Diabetes mellitus with vascular complications;
Venous and arterial thrombosis (including thromboembolism of a pulmonary artery), deep vein thrombosis, cerebrovascular disturbances, myocardial infarction (existence in the anamnesis or now);
Diseases of coronary arteries of heart or vessels of a brain, the complicated defeats of the valve device of heart, uncontrollable arterial hypertension, fibrillation of auricles, smoking are aged more senior than 35 years, serious surgery with a long immobilization and other heavy risk factors of arterial or venous thrombosis;
The stenocardia, the tranzitorny ischemic attacks and other states preceding thrombosis (existence in the anamnesis or now);
Serious illness of a liver and liver failure (before normalization of hepatic tests);
Pancreatitis with the expressed gipertriglitseridemiya (existence in the anamnesis or now);
Benign or malignant tumor of a liver (existence in the anamnesis or now);
Migraine with neurologic focal symptoms (existence in the anamnesis or now);
Vaginal bleeding of an unspecified etiology;
The malignant hormonedependent diseases of mammary glands or generative organs (diagnosed or at suspicion of them);
The period of pregnancy or suspicion on it;
Breastfeeding period;
Hypersensitivity to drug components.

At emergence against the background of Zhanin's use any of the listed states, drug should be cancelled immediately.

With care, having only estimated the expected advantage and potential risk of reception, it is necessary to accept cure for the following diseases and states:

Liver diseases;
Existence of risk factors of development of thrombosis and thromboembolism: obesity, smoking, a dislipoproteinemiya, migraine, arterial hypertension, defects of valves of heart, an extensive injury, serious surgical interventions, a long immobilization, genetic predisposition to thrombosis, existence at any of the immediate family at young age of disturbance of cerebral circulation or a myocardial infarction;
Hereditary Quincke's disease;
Diabetes mellitus, hemolitic uraemic syndrome, disease Krone, system lupus erythematosus, nonspecific ulcer colitis, sickemia, phlebitis of superficial veins;
Gipertriglitseridemiya;
Period after the delivery;
Cholestasia, jaundice, diseases of a gall bladder, porphyria, chorea of Sidenkhem, otosclerosis with deterioration in hearing, the herpeses of pregnant women and other pathologies aggravated or which arose against the background of the previous hormonal contraception or during pregnancy.

Route of administration and dosage

Dragees accept inside, washing down with a small amount of water.

The order of reception is specified on Zhanin's packaging, a drug dosing – 1 dragee a day, surely at the same time, within 21 days. Then throughout a seven-day break there passes menstrualnopodobny bleeding of cancellation which can begin for 2-3 day after reception of the last dragee and proceed prior to use of the following packaging.

In the absence of hormonal contraception last month, it is necessary to begin administration of drug in the 1st day of menstrual bleeding (cycle). If reception is begun for 2-5 day of a cycle, it is necessary to use barrier contraception the first 7 days after the beginning of reception of a dragee from the first packaging.

Upon transition from the combined oral contraceptives of Jeanine begin to accept next day after reception of the last dragee with active agent of the previous means (for calendar packaging on 28 dragees) and not later than the next day after a usual 7-day break (for the drugs containing 21 dragees).

Upon transition from a transdermalny plaster or a vaginal ring it is desirable to begin administration of drug in day of their removal, but not later than day of presumable new gluing of a plaster or introduction of a ring.

Upon transition from an injection contraceptive reception of a dragee is begun in day of an estimated following injection; from the contraceptives consisting only of gestagen ("mini-drank") – in any day, without interruption; from an implant or an intrauterine contraceptive – in day of their removal. In each of the listed cases in the first 7 days of reception of a dragee it is necessary to use a barrier method of contraception in addition.

Administration of drug after abortion in the I trimester of pregnancy can be begun immediately, without additional resources of contraception.

After abortion in the II trimester of pregnancy or childbirth drug is recommended to be used only from 21 to 28 day, in case of later beginning of reception additional barrier methods of contraception during the first 7 days of reception of a dragee are required. Women who had sexual contact during the period between abortion or childbirth and the beginning of reception of Zhanin need to wait for the first menstrual bleeding or to exclude pregnancy existence.

Drug provides reliable contraceptive protection at continuous inclusion in strictly determined time. Effect of drug does not decrease if delay makes less than 12 hours, it is necessary to accept the passed dragee at once as soon as remembered, and the following dragee – in usual time.

It is also necessary to consider that having rummaged in administration of drug never has to exceed more than 7 days, and normal suppression гипоталамо - pituitary and ovarian system requires continuous reception of a dragee within 7 days.

If delay in reception made more than 12 hours (that is more than 36 hours from the moment of reception of the last active dragee) on the first week of use of Zhanin, the passed dragee needs to be accepted as soon as possible even if the concomitant use of two dragees will be required. The following dragee is accepted at the scheduled time, and during the next 7 days it is necessary to use a barrier method of contraception.

