Lindinet 20 is combination drug produced in the form of tablets. It has a contraceptive effect and is used for planned, regular contraception. The composition includes gestodene and ethinylestradiol, which in combination provide a reliable contraceptive effect. The drug inhibits the pituitary secretion of gonadotropins due to the action of estrogen-gestagens. The components of the drug prevent the maturation of the egg and do not allow it to be fertilized. What else is included in Lindinet 20? Feedback will be provided below.

Ethinylestradiol

Ethinylestradiol is a highly effective component belonging to the group of estrogens. It is produced by the adrenal glands and ovaries and has an estrogenic effect. In combination with progesterone, ethinyl estradiol regulates the menstrual cycle, provokes the reproduction and division of endometrial cells and has a stimulating effect on the development of secondary sexual characteristics and the uterus in case of their insufficiency. Besides, this species The hormone is able to mitigate or completely eliminate complications due to gonadal dysfunction and lower blood cholesterol levels. This confirms the instructions for use for Lindinet 20 and 30. Analogies are of interest to many.

Gestodene

Second active ingredient drug - gestodene. It is a synthetic progestin, which is similar in structure to levonorgestrel, but surpasses it in selectivity and potency. It inhibits the synthesis of luteotropin and follitropin by the pituitary gland, while blocking ovulation.

In addition to such effects as blocking the fertilization of the egg, the contraceptive effect is due to a decrease in the sensitivity of the uterine endometrium to the blastocyst and an increase in the viscous properties of the mucus in the cervix, which creates an obstacle to the passage of spermatozoa through it. Regular intake of Lindinet 20 for a certain time, according to gynecologists, contributes to the regulation menstrual cycle reduces the risk of pathology reproductive organs women, including neoplasms.

The drug should be prescribed by a doctor based on the collected history and taking into account individual characteristics female patients.

Contraindications

The drug is contraindicated for use in patients with the following manifestations:

• Individual intolerance to the components of the drug or hormones in a certain combination.
• Tendency or presence of factors that can lead to venous thrombosis.
• Ischemia as a precursor of thrombosis.
• Irregular hypertension.
• Damage to arteries and veins by thrombosis and thromboembolism.
• Frequent migraines associated with disorders of a neurotic nature.
• The operation and, as a result, a prolonged lack of motor activity.
• Blockage of the veins of the next of kin (thromboembolism).
• dyslipidemic syndrome.
• Angiopathy of a diabetic nature (as a consequence of diabetes mellitus).
• Severe liver damage.
• cholelithiasis.
• Neoplasms in the liver.
• Pigmentary hepatosis (only some forms).
• Yellowness of the skin as a result of taking steroid drugs.
• Otospongiosis, severe itching.
• Vaginal bleeding.
• Pathological inflammatory processes in the pancreas with an increase in triglycerides in the blood.
• Smoking, especially over the age of 35.
• Tumors of the mammary glands and organs reproductive system women.
• Lactation.
• Pregnancy.

How to take "Lindinet 20"? Reviews confirm that this should be done only after consulting with a specialist.

Cautious reception

With caution, you should drink the drug in the following situations:

• Development of azotemia, thrombocytopenia and hemolytic anemia(hemolytic uremic syndrome).
• Diseases of the liver.
• Quincke's edema due to a genetic factor.
• Conditions that increase the risk of thromboembolic or thrombotic damage to the arteries and veins, such as age over 35 years, heredity, or smoking.
• Diseases manifested during pregnancy, as well as against the background of taking other hormonal drugs: chloasma, herpes, porphyria, rheumatic chorea.
• Obesity.
• Hypertension.
• Migraines of a regular nature.
• Dyslipoproteinemic syndrome.
• Seizures.
• Dysfunction of the heart valves.
• A state of prolonged immobility.
• Severe injuries.
• Extensive operations.
• Atrial fibrillation.

What other restrictions does the instructions for use indicate to Lindinet 20?

• Superficial thrombophlebitis of veins and varicose veins.
• postpartum period.
• Depression.
• Biochemical changes in blood composition.
• Systemic lupus erythematosus (Libman-Sachs disease).
• Diabetes mellitus that does not affect blood vessels.
• Granulomatous enteritis.
• Liver diseases in acute and chronic form.
• Anemia (sickle cell).
• Inflammatory processes in the large intestine on the background of an ulcer.
• Elevated levels of triglycerides (lipids based on glycerol) in the blood.

Side effects

Birth control pills "Lindinet 20", according to reviews, are usually well tolerated. But there are still side effects.

The drug is completely canceled with the following symptoms: porphyria, hypertension, hearing loss as a result of otospongiosis and hemolytic-uremic syndrome.

The following pathologies are rare: thromboembolism of the arteries and veins of the circulatory system, lower extremities, brain, lungs, as well as aggravation of lupus erythematosus (Libman-Sachs disease).

The most rare are thromboembolism of the arteries and veins of the liver, mesentery of the retina, kidneys and chorea. This is confirmed by the "Lindinet 20" instructions for use and reviews.

Frequent manifestations

Common side effects include:

• From the reproductive system: no menstrual bleeding after discontinuation of the drug, irregular vaginal hemorrhages and discharge, decreased libido, vaginal inflammation, changes in the state of mucus.
• Discomfort, enlargement, soreness and galactorrhea of ​​the mammary glands.
• On the part of the digestive system: diarrhea, vomiting, nausea, granulomatous enteritis, pain in the epigastric region, ulcerative inflammatory process in the colon, vdenomatous liver damage, hepatitis, liver dysfunction, bile stasis and cholelithiasis.
• Allergic reactions: rashes, erythema, alopecia, increased pigmentation.
• From the side of the central nervous system: migraine, depression, headaches and emotional lability.
• Weight gain and fluid retention, hyperglycemia, hypertriglyceridemia, decreased tolerance and absorption of carbohydrate compounds by the body as a result of changes in metabolism.
• Decreased hearing function, feeling of discomfort when wearing contact lenses.
• Hypersensitivity.

There are a lot of reviews of gynecologists about Lindinet 20.

special instructions

Having made the decision to accept oral contraceptive, you need to take into account the following features:

1. Lactation and pregnancy are absolute contraindications for the reception.

2. Before prescribing a medication, the doctor needs to collect comprehensive information about the health of the patient and immediate family. Twice a year, you need to undergo a gynecological and medical examination to eliminate the risk of contraindications and complications.

3. Studies have accurately proven the high contraceptive effectiveness of Lindinet 20, since during the year of use, pregnancy out of 100 women occurred in 0.05 percent of cases.

4. Maximum contraceptive effect achieved two weeks after the start of taking the pills, so during this period there is a need to use additional non-hormonal contraceptives.

5. The drug is prescribed taking into account the individual characteristics of the patient's body. The specialist evaluates the feasibility and necessity of prescribing Lindinet 20, informing the patient about possible side effects. While taking hormonal drugs, regular gynecological control is necessary. This describes the instructions for Lindinet 20. Reviews of gynecologists are given below.

