Buy Marvelon

The contraceptive effect of Marvelon, like other combined oral contraceptives (OCPs), is based primarily on the ability to suppress ovulation and increase the secretion of cervical mucus.

Progestin drug (desogestrel) inhibits the synthesis of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary gland and, thus, prevents the maturation of the follicle (blocks ovulation).

 

Ethinyl estradiol - a synthetic analogue of the follicular hormone estradiol, together with the hormone of the yellow body regulates the menstrual cycle.

 

Along with these central and peripheral mechanisms that prevent the maturation of an oocyte capable of fertilization, the contraceptive effect is due to an increase in the viscosity of mucus in the cervix, which makes it relatively impassable for sperm.

 

Along with the contraceptive properties, OCPs have a number of additional positive effects: the menstrual cycle becomes more regular, menstruation is less painful and is accompanied by less pronounced bleeding. The latter circumstance leads to a decrease in the frequency of concomitant iron deficiency anemia. When using HEC with a high content of hormones (50 µg of ethinyl estradiol), a reduction in the risk of fibrocystic mastopathy, ovarian cysts, inflammatory diseases of the pelvic organs, ectopic pregnancy, ovarian cancer and endometrium has been shown. The applicability of these data to low-hormone OCPs needs further study.

 

Marvelone has a beneficial effect on lipid metabolism, increases the content of high-density lipoprotein (HDL) in plasma, while not affecting the content of low-density lipoprotein (LDL). It has a beneficial effect on the skin, improves its condition in acne vulgaris.

Desogestrel, taken orally, is quickly and completely absorbed and then turns into etonogestrel. Its maximum plasma concentration (approximately 2 ng / ml) is reached after 1.5 hours. Bioavailability is 62-81%.

Etonogestrel binds to plasma albumin and the sex hormone-binding globulin (SHBG). Only 2-4% of the total concentration of etonogestrel in plasma are present as a free steroid, 40-70% are specifically associated with SHBG. An increase in the level of SHBG caused by ethinyl estradiol affects the distribution between blood proteins, leading to an increase in the SHBG-bound fraction and a decrease in the albumin-bound fraction. The apparent volume of distribution of desogestrel is 1.5 L / kg.

Etonogestrel is fully metabolized by the known metabolism of steroid hormones; the rate of metabolic elimination from blood plasma is 2 ml / min / kg. No etonogestrel interaction was detected with concurrent ethinyl estradiol.

The concentration of etonogestrel in plasma decreases in 2 stages. The final stage is characterized by a half-life (T1 / 2) of about 30 hours. Desogesgrel and its metabolites are excreted in urine and bile in a ratio of about 6: 4.

 

The pharmacokinetics of etonogestrel are influenced by SHBG, the level of which is revived by the action of ethinyl estadiol 3 times. With daily intake, the concentration of etonogestrel in plasma increases by 2-3 times, reaching a constant level in the second half of the cycle.

Ethinyl estradiol after oral administration is rapidly and completely absorbed. Its maximum plasma concentration (about 80 pg / ml) is reached within 1-2 hours after administration. Absolute bioavailability (the result of presystemic metabolism) is about 60%.

 

Ethinylestradiol nonspecific binds to plasma albumin almost completely (98.5%), increases the concentration of SHBG. The apparent volume of distribution of ethinyl estradiol is 5 l / kg.

Ethinyl estradiol is subjected to presystemic metabolism in both the mucous membrane of the small intestine and in the liver.

 

Ethinylestradiol is initially metabolized during aromatic hydroxylation to form various hydroxylated and methylated metabolites, which are present both in the free state and in the form of conjugates with glucuronides and sulfates. The rate of metabolic elimination of ethinyl estradiol from blood plasma is about 5 ml / min / kg.

 

The concentration of etonogestrel in plasma decreases in 2 stages. The final stage is characterized by a T1 / 2 of about 24 hours. The drug is not excreted unchanged, the metabolites of ethinyl estradiol are excreted in the urine and bile in the ratio 4: 6. T1 / 2 metabolites is about days.

• Contraception.

Tablets should be taken orally in the order indicated on the packaging, every day at approximately the same time, with a little water, if necessary.

Take 1 tab. per day for 21 days. Acceptance of tablets from the next package should be started 7 days after the end of the previous one. During these 7 days, menstrual bleeding occurs. It usually starts 2-3 days after taking the last pill and may not stop before the next pack is started.

