Mersilon is a monophasic oral estrogen-progestin contraceptive.
Release form and composition
Mersilon is produced in the form of tablets: round, biconvex, white, on one side - engraving “TR” and “4”, on the other - engraving “ORGANON” and the image of a five-pointed star (21 pieces in blisters, 1 blister in sachet from the laminated aluminum foil, in a cardboard pack 1, 3 or 6 sachets).
Active ingredients in 1 tablet:
- Desogestrel - 150 mcg;
- Ethinyl estradiol - 20 mcg.
Auxiliary components: stearic acid, potato starch, α-tocopherol, silicon colloid oxide, povidone and lactose monohydrate.
Indications for use
Mersilon is used for contraception (prevention of unwanted pregnancy).
- Venous thrombosis (including thromboembolism of the pulmonary artery and deep vein thrombosis of the lower leg) is currently or in history;
- Arterial thrombosis (including stroke or myocardial infarction) or precursors of thrombosis (including a transient attack of coronary heart disease and angina pectoris), including a history;
- Diagnosed predisposition to arterial / venous thrombosis, incl. hyperhomocysteinemia, resistance to activated protein C, protein S deficiency, protein C deficiency, antithrombin III deficiency, antiphospholipid antibodies (lupus anticoagulant, cardiolipin antibodies);
- Severe or multiple risk factors for venous / arterial thrombosis (including arterial hypertension with arterial pressure of 160/100 mm Hg);
- Diabetes mellitus with vascular lesions;
- Migraine with focal neurological symptoms in history;
- Vaginal bleeding of unknown etiology;
- The presence or suspicion of hormone-dependent malignant tumors of the genital organs or mammary glands;
- Severe liver disease, including a history (up to normalization of liver function indicators);
- Benign and malignant liver tumors now or in history;
- Pancreatitis, accompanied by severe hypertriglyceridemia (including history);
- Lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
- Active smoking (more than 15 cigarettes per day) over the age of 35;
- Pregnancy or suspicion of it;
- Hypersensitivity to the drug.
If any of the above diseases / conditions occur during the use of the drug, it should be immediately canceled.
Like all oral contraceptives, Mersilon is carefully (after a thorough evaluation of the benefits and risks) prescribed in the following cases:
- Age over 35 years;
- Postpartum period;
- Obesity (body mass index> 30 kg / m 2 );
- Prolonged immobilization;
- Severe injury;
- Extensive surgery or surgery on the lower extremities (in case of planned surgery, it is recommended to stop taking Mersilon 4 weeks before the operation and resume no earlier than 2 weeks after complete remobilization);
- Valvular heart disease;
- Arterial hypertension;
- Atrial fibrillation;
- Systemic lupus erythematosus;
- Family history of thromboembolic diseases (venous / arterial thrombosis / thromboembolism in parents, siblings at a relatively early age);
- Varicose veins, superficial thrombophlebitis;
- Hemolytic uremic syndrome;
- Hypertriglyceridemia (including family history);
- Chronic inflammatory bowel disease (ulcerative colitis, Crohn's disease);
- Liver diseases (acute and chronic), including congenital hyperbilirubinemia (Gilbert, Rotor, Dubin-Johnson syndromes);
- Sickle cell anemia;
- Changes in biochemical parameters that may be markers of congenital or acquired susceptibility to venous / arterial thrombosis.
Dosing and Administration
Mersilon is taken orally in the order indicated on the packaging, every day at about the same time, drinking water if necessary, for 21 days. Then there is a 7-day break, during which (usually 2-3 days after taking the last pill) menstrual-like bleeding occurs, after which a new package of the drug is started.
It is necessary to start taking contraceptives on the 1st day of the menstrual cycle. It is also allowed 2-5 days, but in this case it is recommended to use an additional non-hormonal method of contraception during the week.
