Logest - monophasic progestin-estrogen combination contraceptive.
Release form and composition
Logest is available in the form of dragees and coated tablets: round, white (21 pieces in blisters, 1 or 3 blisters in a carton box).
Active substances (in 1 tablet / dragee):
- Gestoden - 75 mcg;
- Ethinyl estradiol - 20 mcg.
Auxiliary components: corn starch, polyvidone 700 000, sucrose, calcium carbonate, polyvidone 25 000, talc, macrogol 6000, magnesium stearate, mountain glycolic wax, lactose monohydrate.
Indications for use
Logest is used for contraception.
The following diseases and conditions are absolute contraindications to taking the drug; If any of them develops for the first time during Logest's application, the contraceptive should be canceled:
- Arterial and venous thrombosis, including a history (for example, myocardial infarction, thromboembolism of the branches of the pulmonary artery, deep vein thrombosis of the lower extremities, cerebrovascular disorders);
- Conditions preceding thrombosis, including a history of (for example, angina pectoris or transient ischemic attacks);
- The presence of pronounced and / or multiple risk factors for thrombosis;
- Severe liver disease or liver failure (until the normalization of liver tests);
- Liver tumors (both malignant and benign), including a history of;
- Pancreatitis with severe hypertriglyceridemia, including a history of;
- Diabetes with vascular complications;
- Migraine with focal neurological symptoms, including a history of;
- Established or suspected hormone-dependent malignant neoplasms;
- Vaginal bleeding of unknown origin;
- Pregnancy or suspicion of it;
- Hypersensitivity to the drug.
In the following cases, Logest can only be assigned after assessing the expected benefit from taking a contraceptive and potential risks:
- The presence of risk factors that can lead to thrombosis or thromboembolism, such as: smoking, predisposition (the presence of someone from the next of kin at a young age, thrombosis, cerebrovascular accident or myocardial infarction), obesity, valvular heart disease, arterial hypertension, disorders heart rhythm, migraine without focal neurological symptoms, dyslipoproteinemia, extensive trauma, serious surgical interventions, prolonged immobilization;
- The presence of other diseases in which a violation of the peripheral circulation is possible, such as: phlebitis of the superficial veins, ulcerative colitis, Crohn's disease, hemolytic-uremic syndrome, sickle cell anemia, systemic lupus erythematosus, diabetes mellitus without vascular complications;
- Liver disease;
- Hereditary angioedema;
- Diseases that have occurred for the first time or worsened during a previous pregnancy or as a result of previous use of sex hormones (for example, Chorenia Sidengam, otosclerosis with impairment of hearing, cholestasis, porphyria, jaundice, gall bladder diseases, pregnant herpes).
Dosing and Administration
Tablets / pills should be taken orally for 1 pc. per day according to the order indicated on the packaging, at the same time of the day, washing it down with a small amount of water for 21 days. Then they make a standard 7-day break, during which (usually for 2-3 days after taking the last pill), withdrawal bleeding develops, which may not end before the start of a new package.
Rules for starting admission, depending on the circumstances:
- The absence in the previous month of any hormonal contraceptives: on the 1st day of the menstrual cycle. You can start using the drug and for 2-5 days of menstrual bleeding, but then within the first 7 days you must additionally use a barrier method of contraception;
- Transfer from another combined oral contraceptive: optimally - the next day after taking the last hormone-containing pill, but no later than the end of the 7-day break (when using the drug calculated on a 21-day course) or the next day after taking the last inactive pill (when using the drug calculated for the 28-day course);
- Transfer from a contraceptive patch or vaginal ring: on the day the patch or ring is removed, but not later than the day when a new patch is to be pasted or a new ring is inserted;
- The transition from a contraceptive containing only a gestagen: mini-drank - on any day without a break; implant or intrauterine contraceptive releasing the progestogen (Mirena) - on the day of its removal; the injection form is on the day when the next infection should be made. In all cases, during the first 7 days of taking Logest, an additional barrier contraceptive should be used;
- Abortion in the first trimester of pregnancy: on the day of surgery, then additional contraceptive protection is not required;
- Abortion in the II trimester or childbirth: for 21-28 days. If reception is started later, an additional barrier method of contraception is needed during the week. If sexual intercourse took place in this period, it is recommended to wait for the first menstruation or to exclude pregnancy before starting Logest.
If you miss the next pill / dragee, take the drug as soon as possible, then take it at the scheduled time. Thus, in one day you can take 2 tablets / dragees. If no more than 12 hours have passed since the pass, the contraceptive efficacy of the drug does not decrease. If more than 12 hours have passed, the effectiveness of the drug may be reduced, therefore, additional barrier methods of contraception are recommended for 7 days. If at the same time less than 7 tablets / dragees remain in the package, the next package should be started without interruption. The more pills missed and the closer the pass to the 7-day break, the greater the likelihood of pregnancy.
In the case of vomiting and diarrhea, the woman should be guided by the guidelines for skipping the next admission.
Change the days of the onset of menstrual bleeding:
- To postpone menstruation, you should continue taking the drug from a new package without the usual 7-day break. Tablets / pills from the new packaging can be taken as long as necessary (until the packaging is over). In this case, there may be spotting or breakthrough uterine bleeding. It is necessary to resume reception from new packing after a usual break;
- To postpone the onset of menstruation to another day of the week, you should reduce the break in reception for as many days as necessary. However, it should be borne in mind that the shorter the break, the higher the risk of withdrawal bleeding, as well as the appearance of spotting or breakthrough bleeding during the period of taking the drug from the second package.