6. There are situations when it is necessary to completely abandon the use of hormonal contraceptives and switch to other contraceptives. These complications include: convulsions, impaired hemostasis and, as a result, the development of problems in the circulatory system and kidneys, migraines, diabetes, depression, bad analysis blood for biochemistry, anemia and high risk the appearance of a neoplasm due to the intake of hormones.

7. A scientifically proven fact is the relationship between taking hormonal drugs and the development of blood clots and thromboembolism in different systems and organs.

8. The risk of thrombosis and thromboembolism is especially high with the following factors: the patient's age is over 35 years old, genetic predisposition, smoking, obesity, atrial fibrillation, hypertension, heart valve pathology, etc.

9. In postpartum period the risk of thromboembolism is significantly increased.

10. Deviations of biochemical parameters of blood from the norm increase the risk of developing thromboembolism of veins and arteries. Bringing the indicators back to normal reduces the likelihood of the disease. Most common the following symptoms thromboembolism: shortness of breath, pain in the retrosternal region, radiating to left hand, headaches that provoke visual impairment, dizziness, speech disorder, epilepsy, heart failure, numbness and weakness of the body, acute abdomen, pain in calf muscle.

11. Studies have shown that taking hormonal contraceptives increases the risk of developing cervical cancer. The same applies to the development of breast cancer.

12. Oral hormonal contraceptives do not protect against contracting sexually transmitted infections.

13. The appearance of pain in the abdomen against the background long-term use Lindineta 20 may indicate the development of a neoplasm (benign or malignant), which may be a sign of hepatomegaly or bleeding into the abdominal cavity.

14. The effect of taking the drug may decrease against the background of a missed pill, diarrhea, vomiting, improper combination with other drugs.

15. While taking a contraceptive with drugs that reduce the contraceptive effect, it is necessary to use additional methods contraception. There are reviews of gynecologists about this. Lindinet 20 may not be up to the task.

16. A common complication during pregnancy is chloasma. It can also occur while taking oral contraceptives. If such a probability is not excluded, it is necessary to exclude exposure to ultraviolet and sunlight during the reception.

17. Estrogens can affect the kidneys, liver, thyroid gland and adrenal glands, making changes in the indicators of analyzes.

18. After therapy of a liver affected by a virus, Lindinet 20 can be taken only after six months.

19. The effect of the contraceptive may decrease as a result of severe intestinal disorders and vomiting.

20. Smoking at the same time as taking the drug can cause problems with blood vessels, especially after 35 years.

Method of application and dosage of "Lindinet 20"

How to take Lindinet 20 (LS)? Reviews confirm that there is nothing complicated in this.

The drug is taken 1 tablet once a day, it is undesirable to change the time of admission. After three weeks of admission, a week-long break is made, after which a new package begins on the eighth day. During the break between doses of the drug, bleeding begins.

The first tablet should be taken from the first to the fifth day of menstruation. If you switch to Lindinet 20 from another hormonal contraceptive, then the first tablet is taken the next day after the end of the previous drug. When switching from progestin drugs, you can start taking it on any day of the cycle. After removal of the implant, you can start taking the drug the next day, after the injection before the last injection.

During the first week of admission, you will need to use additional methods of contraception to avoid unwanted pregnancy.

The contraceptive effect is maintained even if you miss one pill. This is confirmed by reviews of gynecologists about Lindinet 20.

IN Lately all more women choose Lindinet 20 as an oral contraceptive. It is believed that this hormonal agent has a rather mild effect on female body. According to statistics, the number of pregnant women while taking a contraceptive varies within 0.05%. Despite this, it should be taken seriously in its use. This will help the reviews of the women and specialists who received it.

Lindinet 20: features of the drug

Lindinet 20 is a coated tablet. They are sold in individual blisters and are designed for certain admission courses. Moreover, all tablets have the same doses of hormones.

The action of the drug is due to the presence of ethinylestradiol and gestodene in its composition. The first is a synthetic analogue of a hormone that has an effect on the menstrual cycle. How the drug works: its components affect ovulation. They also make the mucus in the cervix more viscous. Due to this, the spermatozoa cannot continue to move towards the egg.

The drug is interesting in that it can have a positive therapeutic effect on the female body. It manifests itself in the fact that menstruation becomes less painful. There is also a cycle going on. It is believed that Lindinet 20 has a preventive effect. In particular, it can prevent the occurrence of fibroids and ovarian cancer.

How to take Lindinet 20?

The main feature of the drug is in the method of application. The pills in the blaster are numbered. You need to drink them in this sequence, 1 pc per day. It is better to choose the same time. There is a nuance. It is believed that oral hormonal contraceptives increase appetite. Therefore, it is better to drink them in the evening, when you are less hungry. Some physicians believe that optimum time is 9 o'clock, since at this time hormones begin to be better absorbed. Take the drug according to the following scheme:

• Begin to drink Lindinet 20 from the 1st to the 5th day of the menstrual cycle. In the first days of admission, menstruation may stop. Don't be scared. This is the reaction of the body.
• In the first 14 days of taking a contraceptive, non-hormonal methods of protection should be used. This is due to the fact that the contraceptive effect at this time may not occur. A similar reaction is associated with the absorption of hormones and their effect on the body.
• Then drink 1 tablet for 21 days. Then you need to take a 7-day break. During this period, you may begin menstruation. During this period of time, you can do without other methods of contraception if you continue the course.
• Resume drinking Lindinet strictly on the 8th day of the break. This is done even if your period has begun.
• The drug has a number of features. Often they are related to how to take Lindinet 20 after other contraceptives. Reception regimens depend on the course of previous drugs. If it contained 28 tablets, then Lindinet 20 is taken the next day. It happens that contraceptives are designed for 21 days. In this case, you can take Lindinet 20 immediately the next day after the last tablet. It is also allowed to take a 7-day break and drink it for 8 days.
• A separate scheme exists if you stick a hormonal contraceptive patch Or put on a ring. Then you can start drinking Lindinet 20 after you have taken them off. Or they drink it on the day when they need to be replaced.
• The instructions for the drug also indicate how it should be drunk when “missing” tablets. If this happened in the period from 1 to 7 days, then the drug should be drunk as soon as possible. A double dose is allowed. By the way, it has the desired effect only for 12 hours. In the next week, you will have to use additional protection. In the period from 8 to 14 days they do the same. If there were no missed pills in the previous week, then you can not protect yourself in other ways. The same rule applies to a pass in the period of 15-21 days.

Lindinet 20 side effects

The side effects of Lindinet 20 may scare some women. The manufacturer claims that in some cases the drug can also lead to hearing loss! To the main unpleasant symptoms from taking the drug include:

1. Deterioration - occurs headache up to migraines, nausea, weakness. Possible abrupt change moods, and even depression.
2. Skin and hair problems - hair may begin to fall out. On the skin eczema or rash occurs.
3. Changes are also possible in the reproductive system. Discharge or inflammation may begin. Sometimes women have a severe decrease in sexual activity.
4. The digestive system reacts with stomach pain and even ulcerative colitis!
5. Vision loss is also possible.
6. This drug should not be taken by diabetics, women with problems with blood clots, in the presence of liver tumors, jaundice, during pregnancy and lactation, and in a number of other cases.

