What is the difference between Lindinet 20 and Lindinet 30. Birth control pills Lindinet

"Lindinet 20" is a combined drug, presented in the form of small round tablets. Tablets are distinguished by their contraceptive effect, they are used for permanent planned contraception for women.

"Lindinet 20" and analogues in the rating of sold drugs as contraceptives occupy a leading position. This is explained by the fact that studies conducted by scientists have confirmed that these drugs are highly effective in protecting against unplanned pregnancy. With their use, pregnancy rates do not exceed 0.05 per hundred women during one year of studies.

What drugs can replace the reception of "Lindinet 20"?

The unconditional analogues of "Lindinet 20" in terms of the active substance in the composition, dosage form and dosage regimen today are:

• "Logest" is a drug that is also an oral contraceptive. White tablets are produced in France by Delpharm.
• "Femoden" is a highly effective estrogenic drug. Analogue of "Lindinet 20" in composition, but the dosage is increased. Produced in Germany by the Bayer team.
• "Gestarella" is a monophasic low-dose contraceptive drug. Producer - "Abbot Laboratories" in Germany.

Of all the analogues presented, Lindinet 20 is the cheapest, but more on that below. The German pharmaceutical company "Gedeon Richter" also manufactures a drug of the same name but with a high content of the active element ethinylestradiol up to 0.03 mg per tablet - "Lindinet 30". Above in the photo is an analogue of "Lindinet 20" - "Logest".

Composition of contraceptives

"Lindinet 20" and similar drugs in composition contain only 2 active ingredients - ethinylestradiol 0.02 mg and gestodene 0.075 mg. These two elements guarantee a reliable contraceptive result. The effect of estrogen-gestagen tablets makes it possible to suppress the pituitary secretion of gonadotropins. If expressed in plain language, then the effect of the drug is that both of these components do not allow the egg to form and mature. This effect prevents the possibility of fertilization.

The estrogenic effect of "Lindinet 20" and analogues causes a highly effective component - ethinyl estradiol. This is a hormonal agent of the estrogen series, which is produced naturally by the ovaries and adrenal glands in the body of a woman. Together with progesterone, its tasks include stabilization menstrual cycle women, and among other things, also division, reproduction of endometrial cells and stimulation of the development of the uterus in case of insufficiency of the gonads. Auxiliary function of ethinyl estradiol is to lower the level of cholesterol in the blood.

Gestodene is an artificial substance similar in structure to levonorgestrel. It inhibits the synthesis of follitropin and blocks natural monthly ovulation. With the exception of the effects described above, birth control pills increase the viscosity of mucus in the cervix, preventing sperm from entering there.

From customer reviews: "Lindinet 20" and analogues, when used systematically, give not only the effect of a contraceptive, but also restore the menstrual cycle. They significantly reduce the risk of developing neoplasms in the pelvic organs and diseases of the female reproductive system. "Lindinet 20" and analogues for the active substance are drugs from the prescription group and can be used strictly as prescribed by the attending physician after a thorough examination of the patient.

Release form of the drug

The dosage form is sold in the form of glossy tablets of a pale yellow hue, film-coated. Tablets of rounded shape without inscriptions. The drug is produced in cardboard packaging. Inside the package there may be one or three blisters with tablets. It can be 21 tablets or 63. The manufacturing company Lindineta 20 is from Hungary.

Indications for use

"Lindinet 20" and analogues are prescribed as modern facility contraception. Can be used to normalize the menstrual cycle.

Contraindications and restrictions

The drug is not indicated for girls before puberty and women after menopause. Contraindications to taking Lindinet 20 are the following chronic pathologies or diseases in history:

• hypersensitivity to single components of the drug or a combination of hormones from the composition;
• a clear predisposition or existing circumstances that provoke the formation of thrombosis;
• unstable performance blood pressure;
• coronary artery disease;
• frequent migraines with neurological symptoms;
• thrombotic or thromboembolic lesions of veins and arteries;
• thromboembolic lesions of the veins in immediate family members;
• surgical intervention that causes prolonged immobility of the patient;
• damage to small vessels against the background of developing diabetes mellitus of all types;
• the state of inflammation of the pancreas, when the level of triglycerides in the blood is significantly elevated;
• the formation of fatty deposits on the walls of blood vessels - dyslipidemic syndrome;
• diseases or severe inflammation of the liver and kidneys;
• yellow skin due to steroid medications;
• cholelithiasis;
• progressive genetic disease - ;
• neoplasms on the liver;
• damage to the capsule of the inner ear;
• hormone-sensitive neoplasms on the organs of the reproductive system or mammary glands;
• bleeding from the vagina;
• prolonged smoking;
• pregnancy and the period after childbirth;
• lactation period.

In the following situations, according to the reviews of doctors, "Lindinet 20" and analogues are allowed to be taken, but only if precautions are observed and under the supervision of the attending gynecologist:

• the age of the patient is more than 35 years;
• conditions that provoke the occurrence of thrombotic lesions of the veins;
• being overweight or obese;
• migraine;
• hypertension;
• diabetes if vascular damage is excluded;
• ulcerative lesions of the colon;
• hereditary angioedema;
• diseases of the liver and kidneys;
• diseases that have intensified during pregnancy or from taking hormonal drugs;
• severe trauma;
• phlebeurysm;
• pathological processes of heart valves;
• change in indicators biochemical analysis blood;
• sudden onset of seizures;
• violations heart rate;
• prolonged immobility of the patient;
• extensive surgery;
• Libman-Sachs disease (lupus erythematosus);
• coronary artery disease;
• severe depression;
• Crohn's disease;
• hereditary violation of the structure of the hemoglobin protein;
• elevated levels of triglycerides in the patient's blood;
• atypical hemolytic-uremic syndrome;
• a short period of time after childbirth.

Method of application and dosage of the medicinal product and its analogues

According to the instructions, "Lindinet 20" and analogues are taken orally with a moderate amount of water or other liquid. Reception is carried out regardless of meals, one tablet once a day, preferably at the same time. After 21 days from the moment you start taking the pills, you must definitely take a break for seven days. During the seven-day break from the use of hormones, withdrawal bleeding (imitation of menstruation) occurs. Then the tablets from the new blister are taken on the eighth day of the break.

If Lindinet 20 is taken for the first time, then it is advisable to take the initial blister tablet from the first to the fifth day from the onset of menstruation. In the first two weeks from the start of taking "Lindinet 20" and analogue tablets, it is important to take advantage of auxiliary contraceptives in order to avoid unwanted pregnancy.

Switching from other contraceptives

If the drug "Lindinet 20" is used as a replacement for another contraceptive, then the reception is started without a seven-day interval. That is, when drinking the final pill from the pack of the previous drug, it is very important to start taking Lindinet 20 the next day. It is allowed to switch to "Lindinet 20" from contraceptive preparations "mini-drank" any day. Nevertheless, in the first week of using Lindinet 20, you should not rely on it, so it is better to use additional methods of contraception.

With the appearance of sudden vomiting or diarrhea some time after taking the pill, the absorption of the drug is defective. If the symptomatology ended within twelve hours, then it is advisable to take another pill and continue taking it according to the scheme. If the symptoms last more than twelve hours, then additional contraception is absolutely necessary for the next seven days.

Abortion in the first trimester

After an abortion in the first trimester, Lindinet 20 is prescribed from the first day, immediately after the mechanical abortion. In this case, there is no need for additional contraception.

Use after childbirth or after an abortion in the second trimester

Use "Lindinet 20" and analogues can be started 21-28 days after childbirth or abortion. It is allowed to start taking after childbirth only if the woman is not breastfeeding. If you start taking the pills later than the specified period, then you will need additional barrier protection against pregnancy during the week.

Postponement of menstruation

In case of urgent need to delay menstruation and prolong the cycle, you can resume taking the tablets from the next package without a seven-day break. The appearance of spotting bleeding in this case does not reduce the contraceptive effect.

From the instructions for use of "Lindinet 20" and analogues: if the tablet was not taken on time, and no more than twelve hours have passed since the missed one, then you need to drink the missed tablet and continue taking the drug "Lindinet 20" according to the scheme. If more than twelve hours have passed, then the effectiveness of the drug as a contraceptive decreases, and it is recommended to use additional funds barrier contraception, such as a condom.

