its amount, therefore, the use of Mikroginon is prohibited during lactation. Sex steroids and / or their metabolites can be secreted in small amounts in milk, but there is no confirmed data on their negative impact on the health of the child.
For violations of liver function
Mikroginon is contraindicated in women with severe liver disease or liver failure (until liver tests normalize).
Drug interactions
With the joint appointment of Mikroginon with some drugs, the following effects may occur:
- Medicines that induce liver enzymes (long-term therapy): the appearance of breakthrough bleeding and / or a decrease in the contraceptive effectiveness of Mikroginon;
- Derivatives of pyrazolone, sulfonamides: increased metabolism of steroid hormones that are part of the drug;
- Antibiotics (ampicillins, tetracyclines): a decrease in the contraceptive protection of Mikroginon (due to a decrease in the concentration of ethinyl estradiol).
During therapy with estrogen-progestational drugs, it may be necessary to adjust the doses of drugs with hypoglycemic action and indirect anticoagulants.
Microginone can affect the metabolism of other drugs (including cyclosporine), which can change their concentration in tissues and plasma.
Analogs
The analogues of Mikroginon are: Minisiston 20 Fem, Rigevidon, Rigevidon 21 + 7, Trikvilar, Tri-regol, Anteovin, Gravistat 125, Miranova, Ovidon, Oralkon, Triziston, Trinordiol.
Terms and conditions of storage
Keep out of reach of children under normal conditions.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Mikroginon
On the Internet you can find diametrically opposite reviews about Mikroginon. Many women who have taken the drug to prevent unwanted pregnancy are completely satisfied with this drug and have been using it as contraception for years without experiencing any side effects. The drug normalizes the menstrual cycle, painful sensations during menstruation disappear or become less noticeable.
Mikroginon did not suit other patients, which they also share in their reviews, describing the undesirable reactions that have arisen (headaches, hardening and chest pains, weight gain, lethargy and apathy, decreased libido).
Reviews of specialists about the drug are mainly associated not with its effectiveness, but with tolerance and the absence or presence of adverse reactions. Doctors note that contraceptives are selected individually and only after consultation with a specialist.
The price of Mikroginon in pharmacies
The drug is relatively inexpensive (cheaper than some analogues). The price for Mikroginon No. 21 ranges from 230 to 375 rubles.
Microginon: prices in online pharmacies
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Drug name Price Pharmacy |
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Microginon 150 mcg + 30 mcg dragee 21 pcs. 280 RUB Buy |
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Microginon tablets p.p. 21 pcs. 383 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
