Bekyree (desogestrel and ethinyl estradiol) is an oral hormonal contraceptive indicated for the prevention of unwanted pregnancy.
- Oral contraception.
The contraceptive effect of the drug is due to the inhibition of the ovulation process, which is confirmed by the absence of the ovulatory follicle during an ultrasound and the absence of an increase in the values of luteotropic hormone (LTG) and progesterone in the blood in the middle of the menstrual period. At the same time, desogestrel, as well as other progestogens, has the ability to increase the viscosity of cervical mucus, preventing the spermatozoa from progressing. Pearl’s Index is 0.4. The use of the drug leads to a decrease in the content of estradiol in the blood plasma to values corresponding to the early follicular phase. Progestagens affect carbohydrate and lipid metabolism.
Each Bekyree pack contains 28 tablets:
- 21 white tablets each containing desogestrel 0.15 mg/ethinyl estradiol 20 mcg;
- 2 green inert tablets (no medication);
- 5 yellow tablets each containing ethinyl estradiol 10 mcg.
Tablets are started on the first day of the menstrual period. Take 1 tablet a day for 28 days, if possible at the same time of a day. Begin a new pack without interruption, even if the bleeding has not stopped. This method of taking tablets is followed as long as it is necessary to prevent pregnancy. If tyou take tablets correctly, the contraceptive effect is maintained for a period of taking inert tablets.
The first dose of the drug:
The first pill should be taken on the first day of the menstrual period. In this case, you do not need to use additional methods of contraception. The drug can be started on 2-5 days of menstruation, but in this case, you should use additional methods of contraception in the first 7 days (the first period only).
Taking the drug after childbirth:
Women who do not breastfeed should start taking birth control pills 21 days after delivery. In this case, there is no need to use other methods of contraception. If a woman had sexual contact after childbirth, she should wait until the next menstruation. If a woman decides to take pills later than 21 days after delivery, then additional contraceptive methods should be used in the first 7 days.
Taking the drug after an abortion:
After an abortion, pills should be started on the first day, in this case, there is no need to use additional methods of contraception.
Switching from another oral contraceptive:
Switching to Bekyree from another oral preparation (21 or 28-day contraceptive) the first tablet should taken the day after the end of the course of the previous preparation. You do not need to make any breaks between contraceptives and do not need to use additional methods of contraception.
Switching from mini-pills containing only progestogen:
The first pill must be taken on the first day of the period.
You do not need to use additional methods of contraception. If menstruation does not occur while taking mini-pils, you can start taking Bekyree on any day of the period, but in this case, additional contraceptive methods should be used in the first 7 days.
In the above cases, the following non-hormonal methods are recommended as additional methods of contraception: use of a cervical cap with a spermicidal gel, a condom or abstaining from sexual contact. The use of the calendar method, in this case, is not recommended.
Delayed menstrual period:
If there is a need to postpone menstruation, then birth control pill should be continued from the new package without taking inert tablets. This does not reduce the contraceptive effect of the drug.
After taking large doses of desogestrel and ethinyl estradiol, the following symptoms of overdose were reported: a severe headache, dyspeptic disorders, cramps of the calf muscles.
Treatment: if an overdose is detected in the first 2-3 hours or a large number of tablets have been taken, it is necessary to wash the stomach. The drug does not have a specific antidote, the treatment is symptomatic.
In some cases, Bekyree pills can cause the following side effects:
- genitals: intermenstrual bleeding, amenorrhea after discontinuation of the drug, changes in vaginal mucus, growth of uterine fibroids, worsening of endometriosis, vaginal infections;
- mammary glands: feeling of tension, pain, increase, milk excretion;
- gastrointestinal tract: nausea, vomiting, cholelithiasis, cholestatic jaundice;
- skin: nodular erythema, rash, chloasma;
- eyes: increased corneal sensitivity when using contact lenses;
- central nervous system: headache, migraine, mood changes, depressive state;
- metabolic changes: fluid retention in the body, changes in body weight, reduced tolerance to carbohydrates.
If you have severe side effects, it is necessary to interrupt the course of taking the drug: arterial and venous thromboembolic diseases (myocardial infarction, stroke, deep vein thrombosis of the lower extremities, thromboembolism of the lungs, thromboembolism in the hepatic, mesenteric, renal vessels or in one of the wipes,; severe or moderate severity, sex-hormone-dependent tumors, breast cancer, reactive systemic lupus erythematosus, Sydenhem chorea, a malignant liver tumor in women who take hormonal contraceptives for a long time.
Contraceptives are contraindicated in the following cases:
- pregnancy or suspicion of it;
- hypertensive disease (moderate or severe);
- violation of lipid metabolism;
- the presence or indication of a history of the arterial thromboembolic disease (myocardial infarction, cerebrovascular disease);
- a risk of arterial or venous thromboembolism;
- venous thromboembolism, including a family history;
- diabetic angiopathy;
- the presence or indication of a history of a severe liver disease, cholestatic jaundice, hepatitis, jaundice during pregnancy, jaundice when using drugs containing steroids, Dubin-Johnson syndrome or Rotor syndrome, liver tumors, porphyria;
- hepatitis (before the restoration of laboratory parameters and within three months after the return of these indicators to normal);
- the presence or suspicion of estrogen-dependent tumors, endometrial hyperplasia, genital bleeding of unknown etiology;
- the presence or a history of systemic lupus erythematosus;
- previously noted: severe itching, genital herpes, otosclerosis, or worsening of the symptoms of otosclerosis during a previous pregnancy or taking steroids;
- hypersensitivity to desogestrel and ethinyl estradiol.