When switching to Mersilon from other hormonal combined oral contraceptives (CCP), the drug should be started the next day after taking the last active pill of the previous CPC, but no later than the next day after the end of the standard 7-day break, or the next day after taking the last inactive pill.
When switching to Mersilon from the vaginal ring or transdermal patch, you should start taking the drug on the day of their removal or on the day when the next patch should be applied or a new ring should be injected.
In both cases described above, if the woman used the indicated methods of contraception correctly and consistently, it is possible to switch to Mersilon on any day of the cycle (provided there is no pregnancy). However, it is important to remember that the usual interval in using the previous method should not exceed the one recommended by the physician (instruction).
When switching to Mersilon from drugs that contain only progestogen, or from the progestogen-releasing intrauterine system (IUD): if it is a mini-drink, you can start taking the drug on any day; injections - on the day when it is necessary to do the next; implant or IUD - on the day they are removed. In all these cases, during the first week it is recommended to use barrier contraceptives in addition.
After an abortion in the first trimester, it is necessary to start taking Mersilon on the day of surgery, then additional contraceptive methods are not needed.
After an abortion in the second trimester, as well as after childbirth, it is recommended to start taking Mersilon no earlier than on the 21-28th day after the abortion / childbirth. If contraceptive use begins later, then additional methods of contraception should be used within the first 7 days. Women who have had sexual intercourse prior to taking Mersilon should be excluded from pregnancy or wait for the first menstruation.
In the case of skipping the next pill, if less than 12 hours have passed, the reliability of the contraceptive is not reduced, so you need to take the drug as soon as possible, and then continue to use at normal time.
If more than 12 hours have passed, Mersilon’s contraceptive reliability may decrease. In this case, you should follow certain rules depending on the week of the menstrual cycle, which was skipping:
- Week 1: Take a pill as soon as a woman remembers this, even if it means taking 2 tablets at the same time. In the future, follow the standard scheme. Over the next 7 days, in addition, use a reliable non-hormonal method of contraception. If during the previous week there were sexual intercourses, the likelihood of pregnancy cannot be excluded. The more pills are missed and the closer the skipping period to the time of sexual intercourse, the higher the risk of pregnancy;
- Week 2: Take a pill as soon as a woman remembers, even if it means taking 2 tablets at the same time. In the future, follow the standard scheme. If during the previous week (7 days before the admission), the woman took the drug on time, there is no need to use additional barrier methods of contraception. Otherwise, as well as if more than the 1st pill is missed, additional barrier contraceptives are recommended for 7 days;
- Week 3: If a woman took the drug on time during the previous week (7 days before the release), additional barrier methods of contraception will not be needed if you use one of the two schemes below. Otherwise, additional contraception is needed during the next week.
Scheme 1: take a pill as soon as a woman remembers about it, even if it means taking 2 tablets at the same time. Next, follow the standard scheme. However, after the end of the current packaging, immediately start a new one, i.e. Do not make the usual 7-day break.
Scheme 2: stop taking the drug from the current package and take a 7-day break (considering the days when the woman forgot to take the pill), and then start a new package.
In any case, if there was a skip of the next dose of Mersilon, and there is no withdrawal bleeding in the near break, you should consider the probability of pregnancy.
If a woman taking this contraceptive has a gastrointestinal disorder, the absorption of the active substances of the drug may be incomplete, therefore it is recommended to use additional methods of contraception. If vomiting occurs within 3-4 hours after taking Mersilon, then you should follow the rules regarding skipping the next reception.
How to change the period of menstruation
- To delay menstruation, you need to continue taking pills from another package without a 7-day break. Thus, you can delay menstruation for any number of days, but not more than until the end of the tablets from the second package. The contraceptive pill should be resumed as usual after the break;
- To shift menstruation to another day of the week, you need to reduce the break in reception for as many days as necessary.