 

How to start taking the drug Marvelon

If hormonal contraceptives have not been used in the last month, the intake should begin on the first day of the menstrual cycle. You can start taking the drug for 2-5 days after the start of the menstrual cycle, but in this case it is recommended to use an additional (non-hormonal) method of contraception during the first 7 days of taking the pills in the first cycle.

 

Transition from other combined oral contraceptives: it is advisable to start taking Marvelon on the next day after taking the last tablet of a previously used hormone-containing drug, in extreme cases, immediately after a break in taking the pills or after taking a pill that does not contain hormones.

 

Switching from drugs containing progestogen only (mini-pili, implant injection). A woman taking "mini-drank", can switch to taking the drug Marvelon on any given day; using the implant - on the day of its removal; using the drug in the form of injections - on the day when there should be the next injection, in all cases during the first seven days of taking Marvelon, it is recommended to use additional methods of contraception.

 

After an abortion made in the first trimester: a woman can start taking the drug immediately. No need to use any additional methods of contraception.

 

After childbirth or an abortion made in the second trimester, it is recommended to start taking the drug on day 21 or 28 after the childbirth or abortion made in the second trimester of pregnancy. When you start taking the drug at a later date, it is recommended to use barrier methods of contraception during the first seven days of taking Marvelon. In any case, if a woman after childbirth or an abortion has already had sexual contact before starting to take Marvelon, you should exclude pregnancy before taking the drug or wait until the first menstruation.

 

What to do if you miss the next drug intake

If the reception of the next pill is delayed for less than 12 hours, the reliability of contraception is not reduced. A woman should take a pill as soon as she remembers, and take the next pill at the usual time.

If the reception of a regular pill is delayed by more than 12 hours, the reliability of contraception can be reduced. In this case, the following rules should be followed:

 

Week 1. A woman should take a missed pill as soon as she remembered it, even if it means taking two pills at the same time. Then you should continue to receive the usual pattern. Additionally, you should use the barrier contraceptive method for the next 7 days. If a woman has had sexual intercourse within the previous 7 days, consider the possibility of pregnancy. The more tab. missed, and the closer the break in taking the drug to sexual intercourse, the higher the risk of pregnancy.

 

Week 2. A woman should take the missed pill as soon as she remembered it, even if it means taking two tabs. at the same time. Then you should continue to receive the usual pattern. Provided that the woman took the tab. on time within 7 days preceding the first missed dose, there is no need to use additional (non-hormonal) methods of contraception. Otherwise, or if the woman missed more than 1 tablet, it is recommended to use additional methods of contraception for the next 7 days.

 

Week 3. The reliability of contraception can be reduced, due to the subsequent interruption in the intake of the drug. This can be avoided by adapting the regimen. If you use either of the following two schemes, there is no need to use additional contraceptive measures, provided that the woman took the tab. On time within 7 days preceding the first missed dose.

 

Otherwise, it is recommended to use one of the two following schemes and also to use additional contraceptive measures for the next 7 days.

A woman should take the missed pill as soon as she remembered it, even if it means taking two tabs. at the same time. Then you should continue to receive the usual pattern. New packaging should start as soon as the current packaging ends, i.e. do not break between packs. The likelihood of withdrawal bleeding before the end of the second package is small, but some may experience a spotting or heavy bleeding even while taking the drug.

 

It may be recommended to stop taking the drug from the current pack.A woman should take a break in taking Marvelon for up to seven days, including the days when she forgot to take a tab., And then start a new package.When you skip the drug intake and the subsequent absence of bleeding in the near interruption in the reception, you should consider the possibility of pregnancy.Recommendations in case of vomiting. If vomiting occurs within 3-4 hours after taking the drug, absorption may be incomplete. In this case, you should use the recommendations regarding the admission of the next drug intake. If a woman does not want to change her usual regimen, she needs to take an extra pill from another package.How to change the period of the onset of menstruation. In order to delay menstruation, you should continue taking tab. from another package of Marvelone without the usual interruption in the intake. You can postpone menstruation for any period until the end of the tab. from the second pack. During this period, women may experience a spotting or heavy bleeding.

 

Reception of the drug in the usual way should be resumed after a 7-day interval in reception.In order to shift menstruation on a day of the week that differs from that which is expected if the usual regimen is observed, it is possible to reduce the usual interruption in reception for as many days as necessary. The shorter the break, the higher the risk of the absence of menstruation during the break and the occurrence of heavy or spotting bleeding while taking the drug from the second package.