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Enpresse Review


Enpresse is a hormonal contraceptive containing a combination of 2 hormones, levonorgestrel and ethinyl estradiol, that are used to prevent ovulation.

Contents:

Indications for use

Enpresse is used as a contraceptive agent. Also, it’s used to eliminate a number of gynecological symptoms associated with the period, such as premenstrual tension, dysmenorrhea (menstrual disorder), polymenorrhea (a menstrual disorder characterized by prolonged and abundant menstruation, pain in the middle of the period, etc.)

Mechanism of action

The drug has an estrogen-progestin contraceptive effect. Levonorgestrel in combination with ethinyl estradiol inhibits ovulation, increases the viscosity of mucus in the cervix, making it difficult for sperm to enter the uterine cavity. With regular use, the preparation normalizes the menstrual period and helps prevent a number of gynecological diseases.

Dosage and mode of application

Each pack of Enpresse contains:

  • 6 tablets each containing 0.5mg/30 mcg;
  • 5 tablets each containing 0.075 mg/40 mcg;
  • 10 tablets each containing 0.125 mg/30 mcg;
  • 7 inert tablets.

Take Enpresse daily at the same time of a day (preferably after breakfast or dinner), 1 tablet for 28 days, starting from the first day of the period (1 day of menstrual bleeding). Menstrual-like bleeding occurs when taking 7 inert tablets.

Start a new pack regardless of whether the vaginal bleeding has ended or is just beginning.

Taking the pills from each package starts on the same day of the week.

After the withdrawal of the drug, the functions of the sex glands are quickly restored, which ensures the ability to conceive.

Usually, after cessation of treatment, the first menstrual cycle is extended by 1 week. If the normal cycle is not restored within 2-3 months, it is necessary to consult a doctor.

When switching from combined oral contraceptives, it is preferable to start taking Enpresse the next day after taking the last active tablet from the previous package (for drugs containing 21 tablets) or after taking the last inert tablet (for drugs containing 28 tablets).

If you used contraceptives containing only progestogen (“mini-pills”), you can switch to Enpresse on any day (without a break).

After termination of pregnancy in the first trimester, a woman can start taking the drug immediately and does not need additional contraceptive measures.

After childbirth or termination of pregnancy in the II trimester, the drug should be started no later than the 21st – 28th day. Additionally, you need to use a barrier method of contraception during the first 7 days.

In any case, before taking birth control pills, pregnancy should be excluded.

Overdose

Symptoms: nausea, vomiting, spotting from the vagina.

There is no specific antidote; symptomatic treatment is required.

Side effects

Digestive system:

  • often – nausea, gastralgia, fecal staining in black, darkening of the tooth enamel;
  • infrequently – vomiting, constipation, diarrhea;
  • rarely – cholestasis;
  • very rarely – pancreatitis, jaundice, hepatocellular adenoma.

Reproductive system:

  • often – a feeling of tension, tenderness of the mammary glands;
  • rarely – changes in libido, increase and discharge from the mammary glands; metrorrhagia during the first few months of use, changes in vaginal secretion.

Nervous system:

  • often – headache, anxiety, depression;
  • infrequently – a migraine.

Cardiovascular system:

  • very rarely – thrombophlebitis, thromboembolism.

Senses:

  • very rarely – visual impairment, hearing loss.

Other:

  • infrequently – fluid retention, hyperlipidemia;
  • rarely – allergic reactions (skin rash, itching, eyelid edema, conjunctivitis), poor tolerance to contact lenses, changes in body weight;
  • very rarely – metabolic Na + and Ca2 +,
  • with long-term use – chloasma (focal pigmentation).

Contraindications

Do not use Enpresse if you have any of the conditions listed below:

  • presence or a history of thrombosis (venous and arterial), deep vein thrombosis of the lower extremities, thromboembolism of pulmonary artery branches, as well as the conditions preceding thrombosis (transient ischemic attack, angina, myocardial infarction, complicated lesion valvular heart disease (pulmonary hypertension, atrial fibrillation, subacute bacterial endocarditis), ischemic or hemorrhagic cerebrovascular disorders), serious surgical intervention with prolonged immobilization;
  • severe or multiple risk factors for venous or arterial thrombosis;
  • diabetes with vascular complications (angiopathy, retinopathy);
  • jaundice, congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes), severe forms of liver disease (before normalization of liver tests), benign or malignant tumors of the liver;
  • pancreatitis with severe hypertriglyceridemia (including a history);
  • epilepsy, a migraine with focal neurological symptoms (present or a history);
  • sickle cell anemia;
  • hormone-dependent malignant diseases of the genital or mammary glands (including a history), hyperprolactinemia, menopause hyperfollicular stage, inflammatory diseases of the female genital organs (salpingoophoritis, endometritis), uterine bleeding of unclear genesis;
  • pregnancy, breastfeeding period;
  • hypersensitivity to levonorgestrel and ethinyl estradiol;
  • hemolytic (hereditary and acquired) and other anemias not related to iron deficiency, hemochromatosis, gastric ulcer and duodenal ulcer in the acute phase, inflammatory bowel disease (Crohn’s disease, ulcerative colitis).