Mersilon may have the following side effects:
- Reproductive system: acyclic bleeding (most often in the first months of administration);
- Cardiovascular system: high blood pressure, thrombosis or thromboembolism (including stroke, myocardial infarction, thromboembolism of the pulmonary artery, deep vein thrombosis, thromboembolism of the arteries of the retina, renal, mesenteric, hepatic arteries, and veins;
- Hormone-dependent tumors: breast cancer, liver tumors;
- Skin: chloasma (especially in women with a history of chloasma for pregnant women);
- Other: allergic reactions.
The side effects registered in post-marketing research, the connection of which with the intake of Mersilon has not been proven:
- Immune system: rarely - hypersensitivity reactions;
- Metabolism and nutrition: often - an increase in body weight; infrequently - fluid retention; rarely, weight loss;
- Nervous system: often - headache, change of mood, depression; infrequently - migraine, decreased libido; rarely - increased libido;
- Body of vision: rarely - intolerance to contact lenses;
- The digestive system: often - abdominal pain and nausea; infrequently - vomiting;
- Reproductive system: often - breast tenderness; infrequently - an increase in the mammary glands; rarely - discharge from the vagina or mammary glands;
- Skin and subcutaneous tissue: infrequently - rash, urticaria; rarely - erythema nodosum or multiforme.
Before starting or resuming taking Mersilon, the doctor should collect a detailed medical history of the woman (including family) and conduct a thorough examination. If significant clinical signs are detected when measuring blood pressure, a physical examination is necessary. The entire period of use of the oral contraceptive should be repeated examinations. What exactly and how often the doctor determines individually for each woman. However, this should be done at least once every six months.
Every woman should be warned that PDAs do not protect against sexually transmitted infections.
When taking a contraceptive, especially in the first months, irregular copious or spotting may be possible, therefore, the patient’s condition should be assessed after 3 months (this is how long the adaptation period usually lasts).
In the event that irregular bleeding persists and further or appear periodically after regular cycles, one should take into account the probability of non-hormonal causes of cycle disturbances and conduct additional research to exclude malignant neoplasms and pregnancy.
Some women may not have menstrual bleeding during the interval between taking Mercilon. If all recommendations on the use of the drug have been followed, then the probability of pregnancy is small. Otherwise, and also in the absence of bleeding 2 times in a row, it is necessary to exclude pregnancy.
The negative effect of Mersilon on the reaction rate and ability to concentrate was not noted.
In the case of simultaneous use of oral contraceptives with other drugs may develop acyclic bleeding and / or a decrease in contraceptive efficacy.
Such reactions are possible with the combined administration of Mersilon with inducers of microsomal liver enzymes, for example, barbiturates, rifampicin, carbamazepine, rifabutin, phenytoin, primidone, and, possibly, felbamate, rifabutin, topiramate, ritonavir, and the heart of heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate, heart rate level, ritonavir, heart rate, heart rate level, ritonavir, heart rate, heart rate level, ritonavir, heart rate, heart rate level, ritonavir, and other forms of
A violation of the contraceptive effect was also reported when taking Mersilon with tetracyclines and ampicillin.
Women who have been prescribed any of these drugs should use an additional barrier method of contraception during the entire period of treatment, and in the case of antibiotics (with the exception of griseofulvin and rifampicin, since they are inducers of microsomal enzymes), within 7 days after their cancellation , in the case of inducers of microsomal liver enzymes (including rifampicin and griseofulvin) - within 28 days after their cancellation. If the antibiotic treatment period, during which the barrier method of contraception is applied, continues after the end of the tablets in the current packaging, the following should be started without the usual 7-day break. If inducers of liver microsomal enzymes are to be used for a long time, PDA should be replaced with another method of contraception.
Like all oral contraceptives, Mersilon can affect the metabolism of other drugs and change their concentrations in blood plasma and tissues (both increase and decrease). For this reason, with the concomitant appointment of any funds, you should consult with your doctor.
Terms and conditions of storage
Store at 2-30 ° C. Avoid exposure to moisture and light. Keep out of the reach of children.
Shelf life - 3 years.