Mechanism of action
Combined contraceptive drug for oral administration.
Chlormadinone - progestogen with antiandrogenic properties. The daily dose of chlormadinone, which provides complete suppression of ovulation, is 1.7 mg. The required dose per cycle is 25 mg. The mechanism of antiandrogenic action is associated with the ability to replace androgens at specific receptors.
Ethinyl estradiol is a synthetic estrogen that inhibits the secretion of the skin sebaceous glands, increases the production of globulin that binds sex hormones, which leads to a decrease in the amount of free testosterone in the blood plasma.
Prolonged (over 21 days) use of the drug leads to a decrease in the secretion of follicle-stimulating and luteinizing hormones, and, consequently, to suppression of ovulation, endometrial proliferation and its secretory transformation. At the same time, the mucus properties of the cervical canal change, which is accompanied by difficulty in passing spermatozoa through the cervical canal and a violation of their mobility.
Reception Belara contributes to the normalization of the menstrual cycle, reduce blood loss during menstruation, reduce the intensity of premenstrual pain. On the background of the use of the drug may reduce the incidence of iron deficiency anemia, dysmenorrhea, functional ovarian cysts, ectopic pregnancy.
Indications and usage
- contraception.
Adverse Effects
Cardiovascular: increased blood pressure, increased risk of developing thromboembolic diseases of arteries and veins.
Gastrointestinal: nausea, vomiting, gastrointestinal disorders, lesions of the biliary tract, liver tumors (benign and malignant).
From the side of the central nervous system: depression, irritability, headache, blurred vision, tinnitus.
From the reproductive system: breast engorgement, vaginal discharge, dysmenorrhea.
Dermatologic: chloasma, dry skin, urticaria, pruritus, acne, seborrhea.
Other: allergic reactions, back pain.
Contraindications
- venous or arterial thrombosis (including in history);
- severe or multiple risk factors for thrombosis;
- diabetes with angiopathy;
- severe liver disease (includingin history) to normalize the performance of liver tests;
- Dubin-Johnson syndrome;
- Rotor syndrome;
- benign or malignant liver tumors (including history);
- sickle cell anemia;
- porphyria;
- pronounced disorders of lipid metabolism;
- severe arterial hypertension;
- atherosclerosis;
- migraine;
- epilepsy;
- hormone-dependent malignant diseases of the genital organs or mammary glands (including suspects);
- vaginal bleeding of unknown etiology;
- idiopathic jaundice or itching during a previous pregnancy;
- otosclerosis with hearing loss during a previous pregnancy;
- pregnancy (including suspect);
- lactation (breastfeeding);
- hypersensitivity to the drug.
The drug Belara is contraindicated in pregnancy. The drug should be stopped immediately as soon as the pregnancy is diagnosed. The use of the drug in the early stages of pregnancy is not an indication for medical abortion. According to the data available to date, there was no increase in the risk of developing malignant neoplasms in newborns whose mothers used the drug during pregnancy.
Do not recommend the use of the drug Belara during breastfeeding, because against the background of its reception decreases the amount of milk produced and changes its consistency.When taking the drug during lactation, the active substances in small quantities can be excreted in breast milk. There is no evidence that they have a negative impact on the newborn.
Special notes
Before the appointment of the drug and at least 1 time per year during its regular use should be a medical examination to exclude possible contraindications.
Be careful with the use of Belar in epilepsy, multiple sclerosis, otosclerosis, convulsive syndrome, migraine, cardiac or renal failure, minor chorea, diabetes, liver disease, lipid metabolism disorders, autoimmune diseases (including systemic lupus erythematosus), obesity, arterial hypertension, endometriosis, varicose veins, inflammatory diseases of the veins, bleeding disorders, mastopathy, uterine myoma.
Patients with a tendency to develop chloasma should avoid exposure to the sun and UV radiation during the use of the drug.
During the reception of Belara, irregular bleeding from the vagina (spot or abundant) may occur, especially during the first months of the drug use. In this case, such bleeding is not an indication for additional examination, and the use of the drug can be continued. If bleeding resumes after several cycles, an examination should be conducted to rule out organic pathology.
Intermenstrual bleeding may indicate a lack of contraceptive effect.
In the first months of use of Belar, menstrual-like bleeding may not occur, which is not an indication of a decrease in the contraceptive effect. If the bleeding does not occur after a cycle in which no pills are missed, the 7-day interval is not exceeded, other drugs are not taken at the same time, there are no episodes of vomiting or diarrhea, Belar pills can be continued, because pregnancy is unlikely. Pregnancy should be excluded during the first 10 days of the new cycle.
If menstrual bleeding has not occurred in two consecutive cycles, a follow-up examination for the presence of pregnancy should be performed.
On the background of the use of the drug may change some laboratory indicators of the function of the liver, adrenal glands and thyroid gland.
With the simultaneous use of the drug Belar and rifampicin, as well as within 28 days after its cancellation, it is recommended to use another method of contraception in addition to taking a contraceptive.
If necessary, the simultaneous use of the drug Belar with phenytoin, barbiturates, Carbamazepine, oxcarbazepine, topiramate, felbamate, Griseofulvin, phenylbutazone, rifampicin, ampicillin, Tetracycline should be taken additional barrier methods of contraception during the entire treatment period and 7 days after the entire treatment period and after 7 days after the entire treatment period.
Patients should be warned that taking Belar does not protect against HIV infection or other sexually transmitted diseases.
Overdosage
With an overdose of the drug is not observed any serious toxic reactions.
Symptoms: If you accidentally take a large number of pills may nausea, vomiting, vaginal bleeding (in girls).
Treatment: if necessary, conduct symptomatic therapy. There is no specific antidote. In rare cases, it is necessary to monitor indicators of water and electrolyte metabolism and liver function.
With simultaneous use with phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate, griseofulvin, phenylbutazone, rifampicin, ampicillin, tetracycline, there is a decrease in the contraceptive efficacy of Belar.
The drug should be stored in its original packaging out of the reach of children at a temperature not exceeding 25 ° C. Shelf life - 3 years.
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