Structure of a cover: yellow dye iron oxide (E172) – 0,027 mg, sucrose – 19,371 mg, talc – 4,198 mg, поливидон 700 000 – 0,189 mg, polyethyleneglycol of 6000 - 2,148 mg, titanium dioxide (E171) – 0,274 mg, calcium carbonate – 8,606 mg, mountain glycolic wax – 0,05 mg, 85% глицерол – 0,137 mg.

Indications to use

Mikroginon appoint for the purpose of prevention of undesirable pregnancy.

Contraindications

Absolute:

The migraine which is followed by focal neurologic symptoms (instructions in the anamnesis);
The states preceding thrombosis, including the tranzitorny ischemic attacks, stenocardia (instructions in the anamnesis or existence now);
Fibrinferments (venous and arterial) and thromboembolisms, including cerebrovascular disturbances, a deep vein thrombosis, a myocardial infarction, a thrombembolia of a pulmonary artery (the instruction in the anamnesis or existence now);
Uncontrollable arterial hypertension;
The diabetes mellitus proceeding in combination with vascular complications;
Vaginal bleedings which etiology is not found out;
The expressed or multiple factors of risk of thrombosis (venous or arterial), including disturbances of a heart rhythm, defeat of the valve device of heart, a disease of coronary arteries of heart or vessels of a brain;
The pancreatitis proceeding in combination with the expressed gipertriglitseridemiya (instructions in the anamnesis or existence now);
Extensive injuries, serious surgical interventions, long immobilization, surgeries standing;
The revealed malignant hormonedependent diseases (including damages of mammary glands or generative organs), and also at suspicion of them;
Benign or malignant tumors of a liver (the instruction in the anamnesis or existence now);
Serious illnesses of a liver and liver failure (after normalization of hepatic tests Mikroginon's reception can be resumed);
The pregnancy (confirmed or in the presence of suspicion on it) and the period of chest feeding;
Hypersensitivity to drug components.

Relative (at Mikroginon's appointment it is required to be careful):

Arterial hypertension;
Disease Krone (granulematozny enteritis);
Thrombophlebitis of superficial veins (a vein inflammation with her thrombosis);
Diabetes mellitus;
The expressed disturbances of a lipometabolism (lipidemia, obesity);
Migraine;
Hemolitic uraemic syndrome;
Otosclerosis with deterioration in hearing, an itch or idiopathic jaundice during the previous pregnancy;
Inborn hyperbilirubinemia – increase in amount of bilirubin in blood serum (Gilbert's syndromes, the Rotor and the Cudgel Johnson);
Liebman-Saks's disease;
Sickemia.

Route of administration and dosage

Mikroginon accept inside, washing down with water in a small amount, it is desirable – at the same time.

The dosing mode – daily on 1 dragee, following the order specified on packaging, for 21 days. After reception of the last dragee from the blister it is necessary to take a break of 7 days. As a rule, at this time there is cancellation bleeding.

If last month the woman did not apply hormonal contraceptives, to begin to accept Mikroginon is more preferable in the first day of a menstrual cycle. In cases if the beginning of therapy matches with 2-5 day of a menstrual cycle, for 7 days it is recommended to apply additional barrier methods of contraception.

At implementation of transition from other combined peroral contraceptive drugs Mikroginon begin to accept next day after reception of the last active dragee from the previous packaging. Boundary starting date of therapy: for drugs with the maintenance of 21 dragees – the next day after a usual seven-day break; drugs with the maintenance of 28 dragees in packaging – the next day after reception of the last dragee containing inactive components.

Features of transition from other contraceptive medicines (using additional barrier methods of contraception for the first 7 days of therapy):

Implant, intrauterine contraceptive with gestageny: in day of its removal;
Mini-drank: without interruption in any day;
Injection form of drug: in day when the following injection was planned.

In cases of purpose of therapy after the abortion which is carried out in the first trimester of pregnancy, Mikroginon it is possible to begin to accept immediately (additional contraceptive protection is not required).

If to the woman appoint drug after the delivery or the abortion which is carried out in the second trimester of pregnancy, it is recommended to begin Mikroginon's reception for 21-28 day. In cases when administration of drug is begun later, for 7 days it is recommended to apply protective contraceptive measures in addition. If prior to reception Mikroginona the woman already led sex life, it is required to exclude pregnancy, or to wait for the first periods.

Contraceptive effect of drug does not decrease at the admission of reception of a daily dose of Mikroginon till 12 o'clock. In this case it is necessary to accept as soon as possible a dragee, then to return to the usual mode of dosing.

