Marvelon (Box)

✔️ Uses of Marvelon

• Contraception
• Treatment of Dysmenorrhea (Irregular Periods).

✔️ How does Marvelon work?

Ethinyl Estradiol works by replacing or replenishing the hormone estrogen that is normally produced in the body. Desogestrel works by preventing the fertilization of the egg with the sperm. It also induces changes in hormonal levels contributing to the prevention of pregnancy. Thus, this combination is an effective oral contraceptive for the prevention of pregnancy.

✔️ Side Effects of Marvelon

• Nausea
• Abdominal pain
• Vomiting
• Depression
• Acne
• Hair loss
• Missed or irregular menstrual periods
• Weight gain
• Breast pain and tenderness
• Dizziness
• Back pain
• Headache
• Vaginal discharge with no odor
• Change in the texture of breast skin and nipples
• Oedema (accumulation of water in the tissues)
• Breast enlargement

✔️ Quick Suggestions:

• Marvelon tablets can be used as a birth control pill for females.
• Take this tablet as directed by the doctor. It would be best if you took it at a fixed time for optimal results and should not consume it more than that prescribed by your doctor.
• Inform your doctor about any medical conditions or medications you are taking before starting Marvelon tablet.
• Do not use this tablet if you are pregnant or are likely to be pregnant if you are breastfeeding.
• Smoking can increase the risk of blood clots and other complications in women taking oral contraceptives. Quitting smoking can help reduce these risks.
• Regular exercise can help maintain a healthy weight, reduce stress, and improve overall health. It can also help regulate menstrual cycles.

✔️ Indication

This is used to avoid getting pregnant. Oral contraceptives are a highly efficient birth control strategy. When administered properly (no missing tablets), the chances of falling pregnant are extremely slim.

✔️ Pharmacology

The 'combined Pill' is an oral contraceptive containing two female hormones: Desogestrel (a progestogen) and ethinylestradiol (an estrogen). Each tablet has a modest amount of both hormones, making it a low-dose contraceptive. All tablets in the pack have the same hormones and doses, classifying it as a monophasic combination oral contraceptive.

✔️ Dosage & Administration of

Taking Marvelon Tablet 21's:

• This pack contains 21 tablets, each marked with the day of the week for easy tracking.
• Take one tablet daily at roughly the same time, with water if needed, following the direction of the arrows until all 21 tablets are consumed.
• After these 21 days, take no tablets for the next 7 days. During this period, a withdrawal bleed (similar to a period) should occur, usually starting on days 2-3 after the last tablet.
• Start the next pack on the 8th day, regardless of whether your period continues. This ensures consistent scheduling and withdrawal bleeding timing.

Starting Your First Pack:

• No prior hormonal contraceptive use: Begin on the first day of your cycle (first day of menstrual bleeding). Use the tablet marked with that day of the week.
• Changing from another combined Pill: Start the day after your last tablet from the current pack, with no tablet-free break. If inactive tablets are present, start after the last active tablet.
• Changing from progestagen-only Pill (minipill): Stop the minipill, start this tablet the next day, and use a barrier method for the first 7 days.
• Changing from an injectable or implant: Start when your next injection is due or on implant removal day, using a barrier method for the first 7 days.

After Pregnancy, Miscarriage, or Abortion:

• After a baby: Your doctor may recommend starting after your first normal period, or sooner.
• After miscarriage or abortion: Follow your doctor's advice.

Missed Tablets:

• Less than 12 hours late: Take the tablet as soon as remembered, maintaining reliability.
• More than 12 hours late: Reliability may decrease. Risk is higher near pack start or end.
• Specific actions for missed tablets in each week are provided.

Vomiting:

• Vomiting within 3-4 hours after taking a tablet may reduce absorption. Follow the advice for missed tablets.

Delaying or Changing Period:

• To delay: Start the next pack immediately after finishing the current one. Stop tablet-taking for your desired period to begin.
• To change starting day: Shorten tablet-free break. No more than 3 days.

Unexpected Bleeding:

• Irregular bleeding (spotting) can occur initially but usually stops after about 3 tablet-taking cycles.