If in the next week before the admission of a dragee the woman had a sexual contact, then the risk of approach of pregnancy increases. The probability of pregnancy depends on quantity of the passed dragees so, how close it occurred to an estimated break in reception.

If delay made more than 12 hours on the second week of use of drug, the passed dragee needs to be accepted as soon as possible even if reception of two dragees at the same time will be required, and the following dragee – according to the scheme in usual time. To the women accepting drug regularly within 7 days to the first admission of a dragee, additional measures of contraception are not required. Otherwise, at the admission more than two dragees, during the next 7 days it is necessary to apply barrier methods of contraception.

If delay more than for 12 hours happened on the third week of administration of drug, the probability of pregnancy increases because of the forthcoming break in reception of a dragee. Additional methods of contraception are not required for women who to the first passed dragee accepted all others correctly. Further use of drug should be carried out by one of the following options:

It is possible to interrupt reception from the current packaging, to take a 7-day break, including day of the admission and to begin reception from new packaging. If in the period of a break at the woman there did not come cancellation bleeding, it is necessary to exclude pregnancy existence;
The second option is applied if the woman decided to continue reception from this packaging. First of all, it is necessary to accept the passed dragee as soon as possible even if the concomitant use of two dragees will be required, the following dragees are accepted according to the scheme in usual time before the end of packaging. Without doing a break, it is necessary to begin the following packaging of Jeanine. Before its termination menstrualnopodobny bleeding is improbable, but breakthrough bleedings or the smearing allocations can be observed.

If the woman within the first 4 hours after reception of a dragee had a diarrhea or vomiting, absorption of active ingredients can be incomplete therefore it is necessary to take additional measures of protection, being guided by recommendations at the admission of a dragee.

To change the beginning of periods the next day of week, it is necessary to reduce a break in reception of a dragee from the next packaging by the desirable number of days. The interval is less, the risk of absence of bleeding of cancellation and existence of the smearing bloody allocations and breakthrough bleedings during reception of the second packaging is more.

To delay the beginning of periods, the woman can continue reception of a dragee from new packaging without interruption in reception previous. It is possible to continue reception as long as that is wished by the woman, up to the termination of a dragee. Against the background of reception of the second packaging in a row at the woman breakthrough uterine bleedings or the smearing allocations can be observed. Use of drug from new packaging should be resumed after usual 7 days of a break.

Use of drug is shown to children and teenagers only after approach of menarche.

It is impossible to accept Jeanine after approach of a menopause.

At women with renal failures effect of drug specially was not studied therefore the available data do not assume change of treatment at such patients.

Side effects

From a nervous system: often – a headache; infrequently – migraine, dizziness; seldom – cerebrovascular frustration, an ischemic stroke, dystonia;
From reproductive system and mammary glands: often – a nagrubaniye of mammary glands, pain and/or a sensation of discomfort in mammary glands; infrequently – intermenstrual bleedings (including a metrorrhagia and vulval bleedings), plentiful bleedings of cancellation (including a menorrhagia, a hypomenorrhea, an amenorrhea and an oligomenorrhea), hypostasis of a mammary gland, increase (swelling and feeling of a raspiraniye) in the sizes of mammary glands, a dysmenorrhea, oothecomas, allocations from a vagina or a genital tract, pain in a small pelvis; seldom – a dysplasia of a neck of uterus, a cyst of mammary glands, cysts of appendages of a uterus, pain in the field of appendages of a uterus, disturbance of a menstrual cycle, a dispareuniya, a fibrous and cystous mastopathy, a galactorrhoea; perhaps – allocations from mammary glands;
From lymphatic system and blood: seldom – anemia;
From endocrine system: seldom – virilescence;
From sense bodys: seldom – dizziness, an ostsillopsiya, irritation and/or dryness of a mucous membrane of eyes, a sonitus, disturbance or a sudden hearing loss; perhaps – intolerance (unpleasant feelings when carrying) contact lenses;
From cardiovascular system: infrequently – arterial hypotension or hypertensia; seldom – tachycardia (including increase in heart rate), cardiovascular frustration, thrombosis or a thrombembolia of a pulmonary artery, thrombophlebitis, orthostatic circulator dystonia, diastolic hypertensia, inflows, pathology of veins (including a varicosity and pain in veins);
From respiratory system: seldom – bronchial asthma, a hyperventilation;
From the alimentary system: infrequently – pains in upper and lower parts of a stomach, swelling or discomfort, nausea, vomiting, diarrhea; seldom – dyspepsia, gastritis, enteritis;
From a musculoskeletal system: seldom – a mialgiya, a sensation of discomfort in bones and muscles, a dorsodynia and/or extremities;
Allergic reactions: seldom – allergic dermatitis and other manifestations of allergic reactions; perhaps – a knotty erythema, a small tortoiseshell;
Dermatological reactions: infrequently – an acne, an alopecia, macular and other rash, an itch (including generalized); seldom – eczema, a hirsutism, neurodermatitis or atopic dermatitis, psoriasis, a hloazma, a hyperhidrosis, disturbance of pigmentation or a hyperpegmentation, dandruff, seborrhea, pathological changes of skin (an orange-peel, vascular asterisks); perhaps – a mnogoformny erythema;
From a metabolism: infrequently – appetite strengthening, is rare – anorexia;
Psychiatric disturbances: infrequently – decrease in mood; seldom – mental disturbances, a depression, sleep disorders, sleeplessness, aggression; perhaps – decrease or increase in a libido, change of mood;
Infection and infections: infrequently – vaginal candidiasis, a vaginitis and other vulvovaginal infections; seldom – a salpingo-oophoritis (adnexitis), cystitis, infections of urinary tract, mastitis, fungal infections, a cervicitis, candidiasis, viral infections, including flu, herpetic damage of an oral cavity, sinusitis, bronchitis, upper respiratory tract infections;
The malignant, benign and not specified tumors, including cysts and polyps: seldom – a lipoma of a mammary gland, a hysteromyoma;
General symptoms: infrequently – fatigue, feeling sick, an adynamy; seldom – peripheral hypostases, stethalgias, irritability, grippopodobny symptoms (temperature increase and an inflammation); perhaps – a liquid delay;
Indicators of results of inspections: infrequently – changes of body weight (decrease, increase or fluctuations); seldom – increase in level of triglycerides in blood, a hypercholesterolemia;
Genetic and inborn disorders: seldom – a polymastia.

