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Demulen 1/35-21/28 Review


Indications for use

Hormonal contraception

Mechanism of action

Demulen 1/35-21/28 belongs to combined hormonal contraceptives. It inhibits ovulation through a negative feedback mechanism on the hypothalamus. It has a direct effect on the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitary. Additionally, combinated hormonal contraceptives change the cervical mucus. It becomes unfavorable for sperm to penetrate in the uterine cavity. Changes in the endometrium may also take place.

Mode of application and dosage

  • 21-tablet pack: 1 tablet/day for 21 consecutive days. Then, 7-days break is followed. A new course starts on the 8th day after the last tablet is taken.
  • 28-tablet package: 1 tablet/day without any breaks.


  • Hypersensitivity to the birth control drug components;
  • Prior or currently diagnosed thrombophlebitis or venous thromboembolic diseases;
  • Active or prior arterial thromboembolic disease;
  • Cerebral vascular disease, coronary artery disease, valvular heart disease with complications;
  • Severe hypertension;
  • Diabetes mellitus;
  • Migraine with focal neurological symptoms;
  • Diagnosed or suspected breast carcinoma, endometrial cancer, estrogen-dependent neoplasms, undiagnosed abnormal genital bleeding;
  • Liver dysfunction or tumor, cholestatic jaundice of pregnancy, jaundice with prior combination hormonal contraceptive use;
  • Smoking over 15 cigarettes/day in patients over 35 years of age;
  • Pregnancy/lactation.

Side effects

  • Cardiovascular system: cerebral thrombosis, arterial thromboembolism, cerebral hemorrhage, high blood pressure, mesenteric thrombosis, myocardial infarction, edema.
  • Central nervous system: depression, dizziness, headache/migraine, nervousness, premenstrual syndrome, stroke.
  • Dermatologic diseases: acne, erythema multiforme, erythema nodosum, hirsutism, hair loss, allergic rash.
  • Endocrine and metabolic systems: amenorrhea, bleeding, breast tenderness, breast secretion, intolerance to carbohydrate, decrease in lactation, glucose intolerance, changes in libido, menstrual flow changes, increase in sex hormone-binding globulins, spotting, temporary infertility (following discontinuation), thyroid-binding globulin increased, increase in triglycerides.
  • Gastrointestinal system: abdominal convultions, changes in appetite, bloating, cholestasis, colitis, gallbladder disease, jaundice, nausea, vomiting, weight gain/loss.
  • Genitourinary system: cervical erosion changes, cervical secretion changes, cystitis-like syndrome, vaginal candidiasis, vaginitis.
  • Liver function: benign liver tumors, cholestatic jaundice, hepatic adenomas.
  • Local: thrombophlebitis.
  • Kidney function: impaired renal function.
  • Respiratory system: pulmonary thromboembolism.


Contact your healthcare provider to define possible interactions.

What if I miss a dose?

If you miss 1-pill, take birth control drug as soon as possible or take 2 tablets next day. If you miss 2 consecutive pills in the first 2 weeks, a woman should take 2 tablets as soon as possible or 2 tablets next 2 days. An additional barrier contraceptive option should be applied for 7 days after missed dose.

Demulen 1/35-21/28 and pregnancy

This birth control is contraindicated during pregnancy and lactation.

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