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Afirmelle Review

Afirmelle is an oral contraceptive which contains 2 female hormones, ethinyl estradiol and levonorgestrel, that are used to prevent pregnancy.


Indications for use

  • Contraception.

Mechanism of action

Ethinyl estradiol and levonorgestrel block the release of the hypothalamus, suppressing the secretion of the gonadotrophic hormones by the pituitary gland, which leads to inhibition of maturation and release of the ovum ready for fertilization. Ethinyl estradiol helps maintain a high viscosity of the cervical mucus, which makes it difficult for sperm to penetrate into the uterine cavity.

In addition to the contraceptive effect, the drug normalizes menstrual periods.

Dosage and mode of application

Take tablets following the directions and marks indicated on the back of the blister.

Take tablets at the same time of the day, from the first day of your menstruation, 1 tablet a day, for 28 days in a row, without interruption. Begin a new Afirmelle pack once you have taken the last tablet from the previous pack.

Side effects

In some cases, Afirmelle can cause the following side effects:

  • reproductive system: engorgement of the mammary glands, decreased libido, intermenstrual bleeding, increased vaginal discharge, candidiasis of the vagina;
  • digestive system: nausea, vomiting, jaundice, hepatitis, liver adenoma, gallbladder disease (for example, cholelithiasis, cholecystitis), diarrhea;
  • nervous system: headache, depressed mood, an increase in the frequency of epileptic seizures;
  • senses: eyelid edema, conjunctivitis, visual impairment, discomfort when wearing contact lenses, a hearing loss;
  • metabolism: an increase in body weight, an increase in the concentration of triglycerides, glucose in the blood, a decrease in glucose tolerance;
  • skin and subcutaneous tissues: chloasma, skin rash, hair loss, generalized itching;
  • other: increased fatigue, increased blood pressure, thrombosis and venous thromboembolism, cramps calf muscles, coarsening of the voice.


Afirmelle for birth control is contraindicated in the following cases:

  • hypersensitivity to ethinyl estradiol / levonorgestrel or other components of the drug;
  • pregnancy, lactating period;
  • severe liver disease;
  • congenital hyperbilirubinemia (Gilbert / Dubin-Johnson / Rotor syndrome);
  • cholecystitis;
  • the presence or a history of severe cardiovascular and cerebrovascular changes;
  • thromboembolism and predisposition to it;
  • liver tumors, malignant tumors, especially breast cancer or endometrium;
  • family forms of hyperlipidemia;
  • severe forms of arterial hypertension;
  • severe diabetes and other endocrine gland diseases;
  • sickle cell anemia;
  • chronic hemolytic anemia;
  • gallbladder disease;
  • age over 40 years;
  • vaginal bleeding of unknown etiology;
  • a migraine;
  • otosclerosis;
  • idiopathic jaundice of pregnant women in anamnesis;
  • severe pruritus of pregnant women;
  • herpes of pregnant women.

With caution:

  • diseases of the liver and gallbladder;
  • epilepsy;
  • depression;
  • ulcerative colitis;
  • uterine myoma;
  • mastopathy;
  • tuberculosis;
  • kidney disease;
  • adolescence (without regular ovulatory cycles);
  • diabetes;
  • cardiovascular diseases;
  • arterial hypertension;
  • renal dysfunction;
  • varicose veins;
  • phlebitis;
  • otosclerosis;
  • multiple sclerosis;
  • epilepsy;
  • small chorea;
  • intermittent porphyria;
  • latent tetany;
  • bronchial asthma.


Avoid combining Afirmelle with the following drugs:

  • ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines, dihydroergotamine, tranquilizers, phenylbutazone;
  • anticoagulants, coumarin derivatives or indanedione;
  • tricyclic antidepressants, maprotiline, beta-blockers;
  • oral hypoglycemic drugs, insulin;
  • bromocriptine;
  • drugs with possible hepatotoxic effect, especially dantrolene.

Pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation period (breastfeeding).

What if I miss a pill?

If you missed an active tablet, take it within the next 12 hours. If the interval exceeds 36 hours, a contraceptive effect is not guaranteed. You should continue taking birth control pills in order to prevent premature menstruation associated with discontinuation of Afirmelle). During this period, you need to use other non-hormonal contraceptive methods. If you missed an inert tablet, discard it and continue taking the drug according to your usual scheme.


Before using Afirmelle for birth control, you need to make sure you are not pregnant. Besides, you need to undergo a general medical and gynecological examination. A regular gynecological examination is required every 6 months.

The use of the drug is allowed no earlier than 6 months after the former viral hepatitis provided that your hepatic functions are normalized.

If you feel a sharp pain in the upper abdominal areas, hepatomegaly or signs of intra-abdominal hemorrhage, you need to exclude a liver tumor. In this case, you should stop taking the drug.

If you have acyclic bleeding, you may continue taking birth control pills after excluding organic pathology.

If you have violations of the liver during the use of the contraceptive, you should consult a doctor.

Vomiting or diarrhea can reduce a contraceptive effect of the drug, so if you have these symptoms, take an additional pill. If these symptoms persist for a longer time, you should use additional methods of preventing pregnancy.

If you plan a pregnancy, the contraceptive should be discontinued at least 3 months before the planned pregnancy.

Under the influence of oral contraceptives with ethinyl estradiol, some laboratory parameters (functional parameters of the liver, kidneys, adrenals, thyroid gland, blood coagulation factors and fibrinolytic factors, levels of lipoproteins and transport proteins) can vary.

Afirmelle should be discontinued immediately in the following cases:

  • jaundice or hepatitis;
  • generalized itching;
  • an increase in epileptic seizures;
  • pregnancy;
  • a migraine or unusually severe headache,
  • acute worsening of visual acuity,
  • thrombosis or infarct symptoms;
  • a sharp increase in blood pressure,
  • 6 weeks before the planned surgery.

The drug does not affect the ability to drive a vehicle and work with mechanisms.

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