If the admission made more than 12 hours, it is necessary to adhere to the following guide:

Not to interrupt Mikroginon's reception longer, than for 7 days;
To carry out continuous therapy for 7 days for adequate suppression гипоталамо - pituitary and ovarian regulation.

At the admission of a daily dose of Mikroginon within the first week of administration of drug, a dragee it is necessary to accept even if it leads to reception of two dragees at the same time. Further it is necessary to adhere to the usual scheme of reception of Mikroginon, however for the next 7 days it is necessary to apply barrier contraceptive measures. If within a week before the admission of a dragee the sexual intercourse took place, it is necessary to consider a possibility of approach of pregnancy.

Than more the dragee was passed, and the this period is closer to a break in reception of active agents, the probability of pregnancy is higher.

At the admission of a daily dose of Mikroginon within the second week of administration of drug, a dragee it is necessary to accept even if it leads to reception of two dragees at the same time. Further it is necessary to adhere to the usual scheme of reception of Mikroginon without use of additional protective measures. If in the previous 7 days the woman also missed administration of drug, there is a need for use of additional contraception.

At the admission in Mikroginon's reception for the third week of therapy the risk of decrease in reliability of drug is inevitable that it is connected with the forthcoming break in its reception. In this case it is possible to hold with one of two schemes:

The last passed dragee needs to be accepted as soon as possible (reception of two tablets at the same time is possible). Further therapy is continued according to the usual scheme and, having finished packaging, begin reception from following without interruption. Cancellation bleeding, most likely, will come after the end of the second packaging, however during reception of a dragee there is a probability of emergence of the smearing allocations and breakthrough bleedings;
Reception of a dragee from the operating packaging is stopped for 7 days (taking into account day of the admission) then therapy is continued throughout a full cycle from 21 dragees from new packaging.

If reception of a single dose was missed, and then during a seven-day break bleeding of cancellation did not come, it is necessary to exclude pregnancy.

Dispepsichesky disturbances in the form of vomiting and the diarrheas which developed in an interval lasting up to 4 watch after reception of an active dragee can lead to disturbance of absorption of active agents of Mikroginon therefore the woman should apply additional protective measures (it is necessary to follow recommendations about the admission of reception of a single dose of drug).

Mikroginon's reception from new packaging without interruption leads to a delay of the beginning of periods (possibly development of the smearing allocations or breakthrough uterine bleedings). Reducing break time between reception of a dragee from packagings it is possible to transfer day of the beginning of periods.

Side effects

During Mikroginon's use development of the following disturbances is possible:

Morbidity, increase, tension of mammary glands, allocations from mammary glands;
The smearing bloody allocations and breakthrough uterine bleedings;
Change of a libido;
Allergic reactions;
Headache;
Change/decrease in mood;
Vision disorder, bad portability of contact lenses;
Change of body weight;
Changes of vulval secretion;
Migraine;
Abdominal pains, nausea, vomiting;
Liquid delay;
Skin rash, multiformny erythema, knotty erythema, generalized itch;
Cholestatic jaundice.

Development of increased fatigue and dispepsichesky disturbances in the form of diarrhea is in rare instances possible. There can sometimes be a hloazma, in particular in the presence of a hloazma of pregnant women in the anamnesis.

Development of thromboembolisms and thromboses is in some cases possible.

Special instructions

When planning performing surgery Mikroginon's reception is recommended to be stopped, at least, a month before it. It is possible to resume therapy in 14 days after the termination of an immobilization.

In addition it is necessary to apply barrier contraceptive methods:

During reception of the medicines exerting impact on microsomal enzymes and during 28 days after their cancellation;
During reception of antibiotic drugs (ampitsillina, tetracyclines) and during 7 days after their cancellation.

If usage time of a barrier contraceptive method comes to an end later, than a dragee in packaging, it is necessary to pass to the following packaging of Mikroginon without usual seven-day break in reception of a dragee.

At purpose of drug it is necessary to consider risk factors, estimating a ratio of potential advantage with the existing threat (when weighting, strengthening or the first manifestations of any of these factors of risks/states it is necessary to consult with the specialist).

There are data on increase in frequency of development of arterial and venous thromboses and a thromboembolism. It is necessary to see a doctor at emergence of such signs as: hypostasis and/or a unilateral scelalgia, sudden severe pain in a breast with irradiation in the left hand or without it, the sudden attacks of cough, sudden short wind, any unusual, strong, it is long the proceeding headache, a diplopia, sudden partial or total loss of sight, dizziness, the inarticulate speech or aphasia, a loss of consciousness with a convulsive attack or without it, motive disturbances, symptoms of "acute abdomen", the weakness or a significant anesthesia which suddenly developed on the one hand or in one part of a body.