Missed tablet in the first and second week of the cycle: the next day, take two tablets at once and continue the regular intake of the drug according to the scheme, applying additional protection until the end of the cycle. Missed tablet in the third week of the cycle: take a tablet and do not take a seven-day break before the next pack.

Side effects

During the reception of "Lindinet 20" and analogues, there are often malfunctions following functions body:

• mammary glands: aching pain from the side and from above, an increase in breast volume, discomfort, a feeling of heaviness, discharge from the nipples.
• reproductive system- change in libido (decrease occurs much more often), inflammation in the vagina, lack of menstruation after discontinuation of the drug, non-cyclic bloody spotting from the vagina.
• Disorders of the gastrointestinal tract: pain in the stomach, nausea, vomiting, diarrhea, inflammation of the colon, liver damage, bile stasis, development of cholelithiasis.
• Skin: rashes, pigmentation, alopecia.
• Neurology: headaches, psycho-emotional instability, depressive states, migraines.
• Metabolism: rapid weight gain without change in diet, edema due to fluid retention, increased blood glucose, increased triglycerides in the blood.
• Sense organs: discomfort in the eyes, hearing impairment.

Rarely occurring side effects from "Lindinet 20" and analogues of the drug:

• Thromboembolic damage to the veins and circulatory system, including the brain.
• Vein damage lower extremities.
• Complication of lupus erythematosus.

Extremely exceptional violations:

• Damage to the arteries of the kidneys and liver.
• Retinal injury.

Cancellation of the drug is indicated in case of development of the following disorders:

• Sustained increase in blood pressure.
• progression of porphyria.
• Blockage of blood vessels by blood clots.
• Hearing loss due to otosclerosis.

Strengthening the symptoms of one of the above diseases during the use of hormones requires urgent discontinuation of the drug and the use of non-hormonal contraception.

Special instructions before using oral contraceptives

During the period of pregnancy and lactation, the described remedy is strictly contraindicated. Therefore, some time before the start of the reception, it is better to do a pregnancy test or donate blood for hCG. Reason: in the first months of pregnancy, sluggish menstruation is possible.

Before using Lindinet 20, it is important to collect all the required information about the health status of the patient and immediate family members. While taking "Lindinet 20" and analogues in the reviews and instructions, it is said that every six months it is necessary to undergo a medical examination, as well as a gynecological examination for the timely identification of possible risk factors.

Since a stable contraceptive effect from the pills is achieved two weeks after the start of use, doctors recommend that additional non-hormonal methods be adopted these days to protect against pregnancy. The use of hormonal contraceptives is individual in each individual case.

Before starting, it is important to evaluate all the possible advantages and disadvantages of using the drug, after consulting in person with the attending gynecologist. Before you start taking drugs, it is important to consider that the relationship between taking oral hormonal contraceptives and the occurrence of thrombosis has been scientifically confirmed.

The risk of developing thromboembolic lesions is due to provoking factors:

• mature age of the patient;
• prolonged smoking;
• heredity;
• hypertension;
• diabetes;
• prolonged immobility of the patient.

The postpartum period significantly increases the risk of thromboembolism. Unfortunately, there is information about the increased incidence of cervical cancer in the case of prolonged use of hormonal contraceptives. Nevertheless, research data contradict each other, since there are many conditions for the development of cervical cancer, and the effect of oral contraceptives will not necessarily be dominant. It is also known that the regular use of oral contraceptives can cause the development of breast cancer.

When taking "Lindinet 20" and analogues in composition, it is important to remember that the drug is not able to protect against infection with HIV and other types of sexually transmitted diseases. condom - The best way protection from infection.

The effectiveness of hormonal contraceptives can decrease if:

• missing pills;
• vomiting;
• repeated diarrhea;
• a long period of time between taking pills;
• the use of drugs that reduce the effect of contraceptives.

After a long time after taking Lindinet 20, the effectiveness of the drug may decrease. If non-cyclic bleeding of unknown origin appears and does not stop until the end of the blister, then it is necessary to stop taking the drug and not resume until pregnancy is excluded at a gynecologist's appointment.

Estrogens contained in "Lindinet 20" can affect the performance of laboratory tests of such organs as the kidneys and liver, thyroid gland, adrenal glands. Viral liver damage delays taking the drug for six months.

Smoking while taking Lindinet 20 birth control pills and analogues increases the occurrence of possible vascular diseases, which is extremely dangerous for patients over 35 years of age. There is no research data regarding the safety of reception when driving a motor vehicle and other activities that require increased concentration and speed.

Hormone overdose

Medicine is not aware of cases of serious side effects from a significant increase in the daily dosage of oral contraceptives. In isolated cases, situations are possible when nausea or vomiting occurs. In young girls, slight bleeding from the vagina is possible. However, exceeding the dosage of the drug is a reason for an urgent visit to the doctor to inform him about it.

Interaction with other drugs

The semi-synthetic antibiotic "Rifampicin" reduces the contraceptive effect and increases the occurrence of breakthrough bleeding, and also provokes menstrual irregularities. "Carbamazepine" and "Primidon" also reduce the effect of the drug "Lindinet 20". In this regard, during the period of therapy with these drugs, it is necessary to use additional measures to protect against pregnancy.

Laxatives lower the level of hormones in the blood. "Fluconazole" increases the level of ethinylestradiol in the patient's blood. Antibiotics of the tetracycline series reduce the level of estradiol in the blood. St. John's wort and drugs based on it can not be combined with oral contraceptives.

Storage conditions

According to the manufacturers, "Lindinet 20" is suitable for use within three years from the date of production, which is indicated on the carton of the drug. After the expiration date, use medicinal product and its analogues is strictly prohibited. If a day is not specified, then the expiration date is the last day of the marked month.

Proper storage of medicines:

• avoid direct sunlight and moisture on medicines and even packaging;
• Keep out of the reach of children;
• the optimum storage temperature should not be less than 15 degrees and not exceed 25 degrees.

Disposal of tablets

In order to be able to properly dispose of medicines, you can seek advice from a pharmacist. This knowledge will help protect the environment.

Judging by the reviews, the rating of analogues and Lindinet 20 is quite high, the last remedy occupies a leading position due to its low price. The average cost of Lindinet 20 tablets, from customer reviews, varies greatly across the country and depends on the region. So, for example, in Moscow, prices for a pack of 21 tablets vary from 450 to 570 rubles. For a package with three blisters (63 tablets), you will have to pay from 960 to 1220 rubles.

After analyzing the pharmaceutical market, we can conclude that Lindinet 20 is cheaper than its counterparts. For example, the average cost of a package of "Logest", where 21 tablets, is as much as 740 rubles.

Content

Modern women are protected from unwanted pregnancy. Reliable methods of contraception are considered barrier, including condoms, and hormonal pills. Among the popular oral preparations, Lindinet is distinguished. This medication contains a complex of hormones that prevents ovulation and slows down the penetration of sperm into the egg.

What is Lindinet

Birth control pills Lindinet are part of the group of oral contraceptives based on sex hormones. Lindynette is produced by the Hungarian pharmaceutical company Gedeon Richter and contains ethinyl estradiol and gestodene as active ingredients. Complex impact active substances changes the mechanism of secretion of gonadotropic hormones, inhibiting the maturation of follicles in the ovaries.

pharmachologic effect

Monophasic combination drug is used for contraception. Its action is associated with a decrease in pituitary secretion of gonadotropins, obstruction of ovulatory processes (egg maturation). Ethinylestradiol is a synthetic analogue of the follicular hormone estradiol, which, together with corpus luteum hormones, is involved in the regulation of the menstrual cycle.

Gestodene is a progestogen derivative of nortestosterone and a synthetic progestin, has a strong selective effect compared to natural progesterone, whose secretion is regulated by the corpus luteum. This substance is used in a minimal amount, therefore, it has little effect on carbohydrate-lipid metabolism by enzymes. The drug directly affects sex hormones, but also acts through peripheral centers.

Under the influence of the drug, the susceptibility of the endometrium of the uterus to the blastocyst decreases, so fertilization does not occur, and the fetus cannot be implanted. The drug increases the density and viscosity of the mucus in the cervix, which makes it difficult for sperm to pass through. The estrogenic effect of the drug is also used for the active prevention of gynecological diseases, with dysfunction or deficiency of sex gland hormones.