Lindinet 20: reviews of doctors

Lindinet 20- special drug. The instructions for it say that it can not be assigned independently. If you want to switch to this contraceptive, then first you need to contact a gynecologist. He will spend scheduled inspection and appoint necessary tests. The drug is prescribed only on the basis of diagnosis!

Special attention should be paid to doctors' reviews about the action of Lindinet 20. There are opinions that the drug is "whimsical". This means that there are times when it is difficult for a woman's body to perceive it. This is manifested, among other things, in the manifestation of some side effects. The woman simply becomes ill. The condition worsens to the point that bright red discharge occurs, the temperature rises and severe weakness.

Equally important are the reviews on Lindinet by 20 women who take it. On the network, opinions about this drug differ. So you can find references to strong side effects. Some people have spotting discharge, there is pain in the lower abdomen, which radiates to the lower back. Those who are not suitable for Lindinet 20 may also suffer from nausea up to the rejection of food. It happens that because of the drug there are migraines.

Some women, on the contrary, have positive side effects due to the intake of lindinet 20. So, the fair sex, in some cases, according to reviews, is pleased with the enlarged breasts. In some cases, it becomes 1-1.5 sizes larger! Also note the normalization of weight. One of the women in the reviews on Lindinet 20 wrote that she started taking it when her daughter was 6 months old. At that moment, with a height of 165 cm, she weighed 80 kg. As a result, in six months of taking her weight decreased to 68 kg!

Lindinet 20 can only be used after consulting a gynecologist. He is appointed according to the results of the examination and analysis. They drink a contraceptive from 1 to 5 days of the cycle for 21 days. Then they take a break for 7 days and resume taking it on the 8th day. In the first 14 days, you need to use additional contraceptives. Reviews for the drug are different. In some cases, the woman's body rejects it. This causes severe side effects.

pharmachologic effect

Monophasic oral contraceptive. It inhibits the secretion of gonadotropic hormones from the pituitary gland. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is ethinylestradiol - synthetic analogue follicular hormone estradiol, involved together with the hormone corpus luteum in the regulation of the menstrual cycle. The progestogen component is gestodene, a derivative of 19-nortestosterone, which is superior in strength and selectivity of action not only to the natural corpus luteum hormone progesterone, but also to other synthetic progestogens (for example, levonorgestrel). Due to its high activity, gestodene is used in low dosages, in which it does not exhibit androgenic properties and has practically no effect on lipid and carbohydrate metabolism.

Along with the indicated central and peripheral mechanisms that prevent the maturation of an egg capable of fertilization, the contraceptive effect is due to a decrease in the susceptibility of the endometrium to the blastocyst, as well as an increase in the viscosity of the mucus in the cervix, which makes it relatively impassable for spermatozoa. In addition to the contraceptive effect, the drug, when taken regularly, also has therapeutic effect, normalizing the menstrual cycle and helping to prevent the development of a number of gynecological diseases, incl. tumor nature.

Pharmacokinetics

Gestodene

Suction

After oral administration, it is rapidly and completely absorbed from the gastrointestinal tract. After a single dose, Cmax is noted after 1 hour and is 2-4 ng / ml. Bioavailability - about 99%.

Distribution

Gestodene binds to albumin and sex hormone-binding globulin (SHBG). 1-2% is in plasma in free form, 50-75% specifically binds to SHBG. An increase in the level of SHBG in the blood caused by ethinyl estradiol affects the level of gestodene: the fraction associated with SHBG increases and the fraction associated with albumin decreases. Average V d - 0.7-1.4 l / kg. The pharmacokinetics of gestodene depends on the level of SHBG. The concentration of SHBG in the blood plasma under the influence of estradiol increases by 3 times. With daily intake, the concentration of gestodene in the blood plasma increases by 3-4 times and in the second half of the cycle reaches a state of saturation.

Metabolism and excretion

Gestodene is biotransformed in the liver. The average plasma clearance is 0.8-1 ml / min / kg. The level of gestodene in the blood serum decreases biphasically. T 1/2 in the β-phase - 12-20 hours. Gestodene is excreted only in the form of metabolites, 60% in the urine, 40% in the feces. T 1/2 metabolites - about 1 day.

Ethinylestradiol

Suction

After oral administration, ethinylestradiol is absorbed rapidly and almost completely. Average Cmax in blood serum is achieved 1-2 hours after ingestion and is 30-80 pg / ml. Absolute bioavailability due to presystemic conjugation and primary metabolism is about 60%.

Distribution

Completely (about 98.5%), but non-specifically binds to albumin and induces an increase in the level of SHBG in the blood serum. Average V d - 5-18 l / kg.

C ss is set to 3-4 days of taking the drug, and it is 20% higher than after a single dose.

Metabolism

It undergoes aromatic hydroxylation with the formation of hydroxylated and methylated metabolites, which are present in the form of free metabolites or in the form of conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma is about 5-13 ml.

breeding

Serum concentration decreases biphasically. T 1/2 in the β-phase is about 16-24 hours. Ethinylestradiol is excreted only in the form of metabolites, in a ratio of 2:3 with urine and bile. T 1/2 metabolites - about 1 day.

Indications

- contraception.

Dosing regimen

Assign 1 tablet / day for 21 days, if possible at the same time of day. After taking the last tablet from the package, a 7-day break is taken, during which withdrawal bleeding occurs. The next day after a 7-day break (i.e. 4 weeks after taking the first tablet, on the same day of the week), the drug is resumed.

The first tablet of Lindinet 20 should be taken from the 1st to the 5th day of the menstrual cycle.

At switching to Lindinet 20 from another combined oral contraceptive The first tablet of Lindinet 20 should be taken after taking the last tablet from the package of another oral hormonal contraceptive, on the first day of withdrawal bleeding.

At switching to Lindinet 20 from drugs containing only progestogen ("mini-pill", injections, implant), when taking a "mini-drink", Lindinet 20 can be taken on any day of the cycle, you can switch from using an implant to taking Lindinet 20 the next day after the implant is removed, when using injections - on the eve of the last injection. In these cases, additional methods of contraception should be used in the first 7 days.

After an abortion in the first trimester of pregnancy you can start taking Lindinet 20 immediately after surgery. In this case, there is no need to use additional methods of contraception.

After childbirth or after an abortion in the second trimester of pregnancy taking the drug can be started on the 21-28th day. In these cases, additional methods of contraception must be used in the first 7 days. With a later start of taking the drug in the first 7 days, an additional, barrier method contraception. In the case when sexual contact took place before the start of contraception, before starting the drug, pregnancy should be excluded or the start of the drug should be postponed until the first menstruation.