Missed a Period:

• If all tablets are taken as directed and no vomiting or other medicines occur, pregnancy is unlikely. If you miss two periods, consult your doctor before starting the next pack.

✔️ Interaction

Drug-Drug Interaction: Marvelon Tablet 21's can interact with various medications including:

• Anti-viral medicines (paritaprevir, ritonavir)
• Blood thinners (aspirin)
• Pain-killers (acetaminophen)
• Anti-anginal drugs (diltiazem)
• Medicines for stomach acid (esomeprazole, fluconazole, omeprazole, letrozole)
• Cyanocobalamin
• Anti-allergy medication (cetirizine)
• Antibiotics (moxifloxacin)

Drug-Food Interaction: Marvelon Tablet 21's interactions extend to non-prescription medications, vitamins, nutritional supplements, and herbal products you might be taking or planning to take. Additionally, alcohol consumption and grapefruit juice should be avoided in combination with Marvelon Tablet 21's.

Drug-Disease Interaction: Inform your doctor if you:

• Smoke
• Have a history of liver or kidney disease
• Have heart disease
• Suffer from hypertension
• Have diabetes mellitus
• Have liver disease
• Experience abnormal uterine bleeding
• Have a history of breast, cervix, or uterus cancer
• Have anemia

✔️ Contraindications

• If you are allergic to any of the components of Marvelon tablet.
• If you are at a high risk of vascular blood clot formation.
• If you have a family history of blood clot formation.
• If you have undergone major surgery followed by bedridden for a long time.
• If you have/had heart diseases such as a heart attack or chest pain.
• If you have a history of paralysis.
• If you have low blood circulation to the brain.
• If you have a high blood sugar level.
• If you have high blood pressure.
• If you have dysfunction of the liver and pancreas.
• If you have tumors of the liver.
• If you have female-hormone-dependent tumours.
• If you experience unknown bleeding from the vagina, are pregnant or are likely to be pregnant should not use this medicine.

✔️ Pregnancy & Lactation

• This tablet should not be taken by women who are pregnant or suspect they are pregnant.
• This tablet is not suggested for use while breastfeeding. If you want to use the Pill while breastfeeding, talk to your doctor first.

✔️ Precautions & Warnings

Before beginning to use this tablet, it's important to consider the following conditions. If any of these apply to you, inform your doctor before starting the medication:

• You smoke.
• You have diabetes.
• You are overweight.
• You have high blood pressure.
• You have a heart valve disorder or a certain heart rhythm disorder.
• You have inflammation of your veins (superficial phlebitis).
• You have varicose veins.
• There's a history of thrombosis, heart attack, or stroke in your immediate family.
• You experience migraines.
• You have epilepsy.
• You or your immediate family members have had high blood levels of cholesterol or triglycerides.
• Anyone in your immediate family has had breast cancer.
• You have liver or gallbladder disease.
• You have Crohn's disease or ulcerative colitis.
• You have systemic lupus erythematosus (SLE).
• You have hemolytic uremic syndrome (HUS).
• You have sickle cell disease.
• You have or have had chloasma (skin pigmentation patches, especially on the face); if so, avoid excessive sun exposure or ultraviolet radiation.

If any of the listed conditions appear, worsen, or recur while using the Pill, it's important to contact your doctor.

Regarding thrombosis and the Pill: Thrombosis is the formation of blood clots that block blood vessels. Deep venous thrombosis, which occurs in the deep veins of the legs, can occur with or without the use of the Pill. This clot can potentially travel to the lungs, causing a pulmonary embolism. While the risk of thrombosis is increased in Pill users compared to non-users, it's not as high as during pregnancy.

A breast cancer diagnosis has been slightly more frequent in Pill users than in non-users of the same age. However, this increased risk diminishes over time after discontinuation of the Pill.

There have been cases of benign and even rarer malignant liver tumors among Pill users, which can result in internal bleeding. If you experience severe abdominal discomfort, consult your doctor promptly.

✔️ Storage Conditions

• Store the Marvelon Tablet below 25°C in the original packaging to protect it from moisture and light.
• Keep this medicine out of sight and reach of children.
• Do not use this medicine after its expiry date.
• Do not throw away any medicines via wastewater or household waste.