Oral contraception.
When deciding whether to prescribe Lindinet 20, it is necessary to take into account the current risk factors for the individual woman, especially the risk factors for venous thromboembolism (VTE), and how high the risk of VTE is when using Lindinet 20 compared with other combined hormonal contraceptives (see sections "Contraindications and "Peculiarities of application").
Combined hormonal contraceptives (CHCs) should not be used in the following cases. If any of these conditions occur while using the preparation, you should immediately stop using it.
Hypersensitivity to the active substances or any of the excipients.
A history of pancreatitis or pancreatitis if associated with severe hypertriglyceridemia.
Presence of severe liver dysfunction or a history of abnormalities (until liver function is restored).
The presence of liver tumors (benign or malignant) or a history of such tumors.
Known or suspected steroid-dependent malignancies (eg, genital, breast).
Undiagnosed abnormal vaginal bleeding.
The use of the preparation Lindinet 20 with preparations containing ombitasvir / paritaprevir / ritonavir and dasabuvir is contraindicated (see sections "Peculiarities of use" and "Interaction with other preparations and other types of interactions").
other ingredients: sodium calcium edetate, magnesium stearate, colloidal anhydrous silicon dioxide, povidone, corn starch, lactose monohydrate, quinoline yellow (E 104), titanium dioxide (E 171), cargol 600,
The tablets must be taken daily at about the same time in the order indicated on the blister pack. You should take 1 tablet per day (preferably at the same time of day) for 21 days. Then you should take a seven-day break from taking the pills. During the seven-day break, menstrual-like bleeding should appear due to preparation withdrawal. Bleeding usually begins on the 2nd or 3rd day after taking the last tablet and may continue until the next tablet is taken.
The next day after a seven-day break, you should start taking the tablets from the next package containing 21 tablets.
The first dose of the preparation.
Taking the preparation Lindinet 20 should be started from the first day of the menstrual cycle.
You can start taking the pills from the 2nd to the 7th day of menstruation, but in this case, you must use additional non-hormonal contraceptives (eg, condoms, spermicide) during the first 7 days of taking the pills.
Switching to Lindinet 20 from another combined contraceptive (combined oral contraceptives / CPC /, vaginal ring or transdermal patch).
The first tablet of Lindinet 20 should be taken after taking the last tablet from the prepackage of another combined oral contraceptive on the first day of menstrual bleeding, but no later than the next day after the usual break in taking the pills (or taking the placebo tablet) from the prepackage of oral contraceptives .
When switching to Lindinet 20 from a vaginal ring or transdermal patch, it is advisable to start taking Lindinet 20 on the day of removal of the vaginal ring or transdermal patch, but no later than on the day of the planned use of a new vaginal ring or transdermal patch.
Switching to Lindinet 20 from progestogen-only preparations (mini-pili, injections, implant or intrauterine system).
From the mini-pill, you can switch to taking Lindinet 20 on any day of the menstrual cycle. From the implant, you can switch to Lindinet 20 on the day of removal of the implant or intrauterine system. When switching to Lindinet 20 from injections, you should start taking the preparation on the day of the scheduled injection. In these cases, additional methods of contraception should be used in the first 7 days.
The use of the preparation Lindinet 20 after an abortion in the first trimester of pregnancy.
The preparation can be started immediately after an abortion in the first trimester of pregnancy, in this case there is no need to use additional methods of contraception.
The use of Lindinet 20 after childbirth or abortion in the second trimester of pregnancy.
Information on the use of the preparation during lactation is described in the section "Use during pregnancy or lactation".
Since the postpartum period is associated with an increased risk of thromboembolism, Lindinet 20 can be started no earlier than 28 days after birth in non-breastfeeding women or after an abortion in the second trimester. The woman should be advised to use an additional non-hormonal backup method of contraception during the first 7 days of taking the pills. However, if sexual contact has already taken place after childbirth or abortion, pregnancy must be excluded before taking Lindinet 20 or wait until the first menstruation occurs (see also sections "Peculiarities of use" and "Use during pregnancy or lactation").
Gap of taking pills.
If the delay in taking the pill does not exceed 12 hours, the contraceptive effect of the preparation is not reduced. The missed tablet should be taken as soon as it is discovered. The next tablet in this pack should be taken at the usual time. If the delay in taking the pill exceeds 12 hours, contraceptive protection may decrease. In this case, two basic rules must be followed:
A break in taking pills can never exceed 7 days.
Adequate inhibition of the hypothalamus-pituitary-ovarian system is achieved as a result of continuous administration of the preparation for 7 days.
Accordingly, the following recommendations should be followed in everyday life:
1st week
The last missed tablet should be taken as soon as possible, even if you have to take two tablets at the same time. After that, you should continue to take the tablets at the usual time. In addition, a barrier method of contraception, such as a condom, should be used for the next 7 days. If sexual intercourse has occurred in the previous 7 days, the possibility of pregnancy should be considered. The more pills missed and the closer the gap is to a seven-day break in the use of the preparation, the higher the risk of pregnancy.
2nd week
The last missed tablet should be taken as soon as possible, even if you have to take two tablets at the same time. After that, you should continue to take the tablets at the usual time. If the pills are taken correctly for 7 days before missing the pill, there is no need to use additional methods of contraception. Otherwise, or if more than 1 tablet is missed, it is recommended to additionally use a barrier method of contraception for
7 days.
3rd week
The risk of a decrease in the contraceptive effect increases with the approach of a seven-day break in taking the preparation. However, if the pill regimen is followed, a decrease in contraceptive protection can be avoided. If you follow one of the options below, then there will be no need to use additional methods of contraception if you take the pills correctly within 7 days before missing the pill. If this is not the case, you should stick to the first of the suggested options and use additional methods of contraception for the next 7 days.
The last missed tablet should be taken as soon as possible, even if you have to take 2 tablets at the same time. After that, you should continue to take the tablets at the usual time. Taking tablets from the next package should be started immediately after the end of the previous one, that is, there should not be a break in the use of the preparation. It is unlikely that a woman will begin menstrual-like bleeding before she has finished taking the pills from the second pack, although spotting or breakthrough bleeding may occur.
You can stop taking the tablets from the current package. In this case, the break in the use of the preparation should be 7 days, including the days of missing pills, after which you should start taking the pills from the subsequent packaging.
If, after missing pills, there is no menstrual bleeding during the first usual break in taking pills, the possibility of pregnancy should be considered.
Measures taken in case of vomiting and/or diarrhea.
If vomiting or diarrhea begins within 4 hours after taking the preparation, this means that the active substance of the tablet may not have been completely absorbed. In this case, you should act in accordance with the paragraph "Missing a pill". If the patient does not want to deviate from the regimen, the missed tablets should be taken from the additional package.
Delay or acceleration of the menstrual cycle.
To delay menstruation, the tablets should be continued from a new package without a seven-day break in the use of the preparation. Menstrual bleeding can be delayed as long as necessary until the end of the pills from the second package. With a delay in menstrual bleeding, spotting or breakthrough bleeding may occur. Regular intake of Lindinet 20 can be resumed after the usual seven-day break.
In order to accelerate the onset of menstrual bleeding, the seven-day break in the use of the preparation can be reduced by the desired number of days.
The shorter the break in taking the preparation, the higher the risk that menstrual bleeding will not occur or that spotting or breakthrough bleeding will occur when taking the pills from the next pack.
Children.
Lindinet 20 is indicated for use only after the onset of regular menstruation.