The drug can reduce the risk of functional ovarian cysts in the vagina, ectopic pregnancy. While taking the tablets, the degree of manifestation of acne is reduced, hemostasis is preserved. Pharmacokinetic properties of the drug:

What is the difference between Lindinet 20 and Lindinet 30

Contraceptive Lindinet have a different dosage - 20 and 30 mcg of ethinyl estradiol. The drug with a dosage of 20 mcg is milder in terms of pharmacological action, it is used for contraception, but not for therapeutic needs. A drug with a hormone level of 30 micrograms per tablet can be used to protect against unwanted pregnancy, but the change in the load on the hormonal system of a woman is increased.

Release form

Both forms of Lindinet are presented in the form of round biconvex tablets, coated with a light yellow film coat. On the surface there are no markings and marks, inside the tablet is white. The drug is presented in cardboard packs of 1 or 3 blisters inside with instructions for use. Each blister contains 21 tablets - according to the average menstrual cycle.

Composition

Depending on the form of release, only the concentration of hormones differs. The main composition of the tablets is similar:

Indications for use

Contraceptive oral contraceptives have only two indications for use: protection against the onset of unwanted pregnancy (contraception) and functional menstrual disorders. Indirect factors in the use of the drug are the improvement of the condition of the skin of the face, the elimination of acne and excessive oiliness associated with hormonal disruptions.

Instructions for use

The dosage of tablets is set individually after examination by a gynecologist and testing. Useful information about taking a regular drug:

Lindinet 20

Pills for contraception are used orally once a day without chewing. They are washed down with water, taken regardless of the meal, preferably at the same time of day. The course lasts 21 days, then a seven-day break is made, and then the course is repeated. During the break, menstruation will come. It is desirable to start the course on days 1-5 of the menstrual cycle, if other contraceptives have not been taken before.

If others were accepted hormonal preparations, the first tablet is taken after the last dose of the previously taken drug, on the first day of bleeding after withdrawal. Switching to a medication with progestogen-containing drugs requires additional methods of contraception. The first intake of a new contraceptive drug in the form of mini-pills is made on any day of the cycle, injections - on the eve of the last one, implants - on the next day after removal.

Lindinet 30

Another type of drug is prescribed after an abortion for a quick and painless restoration of the hormonal background and the physiological state of the woman. If the abortion was performed in the first trimester of pregnancy, then you can take pills immediately after surgery without using additional methods of contraception. If an abortion or childbirth took place in the second trimester, then the use of tablets is indicated on the 21-28th day after the manipulation. In the first week, additional protection is required.

Pregnancy and lactation

The use of contraceptive pills Lindinet is contraindicated during pregnancy and lactation ( breastfeeding). This is due to the effect of the drug on the hormonal background of the body and possible negative consequences on the development of the fetus. During lactation, hormonal components are secreted from breast milk, which leads to their penetration into the body of the child.

Side effects

While taking the tablets, side effects may occur that require discontinuation of therapy or analysis of its feasibility. These include:

• arterial hypertension, myocardial infarction, stroke, deep vein thrombosis, pulmonary embolism, venous or arterial thromboembolism of the vessels of the liver, kidneys;
• hearing loss, otosclerosis;
• porphyria, exacerbation of lupus erythematosus;
• acyclic vaginal bleeding, amenorrhea;
• candidiasis, inflammatory diseases;
• pain, breast enlargement, galactorrhea;
• depression, migraine, acute headache;
• anemia;
• erythema, skin rash, alopecia, chloasma, pruritus, allergic reactions, Stevens-Johnson syndrome;
• abdominal pain, nausea, Crohn's disease, vomiting, ulcerative colitis, jaundice, liver adenoma, hepatitis;
• edema, decreased glucose tolerance, weight gain.

Contraindications

Contraceptive pills have many contraindications for use. These are:

• hypersensitivity to the components of the composition;
• risk of arterial or venous thrombosis;
• moderate and severe degrees of arterial hypertension;
• angina pectoris, transient ischemic atrial attack;
• prolonged immobilization after surgery;
• diabetes;
• pancreatitis, dyslipidemia, hypertriglyceridemia;
• hepatitis, cholestatic jaundice, cholelithiasis;
• hepatic neoplasms;
• otosclerosis, its presence in history;
• smoking after 35 years;
• malignant hormone-dependent tumors (cancer);
• pregnancy, lactation;
• epilepsy;
• vaginal bleeding of unknown origin;
• age to puberty.

Overdose

Excessive intake of the tablet preparation is accompanied by nausea, vomiting, spotting or breakthrough vaginal bleeding, stomach pain, dizziness. There is no specific antidote for overdose. It is recommended to consult a doctor for the appointment of symptomatic therapy clinical manifestations intoxication.

special instructions

After therapy with contraceptives, the effect of contraception gradually disappears. In the first two weeks of taking the tablets, it is recommended to adhere to additional contraceptive regimens. To become pregnant after discontinuation of therapy, consult a doctor to ascertain the state of health and conduct additional tests. Some experts suggest taking a course of treatment with pills to speed up conception.

Alcohol and Lindinet

According to biochemical studies, a small amount of alcohol consumed does not affect the degree of effectiveness of oral contraception using the agent in question. A moderate dose of ethanol-containing drinks is considered to be up to three glasses of wine or 50 g of cognac or vodka per day. The amount of alcohol above the specified leads to a decrease in the properties of the drug.

I have been using Lindinet for a long time, for me it is the best type of contraception! Very convenient and how nice))

I started with Lindinet 20, but then there was some kind of failure after the cancellation, most likely the dose of the hormone was low, and I had to switch to Lindinet 30. What can I say about the differences? it hurts. Sometimes it hurts a lot, sometimes not so much, but still better than before taking contraceptives. Then I couldn’t get out of bed at all.

Do you know what is the huge plus of this tool for me? Discharge during menstruation is minimal! I don’t buy pads at all, I use daily. Menstruation lasts 3 days, just a few drops a day.

Second plus: if for some reason you need to prevent menstruation, then it is very simple to do this: after drinking 21 tablets, you do not take a seven-day break, but start drinking the next pack right away. I do this periodically, there were no problems. PMS on the days of the expected menstruation does not bother either. In general, it is very very convenient. You need to be prepared that when the menstruation does come (at the end of the second pack), they can be more abundant than usual.

Dear girls! If you decide to use hormonal contraceptives, be prepared for the fact that without lubrication, making love may not work! As a lubricant, I use this and that. Just do not try to combine the first with condoms! Unless, of course, you want a baby.

I do not attach the instruction, because it is HUGE! You can find it on the Internet

I will include only the most important.

And now I’ll tell you how I once bought Lindinet 30. So I decided to buy myself 3 packs, in reserve. I went to one of the cheapest pharmacies, bought 1 pack for 543 rubles. I thought it was a little expensive, so I didn’t buy 2 more .And in the evening, when I was walking with my beloved, I looked into another pharmacy, and there ... There one pack (from one batch) cost 327 rubles, but this pack was the last one, and they gave me another (from another batch) it cost 407 r .. Here is such a fun in our pharmacies!

So do not rush to take it right away, it is better to find out the price of the medicine in different pharmacies.

All successful shopping and quality sex!)))))

• Active substance

  Ethinylestradiol and Gestodene Ethinylestradiol and Gestodene

• ATX Anatomical-therapeutic-chemical classification - an international classification system for medicines. Abbreviations are used: Latin ATC (Anatomical Therapeutic Chemical) or Russian: ATH

  G03AB06 Gestodene + ethinylestradiol G03AA10 Gestodene + ethinyl estradiol

• Pharmacological group

  Contraceptive (estrogen + progestogen) [Estrogens, gestagens; their homologues and antagonists in combinations] Contraceptive [Estrogens, gestagens; their homologues and antagonists in combinations]

• Nosological classification (ICD-10)

  Z30 Surveillance of contraceptive use
  Z30.0 General advice and advice on contraception

• Composition
• Description dosage form

  Tablets: round, biconvex, light yellow film-coated, unlabeled on both sides.

  Tablets: round, biconvex, yellow film-coated, unlabeled on both sides.