At pass taking the pill, the missed pill should be taken as soon as possible. If the interval in taking the tablets was less than 12 hours then the contraceptive effect of the drug is not reduced, and in this case there is no need to use an additional method of contraception. The remaining tablets should be taken at the usual time. If the interval was more than 12 hours then the contraceptive effect of the drug may decrease. In such cases, you should not make up for the missed dose, continue taking the drug as usual, but in the next 7 days, you need to use an additional method of contraception. If at the same time there are less than 7 tablets left in the package, the drug from the next package should be started without interruption. In this case, withdrawal bleeding does not occur until the completion of the second pack, but spotting or breakthrough bleeding may occur.

If withdrawal bleeding does not occur after the end of taking the drug from the second package, then pregnancy should be excluded before continuing to take the drug.

If within 3-4 hours after taking the drug begins vomiting and/or diarrhea may reduce the contraceptive effect. In such cases, you should proceed in accordance with the instructions for skipping pills. If the patient does not want to deviate from the usual contraceptive regimen, the missed pills should be taken from another package.

For acceleration of the onset of menstruation you should reduce the break in taking the drug. The shorter the break, the more likely the occurrence of breakthrough or spotting bleeding while taking the pills from the next pack (similar to cases with delayed menstruation).

For delayed start of menstruation the drug should be continued from a new package without a 7-day break. Menstruation can be delayed as long as necessary until the end of the last pill from the second package. With a delay in menstruation, breakthrough or spotting bleeding may occur. Regular intake of Lindinet 20 can be restored after the usual 7-day break.

Side effect

Side effects requiring discontinuation of the drug

From the side of cardio-vascular system: arterial hypertension; rarely - arterial and venous thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, thromboembolism pulmonary artery); very rarely - arterial or venous thromboembolism of the hepatic, mesenteric, renal, retinal arteries and veins.

From the sense organs: hearing loss due to otosclerosis.

Others: hemolytic-uremic syndrome, porphyria; rarely - exacerbation of reactive systemic lupus erythematosus; very rarely - Sydenham's chorea (passing after discontinuation of the drug).

Other side effects are more common but less severe. The expediency of continuing the use of the drug is decided individually after consultation with a doctor, based on the benefit / risk ratio.

From the reproductive system: acyclic bleeding/ bloody issues from the vagina, amenorrhea after discontinuation of the drug, change in condition vaginal mucus, development inflammatory processes vagina, candidiasis, tension, pain, breast enlargement, galactorrhea.

From the side digestive system: epigastric pain, nausea, vomiting, Crohn's disease, ulcerative colitis, the occurrence or exacerbation of jaundice and / or itching associated with cholestasis, cholelithiasis, hepatitis, liver adenoma.

Dermatological reactions: erythema nodosum, exudative erythema, rash, chloasma, increased hair loss.

From the side of the central nervous system: headache, migraine, mood lability, depression.

From the sense organs: hearing loss, increased sensitivity of the cornea (when wearing contact lenses).

From the side of metabolism: fluid retention in the body, a change (increase) in body weight, a decrease in carbohydrate tolerance, hyperglycemia, an increase in TG levels.

Others:allergic reactions.

Contraindications for use

- the presence of severe and / or multiple risk factors for venous or arterial thrombosis (including complicated lesions of the valvular apparatus of the heart, atrial fibrillation, cerebrovascular disease or coronary arteries, arterial hypertension, severe or medium degree severity with BP ≥ 160/100 mm Hg);

- the presence or indication in the anamnesis of the precursors of thrombosis (including transient ischemic attack, angina pectoris);

- migraine with focal neurological symptoms, incl. in history;

- venous or arterial thrombosis / thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower leg, pulmonary embolism) at present or in history;

- the presence of venous thromboembolism in history;

- surgical intervention with prolonged immobilization;

- diabetes mellitus (with angiopathy);

- pancreatitis (including history), accompanied by severe hypertriglyceridemia;

- dyslipidemia;

— serious illnesses liver, cholestatic jaundice (including during pregnancy), hepatitis, incl. in history (before the normalization of functional and laboratory parameters and within 3 months after their normalization);

- jaundice when taking GCS;

- cholelithiasis at present or in history;

- Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome;

- liver tumors (including history);

- severe itching, otosclerosis or its progression during a previous pregnancy or taking corticosteroids;

- hormone-dependent malignant neoplasms genital organs and mammary glands (including if they are suspected);

- vaginal bleeding of unknown etiology;

- smoking over the age of 35 (more than 15 cigarettes per day);

- pregnancy or suspicion of it;

- lactation period;

— hypersensitivity to the components of the drug.

FROM caution the drug should be prescribed in conditions that increase the risk of developing venous or arterial thrombosis / thromboembolism: age over 35 years, smoking, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or impaired cerebral circulation at a young age in one of the next of kin), hemolytic uremic syndrome, hereditary angioedema, liver diseases, diseases that first arose or worsened during pregnancy or against the background of a previous intake of sex hormones (including porphyria, herpes in pregnancy, chorea / Sydenham's disease /, Sydenham's chorea, chloasma), obesity (BMI over 30 kg / m 2), dyslipoproteinemia, arterial hypertension, migraine, epilepsy, valvular heart disease, atrial fibrillation, prolonged immobilization, extensive surgery, surgery on lower limbs, severe injury, varicose veins veins and superficial thrombophlebitis, postpartum period(non-lactating women /21 days after childbirth/; lactating women after the end of the lactation period), the presence of severe depression (including history), changes in biochemical parameters (activated protein C resistance, hyperhomocysteinemia, antithrombin III deficiency, protein deficiency C or S, antiphospholipid antibodies, including antibodies to cardiolipin, lupus anticoagulant), diabetes mellitus, uncomplicated vascular disorders, SLE, Crohn's disease, ulcerative colitis, sickle cell anemia, hypertriglyceridemia (including family history), acute and chronic diseases liver.

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation.

In small quantities, the components of the drug are excreted in breast milk.

When used during lactation, milk production may decrease.

Overdose

Has not been described severe symptoms after taking the drug in high doses.

Symptoms: nausea, vomiting, in girls - bloody discharge from the vagina.

Treatment: symptomatic therapy is prescribed, there is no specific antidote.

drug interaction

The contraceptive activity of Lindinet 20 is reduced when taken simultaneously with ampicillin, tetracycline, rifampicin, barbiturates, primidone, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine. Contraceptive action oral contraceptives is reduced with the use of these combinations, breakthrough bleeding and menstrual disorders become more frequent. While taking Lindinet 20 with the above drugs, as well as within 7 days after completing the course of taking them, it is necessary to use additional non-hormonal (condom, spermicidal gels) methods of contraception. When using rifampicin, additional methods of contraception should be used within 4 weeks after completion of the course of its administration.

When used simultaneously with Lindinet 20, any drug that increases gastrointestinal motility reduces the absorption of active substances and their level in blood plasma.

Sulfation of ethinyl estradiol occurs in the intestinal wall. Drugs that also undergo sulfation in the intestinal wall (incl. vitamin C), competitively inhibit the sulfation of ethinylestradiol and thereby increase the bioavailability of ethinylestradiol.