When taking Logest possible irregular bleeding (breakthrough or spotting), especially in the first months of taking the drug.
There are also cases of other side effects. Their relationship with the combined oral contraceptive has not been confirmed, but it has not been refuted either:
- Organ of vision: rarely (<1/1000) - intolerance to contact lenses (discomfort when wearing them);
- Gastrointestinal tract: often (> 1/100) - abdominal pain, nausea; infrequently (> 1/1000 and <1/100) - vomiting, diarrhea;
- Nervous system: often - headache; infrequently - migraine;
- Mental disorders: often - decrease or mood swings; infrequently - decreased libido; rarely - increased libido;
- Reproductive system and mammary glands: often - tenderness and engorgement of the mammary glands; infrequently - breast hypertrophy; rarely - discharge from the mammary glands, vaginal discharge;
- Immune system: rarely - hypersensitivity;
- Metabolism: Infrequent - fluid retention;
- Skin and subcutaneous tissue: infrequently - rash, urticaria; rarely, erythema nodosum and multiforme;
- Others: often - weight gain; rarely - weight loss.
Possible serious side effects in women taking combined oral contraceptives:
- Cerebrovascular disorders;
- Arterial and venous thromboembolic disorders;
- High blood pressure;
- Violation of the functional parameters of the liver;
- Liver tumors (benign and malignant);
- Changes in glucose tolerance or effect on peripheral insulin resistance;
Also known are rare cases of development or deterioration of conditions, the relationship of which with the use of oral contraceptives has not been proven:
- Herpes pregnant;
- Cervical cancer;
- Porphyrin disease;
- The formation of stones of the gallbladder;
- Hemolytic uremic syndrome;
- Ulcerative colitis;
- Crohn's disease;
- Systemic lupus erythematosus;
- Hearing loss associated with otosclerosis;
- Jaundice and / or pruritus associated with cholestasis.
Before prescribing Logest, like any other hormonal contraceptive, a woman should exclude pregnancy and blood clotting disorders, complete a general medical examination (including personal and family history, blood pressure measurement, body mass index) and gynecological examination (including cytological examination of a smear from cervical canal and breast examination). Control examinations are recommended 1 time in half a year.
Patients who are prescribed an oral contraceptive should be warned that these drugs do not protect against HIV infection and other sexually transmitted diseases.
If during the 7-day break in the reception of the drug there is no menstrual bleeding, you should, without resuming the reception of Logest, conduct an examination of the patient.
Due to the increased risk of thrombosis, taking the drug should be stopped 6 weeks before the planned surgical intervention, and you can resume it no earlier than 2 weeks later.
Patients who are prone to developing chloasma, during the application of Logest are advised to avoid exposure to the sun.
Women taking oral contraceptives should be aware that the drug can affect the course of the menstrual cycle, the properties of the cervical mucus and the rectal temperature.
In the event of symptoms that may indicate the development of thrombosis or thromboembolism (swelling of limbs and pain in the legs along the vein, acute pain, heaviness or constriction in the chest, sudden shortness of breath), you should stop taking Logest and conduct an examination.
Cancel the drug and conduct an additional examination is also necessary in the event of severe pain in the lower abdomen, persistent pruritus, severe depression, severe headaches and migraines, as well as more frequent seizures, a significant increase in blood pressure, sudden changes in speech, hearing or vision.
In the case of prescribing drugs that reduce the contraceptive effect of Logest, during the entire period of treatment and within 7 days after its termination (in the case of rifampicin - 4 weeks), additional methods of contraception should be used.
The interaction of oral contraceptives with other drugs may cause breakthrough bleeding or a decrease in contraceptive efficacy.
Drugs that induce microsomal liver enzymes can increase the clearance of sex hormones. These include barbiturates, rifampicin, primidone, phenytoin, carbamazepine. A similar reaction is presumably possible with the simultaneous use of preparations of Hypericum perforatum, topiramate, griseofulvin, oxcarbazepine, felbamate. During their admission and within 28 days after the end of the course of treatment, an additional barrier method of contraception should be used.
HIV proteases (for example, ritonavir), non-nucleoside reverse transcriptase inhibitors (including nevirapine), and their combinations also have the potential to affect hepatic metabolism.
Some antibacterial drugs (for example, tetracyclines and penicillins) can reduce the concentration of ethinyl estradiol - one of the active ingredients of Logest. For this reason, during the use of antibiotics and within 7 days after their cancellation, an additional barrier method of contraception must be used. If at the same time the period of use of barrier contraceptives ends later than the pills / pills in the package, you should switch to the new package without the usual 7-day break in reception.
Like all combined oral contraceptives, Logest can affect the metabolism of any other drugs used simultaneously, which can lead to a decrease (for example, lamotrigine) or an increase (for example, cyclosporine) in plasma and tissue concentrations.
Terms and conditions of storage
Store in a dark place, out of reach of children at a temperature not exceeding 25 ºС.
Shelf life of tablets - 3 years, dragee - 4 years.