  At the break: white or almost white, with a light yellow edging.

• Characteristic
• pharmachologic effect

  Contraceptive, estrogen-gestagenic.

• Pharmacodynamics

  Combined remedy, the action of which is due to the effects of the components that make up its composition. Inhibits pituitary secretion of gonadotropic hormones. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is a highly effective oral drug - ethinyl estradiol (a synthetic analogue of estradiol, which participates together with the corpus luteum hormone in the regulation of the menstrual cycle). The progestogen component is a derivative of 19-nortestosterone - gestodene, which is superior in strength and selectivity of action not only to the natural hormone of the corpus luteum progesterone, but also to modern synthetic gestagens (levonorgestrel). Due to its high activity, gestodene is used in very low dosages, in which it does not exhibit androgenic properties and has virtually no effect on lipid and carbohydrate metabolism.

  Combined remedy, the action of which is due to the effects of the components that make up its composition. Inhibits pituitary secretion of gonadotropic hormones. The contraceptive effect of the drug is associated with several mechanisms. The estrogenic component of the drug is a highly effective oral drug - ethinyl estradiol (a synthetic analogue of estradiol, which participates together with the corpus luteum hormone in the regulation of the menstrual cycle). The progestogen component is a derivative of 19-nortestosterone - gestodene, which is superior in strength and selectivity of action not only to the natural hormone of the corpus luteum progesterone, but also to modern synthetic gestagens (levonorgestrel). Due to its high activity, gestodene is used in very low dosages, in which it does not exhibit androgenic properties and has virtually no effect on lipid and carbohydrate metabolism.

  Along with the indicated central and peripheral mechanisms that prevent the maturation of an egg capable of fertilization, the contraceptive effect is due to a decrease in the susceptibility of the endometrium to the blastocyst, as well as an increase in the viscosity of the mucus in the cervix, which makes it relatively impassable for spermatozoa. In addition to the contraceptive effect, the drug, when taken regularly, also has a therapeutic effect, normalizing the menstrual cycle and helping to prevent the development of a number of gynecological diseases, incl. tumor nature.

• Pharmacokinetics

  Gestodene

  Distribution. It binds to albumin and sex hormone-binding globulin (SHBG). 1–2% are in the free state, 50–75% are specifically bound to SHBG. The increase in SHBG levels caused by ethinyl estradiol affects the level of gestodene, leading to an increase in the fraction associated with SHBG and a decrease in the fraction associated with albumin. Vd of gestodene - 0.7–1.4 l / kg.

  Ethinylestradiol

  stable concentration. Settled by day 3–4, with ethinyl estradiol levels 20% higher than after a single dose. Gestodene

  Suction. When taken orally, it is rapidly and completely absorbed. After taking a single dose, Cmax in plasma is measured after an hour and is 2-4 ng / ml. Bioavailability about 99%.

  Distribution. It binds to albumin and sex hormone-binding globulin (SHBG). 1–2% are in the free state, 50–75% are specifically bound to SHBG. The increase in SHBG levels caused by ethinyl estradiol affects the level of gestodene, leading to an increase in the fraction associated with SHBG and a decrease in the fraction associated with albumin. Vd of gestodene - 0.7–1.4 l / kg.

  Metabolism. Corresponds to the metabolism of steroids. The average plasma clearance is 0.8-1 ml / min / kg.

  Withdrawal. Blood levels decrease in two stages. The half-life in the final phase is 12-20 hours. It is excreted exclusively in the form of metabolites - 60% in the urine, 40% in the feces. T1 / 2 metabolites - about 1 day.

  stable concentration. The pharmacokinetics of gestodene is largely dependent on the level of SHBG. Under the influence of ethinylestradiol, the concentration of SHBG in the blood increases by 3 times; with daily administration of the drug, the level of gestodene in plasma increases by 3-4 times and reaches a state of saturation in the second half of the cycle.

  Ethinylestradiol

  Suction. When taken orally, it is absorbed quickly and almost completely. Cmax in the blood is measured after 1-2 hours and is 30-80 pg / ml. Absolute bioavailability »60% (due to presystemic conjugation and primary metabolism in the liver).

  Distribution. Easily enters into a non-specific relationship with blood albumin (about 98.5%) and causes an increase in the level of SHBG. Average Vd - 5–18 l / kg.

  Metabolism. It is carried out mainly due to aromatic hydroxylation with the formation of large amounts of hydroxylated and methylated metabolites, which are partly in free, partly in conjugated form (glucuronides and sulfates). Plasma clearance »5-13 ml / min / kg.

  Withdrawal. Serum concentration decreases in 2 steps. T1 / 2 in the second phase "16-24 hours. Excreted exclusively in the form of metabolites in a ratio of 2: 3 with urine and bile. T1 / 2 metabolites "1 day.

  stable concentration. Settled by day 3–4, with ethinyl estradiol levels 20% higher than after a single dose.

• Indications

  contraception contraception

• Contraindications

  Dyslipidemia;

  Lactation.

  individual hypersensitivity to the drug or its components;

  The presence of severe or multiple risk factors for venous or arterial thrombosis (including complicated lesions of the valvular apparatus of the heart, atrial fibrillation, diseases of the cerebral vessels or coronary arteries);

  Uncontrolled arterial hypertension of moderate or severe degree with blood pressure of 160/100 mm Hg. Art. and more);

  Harbingers of thrombosis (including transient ischemic attack, angina pectoris), incl. in history;

  Migraine with focal neurological symptoms, incl. in history;

  Venous or arterial thrombosis / thromboembolism (including deep vein thrombosis of the lower leg, pulmonary embolism, myocardial infarction, stroke) at present or in history;

  The presence of venous thromboembolism in relatives;

  Major surgery with prolonged immobilization;

  Diabetes mellitus (with the presence of angiopathy);

  Pancreatitis (including history), accompanied by severe hypertriglyceridemia;

  Dyslipidemia;

  Severe liver disease, cholestatic jaundice (including during pregnancy), hepatitis, incl. in history (before the normalization of functional and laboratory parameters and within 3 months after the return of these indicators to normal);

  Jaundice due to taking drugs containing steroids;

  Gallstone disease at present or history;

  Syndrome of Gilbert, Dubin-Johnson, Rotor;

  Tumors of the liver (including history);

  Severe itching, otosclerosis, or progression of otosclerosis during a previous pregnancy or when taking corticosteroids;

  Hormone-dependent malignant neoplasms of the genital organs and mammary glands (including suspicion of them);

  Vaginal bleeding of unknown etiology;

  Smoking over the age of 35 (more than 15 cigarettes per day);

  Pregnancy or suspicion of it;

  Lactation.

  With caution: conditions that increase the risk of developing venous or arterial thrombosis / thromboembolism (age over 35 years, smoking, hereditary predisposition to thrombosis - thrombosis, myocardial infarction or violation cerebral circulation at a young age in one of the next of kin); hemolytic uremic syndrome; hereditary angioedema; liver disease; diseases that first arose or worsened during pregnancy or against the background of a previous intake of sex hormones (including porphyria, herpes in pregnancy, chorea minor - Sydenham's disease, Sydenham's chorea, chloasma); obesity (body mass index over 30); dyslipoproteinemia; arterial hypertension; migraine; epilepsy; valvular heart disease; atrial fibrillation; prolonged immobilization; extensive surgery; surgery on the lower extremities; severe injury; varicose veins and superficial thrombophlebitis; postpartum period (non-lactating women - 21 days after childbirth; lactating women - after the end of the lactation period); the presence of severe depression, incl. in history; changes in biochemical parameters (activated protein C resistance, hyperhomocysteinemia, antithrombin III deficiency, protein C or S deficiency, antiphospholipid antibodies, including antibodies to cardiolipin, lupus anticoagulant); diabetes mellitus, not complicated by vascular disorders; systemic lupus erythematosus (SLE); Crohn's disease; ulcerative colitis; sickle cell anemia; hypertriglyceridemia (including family history); acute and chronic liver diseases.

• Use during pregnancy and lactation

  The use of the drug during pregnancy and lactation is contraindicated.

