TRIKVILAR

Active material: Ethinylestradiol, Levonorgestrel
When ATH: G03AB03
CCF: The three-phase oral contraceptive
When CSF: 15.11.04.01
Manufacturer: SCHERING AG (Germany)

DOSAGE FORM, STRUCTURE AND PACKAGING

Drop three species.

Drops of light brown color (6 PC. v up.).

Drops white (5 PC. v up.).

Drops ocher (10 PC. v up.).

21 PC. – blisters (1) – packs cardboard.

Fapmakologicheskoe action

Trikvilar effect when taken orally and is the first three-stage low-dose, progestogen-estrogen drug to prevent pregnancy. As a progestin component (progestin) it comprises a derivative of 19-nortestosterone - levonorgestrel, surpassing the activity as the hormone progesterone luteum, and its synthetic analogue pregnin and acts at the receptor level without preliminary metabolic transformations. Trikvilar estrogen component is a highly effective means of oral estrogen - ethinyl estradiol.
A distinctive feature of trikvilar compared with monophasic contraceptive is, it is a set of pills, containing varying amounts of (3 dose) progestogen and estrogen, serial reception of which simulates physiological fluctuations of sex hormones in the blood during the menstrual cycle. Besides, product contains a lower dose of hormones, contraceptives than the first and second generations, and therefore it is less, than they, influence on metabolic processes (lipids, blood clotting), other causes fewer side effects. Trikvilar contraceptive effect is primarily due to the ability to block the release of levonorgestrel-releasing factor (luteinizing hormone and follicle-stimulating) gipotalamusa, depress the secretion of pituitary gonadotropins and thus inhibit ovulation. Its contraceptive effect is enhanced ethinylestradiol - the synthetic analogue of the follicular hormone estradiol, involved with the hormone of the corpus luteum (progestin, progestogen) the implementation of the menstrual cycle. In addition to these central and peripheral mechanisms preventing the maturation of the ability to fertilize the egg, trikvilar contraceptive effect is due to the conservation and under its influence the high viscosity of the cervical mucus, making it difficult to hit the sperm into the uterus.
The dosages of estrogen and progestin components Trikvilar virtually no impact on the basic functions of the central and peripheral nervous system, blood circulation, activities of other body systems.

Both active ingredients after administration trikvilar dragees rapidly and completely absorbed from the gastrointestinal tract. Their maximum plasma concentration is reached in the range 0,5-1 o'clock. Subsequently, the concentration level is characterized by a biphasic decline with a half-life 2 or 24 hours for levonorgestrel and 1-3 or 24 hours for ethinyl estradiol. Daily re-taking the drug is not accompanied by a noticeable cumulation of active substances and their metabolites.
Selecting components trikvilar: levonorgestrel - through the kidneys (50-60%) and liver (40-50%), and ethinyl estradiol - by 40% via the kidneys and 60% - Through the liver. In both cases the half-life is about 24 hours.

The drug can be allocated to human milk. When this selection is less progestogen 0,01 % of the administered dose, and estrogen - about 0,02%.
Due to lack of levonorgestrel metabolize fully cooperates with the organs and systems of the body, and ethinyl estradiol for this interaction is around 40-60%.

Testimony

Contraception.

Contraindications

Pregnancy, severe liver dysfunction, Dubin-Johnson syndrome and Rotor (hereditary benign hyperbilirubinemia), the available or existing liver tumors, embolic processes, in t. no. in disorders of cerebral circulation, other cardiovascular diseases, severe diabetes with vascular complications, drepanocytemia, or had an existing breast cancer and endometrial, disorders of lipid metabolism, idiopathic jaundice or itching during a former pregnancy, a history of herpes, otosclerosis with deterioration during pregnancy occurred.

Side effect

Trikvilar generally well tolerated, It causes a small number of significant side effects nerezko. In some rare cases, it can be observed taking headaches, pain in the stomach, feeling of tension in the breast, change in body weight and libido, depressed mood.
In cases of long-term treatment trikvilar in individual women with a predisposition may sometimes appear dark spots on the skin (chloasma), which are enhanced by prolonged exposure to the sun.
In very rare cases there may be a poor tolerance of contact lenses.