Besides, drug can cause irregular bleedings, in the form of the smearing bloody allocations or breakthrough bleedings, especially in the first months of use.

Against the background of Jeanine's reception at women the following side effects can develop: venous and/or arterial tromboembolic episodes, arterial hypertension, cerebrovascular complications, a gipertriglitseridemiya, influence on insulin resistance of peripheral fabrics, change of tolerance to glucose, functional disturbances of a liver, benign or malignant tumors of a liver, a hloazm.

Exogenous estrogen at women with pathology of a hereditary Quincke's disease can activate an aggravation of symptoms.

The interrelation between Jeanine's reception and emergence or aggravation of the following states is definitively not proved: the itch and/or jaundice connected with a cholestasia, a porphyria, formation of stones in a gall bladder, herpes of pregnant women, a system lupus erythematosus, a gemolitiko-uraemic syndrome, ulcer colitis, Sydenham's chorea, an otosclerosis with deterioration in hearing, cancer of a neck of uterus or mammary gland, a disease Krone.

Special instructions

At the women accepting Jeanine, the probability of a deep vein thrombosis increases, but no more than during pregnancy.

The risk of emergence of thrombosis increases with age, it is lower at non-smoking women therefore the smoking patients aged from 35 years are recommended to refuse a habit.

Temporary increase in risk of development of a deep vein thrombosis is observed in the period of a long immobilization or surgical intervention. Before the planned operation or hospitalization it is necessary to warn the attending physician about administration of drug and to resolve an issue of the temporary termination of peroral contraception, as a rule, it is about the period of 4 weeks to and 2 weeks after a forced obezdvizhennost.

The doctor can recommend the termination of administration of drug in case of emergence in the woman of the increased arterial pressure.

Influence of drug on probability of development of a breast cancer is not established, but at women on the combined peroral contraception it comes to light more often than at the women of the same age who are not accepting Jeanine. Perhaps, it is connected with more frequent and regular inspection of patients and diagnosis of a disease at an early stage.

Against the background of reception of sexual steroids development high-quality, and in extremely rare – malignant tumors of a liver is in rare instances observed. Though communication using drug is not proved, it is recommended to see immediately a doctor at emergence of unexpected severe pain in a stomach.

The persistent human papillomavirus infection is the most frequent reason of development of cancer of neck of uterus which probability is higher at the women who are on the long peroral combined contraception. Negative effect of drug is not proved, it can be connected both with features of a sexual behavior, and with more frequent surveys at the gynecologist.

Efficiency of drug decreases at vomiting or diarrhea, a reception irregularity, a concomitant use of other medicines.

At tendency to a hloazma it is necessary to avoid long influence of sunshine and ultraviolet radiation.

If intermenstrual vulval bleedings proceed more than 3 cycles it is necessary to see a doctor.

In the absence of two periods in a row, it is necessary to see urgently a doctor to exclude pregnancy.

During Jeanine's use carrying out control surveys is necessary regular (at least 1 time a year).

It is necessary to stop reception of a dragee and to see immediately a doctor at emergence of symptoms, characteristic of thrombosis.

Drug does not protect from diseases, sexually transmitted, including from infection with HIV infection (AIDS).

Medicinal interaction

The doctor makes Zhanin's appointment on the basis of the full volume of clinical data of the patient, considering influence of a possible concomitant use of other medicines on efficiency of contraception.