Inducers of microsomal liver enzymes reduce the level of ethinylestradiol in blood plasma (rifampicin, barbiturates, phenylbutazone, phenytoin, griseofulvin, topiramate, hydantoin, felbamate, rifabutin, oscarbazepine).

Liver enzyme inhibitors (itraconazole, fluconazole) increase plasma levels of ethinylestradiol.

Some antibiotics (ampicillin, tetracycline), preventing the intrahepatic circulation of estrogens, reduce the level of ethinyl estradiol in plasma.

Ethinylestradiol, by inhibiting liver enzymes or accelerating conjugation (primarily glucuronidation), can affect the metabolism of other drugs (including cyclosporine, theophylline); the concentration of these drugs in the blood plasma may increase or decrease.

With the simultaneous use of Lindinet 20 with St. John's wort (including infusion), the concentration of active substances in the blood decreases, which can lead to breakthrough bleeding, pregnancy. The reason for this is the inducing effect of St. John's wort on liver enzymes, which continues for another 2 weeks after completion of the course of taking St. John's wort. This combination of drugs is not recommended.

Ritonavir reduces the AUC of ethinylestradiol by 41%. In this regard, during the use of ritonavir, a hormonal contraceptive with more high content ethinyl estradiol or use additional non-hormonal methods of contraception.

It may be necessary to adjust the dosing regimen when using hypoglycemic agents, tk. oral contraceptives may reduce carbohydrate tolerance, increase the need for insulin or oral antidiabetic agents.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 25°C. Shelf life - 3 years.

Application for violations of liver function

Contraindicated in violations of liver function.

Application for violations of kidney function

special instructions

Before starting the use of the drug, it is necessary to conduct a general medical (detailed family and personal history, measurement of blood pressure, laboratory research) and gynecological examination (including examination of the mammary glands, pelvic organs, cytological analysis of the cervical smear). A similar examination during the period of taking the drug is carried out regularly, every 6 months.

The drug is a reliable contraceptive: the Pearl index (an indicator of the number of pregnancies that occurred during the use of a contraceptive method in 100 women for 1 year) with correct application is about 0.05. Due to the fact that the contraceptive effect of the drug from the start of administration is fully manifested by the 14th day, it is recommended to additionally use non-hormonal methods of contraception in the first 2 weeks of taking the drug.

In each case, before prescribing hormonal contraceptives, the benefits or possible negative effects of their use are individually assessed. This issue must be discussed with the patient, who, after receiving the necessary information, will make the final decision on the preference for hormonal or any other method of contraception.

The state of health of women must be carefully monitored. If any of the following conditions / diseases appear or worsen while taking the drug, you must stop taking the drug and switch to another, non-hormonal method of contraception:

- diseases of the hemostasis system;

conditions/diseases predisposing to the development of cardiovascular, kidney failure;

- epilepsy;

- migraine;

- the risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;

- diabetes mellitus, not complicated by vascular disorders;

- severe depression (if depression is associated with impaired tryptophan metabolism, then vitamin B 6 can be used to correct it);

- sickle cell anemia, tk. in some cases (for example, infections, hypoxia), estrogen-containing drugs in this pathology can provoke thromboembolism;

- the appearance of deviations in laboratory tests for assessing liver function.

Thromboembolic diseases

Epidemiological studies have shown that there is an association between the intake of oral hormonal contraceptives and an increased risk of developing arterial and venous thromboembolic diseases (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism). An increased risk of venous thromboembolic disease has been proven, but it is significantly less than during pregnancy (60 cases per 100,000 pregnancies). When using oral contraceptives very rarely, arterial or venous thromboembolism of the hepatic, mesenteric, renal or retinal vessels is observed.

The risk of developing arterial or venous thromboembolic diseases increases:

- with age;

- when smoking (heavy smoking and age over 35 are risk factors);

- if there is a family history of thromboembolic diseases (for example, in parents, a brother or sister). If you suspect genetic predisposition, it is necessary to consult a specialist before using the drug;

- with obesity (BMI over 30 kg / m 2);

- with dyslipoproteinemia;

- with arterial hypertension;

- in diseases of the heart valves, complicated by hemodynamic disorders;

- with atrial fibrillation;

- with diabetes mellitus, complicated vascular lesions;

- with prolonged immobilization, after a large surgical intervention, after surgery on the lower extremities, after a severe injury.

In these cases, a temporary cessation of the use of the drug is expected (no later than 4 weeks before surgery, and resumed no earlier than 2 weeks after remobilization).

Women after childbirth have an increased risk of venous thromboembolic disease.

It should be borne in mind that diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia, increase the risk of developing venous thromboembolic diseases.

It should be borne in mind that resistance to activated protein C, hyperhomocysteinemia, deficiency of proteins C and S, deficiency of antithrombin III, the presence of antiphospholipid antibodies increase the risk of developing arterial or venous thromboembolic diseases.

When evaluating the benefit / risk ratio of taking the drug, it should be borne in mind that targeted treatment given state reduces the risk of thromboembolism. The symptoms of thromboembolism are:

— sudden pain in the chest, which radiates to the left arm;

- sudden shortness of breath;

Any unusually severe headache that continues long time or appearing for the first time, especially when combined with sudden complete or partial loss of vision or diplopia, aphasia, dizziness, collapse, focal epilepsy, weakness or severe numbness of one half of the body, movement disorders, severe unilateral pain in the calf muscle, acute abdomen.

Tumor diseases

Some studies have reported an increase in the occurrence of cervical cancer in women who have been taking hormonal contraceptives for a long time, but the results of the studies are conflicting. Sexual behavior, human papillomavirus infection and other factors play a significant role in the development of cervical cancer.

A meta-analysis of 54 epidemiological studies showed that there is relative increase risk of breast cancer among women taking oral hormonal contraceptives, however, higher detection of breast cancer could be associated with more regular medical examination. Breast cancer is rare among women under 40, whether they are taking hormonal birth control or not, and increases with age. Taking pills can be regarded as one of many risk factors. However, women should be advised of the potential risk of developing breast cancer based on a benefit-risk assessment (protection against ovarian and endometrial cancer).

There are few reports of the development of benign or malignant tumor liver in women taking long-term hormonal contraceptives. This should be kept in mind in the differential diagnostic evaluation of abdominal pain, which may be associated with an increase in the size of the liver or intraperitoneal bleeding.

Chloasma

Chloasma can develop in women who have a history of this disease during pregnancy. Those women who are at risk of developing chloasma should avoid contact with sunbeams or ultraviolet radiation while taking Lindinet 20.

Efficiency

The effectiveness of the drug may decrease in the following cases: missed tablets, vomiting and diarrhea, simultaneous use of other drugs that reduce the effectiveness birth control pills.

If the patient is simultaneously taking another drug that can reduce the effectiveness of birth control pills, additional methods of contraception should be used.

The effectiveness of the drug may decrease if, after several months of their use, irregular, spotting or breakthrough bleeding appears, in such cases it is advisable to continue taking the tablets until they are finished in the next package. If, at the end of the second cycle, menstrual bleeding does not begin or acyclic spotting does not stop, stop taking the tablets and resume it only after pregnancy has been excluded.