• Side effects

  Arterial hypertension;

  Porfiria;

  From the reproductive system: acyclic bleeding / bloody issues from the vagina, amenorrhea after discontinuation of the drug, changes in the state of vaginal mucus, the development of inflammatory processes in the vagina (for example, candidiasis), changes in libido.

  Side effects that require immediate discontinuation of the drug:

  Arterial hypertension;

  Hemolytic-uremic syndrome;

  Porfiria;

  Hearing loss due to otosclerosis.

  Rarely occurring - arterial and venous thromboembolism (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism); exacerbation of reactive SLE.

  Very rare - arterial or venous thromboembolism of the hepatic, mesenteric, renal, retinal arteries and veins; Sydenham's chorea (passing after discontinuation of the drug).

  Other side effects, less severe, but more common - the advisability of continuing to use the drug is decided individually after consultation with a doctor, based on the benefit / risk ratio.

  On the part of the reproductive system: acyclic bleeding / spotting from the vagina, amenorrhea after discontinuation of the drug, changes in the state of vaginal mucus, the development of inflammatory processes in the vagina (for example, candidiasis), changes in libido.

  From the mammary glands: tension, pain, enlargement of the mammary glands, galactorrhea.

  From the gastrointestinal tract and hepatobiliary system: nausea, vomiting, diarrhea, epigastric pain, Crohn's disease, ulcerative colitis, hepatitis, liver adenoma, occurrence or exacerbation of jaundice and / or itching associated with cholestasis, cholelithiasis.

  From the side of the skin: nodular / exudative erythema, rash, chloasma, increased hair loss.

  From the side of the central nervous system: headache, migraine, mood changes, depressive states.

  Metabolic disorders: fluid retention in the body, a change (increase) in body weight, an increase in the amount of triglycerides and blood sugar, a decrease in carbohydrate tolerance.

  From the sensory organs: hearing loss, increased sensitivity of the cornea of ​​the eye when wearing contact lenses.

  Other: allergic reactions.

• Interaction

  It is not recommended to use St. St. John's wort activates liver enzymes; after stopping the use of St. John's wort, the effect of enzyme induction may persist for the next 2 weeks.

  The simultaneous use of ritonavir and a combined contraceptive is accompanied by a decrease in the average AUC of ethinylestradiol by 41%. During treatment with ritonavir, it is recommended to use a drug with a higher content of ethinylestradiol or a non-hormonal method of contraception. It may be necessary to correct the dosing regimen when using hypoglycemic agents, tk. oral contraceptives may reduce carbohydrate tolerance, increase the need for insulin or oral antidiabetic agents. The contraceptive effect of oral contraceptives is reduced with the simultaneous use of rifampicin, breakthrough bleeding and menstrual irregularities become more frequent. A similar, but less well understood, interaction exists between contraceptives and carbamazepine, primidone, barbiturates, phenylbutazone, phenytoin, and presumably griseofulvin, ampicillin, and tetracyclines. During treatment with the above drugs, along with oral contraception, it is recommended to use an additional method of contraception (condom, spermicidal gel). After completion of the course of treatment, the use of an additional method of contraception should be continued for 7 days, in the case of treatment with rifampicin - for 4 weeks.

  Absorption-related interactions

  During diarrhea, the absorption of hormones is reduced (due to increased intestinal motility). Any drug that shortens the time a hormone spends in the large intestine leads to low concentrations of the hormone in the blood.

  Interactions related to drug metabolism

  Intestinal wall. Drugs that undergo sulfation in the intestinal wall like ethinylestradiol (eg ascorbic acid) inhibit metabolism and increase the bioavailability of ethinylestradiol.

  Metabolism in the liver. Inducers of microsomal liver enzymes reduce the level of ethinylestradiol in blood plasma (rifampicin, barbiturates, phenylbutazone, phenytoin, griseofulvin, topiramate, hydantoin, felbamate, rifabutin, oxcarbazepine). Liver enzyme blockers (itraconazole, fluconazole) increase the level of ethinylestradiol in the blood plasma.

  Influence on intrahepatic circulation. Some antibiotics (eg ampicillin, tetracycline), by preventing the intrahepatic circulation of estrogens, reduce plasma levels of ethinyl estradiol.

  Influence on the metabolism of other drugs

  By blocking liver enzymes or accelerating conjugation in the liver, mainly increasing glucuronidation, ethinylestradiol affects the metabolism of other drugs (eg cyclosporine, theophylline), leading to an increase or decrease in their plasma concentrations.

  It is not recommended to use St. St. John's wort activates liver enzymes; after stopping the use of St. John's wort, the effect of enzyme induction may persist for the next 2 weeks.

  The simultaneous use of ritonavir and a combined contraceptive is accompanied by a decrease in the average AUC of ethinylestradiol by 41%. During treatment with ritonavir, it is recommended to use a drug with a high content of ethinylestradiol or a non-hormonal method of contraception. It may be necessary to correct the dosing regimen when using hypoglycemic agents, tk. oral contraceptives may reduce carbohydrate tolerance, increase the need for insulin or oral antidiabetic agents.

• Dosage and administration

  The first dose of the drug: taking the drug Lindinet 20 should be started from the 1st to the 5th day of the menstrual cycle.

  The transition from a combined oral contraceptive to taking the drug Lindinet 20. 1st table. Lindinet 20 is recommended to be taken after taking the last hormone-containing tablet of the previous drug, on the 1st day of withdrawal bleeding.

  Switching from progestogen-containing preparations (mini-tablets, injections, implant) to taking Lindinet 20. The transition from mini-tablets can be started on any day of the menstrual cycle; in the case of an implant, the next day after its removal; in case of injections - on the eve of the last injection.

  In this case, in the first 7 days of taking the drug Lindinet 20, it is necessary to use an additional method of contraception.

  Taking the drug Lindinet 20 after an abortion in the first trimester of pregnancy. The contraceptive can be started immediately after the abortion, without the need for an additional method of contraception.

  Taking the drug Lindinet 20 after childbirth or after an abortion in the second trimester of pregnancy. You can start taking a contraceptive on the 21st-28th day after childbirth or abortion in the second trimester of pregnancy. With a later start of taking the contraceptive, in the first 7 days, it is necessary to use an additional, barrier method of contraception. In the case when sexual contact took place before the start of contraception, before you start taking the drug, you should exclude the presence of a new pregnancy or wait for the next menstruation.

  In order to earlier the onset of menstrual bleeding, you can shorten the 7-day break by the desired number of days. The shorter the break, the more likely the occurrence of breakthrough or spotting bleeding while taking the pills from the next pack (similar to cases with delayed menstruation). Inside, without chewing, drinking plenty of water, regardless of the meal.

  Take 1 table. per day (if possible at the same time of day) for 21 days. Then, after taking a 7-day break in taking the tablets, resume oral contraception (i.e. 4 weeks after taking the 1st tablet, on the same day of the week). During the 7-day break, uterine bleeding occurs as a result of hormone withdrawal.

  The first dose of the drug: taking the drug Lindinet 30 should be started from the 1st to the 5th day of the menstrual cycle.

  The transition from a combined oral contraceptive to taking the drug Lindinet 30. 1st table. Lindinet 30 is recommended to be taken after taking the last hormone-containing tablet of the previous drug, on the 1st day of withdrawal bleeding.

  Switching from progestogen-containing drugs (mini-tablets, injections, implant) to taking Lindinet 30. Switching from mini-tablets can be started on any day of the menstrual cycle; in the case of an implant, the next day after its removal; in case of injections - on the eve of the last injection.

  In this case, in the first 7 days of taking the drug Lindinet 30, it is necessary to use an additional method of contraception.

  Taking the drug Lindinet 30 after an abortion in the first trimester of pregnancy. The contraceptive can be started immediately after the abortion, without the need for an additional method of contraception.

  Taking the drug Lindinet 30 after childbirth or after an abortion in the second trimester of pregnancy. You can start taking a contraceptive on the 21st-28th day after childbirth or abortion in the second trimester of pregnancy. With a later start of taking the contraceptive, in the first 7 days, it is necessary to use an additional, barrier method of contraception. In the case when sexual contact took place before the start of contraception, before you start taking the drug, you should exclude the presence of a new pregnancy or wait for the next menstruation.