With caution: overweight, dyslipoproteinaemia, diabetes, hypertension, atherosclerosis, varicose veins, impaired renal function, fibrocystic mastopathy, hysteromyoma, migraine, otosclerosis, multiple sclerosis, epilepsy, severe depression in history, porphyria, systemic lupus erythematosus, Sidegenam chorea, chloasma; with intolerance to contact lenses; a family history of thromboembolism, coagulation disorders, chronic heart failure, strokes, breast cancer.

The relative risk of thrombosis increases with smoking over the age of 35; with prolonged immobilization, extensive injury; in impaired peripheral circulation; Crohn’s disease and ulcerative colitis, phlebitis of the superficial veins.

Interactions

Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin) can increase the metabolism of steroid hormones that make up the contraceptive.

A decrease in the effective concentration is observed with the simultaneous administration of certain antibiotics (ampicillin, rifampicin, tetracycline, griseofulvin) due to changes in the microflora in the intestine. Nonsteroidal anti-inflammatory drugs reduce the effectiveness of the drug.

Patients taking birth control pills may require dosage regimen correction for hypoglycemic drugs.

Pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation. If it’s necessary to use the drug during lactation, breastfeeding should be terminated. Levonorgestrel and ethinyl estradiol are excreted in breast milk in small quantities

What if I miss a pill?

If you miss a pill of Enpresse, the risk of pregnancy will be increased.

  • If you miss 1 pink, white or orange pill, take it as soon as you remember. Take the next pill at your usual time. This might mean taking 2 pills per day;
  • If you miss 2 pink, white or orange pills in a row during week 1 or 2, take 2 pills the day you remember and 2 pills the next day. Use an additional non-hormonal birth control method for 7 days, then continue to take 1 pill a day until the pack is empty;
  • If you miss 2 pink, white or orange pills in a row during week 3, discard the rest of the pills and start a new pack that same day. Use an additional non-hormonal birth control method for 7 days;
  • If you miss 3+ pink, white or orange pills in a row, discard the rest of the pills and start a new pack that same day. Use an additional non-hormonal birth control method for 7 days;
  • If you miss 1 or more pills in week 4, discard them and do not worry since they do not contain any hormones and keep taking 1 pill per day until you finish the pack.

Precautions

Before taking the tablets and every 6 months a woman should undergo a thorough general medical and gynecological examination, exclude pregnancy and coagulation disorders.

In cases of intermenstrual bloody discharge in the first few months of taking the drug, the course should not be interrupted, since mild bleeding disappears after the body adapts to the drug. With the recurrence of such secretions, an increase in their intensity, unusually strong and heavy menstrual-like bleeding, consultation with a physician is necessary. A consultation is also required if you have no menstrual-like reaction during the 7 no-hormone days.

When using the contraceptive, bear in mind hormonal birth control pills can change the usual course of the menstrual period, rectal temperature and properties of cervical mucus.

With vomiting/diarrhea within 3-4 hours after taking the active tablet, its contraceptive effect of Enpresse may decrease. In this case, you should NOT stop taking the drug but should use additional non-hormonal methods of contraception.

The drug is discontinued 6 weeks before the planned surgical intervention/long-term immobilization and resumed 2 weeks after the end of immobilization.

If you experience early signs of phlebitis, thrombosis or embolism, persistent skin itch, severe pain in the lower abdomen, severe headaches pains and migraines, severe depressions, a significant increase in blood pressure, increased seizures, sudden changes in vision, hearing or speech, first appeared motor disorders, hepatitis, jaundice, cholestasis, porphyria, you must stop taking birth control pills immediately and conduct additional tests.

If you suspect a pregnancy, stop taking the tablets and visit a doctor.

Smoking women taking combination oral contraceptives have an increased risk of developing vascular diseases with serious consequences. The risk increases with age and with the number of cigarettes smoked per day (especially in women over the age of 35). The risk of thrombosis increases with high blood pressure.

Patients with chloasma should avoid exposure to the sun when using the contraceptive.

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