Changes in laboratory parameters

Under the influence of oral contraceptive pills - due to the estrogen component - the level of some laboratory parameters may change ( functional indicators liver, kidneys, adrenal glands, thyroid gland, indicators of hemostasis, levels of lipoproteins and transport proteins).

Additional Information

After an acute viral hepatitis the drug should be taken after the normalization of liver function (not earlier than after 6 months).

For diarrhea or intestinal disorders, vomiting contraceptive effect may decrease. Without stopping taking the drug, it is necessary to use additional non-hormonal methods of contraception.

Women who smoke have an increased risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk depends on age (especially in women over 35) and on the number of cigarettes smoked.

A woman should be warned that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Influence on the ability to drive vehicles and control mechanisms

Studies on the effect of the drug Lindinet 20 on the ability to drive a car and work machinery have not been conducted.

Description of the dosage form

Lindinet 20: round, biconvex film-coated tablets, light yellow color, white break or almost white color with a light yellow border, both sides without an inscription.

Lindinet 30: round, biconvex film-coated tablets, yellow, white or almost white kink with a yellow border, unlabeled on both sides.

Characteristic

Monophasic combined progestogen-estrogen contraceptive drug.

special instructions

Studies to identify the possible effect of the drug on the ability to drive a car or on the ability to control dangerous mechanisms were not carried out.

Composition and form of release

Lindinet 20

Lindinet 30

in a blister pack 21 pcs.; in a box of 1 or 3 pcs.

pharmachologic effect

It inhibits the secretion of gonadotropic hormones of the pituitary gland, inhibits the maturation of follicles and prevents the process of ovulation. Increases the viscosity of cervical mucus, which makes it difficult for sperm to enter the uterus.

Pharmacokinetics

Gestodene

Quickly and almost 100% absorbed from the gastrointestinal tract (bioavailability of about 99%). After 1 hour after a single injection, the concentration is 2-4 ng / ml. It binds to albumin and sex hormone-binding globulin (SHBG). 1-2% is in the form of a free steroid, 50-75% specifically binds to SHBG. An increase in the level of SHBG in the blood caused by ethinyl estradiol affects the level of gestodene: the fraction associated with SHBG increases and the fraction associated with albumin decreases. The average volume of distribution of gestodene is 0.7-1.4 l / kg. Undergoes biotransformation similar to other steroids. Average clearance values: 0.8-1.0 ml / min / kg. Serum levels decrease biphasically. In the final phase T 1/2 - 12-20 hours. It is excreted only in the form of metabolites: 60% - with urine, 40% - with feces. T 1/2 metabolites about 1 day.

Ethinylestradiol

Rapidly and almost completely absorbed from the gastrointestinal tract. The average value of C max in blood serum is 30-80 pg / ml, achieved 1-2 hours after administration. Bioavailability due to presystemic conjugation and primary metabolism is about 60%. Completely but non-specifically binds to albumin (about 98.5%) and induces an increase in the level of SHBG in the blood serum. The average volume of distribution is 5-18 l / kg. It mainly undergoes aromatic hydroxylation with the formation of hydroxylated and methylated metabolites, which are present in the form of free metabolites or in the form of conjugates (glucuronides and sulfates). Metabolic clearance from blood plasma is about 5-13 ml / min / kg. Serum concentration decreases biphasically. T 1/2 of the second phase is about 16-24 hours. Ethinylestradiol is excreted only in the form of metabolites, with urine and bile in a ratio of 2:3. T 1/2 metabolites - about 1 day. A stable concentration (20% higher than after a single dose) is established by 3-4 days.

Clinical pharmacology

Oral contraceptives, in addition to preventing pregnancy, have positive influence on the menstrual cycle (if it is violated): monthly cycle becomes regular, the volume of blood loss during menstruation and the frequency of development iron deficiency anemia, the frequency of dysmenorrhea decreases, the appearance of functional ovarian cysts, ectopic pregnancy, the appearance of fibroadenomas and fibrocysts in the mammary glands, inflammatory diseases small pelvis and the formation of endometrial cancer; improves the condition of the skin acne.

Indications

Contraception.

Contraindications

Hypersensitivity to the components of the drug; the diseases which are followed by the expressed disturbances of function of a liver; liver tumors (including history); thrombosis and thromboembolism (including history); myocardial infarction (including history); heart failure; cerebrovascular disorders (including history); conditions preceding thrombosis (including transient ischemic attacks, angina pectoris); coagulopathy; sickle cell anemia; estrogen-dependent tumors, incl. tumors of the breast or endometrium (including history); diabetes mellitus complicated by microangiopathies; uterine bleeding of unknown etiology; idiopathic jaundice and itching during pregnancy; a history of herpes; otosclerosis with deterioration during a previous pregnancy; pregnancy.

With caution - breast cancer, chorea of ​​pregnant women (previous appointment may worsen the course of chorea of ​​pregnant women), diabetes mellitus, epilepsy, gallbladder disease, especially cholelithiasis (including history), liver failure, arterial hypertension, immobilization, large surgical interventions, cholestatic jaundice (including a history of pregnancy), depression (including a history), migraine.

Dosage and administration

inside, without chewing, drinking plenty of water, regardless of the meal.

Take 1 table. per day (if possible at the same time of day) for 21 days, followed by a 7-day break, during which menstrual-like bleeding occurs due to discontinuation. After a 7-day break, regardless of whether the bleeding has ended or is just beginning, continue taking the drug from the next package. At the same time, an easily reproducible rhythm is established: 3 weeks - taking pills, 1 week - a break. Taking the drug from each new package begins on the same day of the week.

First dose of the drug: taking the drug Lindinet should be started from the first day of the menstrual cycle. It is allowed to start taking it on the 2-5th day of the menstrual cycle, but in this case it is recommended to use additional methods of contraception.

Switching to taking the drug from another oral contraceptive. When switching from a contraceptive containing ethinylestradiol 20 mcg, the transition is carried out as usual after a 7-day interval. When switching from tablets containing 30 mcg of ethinyl estadiol, it is recommended to exclude the 7-day interval, and then take it as usual.

Switching to taking the drug from drugs containing only progestogen ("mini-pill", injections, implants): with a "mini-drink" you can switch to taking the drug Lindinet on any day of the cycle. From the implant, you can switch to Lindinet the day after the removal of the implant; with solution for injection - the day before the injection. In these cases, in the first 7 days it is necessary to use additional methods of contraception.

Taking Lindinet after an abortion in the first trimester of pregnancy: after an abortion, you can immediately start taking the drug, in this case there is no need to use an additional method of contraception.

Taking Lindinet after childbirth or after an abortion in the second trimester of pregnancy: the drug can be started 21-28 days after childbirth, provided that the woman is not breastfeeding, or an abortion in the second trimester of pregnancy. In these cases, in the first 7 days it is necessary to use additional methods of contraception. If after childbirth or abortion there was already sexual contact, before taking the drug, pregnancy should be excluded or wait until the first menstruation.