  Missed pills. If the next scheduled pill was missed, then the missed dose should be replenished as soon as possible. With a delay not exceeding 12 hours, the contraceptive effect of the drug does not decrease, and there is no need to use an additional method of contraception. The remaining tablets are taken as usual.

  With more than a 12-hour delay, the contraceptive effect may decrease. In such cases, you should not make up for the missed dose, continue taking the drug as usual, but in the next 7 days, you need to use an additional method of contraception. If at the same time less than 7 tablets remained in the package, then they start taking the tablets from the next package without observing a break. In such cases, uterine withdrawal bleeding occurs only after the completion of the 2nd pack; while taking the tablets from the 2nd package, spotting or breakthrough bleeding is possible.

  If there is no withdrawal bleeding at the end of taking the pills from the 2nd pack, then pregnancy should be ruled out before continuing to take the contraceptive.

  Measures to be taken in case of vomiting and diarrhoea. If vomiting occurs in the first 3-4 hours after taking the next tablet, the tablet is not completely absorbed. In such cases, you should act in accordance with the instructions described in Missed Pills.

  If the patient does not want to deviate from the usual contraceptive regimen, the missed pills should be taken from another package.

  Delay of menstruation and acceleration of the onset of menstruation. In order to delay menstruation, they start taking pills from a new package without observing a break. Menstruation can be delayed at will until all the pills from the 2nd package run out. With a delay in menstruation, breakthrough or spotting uterine bleeding is possible. You can return to the usual intake of tablets after observing a 7-day break.

  In order to earlier the onset of menstrual bleeding, you can shorten the 7-day break by the desired number of days. The shorter the break, the more likely is the occurrence of breakthrough or spotting bleeding while taking the pills from the next pack (similar to cases with delayed menstruation).

• Overdose

  Taking large doses of contraception was not accompanied by the development of severe symptoms.

  Symptoms: nausea, vomiting, in young girls, slight vaginal bleeding.

  Treatment: symptomatic, there is no specific antidote.

• special instructions

  Epilepsy;

  Migraine;

  With age;

  With dyslipoproteinemia;

  sudden shortness of breath;

  Tumor diseases

  The effect of the drug on the ability to drive a car and work mechanisms. Studies to study the possible effect of the drug Lindinet 20 on the ability to drive a car or other machines have not been conducted. Before starting the use of the drug, it is recommended to collect a detailed family and personal history and subsequently undergo a general medical and gynecological examination every 6 months (examination by a gynecologist, examination of a cytological smear, examination of the mammary glands and liver function, control of blood pressure, cholesterol concentration in the blood, urinalysis). These studies must be periodically repeated due to the need for timely identification of risk factors or emerging contraindications.

  The drug is a reliable contraceptive drug - the Pearl index (an indicator of the number of pregnancies that occurred during the use of a contraceptive method in 100 women for 1 year) with correct application is about 0.05. Due to the fact that the contraceptive effect of the drug from the start of taking is fully manifested by the 14th day, it is recommended to additionally use non-hormonal methods of contraception in the first 2 weeks of taking the drug.

  In each case, before prescribing hormonal contraceptives, the benefits or possible negative effects of their use are individually assessed. This issue must be discussed with the patient, who, after receiving the necessary information, will make the final decision on the preference for hormonal or any other method of contraception. The state of health of women must be carefully monitored.

  If any of the following conditions / diseases appear or worsen while taking the drug, you must stop taking the drug and switch to another, non-hormonal, method of contraception:

  Diseases of the hemostasis system;

  Conditions/diseases predisposing to the development of cardiovascular, renal failure;

  Epilepsy;

  Migraine;

  The risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;

  Diabetes mellitus, not complicated by vascular disorders;

  Severe depression (if depression is associated with impaired tryptophan metabolism, then vitamin B6 can be used to correct it);

  Sickle cell anemia, tk. in some cases (for example, infections, hypoxia), estrogen-containing drugs in this pathology can provoke thromboembolism;

  The appearance of abnormalities in laboratory tests for assessing liver function.

  Thromboembolic diseases

  Epidemiological studies have shown that there is an association between taking oral hormonal contraceptives and an increased risk of arterial and venous thromboembolic diseases (including myocardial infarction, stroke, deep vein thrombosis of the lower extremities, pulmonary embolism). An increased risk of venous thromboembolic disease has been proven, but it is significantly less than during pregnancy (60 cases per 100,000 pregnancies). When using oral contraceptives, arterial or venous thromboembolism of the hepatic, mesenteric, renal or retinal vessels is very rarely observed.

  The risk of developing arterial or venous thromboembolic diseases increases:

  With age;

  When smoking (heavy smoking and age over 35 are risk factors);

  If there is a family history of thromboembolic disease (for example, parents, brother or sister). If a genetic predisposition is suspected, it is necessary to consult a specialist before using the drug;

  Obesity (body mass index over 30);

  With dyslipoproteinemia;

  With arterial hypertension;

  With diseases of the heart valves, complicated by hemodynamic disorders;

  With atrial fibrillation;

  With diabetes mellitus complicated by vascular lesions;

  With prolonged immobilization, after major surgery, surgery on the lower extremities, severe trauma.

  In these cases, a temporary discontinuation of the drug is expected. It is advisable to stop no later than 4 weeks before surgery, and resume no earlier than 2 weeks after remobilization.

  There is an increased risk of venous thromboembolic disease in women after childbirth.

  Diseases such as diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease, ulcerative colitis, sickle cell anemia increase the risk of venous thromboembolic disease.

  Such biochemical abnormalities as resistance to activated protein C, hyperhomocysteinemia, deficiency of proteins C, S, deficiency of antithrombin III, the presence of antiphospholipid antibodies increase the risk of arterial or venous thromboembolic diseases.

  When assessing the benefit / risk ratio of taking the drug, it should be borne in mind that targeted treatment of this condition reduces the risk of thromboembolism.

  Signs of thromboembolism are:

  Sudden chest pain that radiates to the left arm;

  sudden shortness of breath;

  Any unusually severe headache that lasts for a long time or appears for the first time, especially when combined with sudden complete or partial loss of vision or diplopia, aphasia, dizziness, collapse, focal epilepsy, weakness or severe numbness of one side of the body, movement disorders, severe unilateral pain in the calf muscle, acute abdomen.

  Tumor diseases

  Some studies have reported an increase in the incidence of cervical cancer in women who have taken hormonal contraceptives for a long time, but the results of the studies are conflicting. Sexual behavior, human papillomavirus infection and other factors play a significant role in the development of cervical cancer.

  A meta-analysis of 54 epidemiological studies showed that there is a relative increase in the risk of breast cancer among women taking oral hormonal contraceptives, but the higher detection of breast cancer could be associated with more regular medical examinations. Breast cancer is rare among women under 40, whether they are taking hormonal birth control or not, and increases with age. Taking pills can be regarded as one of many risk factors. However, women should be advised of the potential risk of developing breast cancer based on a benefit-risk assessment (protection against ovarian, endometrial, and colon cancer).

  There are few reports of the development of benign or malignant liver tumors in women who take hormonal contraceptives for a long time. This should be kept in mind in the differential diagnostic evaluation of abdominal pain, which may be associated with an increase in the size of the liver or intra-abdominal bleeding.

  A woman should be warned that the drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

  The effectiveness of the drug may decrease in the following cases: missed pills, vomiting and diarrhea, simultaneous use of other drugs that reduce the effectiveness of birth control pills.

  If the patient is simultaneously taking another drug that can reduce the effectiveness of birth control pills, additional methods of contraception should be used.

  The effectiveness of the drug may decrease if, after several months of their use, irregular, spotting or breakthrough bleeding appears, in such cases it is advisable to continue taking the tablets until they are finished in the next package. If, at the end of the 2nd cycle, menstrual bleeding does not begin or acyclic spotting does not stop, you should stop taking the tablets and resume it only after pregnancy has been excluded.

  Chloasma can occasionally occur in those women who had a history of it during pregnancy. Those women who are at risk of developing chloasma should avoid contact with sunlight or UV while taking the tablets.

  Changes in laboratory parameters

  Under the influence of oral contraceptive pills - due to the estrogen component - the level of some laboratory parameters (functional parameters of the liver, kidneys, adrenal glands, thyroid gland, indicators of hemostasis, levels of lipoproteins and transport proteins).