Dosing and Administration

• Trikvilar are inside of 1 pills a day. Start taking the drug: reception trikvilar begin in the 1st day of the cycle (1-day cycle = 1st day of menstruation), Using pellet corresponding day of the week (eg, “Mon.” for Monday) red field calendar packaging. Drops accept, without chewing, and washed down with a little water. Reception time is irrelevant, However, subsequent reception should be performed in the same selected hour, preferably after breakfast or dinner.
• Daily intake of the drug is carried out, Using pellets of the calendar packaging sequentially deposited on the direction of the foil until the arrow, until you have taken all the pills. First menstrual cycle may be less than 4 weeks, if the reception trikvilar was launched in the second half of the week.
• Continued administration of the drug: after the reception of the first calendar trikvilar package the next day he continued to receive, using new packaging, since the field of red pills calendar packaging.
  Usually, menstruation occurs during ingestion of red field packing. In the absence of bleeding before further admission trikvilar necessary to consult with your doctor.
• Stopping: after stopping trikvilar function of female reproductive glands quickly restored in full, allowing normal fertility. Usually the first menstrual cycle after stopping treatment extended by one week. If during the 2-3 months of a normal cycle can not be restored, necessary to consult with your doctor.

Interaction with other agents

It is necessary to take into account, derivatives of barbituric acid (barbiturates), pyrazolone derivatives and pyrazolidine (ʙutadion) and antiepileptics (eg, Carbamazepine, fenition et al.) can enhance metabolization members of the steroid hormone trikvilar. Reducing the effective concentration of the drug can be observed while using trikvilar with some antibiotics (eg, Ampicillin, rifampicin), due to changes in the intestinal microflora. Due to the influence of steroid hormones on glucose tolerance, when receiving gestagenestrogennyh drugs may adjust the dosage of antidiabetic drugs.

Further instructions

The contraceptive effect of the drug from the beginning of the reception fully manifested to 14 day and stored during 7-day pause in the use trikvilar. In this regard, in the first 2 week dosing is recommended to use an additional non-hormonal methods of contraception.

Application trikvilar young women

Low-dose estrogen-progestogen contraceptives, which include Trikvilar, no influence on the course of puberty during the formation of a normal menstrual cycle. In this regard, young women and young can optionally use this type of oral contraceptives.

Application trikvilar after childbirth or abortion

After childbirth or abortion (abortion) Trikvilar advised to take no earlier, what will be the first normal menstrual cycle.

Application trikvilar lactation

During breastfeeding (Lactation) in case of application should be considered trikvilar, that in the first period of reception may decrease the milk. Besides, you must bear in mind, the drug in small amounts excreted in breast milk. Usually oral contraceptives is shown only when the long period of lactation, t. to. for short-term breastfeeding menstrual cycle, usually, not restored.

Irregular reception trikvilar

In the case of missing the reception trikvilar must take medication for subsequent 12 hours. When a reception interval in 36 hours are not guaranteed reliable contraceptive effect. But, Despite this, should continue taking the drug from the package started (with the exception of unused pills), so as, to prevent the premature onset of menstruation, associated with discontinuation. During this period it is recommended to use other non-hormonal methods of contraception (other than the calendar method Knaus and Ogino, and the method of temperature measurement).

With diarrhea or intestinal disorders, vomiting and taking certain drugs (cm. section “Interaction with other agents”) contraceptive effect may be reduced. In such cases, without interrupting the reception trikvilar, you must use an additional non-hormonal methods of contraception (cm. higher).

Cautions

Before and every 6 months of use trikvilar advised to undergo general medical and gynecological examination (including the study of the breast). In case of occurrence of the first time when taking trikvilar migraine headaches or unusually severe headaches, sudden visual and hearing impairment, thrombophlebitis or thromboembolic symptoms, hepatitis, generalized itching, increased frequency of seizures, a significant increase in blood pressure, severe pain in the epigastric region should immediately stop taking the drug and seek medical advice.

Release form and storage conditions

The calendar package with 21 drop. Store at room temperature out of reach of children.