Missing pills: if the pill was missed, take the missed pill as soon as possible. If the interval was less than 12 hours, the effectiveness of the drug will not decrease, and in this case there is no need to use an additional method of contraception. The remaining tablets should be taken at the usual time. If the interval was more than 12 hours, the effectiveness of the drug may decrease. In this case, the woman should take the missed pill(s) and take the next pill(s) as normal, with additional methods of contraception needed for the next 7 days. If less than 7 tablets are left in the package, the drug from the next package is started without interruption. In this case, menstrual-like bleeding does not occur due to discontinuation of the drug before the completion of the drug from the second package, but spotting or breakthrough bleeding may occur. If menstrual bleeding does not occur due to discontinuation of the drug after the completion of the second package, then pregnancy should be excluded before continuing to take the drug.

Measures taken for vomiting and diarrhea: if vomiting and / or diarrhea begins within 3-4 hours after taking the drug, the contraceptive effect may decrease. In this case, you must act in accordance with paragraph Missing pills. If the patient does not want to change the regimen, the missed tablets should be taken from a new package.

Changing the start date of your period: it is possible to accelerate the onset of menstruation by reducing the break in taking the drug. The shorter the break in taking the drug, the more likely it is that menstrual-like bleeding will not occur, and breakthrough or spotting bleeding will occur while taking the drug from the next package. To delay menstruation, the drug should be continued from a new package without a 7-day break. Menstruation can be delayed as long as necessary: ​​until the end of the last pill from the second package. With a delay in menstruation, breakthrough or spotting bleeding may occur. Regular use of the drug Lindinet can be restored after the usual 7-day break.

Use during pregnancy and lactation

The drug is contraindicated in pregnancy. If necessary, the appointment of the drug during lactation should decide on the termination breastfeeding (active substances the drug is excreted in breast milk in small amounts).

Interaction

Rifampicin (increases clearance), as well as barbiturates, carbamazepine, phenylbutazone, phenytoin, griseofulvin, topiramate, felbamate, oxcarbazepine can lead to breakthrough uterine bleeding or decreased contraceptive efficacy.

Contraceptive reliability is reduced when taking ampicillin, tetracycline (the mechanism of this action has not been elucidated). During concomitant use with the above drugs, as well as within 7 days after the completion of their course, it is necessary to use other non-hormonal (condom, spermicidal gels) methods of contraception. When using rifampicin, additional methods of contraception should be used within 4 weeks after completion of the course of its administration. Any drug that increases gastrointestinal motility reduces the level of the drug in the blood.

Drugs (for example, ascorbic acid), which undergo sulfation in the intestinal wall, competitively inhibit the sulfation of ethinyl estradiol and enhance its bioavailability. Inhibitors of liver enzymes (eg itraconazole, fluconazole), increase the concentration of ethinyl estradiol in blood plasma.

Ethinylestradiol, by inhibiting liver enzymes or accelerating conjugation (primarily glucuronidation), can affect the metabolism of other drugs, increasing or decreasing their concentration in the blood (for example, cyclosporine, theophylline).

The use of St. John's wort (including tea) reduces the concentration of the drug in the blood, which can lead to breakthrough bleeding, pregnancy (the reason is the inducing effect of St. John's wort on liver enzymes, which continues for another 2 weeks after completion of the course of taking St. John's wort). Ritonavir reduces the AUC of ethinylestradiol by 41%. In this regard, during the use of ritonavir, you should use a drug with a higher dose of ethinyl estradiol (Lindinet 30) or use non-hormonal methods of contraception.

Overdose

Severe symptoms after taking large doses of a contraceptive have not been described.

Symptoms: nausea, vomiting, in young girls - slight vaginal bleeding.

Treatment: symptomatic. There is no specific antidote.

Precautionary measures

Diseases of the circulatory system. Oral contraceptives increase the risk of myocardial infarction. Risk of myocardial infarction and thromboembolic complications different localization increases with smoking women who have other risk factors (for example: arterial hypertension, hypercholesterolemia, obesity, diabetes mellitus, family history of VTZ, age over 35-40 years). This should be taken into account for women over 35 years of age and heavy smokers. In older women and taking the drug long time an increase in blood pressure was noted. An increase in blood pressure is more often observed with the use of drugs with large doses hormones.

It is necessary to consult a specialist before using the drug if a woman has: congenital predisposition to thromboembolic diseases, obesity (body mass index above 30 kg / m 2), impaired fat metabolism (dyslipoproteinemia), arterial hypertension, heart valve disease, atrial fibrillation, in cases of prolonged immobilization, major surgery, surgery on the legs, severe trauma (due to the fact that the risk of thromboembolic diseases increases in postoperative period, it is necessary to stop taking the drug 4 weeks before the planned operation and resume taking it 2 weeks after the activation of the patient).

The drug should be stopped immediately if symptoms of thromboembolism appear: pain in chest, which can radiate to the left hand, is unusual severe pain in the legs, swelling of the legs, acute stabbing pain when inhaling or coughing, hemoptysis.

Tumors. Some studies have noted an increase in cervical cancer among women who have taken oral contraceptives for a long time (however, a causal relationship with taking the drug has not been proven). The likelihood of developing cervical cancer depends on sexual behavior and from other factors (human papillomavirus). Studies have not proven a causal relationship between breast cancer and drug use: in women taking oral contraceptives, the disease was detected in more early stage than in women who did not take these drugs. There have been isolated reports of development benign tumor liver in women taking long-term hormonal contraceptives, with the development of intra-abdominal bleeding.

Other pathological conditions . The drug should be discontinued if there is a loss of vision (complete or partial), exophthalmos, diplopia, or if papilla edema is detected. optic nerve or retinal vascular disorders. According to studies, the relative risk of developing gallstones increases with age among women taking oral contraceptives or drugs containing estrogen. Recent studies have shown that the risk of developing gallstone disease is less with the use of drugs with a low dose of hormones. If a migraine occurs, worsens the course of a migraine, or if a persistent or repeated unusually severe headache occurs, the drug should be discontinued. Lindinet should be discontinued immediately if generalized itching occurs or if epileptic seizure.

