Medicines & You

= Chemical Compound
= Indications
= Dosage
= Contraindication
= Special Precautions
= Adverse Reactions
= Drug-Drug Interaction

Contraceptive Agents

a) Depot Contraceptives

Norethisterone enantate.
Contraception (only for women w/ a history of normal cycles).
pregnancy; phlebitis or thromboembolic diseases; pathological hypertension; acute & severe chronic liver disease w/ or w/o jaundice (particularly primary biliary liver cirrhosis); existing or treated breast or uterus cancers; severe diabetes w/ vascular changes; Dubin-Johnson & Rotor syndrome; history of or existing liver tumours, disturbances of lipometabolism; history of herpes of pregnancy, idiopathic jaundice or severe pruritus of pregnancy; deteriorating otosclerosis during pregnancy; pending operations (12 wk before0; immobilization.
Benign & rarely, malignant liver tumours which may lead to life-threatening intra-abdominal haemorrhage have been observed. If severe upper abdominal complaints, liver enlargement or signs of intra-abdominal haemorrhage occur, a liver tumour should be taken into consideration. Porphyria; diabetes; smoking, age; sickle-cell anemia; history of phlebitis or thromboembolic disease, impaired liver function; history of extrauterine pregnancy, if one tube is missing.
Nausea; headache, dizziness, depressive moods; spotting, breakthrough bleeding, amenorrhea, rarely wt gain.
Action may be impaired by barbiturates, phenylbutazone, hydantoins, rifampicin & ampicillin.

b) Oral Contraceptives

Gestodene 75 µg, ethinylestradiol 30 µg.
OC.
Pregnancy; severe disturbances of liver function; jaundice or severe pruritus duringpregnancy; Dubin-Johnson syndrome; Rotor syndrome, previous or existing liver tumours; history of or existing thromboembolic processes in arteries or veins & states which predispose to such diseases; sickle-cell anemia; existing or treated cancer of the breast or endometrium; severe diabetes w/ vascular changes; disturbances of lipometabolism, history of herpes of pregnancy, otosclerosis w/ deterioration during pregnancy.
diabetes, hypertension, varicose veins, otosclerosis, multiple sclerosis, epilepsy, porphyria, tetany, chorea minor, history of phlebitis, cigarette smoking, age, lactation. Benign & rarely, malignant liver tumours which may lead to life-threatening intra-abdominal hemorrhage have been observed. If severe upper abdominal complaints, liver enlargement or signs of intra-abdominal haemorrhage occur, a liver tumour should be taken into consideration.
Headache; gastric upsets, nausea; breast tension; changes in body wt & libido; intermenstrual bleeding; depressive moods; chloasma; rarely, poor tolerance of contact lenses.
Barbiturates, phenylbutazone, hydantoins, rifampicin & ampicillin may impair the action of the drug. Requirement for oral antidiabetics & insulin can change.

Desogestrel 150 µg, ethinylestradiol 30 µg.
OC.
Thrombophlebitis, thromboembolic disorders, CV disease or past history of these conditions; severe hypertension; severe liver disorders, cholestatic jaundice, Rotor syndrome, Dubin-Johnson syndrome; known or suspected estrogen-dependent tumours; endometrial hyperplasia; undiagnosed vag bleeding; porphyria; hyperlipoproteinemia; history during pregnancy of severe pruritus or herpes gestationis. Pregnancy.
Severe varicose veins; hepatic cell adenoma; latent or overt cardiac failure, renal dysfunction, epilepsy, migraine, hypertension; sickle-cell hemoglobinopathy, diabetes. Smoking, surgery or prolonged immobilization.
GI upsets, cholestatic jaundice; thrombosis, BP elevation; chloasma, erythema nodosum, rash; headache, migraine, mood changes; breast tenderness, pain, enlargement, secretion; fluid retension, reduced glucose tolerance, change in body wt; intermenstrual bleeding, post-medication amenorrhea, changes in cervical secretion, increase in size of uterine fibromyomata, aggravation of endometriosis, vag infection.
Irregular bleeding & reduced efficacy w/ anticonvulsants, barbiturates, tetracyclines, rifampicin, activated charcoal, certain laxatives, anti-diabetic drugs.

Desogestrel 150 µg, ethinylestradiol 20 µg.
OC.
Thrombophlebitis, thromboembolic disorders, CV disease or past history of these conditions; severe hypertension; severe liver disorder, cholestatic jaundice, Rotor syndrome, Dubin-Johnson syndrome; known or suspected estrogen-dependent tumours; endometrial hyperplasia; undiagnosed vag bleeding; porphyria; hyperlipoproteinemia; history during pregnancy of severe pruritus or herpes gestationis. Pregnancy.
Severe varicose veins; hepatic cell adenoma; latent or overt cardiac failure, renal dysfunction, epilepsy, migraine; hypertension; sickle-cell hemoglobinopathy, diabetes. Also see lit.
GI upsets, cholestatic jaundice; thrombosis, BP elevation; chloasma, erythema, nodosum, rash; headache, migraine, mood changes; breast tenderness, pain, enlargement, secretion; fluid retention, reduced glucose tolerance, change in body wt; intermenstrual bleeding, post-medication amenorrhea, changes in cervical secretion, increase in size of uterine fibromyomata, aggravation of endometriosis, vag infection.
Irregular bleeding & reduced efficacy w/ anticonvulsants, barbiturates, tetracyclines, rifampicin, activated charcoal, certain laxatives, antidiabetic drugs.

