Indications for use
- Prevention of unwanted pregnancy;
- Functional disorders of the menstrual cycle.
Mechanism of action
Chateal EQ is a combined oral estrogen-progestogen contraceptive. The contraceptive drug effect is achieved thanks to the complementary mechanisms of the active substances. The most important mechanism includes ovulation inhibition, increase in the viscosity of cervical secretion. It makes it difficult for sperm to penetrate the uterine cavity, and changes in the endometrium that prevent the implantation of a fertilized egg. When using the birth control drug, the amount of menstrual bleeding decreases.
Mode of application and dosage
Oral mode of application. The regimen: 1 tablet 1 time per day, starting from 1 or 5 days of the menstrual cycle. Take 28 tablets continuously in a calendar package. One calendar package contains dragees of the same color (monophasic). Dragees are taken without chewing, washed down with a small amount of water. The time of administration does not play a role, however, subsequent administration should be performed at the same selected hour, preferably after breakfast or dinner (to ensure a constant concentration of hormones in the plasma, the interval between doses should not exceed 36 hours, it should be maintained at 22-26 h).
- Thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis (DVT), pulmonary embolism (pulmonary embolism), myocardial infarction, stroke);
- Conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at present or in the anamnesis;
- The presence of a high risk of arterial thromboembolism due to the presence of multiple risk factors or the presence of one serious risk factor from the following: severe arterial hypertension, severe dyslipoproteinemia, history of migraine with focal neurological symptoms, diabetes mellitus with vascular complications, severe liver disease, liver tumors (benign or malignant) at present or in history, identified hormone-dependent malignant diseases (including genital organs or mammary glands), vaginal bleeding of unknown origin, pregnancy, the period of breastfeeding, hypersensitivity to active substances or any of the excipients.
- Immune system disorders: hypersensitivity.
- Metabolic and nutritional disorders: insulin resistance.
- Mental disorders: mood swings, decreased libido, depression, worsening of the course of depression, depressed mood, insomnia.
- Nervous system: headache, migraine, dizziness, loss of consciousness.
- Violations of the vessels: increased blood pressure, worsening of hypertension, arterial thromboembolism, venous thromboembolism.
- Respiratory system, chest and mediastinal organs: thrombosis and pulmonary embolism.
- Gastrointestinal tract: nausea, pain in the abdomen; vomiting, aggravation of nausea, cholecystitis, cholelithiasis.
- Disorders from the skin and subcutaneous tissues: acne, hyperpigmentation, alopecia.
- Musculoskeletal and connective tissue: peripheral edema, back pain, muscle cramps, arthralgia, joint stiffness, myalgia, neck pain, pain in the limbs.
- Violations of the genitals and mammary gland: metrorrhagia, painful menstrual-like spotting/bleeding, tenderness of the mammary glands.
- General disorders and disorders at the injection site: malaise, fatigue, chest pain, peripheral edema.
- Laboratory and instrumental data: weight gain, increased blood pressure, increased lipid levels.
It is possible to interact with drugs that induce microsomal liver enzymes, as a result of which the clearance of sex hormones can increase, which, in turn, can result in “breakthrough” uterine bleeding and/or a decrease in the contraceptive effect.
Induction of microsomal liver enzymes can be found after a few days of treatment. The maximum induction of microsomal liver enzymes is usually observed within a few weeks. After drug discontinuation, the induction of microsomal liver enzymes can last about 4 weeks.
Women undergoing treatment with such drugs should temporarily use the barrier method in addition to COCs or choose another method of contraception. The barrier method should be used during the entire period of therapy with a drug-inducer of microsomal liver enzymes and within 28 days after its cancellation.
Reduced absorption: drugs that increase the motor activity of the gastrointestinal tract, such as metoclopramide, can reduce the absorption of hormones.
Substances that increase the clearance of COCs are: phenytoin, barbiturates, primidone, carbamazepine, rifampicin, and possibly also oxcarbazepine, topiramate, felbamate, griseofulvin and products containing St. John’s wort.Substances with different effects on COC clearance.
Many HIV/hepatitis C protease inhibitors and non-nucleoside reverse transcriptase inhibitors can increase or decrease plasma concentrations of estrogen or progestin. These changes may be clinically significant in some cases.
Potent and moderate CYP3A4 inhibitors, such as antifungal drugs of the azole group (e.g. itraconazole, voriconazole, fluconazole), verapamil, macrolides (e.g. clarithromycin, erythromycin), can lead to an increase in diltiphizam juice and the concentration of estrogen or progestin, or both hormones in plasma.
What if I miss a dose?
If you miss a dosage, a woman should take the drug within the next 12 hours. With an interval of over 36 hours, a reliable contraceptive effect is not guaranteed. During this period, it is recommended to use other non-hormonal methods of contraception. For therapeutic purposes, the dose is selected individually.
Chateal EQ and pregnancy
Chateal EQ is contraindicated during pregnancy and during breastfeeding. If pregnancy is diagnosed while taking the drug, it should be withdrawn immediately. However, numerous epidemiological studies did not reveal an increased risk of developmental defects in children born to women who took sex hormones before pregnancy, or teratogenicity when sex hormones were taken by negligence in the early stages of pregnancy.
Taking combined birth control pills can reduce the amount of breast milk and change its composition, so their use is contraindicated during breastfeeding.