The probability of development of thrombosis (venous and/or arterial) and thromboembolisms increases at smokers, with age, at women with a dislipoproteinemiya, migraine, diseases of valves of heart, arterial hypertension, fibrillation of auricles, obesity (at an index of body weight of more than 30 ^kg/sq.m), and also at a long immobilization and after serious surgical interventions, any operations standing or extensive injuries. Also the risk increases in the presence of instructions in the family anamnesis on the venous or arterial thromboembolism arising ever at parents or close relatives at rather young age. At genetic predisposition the woman before Mikroginon's reception needs to have examination at the corresponding specialist.

During the puerperal period it is necessary to consider the increased risk of a thromboembolism.

Against the background of a diabetes mellitus, a system lupus erythematosus, a hemolitic uraemic syndrome, chronic inflammatory diseases of intestines (granulematozny enteritis or nonspecific ulcer colitis) and a sickemia development of circulator disturbances can be also noted.

Migraine (at increase in frequency and weight) during Mikroginon's use can be the cause of cancellation of therapy.

There are data on the increased risk of developing of cancer of neck of uterus at long use of drug. Also it was established that at use of the combined contraceptive means the risk of development of a breast cancer increases a little.

In rare instances during therapy emergence of tumors of a liver was observed. At increase in a liver, emergence of severe pains in a stomach or symptoms of intra belly bleeding when carrying out the differential diagnosis it is necessary to consider Mikroginon's reception.

During use of drug it is also necessary to consider probability of development of the following disturbances:

Pancreatitis (as a rule, against the background of abnormally increased level of lipids and/or lipoproteins in blood (gipertriglitseridemiya) or in the presence of this state in the family anamnesis);
Formation of stones in a gall bladder;
Increase in arterial pressure (it is noted seldom). At permanent, clinically significant increase in arterial pressure it is necessary to cancel Mikroginon and to begin therapy of arterial hypertension. Administration of drug can be resumed after normalization of values;
Jaundice and/or the itch connected with a cholestatic syndrome;
System lupus erythematosus;
Porphyrinic disease;
Sydenham's chorea;
Abnormal liver functions (acute or chronic) (in this case therapy cancellation can be required (before normalization of indicators));
Hemolitic uraemic syndrome;
The hearing loss connected with an otosclerosis;
Herpes of pregnant women;
Granulematozny enteritis and nonspecific ulcer colitis.

Against the background of a diabetes mellitus women during Mikroginon's reception should be under medical control.

With tendency to a hloazma during therapy it is necessary to avoid impact of ultraviolet radiation and long stay on the sun.

Mikroginon's use can exert impact on results of separate laboratory researches, including indicators of function of a thyroid gland, kidneys, adrenal glands, to a liver, and also on indicators of carbohydrate metabolism, level of transport proteins in plasma and parameters of a fibrinolysis and coagulation. As a rule, such changes do not overstep the bounds of normal values.

During Mikroginon's use irregular bleedings, in particular within the first months of reception can be noted. Therefore it is necessary to carry out assessment of any irregular bleedings only after the adaptation period (about 3 cycles).

At emergence of irregular bleedings after the previous regular cycles or existence of long irregular cycles the exception of pregnancy or malignant new growths requires carrying out careful inspection.

During a break in Mikroginon's reception in certain cases bleeding of cancellation can not develop. If drug was accepted with observance of recommendations, approach of pregnancy is improbable.

The woman before administration of drug is recommended to undergo the careful inspection (all-medical and gynecologic) including a cytologic research of cervical slime and a research of mammary glands and also to exclude pregnancy and existence of disturbances of system of a blood coagulation.

At long use of Mikroginon in each half a year it is necessary to conduct repeated examinations.

It is necessary to consider that drug and other sexually transmitted diseases does not protect (AIDS) from HIV infection.

Medicinal interaction

At joint appointment of Mikroginon with some drugs there can be following effects:

The medicines inducing liver enzymes (long therapy): emergence of breakthrough bleedings and/or decrease in contraceptive efficiency of Mikroginon;
Pyrazyl ketone derivatives, streptocides: strengthening of metabolism of steroid hormones which are a part of drug;
Antibiotics (ampitsillina, tetracyclines): decrease in contraceptive protection of Mikroginon (because of decrease in concentration of ethinylestradiol).

During therapy estrogen-gestagennymi drugs can arise need of carrying out correction of doses of medicines with hypoglycemic action and indirect anticoagulants.

Mikroginon can exert impact on metabolism of other medicines (including cyclosporine) that can change their concentration in fabrics and plasma.