Ethinyl estradiol 30 µg, gestodene 75 µg.
OC.
defects of coagulation system, valvular heart disease, atrial fibrillation, acute & chronic liver function disturbance; sex steroid-dependent neoplasia; sickle cell anemia; severe diabetes w/ vascular changes; herpes gestationis; undiagnosed vag bleeding; pregnancy; disorders of lipometamolism.
Thromboembolic disorders, smoking, hypertension, hyperlipidemia, obesity & diabetes. Carcinoma of the breast & cervix; hepatic neoplasia; gallbladder disease; bleeding irregularities; pregnancy & lactation. Immediate discontinuation of Minulet: symptoms of migraine, acute disturbance of vision, hearing or speech. Symptoms of thrombophlebitis or thromboembolism. Feeling of pain or tightness in the chest, jaundice, hepatitis or generalized pruritus; increased epileptic seizure; rise in BP; severe clinical depression; severe upper abdominal pain or liver enlargement, 6 wks prior to elective surgery.
Headache, pain, asthenia, elevated BP, nausea, flatulence, vomiting; edema, hypercholesterolemia, wt gain, depression, dizziness/vertigo, emotional lability, nervousness; acne pruiritus; Breast pain, dysmenorrheal, metrorrhagia, amenorrhea, breast engorgement, breast enlargement, breast neoplasm,cervix disorders, leucorrhea, menorrhagia, vag moniliasis, vaginitis.
Rifampicin, barbiturates, hydantoins, primidone, phenylbutazone, carbamazepine & griseofulvin; ampicillin & tetracyclines. Requirements for oral antidiabetic agents & insulin may be altered as a result of an effect in glucose tolerance.

Levonorgestrel 150 µg, ethinylestradiol 30 µg.
OC.
Thrombophlebitis or thromboembolic disorders; deep-vein thrombosis; cerebro-vascular or coronary artery disease; carcinoma of the breast; estrogen-dependent neoplasia; undiagnosed abnormal genital bleeding. Pregnancy; benign or malignant liver tumor.
Age, smoking, obesity, hypertension, hypercholesterolemia, diabetes, history of preeclamptic toxemia, MI, thromboembolic disorders, ocular lesions, visual disturbances, visual disturbances, optic neuritis; carcinoma of the breast, cervix, vag & liver; hepatic tumours, gall bladder disease, bleeding irregularities; mental depression, fluid retention; headache; lactation.
Thrombophlebitis, arterial thromboembolism, pulmonary embolism, MI, cerebral hemorrhage & thrombosis, hypertension, gallbladder disease, hepatic adenoma or benign liver tumors. Nausea, vomiting, GI upsets, breakthrough bleeding, spotting, change in menstrual flow, amenorrhea. Edema, melasma. Breast changes, wt change, change in cervical erosion & secretion. Cholestatic jaundice, migraine, rash, mental depression, reduced tolerance to carbohydrates, vag candidiasis, change in corneal curvature, intolerance to contact lenses.
Rifampin, ampicillin, penicillin, tetracyclines, neomycin, chloramphenicol, sulfonamides, nitrofurantoin, barbiturates, phenylbutazone, meprobamate, phenacetin, pyrazolone containing analgesics, chlorpromazine, dihydroergotamine, chlordiazepoxide.

c) Other Contraceptives

Levonorgestrel.
Contraception, idiopathic menorrhagia.
Known or suspected pregnancy; genital infection; confirmed or suspected uterine or cervical malignancy; undiagnosed abnormal uterine bleeding; congenital or acquired uterine anomaly including fibroids if they distort the uterine cavity; acute liver disease or liver tumor; active thrombophlebitis or thromboembolic disorders.
Discontinue treatment if crescendo migraine or other symptoms indicating transient cerebral ischemia; exceptionally severe headache, jaundice; marked increase of BP; unexplained loss of vision or other symptoms of retinal thrombosis occurs. Hormone dependent neoplasia including breast cancer, malignancies affecting the blood or leukemias, severe arterial disease such as stroke or myocardial. Diabetics. In recurrent endometritis, pelvic infections or if an acute infection dose not respond to treatment w/ in a few days, perforation, accidental pregnancy, the system must be removed. Not a contraceptive of 1st choice during lactation.
Menstrual changes, lower abdominal pain, acne or other skin problems, back pain, mastalgia, headache, vag discharge, mood changes, nausea, edema, wt gain, decreased libido, sweating, hair loss, greasy hair. Ectopic pregnancy, pelvic inflammatory disease, perforation of the uterine well, enlarged follicles (functional ovarian cysts) may develop.

IUD carrying 250 mm²/375 mm² of copper surface area w/ 2 flexible plastic side arms.
Intrauterine contraception.
Pregnancy; ectopic pregnancy or predisposing factors; malformations or distortions of uterus or cervix; active pelvic inflammatory disease, presence or history of venereal disease, infected abortion w/in 3 mth; undiagnosed vag bleeding; coagulopathy, treatment w/ anticoagulant; disorders of copper metabolism; severe anemia. Large or multiple uterine fibromyomata w/ heavy menstrual periods.
Nulliparity, recent history of pelvic inflammatory disease; epilepsy; medical diathermy of abdominal & sacral area; valvular heart disease, anemia; severe dysmenorrheal; uterine scars, small uterine fibromyomata, endometrial polyps or endometriosis. Treatment w/ corticosteroids or NSAIDs.
Uterine cramps &/or abdominal pain; syncope, bradycardia, other neurovascular episodes during or immediately after insertion or removal of IUDs; breakthrough bleeding, prolongation of menstruation, dysmenorrheal; back & leg pain, dyspareunia; pelvic inflammatory disease; abnormal vag discharge; perforated uterus or cervix; spontaneous abortion; septicemia; ectopic pregnancy. Urticarial allergic skin reactions.

Menfegol.
Contraception & prophylaxis of VD.