  After acute viral hepatitis, it should be taken after normalization of liver function (not earlier than after 6 months). With diarrhea or intestinal disorders, vomiting, the contraceptive effect may decrease (without stopping the drug, it is necessary to use additional non-hormonal methods of contraception). Women who smoke have an increased risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk depends on age (especially in women over 35) and the number of cigarettes smoked. During lactation, the excretion of milk may decrease, in small quantities the components of the drug are excreted in breast milk.

  The effect of the drug on the ability to drive a car and work mechanisms. Studies to study the possible effect of the drug Lindinet 30 on the ability to drive a car or other machines have not been conducted.

• Release form

Composition Lindinet 20(1 tablet):

• - 0.02 mg;
• - 0.075 mg;
• magnesium stearate - 0.2 mg;
• povidone - 1.7 mg;
• corn starch - 15.5 mg;

Composition Lindinet 30(1 tablet):

• ethinylestradiol - 0.03 mg;
• gestodene - 0.075 mg;
• sodium calcium edetate - 0.065 mg;
• magnesium stearate - 0.2 mg;
• colloidal silicon dioxide - 0.275 mg;
• povidone - 1.7 mg;
• corn starch - 15.5 mg;
• lactose monohydrate - 37.165 mg.

Both pharmaceutical forms are supplied in the form of tablets, the shell of which has the following components:

• sucrose - 19.66 mg;
• - 8.231 mg;
• macrogol 6000 - 2.23 mg;
• titanium dioxide - 0.46465 mg;
• povidone - 0.171 mg;
• yellow quinoline dye (D + C yellow No. 10 - E 104) - 0.00135 mg.

Release form

In pharmacy kiosks, the drug is presented in the form of round, biconvex tablets, which are coated with a light yellow shell on both sides. There are no inscriptions or symbols. On a break, the tablet is white or close to white in color with a light yellow edging of the shell.

pharmachologic effect

Lindinet belongs to the group of monophasic combined oral medications based on sex hormones , respectively, is used mainly for the purpose of contraception. The main therapeutic effect of the drug is associated with several mechanisms of action, including a decrease in the secretion of gonadotropic hormones. , active obstruction of ovulatory processes and inhibition of the maturation of follicles in the ovaries.

First of all, it should be noted that ethinylestradiol , one of the biologically active constituents, is a synthetic analogue of the follicular hormone , which, together with the hormones of the corpus luteum, is involved in the regulation of the woman's menstrual cycle, largely inhibiting it at certain stages.

Another active ingredient – gestodene is a gestagenic 19-nortestosterone derivative and is a stronger and more selective version of natural secreted by the corpus luteum. This component is used in ultra low amounts, due to which it does not realize its androgenic capabilities (the chemical basis for gestodene is a variation of the male sex hormone) and has the weakest effect on the carbohydrate and lipid metabolism of the body.

In addition to the central mechanisms of action directly on sex hormones, the drug implements contraceptive properties indirectly through peripheral components. Under the influence of a pharmaceutical drug, susceptibility decreases to the blastocyst, which makes the process of implantation of the initial forms of the fetus almost impossible. It also increases the density and viscosity of the mucus localized in the cervix, which becomes largely impassable for spermatozoa that make active movements towards the female egg.

Lindinet has not only contraceptive effects, the pharmaceutical drug contributes active prevention some gynecological diseases and not only. In particular, the possibility of the appearance of functional ovarian cysts And . Reduces the risk of in the mammary glands, congestive inflammatory processes practically disappear. The beneficial properties of the drug extend to skin , as they improve general state and reduced manifestation (with regular use, dermatological defects disappear completely).

Pharmacodynamics and pharmacokinetics

Pharmacokinetic abilities of gestodene

After oral administration, the active component is absorbed from the gastrointestinal tract quite quickly and almost completely, because its bioavailability is about 99%, and the maximum concentration of 2-4 ng / ml is noted after 1 hour.

In the bloodstream gestodene contacts And specific globulin SHBG , only 1-2% of the amount of the active ingredient remains in free form. The pharmacokinetics of gestodene largely depends on the level of SHBG and the concentration of estradiol, because the amount of the selective carrier increases by 3 times under the influence of the sex hormone. The constant intake of oral contraceptives also contributes to the active saturation of gestodene, with its daily use, the concentration increases by 3-4 times.

The active component undergoes the main stages of biochemical transformation in the liver, after which it is excreted in the urine (60%) and feces (40%) only in the form of metabolites. The half-life of the active ingredient is biphasic and takes about 1 day, since the average plasma clearance is from 0.8 to 1 ml / million / kg.

Pharmacokinetic abilities of ethinylestradiol

The second active component has slightly lower absorption rates - due to presystemic conjugation and primary metabolism, the absolute bioavailability of the pharmacological component from the digestive tube is only 60%, and the maximum concentration of 30-80 pg / ml is reached after 1-2 hours.

On the distribution side, ethinylestradiol, on the contrary, outperforms gestodene, because 98.5% of the active substance binds to nonspecific albumins. Also, the active component induces an increase in the level of SHBG, which favorably affects the overall effectiveness of the oral contraceptive. A constant average level of ethinylestradiol is established by 3-4 days after the start of the therapeutic course, and it is 20% higher than after a single dose of the Lindinet tablet.

The biotransformation of the active substance occurs in the liver and is aromatic hydroxylation with the formation of methylated and hydroxylated metabolic products in free form or in the form of conjugates with sulfates or glucuronides. Metabolic clearance from blood plasma ranges from 5-13 ml.

Ethinylestradiol is excreted only in the form of metabolic products with urine and bile in a ratio of 2:3. The half-life, like that of gestodene, is biphasic and is about 1 day.

Indications for use

• contraception;
• functional disorders of the menstrual cycle.

Contraindications

• individual hypersensitivity to a pharmaceutical preparation or its constituent components;
• risk factors for arterial or venous thrombosis;
• moderate and severe;
• or as precursors of thrombosis;
• surgery with prolonged immobilization;
• with a pronounced increase in blood triglycerides;
• dyslipidemia ;
• severe liver disease ( hepatitis , cholestatic jaundice and etc);
• , Dubin-Johnson, Rotor;
• neoplasm localized in the liver;
• otosclerosis or the presence of it in the anamnesis of a previous pregnancy or after taking glucocorticosteroids;
• smoking over the age of 35;
• hormone-dependent malignant tumors genital organs and mammary glands;
• vaginal bleeding of unknown origin;
• period of lactation and childbearing.

Side effects

Adverse effects of treatment requiring immediate cancellation pharmaceutical therapy:

• From the side of cardio-vascular system: arterial hypertension, , , deep vein thrombosis of the lower extremities, venous or arterial thromboembolism hepatic, mesenteric, retinal or renal vessels.
• From the side sense organs: hearing loss due to otosclerosis .
• Others: porphyria , hemolytic-uremic syndrome, exacerbations of reactive , chorea of ​​Sydenham .

Side effects, after the appearance of which the expediency of further use of the drug is decided in individual order:

• From the side reproductive system: acyclic bleeding from the vagina of unknown etiology, , colpocytological changes in vaginal mucus, inflammatory diseases, pain, breast enlargement, galactorrhea .
• From the side central nervous system : hearing loss, , , mood lability.
• Dermatological reactions: or exudative erythema , incomprehensible rash, chloasma, increased .
• From the side digestive system: epigastric pain, nausea and vomiting, Crohn's disease , nonspecific ulcerative , jaundice and itching, which is due to it, cholelithiasis , liver adenoma, hepatitis.
• From the side metabolic processes: fluid retention in the body, decreased tolerance to carbohydrates, increased levels of triglycerides or blood glucose, weight gain.
• Other allergic reactions.

Application instruction of Lindinet (Way and dosage)

Lindinet 20, instructions for use

Contraceptive pills are used orally orally once a day, without chewing and drinking plenty of water, regardless of the meal. If possible, you should take the pills at the same time of day for 21 days, then you need to take a break for 7 days, and then resume the use of contraceptives. That is, the next tablet should be used 4 weeks after the start of the course on the same day of the week. During the break, uterine bleeding will be observed, which corresponds to menstruation in a normal cycle.