The effect of the drug on the metabolism of carbohydrates and lipids. In women taking oral contraceptives, there may be a decrease in carbohydrate tolerance. Some women have been found to have elevated blood triglyceride levels when using oral contraceptives. In women with hereditary hyperlipidemia, taking the drug with estrogen, it was found sharp increase triglycerides in the blood plasma, which could lead to the development of pancreatitis. When using oral contraceptives, especially in the first 3 months, irregular (spotting or breakthrough) bleeding may occur. If bleeding occurs long time or appears after they have formed regular cycles, the cause is usually non-hormonal, and an appropriate gynecological examination to rule out pregnancy or malignant formations. If a non-hormonal cause can be excluded and intermenstrual bleeding continues for more than 4 months, you should switch to another drug. In some cases, menstrual-like bleeding due to discontinuation of the drug during the 7-day interval does not occur. If the regimen of taking the drug was violated before the absence of bleeding or if there is no bleeding after taking the second package, pregnancy must be excluded before continuing the course of taking the drug. Before starting the use of birth control pills, a detailed family and personal history should be taken and a general medical and gynecological examination should be performed. These studies are repeated every 6 months. During a physical examination, blood pressure is measured, breast examinations are performed, abdominal palpation, a gynecological examination is performed with a cytological examination of a smear, as well as laboratory studies according to indications (functional parameters of the liver, kidneys, adrenal glands, thyroid gland, indicators of blood coagulation and fibrinolytic factors, levels of lipoproteins and transport proteins). A woman must be warned that the drug does not protect her from sexually transmitted infections, in particular from AIDS. For acute or chronic disorder hepatic function, you should stop taking the drug until the values ​​​​of liver enzymes are restored. With impaired liver function, the metabolism of steroid hormones may be impaired. For those women who develop depression while taking contraceptives, it is advisable to stop the drug and temporarily switch to another method of contraception, to clarify the relationship between the development of depression and taking the drug. Careful monitoring should be carried out if there is a history of depression, and if depression recurs, the oral contraceptive course should be completed. When using oral contraceptives, the concentration folic acid in the blood may decrease. It has clinical significance only in case of pregnancy within a short time after completion of the course of oral contraceptives.

With diarrhea, intestinal motility increases and absorption of the drug decreases.

Side effects

From the side of the cardiovascular system: rarely - thromboembolism, thrombosis (including retinal vessels), increased blood pressure.

From the digestive system: sometimes - nausea, vomiting, hepatitis, hepatocellular adenoma.

From the reproductive system: sometimes - intermenstrual spotting, changes in vaginal secretion, changes in libido.

From the side endocrine system: sometimes - a feeling of tension in the mammary glands, a change in body weight.

From the side of the central nervous system: emotional lability, depression, dizziness, headaches, migraine, weakness, fatigue.

Others: pain in the lower abdomen, chloasma, discomfort when wearing contact lenses, fluid and sodium retention in the body, allergic reactions, impaired glucose tolerance are possible.

Change in laboratory parameters: under the influence of oral contraceptives, some laboratory indicators(functional parameters of the liver, kidneys, adrenal glands, thyroid gland, blood coagulation and fibrinolytic factors, levels of lipoproteins and transport proteins) may change, but within normal limits.

Lindinet 20 is a modern, which is available in the form of tablets. Ethinylestradiol and gestodene are the active substances of the drug, which suppress the secretion of gonadotropic hormones from the pituitary gland. Lindinet 20 prevents the maturation of the egg, reduces the susceptibility of the endometrium to the blastocyst, and also increases the viscosity of the mucus that is in the cervix. Which in turn makes the uterus relatively impassable for spermatozoa. If Lindinet 20 is used regularly, it also has a therapeutic effect on the body: it normalizes and prevents the development of certain gynecological diseases (including tumors).

Like all drugs, Lindinet 20 has its own contraindications and side effects, therefore, before starting its use, it is necessary to consult a specialist and carefully read the instructions for the drug itself.

2. How to use Lindinet 20 correctly (instruction):

The intake of the drug does not depend on food intake, it is taken orally. The tablet does not need to be chewed, but it must be washed down big amount pure non-carbonated water.

Try to take the drug every day at the same time, daily dose is one tablet. The application period is 21 days. After this period, take a short break for a period of 7 days. After the end of the break or after the start of taking the 1st tablet, count the 4th week (note that the day of the week must be the same), on this day it is necessary to continue taking Lindinet 20.

Please note that as a result of hormone withdrawal, when you are on a break, bleeding from the uterus occurs !!!

• admission start:

Lindinet 20 should be started either on the first day of menstruation, or on any other day, but no later than the fifth day of menstruation. If you wish to start taking Lindinet 20 after you have taken another oral combination contraceptive, the 1st tablet of this drug should be taken after you have taken the last tablet of your previous drug. If before that you used mini-pills that contain progestogen, then you can start taking Lindinet 20 on any day of your period. If you are switching from injections that contain progestogen, then the 1st tablet of the drug must be taken on the eve of the injection, which will be the last one. If it is a progestogen-containing implant, then you need to start using Lindinet 20 after you remove the implant (namely, the next day).

Please note that in the situations listed above, while you are on a 7-day break (while taking Lindinet 20), you must start using additional methods of contraception.

• taking the drug after an abortion or childbirth:

If you start using Lindinet 20 immediately after an abortion in the first to third months of pregnancy, then additional means of contraception are not provided.
After an abortion at a gestational age of more than three months or immediately after the birth of a child, Lindinet 20 is allowed to be used no earlier than after the 21st day, namely from the 21st to the 28th day. If the first time admission teaches for more late period, and before that unprotected intercourse did not take place, then during the first week of using Lindinet 20, additionally use any barrier contraceptive. In the presence of an act, it is desirable to exclude, or postpone the start of admission on the first day of menstruation.

Please note that Lindinet 20 is contraindicated for use if you are breastfeeding. Its use can reduce lactation. The drug is also contraindicated in pregnancy!

• taking the drug when skipping pills:

If you suddenly missed taking the next pill and the missed period is up to 12 hours, you need to as soon as possible make up for the dose you missed. In such a situation, you do not need to use additional means of contraception. Continue using the drug for standard mode.
If the missed period is more than 12 hours, the dose you missed is not replenished. The drug should be taken as usual. Please note that the effectiveness of the drug itself may decrease, so start using it the next week of taking additional funds pregnancy protection. You do not need to take a break if there are less than seven tablets left in your package. Start accepting the packaging that should be next.

Please note that bleeding from the uterus will begin after the end of the second pack. And keep in mind that slight bleeding can still be observed while you are taking the next package. In the absence of bleeding when the drug is discontinued, pregnancy should be excluded.

• taking the drug in case of vomiting:

During the occurrence of vomiting in the interval of three to four hours after taking the tablet, you should act as described in situations where the next tablet is missed, due to the fact that its absorption is not complete. Try to take the pill that you missed from the package, which will be next, so as not to deviate from the standard contraceptive intake.

• taking the drug to regulate the cycle:

You can not observe a break if there is a desire to delay menstruation. You just need to start the next pack right away. The maximum delay period is the end of the tablets that are in the second pack.

Please note that bleeding from the uterus is not excluded.

After a week break, you can return to the standard Lindinet 20. For an early onset of menstruation, the number of days of the break is shortened.

3. Useful reviews for Lindinet 20:

The main reviews on the direct use of the drug are positive. Lindinet 20 is easily tolerated and does not have pronounced side effects. Girls who took Lindinet 20 sometimes have side effects such as breast enlargement, and sometimes pain in this area, headache, drowsiness, depression, facial rashes and nausea. For some, these symptoms disappeared within the first week of taking Lindinet 20. In rare cases I had to stop taking this drug.
And most importantly, Lindinet 20 does not affect the ability to become pregnant and bear a child in the future in case of termination of its use.