In the presence of any of the following conditions, the benefits or the possible negative effects of taking oral contraceptives are individually assessed in each case:
- diseases of the blood coagulation system;
- all diseases in which circulatory disorders are more likely to form: latent or existing heart failure, renal failure, and a history of these diseases;
- epilepsy or a history of it;
- a migraine or a history of it;
- history of gallstone disease;
- risk of developing an estrogen-dependent tumor or estrogen-dependent gynecological diseases;
- severe depression, including in the anamnesis;
- sickle cell anemia, because in some cases (for example, infections, hypoxia) preparations containing estrogens can provoke the effects of thromboembolism in women with this pathology;
- deviations in the functional laboratory parameters of the liver.
The condition of a woman must be carefully controlled. If any of these conditions appear or worsen while taking the drug, you should stop taking pills and switch to another, non-hormonal method of contraception.
A disruption of the period or a decrease in efficacy: antispasmodics, barbiturates, antibiotics (tetracycline, ampicillin, rifampicin), griseofulvin, laxatives and certain medicinal plants (for example, St. John’s wort).
Oral contraceptives can reduce tolerance to carbohydrates, which increases the need for insulin or oral antidiabetic agents.
Use of Bekyree during pregnancy and lactation is contraindicated.
Teratogenic effect of the drug is not found if the woman took birth control pills at the beginning of pregnancy.
Hormonal contraceptives reduce the release of milk, change the composition of milk and enter mother’s milk in small quantities, so this drug is not indicated for use during a breatfeeding period.
If you missed 1 white tablet, take the missed tablet as soon as possible. If you missed 2 white tablets in Week 1 or Week 2, take 2 tablets the day you remember and 2 tablets the next day, then switch to your normal dosing schedule. You should use a backup birth control method if you had sexual intercourse in the 7 days after missing pills. If you missed 2 white tablets in the Week 3 or missed 3 or more white tablets in a row at any time during the cycle, you should continue taking 1 white tablet daily until the next Sunday. On Sunday you should discard the rest of the pills and start a new Bekyree pack that same day.
Before starting the use of birth control pills, you should collect a detailed family and personal history and undergo general and gynecological examinations (blood pressure measurement, laboratory tests, mammary gland and pelvic examination, cytological smear examination) to exclude possible contraindications for use and pregnancy. These studies need to be repeated periodically. Periodic studies are important, as risk factors or contraindications are identified at the beginning of taking the tablets. When deciding whether to take contraceptives, it is necessary to evaluate the ratio of potential risk and apparent benefits in the form of oncoproteactive properties in relation to ovarian and endometrial cancer.
Under the influence of oral contraceptive pills – in connection with the estrogen component – the level of certain laboratory parameters (functional parameters of the liver, kidneys, adrenal glands, thyroid gland, blood coagulation factors and fibrinolytic factors, the level of lipoproteins and transport proteins) may change.
It is necessary to monitor the status of a woman with the purpose of timely detection of thromboembolic complications.
The risk of arterial or venous thromboembolic disorders increases:
- with age;
- when smoking (intensive smoking and age over 35 years are considered an increased risk);
- if there is a history of thromboembolic disease (for example, in parents, a brother or a sister). If there is a suspicion of genetic predisposition, it is necessary to consult a specialist;
- with obesity (body mass index above 30 kg / m2);
- with dyslipoproteinemia;
- with hypertension;
- with heart valve disease;
- with atrial fibrillation;
- with diabetes mellitus;
- with prolonged immobilization, after a large surgical intervention, after surgery on the lower limbs, after severe trauma.
In these cases, the course of taking the tablets is temporary discontinued: it is desirable to stop taking the medication 4 weeks before the surgery and to restore it 2 weeks after the remobilization.
Diseases that may cause circulatory disorders, such as diabetes mellitus, systemic lupus erythematosus, hemolytic syndrome, Crohn’s disease, ulcerative colitis, sickle cell anemia, present an increased risk of venous thromboembolic disease.
The effectiveness of Bekyree may decrease if irregular bleeding or spotting occurs after several months of its use. If a woman has no related disorders and pregnancy is doubtful, then the drug should be continued until the package is empty. If you do not have menstrual bleeding in the second cycle, then you need to stop taking the pills and resume it only after the pregnancy is excluded.
If vomiting or diarrhea occurs after taking an active pill, then the absorption of the drug may be incomplete. If the symptoms disappeared within 12 hours, then you need to take an additional pill. After this, you should continue taking the pills as usual. If symptoms persist for more than 12 hours, additional contraceptive methods should be used during vomiting or diarrhea and for the next 7 days.
Studies to identify the possible effects of the drug on the ability to drive a car or the ability to drive machines have not been conducted.