A course of conservative contraception should be started from the 1st to the 5th day of the menstrual cycle, if other oral contraceptives have not been used before. Otherwise, the 1st tablet must be taken after the last dose of the previous hormone-containing pharmaceutical preparation, on the 1st day of bleeding after withdrawal.

Transition from progestogen-containing agents on Lindinet requires the use of an additional method of contraception in the first week. The date of the first intake of a new contraceptive must be consistent with the pharmaceutical form of the previous drug:

• in the form of mini-tablets - on any day of the menstrual cycle;
• in the case of injections - on the eve of the last injection;
• implant - the next day after its removal.

Lindinet 30, instructions for use

Since this pharmaceutical form is an enhanced version of Lindinet 20 with a higher concentration of ethinylestradiol, it is recommended to prescribe it after abortion so that the restoration of the physiological hormonal background takes place much faster and less painfully.

If the abortion was performed in 1st trimester of pregnancy , then there is nothing to worry about. Oral contraceptives can be started immediately after gynecological manipulation and there is no need to use additional methods of contraception.

If the abortion or childbirth occurred during 2nd trimester of pregnancy , then taking the pharmaceutical preparation can be started only on the 21-28th day after the obstetric operation. With a later start of the course of conservative protection in the first week, a barrier method of contraception should be used. If a full-fledged sexual intercourse took place before the start of taking the drug, then before taking contraceptives, you must make sure that there is no new pregnancy.

Missing an oral contraceptive pill

If the next pill was missed, then the missing amount of the pharmaceutical drug in the bloodstream must be replenished as soon as possible. With a delay that duration does not exceed 12 hours , the clinical effects of the contraceptive are not reduced and the need for additional protection by other methods of contraception itself disappears. Subsequent tablets are taken according to the usual regimen.

If a woman misses a pill and did not make up for her loss within 12 hours , then the pharmacological efficacy of the drug is reduced, which requires special measures and precautions. First of all, as soon as possible, you should resume taking the drug and continue to carry it out as usual. It is recommended to use any other methods of contraception for a week after the pass.

This situation may become more difficult if less than 7 tablets left in the package . How to take in this case - start the next pack without observing the necessary weekly break, which is carried out only at the end of the 2nd pack of contraceptives. It should be noted that during the use of the 2nd pack, spotting or even breakthrough bleeding may be observed, which can indirectly indicate the presence of pregnancy. If hemorrhages have not stopped at the end of the 2nd package, then before continuing to take contraceptives, you should consult a doctor and exclude the presence of a developing fetus in the womb.

Overdose

Taking an excessive amount of contraceptive is accompanied by the following symptoms:

• nausea;
• vomit;
• vaginal bleeding in small amounts.

Specific pharmaceutical antidote for medicinal product no, therefore, symptomatic therapy of individual clinical manifestations of intoxication is used.

Interaction

The contraceptive properties of a pharmaceutical product are reduced when it is used with drugs such as , , , barbiturates, primidon , , Phenylbutazone , Phenytoin , , Oxcarbazepine .

Therefore, if it is necessary to share these drugs with Lindinet, it is necessary to use additional non-hormonal contraceptives for 7 days (it is recommended to visit an additional consultation with your doctor and clarify the period for certain). It is also possible the appearance of spotting or breakthrough bleeding, menstrual irregularities, or some other side effects.

In conditions increased peristalsis or diarrhea the residence time of the contraceptive in the lumen of the gastrointestinal tract is reduced, which significantly reduces the absorption properties of the hormonal contraceptive. Any drug that shortens the stay of Lindinet in the digestive tube leads to a decrease in the concentration of active constituents in the blood, and, accordingly, to a decrease in their beneficial effect.

Drug Interactions at the stage of absorption are modeled on the combined use of a contraceptive with, since biologically active substances are equally exposed to sulfation in the intestinal wall, which inhibits metabolic chains and increases the bioavailability of ethinyl estradiol.

Terms of sale

The acquisition of the medicinal product is allowed only on the basis of the prescription form.

Storage conditions

It is necessary to save the pharmaceutical product in a dry place, protected from direct sunlight, inaccessible to young children at a temperature not exceeding 25 degrees Celsius.

Best before date

special instructions

Pregnancy after using hormonal contraceptives

Oral hormonal contraceptives are a group of pharmaceuticals based on synthetic analogues of female sex hormones (estrogen and progesterone) that prevent ovulation from occurring, preventing the very possibility of fertilization. Of course, a large audience of women is convinced that it is harmful to use them for contraceptive purposes, since a normal, physiological pregnancy after a drug change in hormonal levels most likely will not occur. However, this is one of the myths about this group of drugs.

After stopping the use of hormonal contraceptives and at the end of the course of conservative contraception, the effects of the drugs gradually disappear. The only peculiarity is that pregnancy planning you should find out the exact timing of the optimal moment for fertilization in antenatal clinic or a personal gynecologist. After all, every time a woman takes a pill for a headache, she does not worry about the health of an unconceived child, in this case the situation is almost identical.

When you can not be protected by barrier methods of contraception

Lindinet is a reliable hormonal contraceptive, which can be found in a special indicator of the number of pregnancies that occurred during the course of oral contraception in 100 women for 1 year. For this pharmaceutical, it is only 0.05 if the contraceptive is used correctly and only according to the scheme of application. However, the pharmacological effects of Lindinet do not develop fully immediately, but only by the 14th day from the start of taking the tablets, because in the first 2 weeks It is recommended to use barrier methods of contraception.

Lindinet 20 and Lindinet 30 - what's the difference?

A large number of visitors to pharmaceutical forums for women are asked by the following series of questions: “Lindinet 20 and 30 - what is the difference?”, As well as whether the drugs are interchangeable and, finally, which is the best of the two forms of contraception. The difference in the forms of the same contraceptive lies in concentration one of the active ingredients is ethinyl estradiol. In oral tablets, its level can be 0.02 mg and 0.03 mg, respectively, which in biochemical terms really puts them in different categories.

Lindinet 20 has a milder pharmacological effect and to a lesser extent contributes to an increase in the selective SHBG transporter, which allows it to be used for contraception, however for therapeutic needs , as a rule, a stronger form of the drug is required, therefore Lindinet 30 is used. What distinguishes the more concentrated form of the drug from weaker tablets is not advertised, since sometimes, according to individual indications, even as a contraceptive, it is necessary to use Lindinet 30, which can be perceived by a woman as an unfair load of a hormonal drug.

It is categorically contraindicated to independently replace the pharmaceutical forms of the drug, because a qualified specialist who prescribes contraceptives or therapeutic agents relies on the results clinical research, their interpretation and many years of experience in their field, and not a rough idea of ​​the biomechanism female body. If you experience any side effects or other adverse effects, you should seek advice and resolve this issue on an individual basis.

Since Lindinet is produced in Hungary, its cost in pharmacy kiosks is much lower than that of a drug produced jointly by French and German pharmacists, but this in no way speaks of the effectiveness of the first, because the choice of a contraceptive should be entrusted to a qualified specialist, because he based on individual indicators of hormonal balance and some other medical aspects.

Which is better: Novinet or Lindinet 20?

Novinet - monophasic oral contraceptive, which, in addition to ethinyl estradiol, contains a synthetic progestogen , which somewhat changes the mechanism of action of the contraceptive drug. Like all artificial pharmaceutical components of this nature, desogestrel has a high affinity for progesterone receptors located in the hypothalamic-pituitary region, on which its effects are based. In sufficiently small quantities, it is able to "turn on" the mechanism of negative feedback, resulting in a sharp inhibition of the release and production of gonadotropins and a complete blockage of ovulation.

Since Novinet includes such a potent pharmaceutical component as one of the active substances, accordingly, its price is almost twice as high as that of Lindinet. However, with certain individual indications or contraindications, a woman does not have the opportunity to use a cheaper contraceptive, which makes it possible to include Novinet in a conservative contraceptive course.

Alcohol and Lindinet

Biochemical studies have shown that alcohol in small quantities does not affect the effectiveness of oral contraception. Moderate dosages of alcoholic beverages are considered to be up to 3 glasses of wine or 50 grams of cognac, but no more, since an increase in the amount of alcohol in the blood increases the risk of a possible pregnancy.