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Jaimiess Review

Jaimiess is an extended-cycle contraceptive containing 2 female hormones, ethinyl estradiol and levonorgestrel that are used to prevent pregnancy.

Contents:

Indications for use

  • Oral contraception.

Mechanism of action

The drug suppresses ovulation, changes the properties of the cervical secret, changes the endometrium, which makes prevents a fertilized egg from implanting.

It also normalizes the menstrual cycle making it more regular, reduces pain and the intensity of bleeding, which reduces the risk of iron deficiency anemia.

Dosage and mode of application

The drug must be taken daily, at the same time and in strict accordance with the instructions on the package. Start taking tablets on day 1 of the period. Take 1 tablet for 91 days in a row. The use of tablets from the new package is started without intervals.

If a woman did not take any hormonal contraceptives in the previous month, she can start taking Jaimiess on the first day of the menstrual bleeding (period). It’s also allowed to start using tablets of the 2-5 day of the period. In this case, an additional barrier method of contraception should be used during the first 7 days.

When switching from other COCs, it is advisable to start using tablets on the following day after taking the last active tablet from the previous package.

When switching from progestin contraceptive drugs (mini-pills, implants, injection forms) or intrauterine devices, the following recommendations should be observed:

  • switching from mini-pills can be carried out without interruption on any day;
  • switching from an intrauterine progestin or implant is indicated on the day of its removal;
  • switching from an injection form is possible at the time of the next recommended injection.

In all of the above cases, you need to use an additional birth control method for the next 7 days.

After an abortion in the first trimester, you can start taking birth control pills without delay, in this case, there is no need for additional contraception.

After an abortion or childbirth in the II trimester, you should start taking pills after 21-28 days. In the case of a later start, you need to use an additional birth control method for the next 7 days.

Overdose

Symptoms of overdose include nausea, spotting, vomiting and metrorrhagia.

Symptomatic treatment is recommended.

Side effects

Side effects that may occur when taking the drug Triquilar:

  • breast enlargement;
  • soreness,
  • tightness of mammary glands;
  • uterine bleeding;
  • migraine;
  • decreased libido;
  • depressed mood;
  • visual impairment;
  • nausea;
  • severe abdominal pain;
  • vomiting;
  • skin rash;
  • generalized itching;
  • jaundice;
  • weight gain;
  • allergy.

In very rare cases, women reported an increased fatigue, diarrhea, chloasma, thromboembolism, thrombosis.

Contraindications

Stop taking Jaimiess, if you have at least one of the following conditions:

  • migraine;
  • diabetes with complications;
  • thromboses;
  • conditions preceding thrombosis;
  • liver disease;
  • malignant and benign liver tumors;
  • risk factors for arterial or venous thrombosis;
  • pancreatitis;
  • hormone-dependent diseases of the mammary glands or genitals;
  • pregnancy;
  • vaginal bleeding;
  • surgical interventions (surgery on the legs, injuries);
  • intolerance of the drug components.

With caution:

  • otosclerosis;
  • obesity;
  • itching, jaundice;
  • migraine;
  • Crohn’s disease;
  • systemic lupus erythematosus;
  • diabetes;
  • arterial hypertension;
  • sickle cell anemia.

Interactions

Effect of other drugs on Jaimiess

Birth control pills can interact with drugs that induce microsomal enzymes, as a result of which the clearance of sex hormones can increase, which in turn can lead to “breakthrough” uterine bleeding and/or a reduction in the contraceptive effect.

Women who are treated with induction drugs microsomal enzymes are recommended to temporarily use a barrier method of contraception or choose a different non-hormonal method of contraception. A barrier contraceptive method should be used during the entire period of administration of the drug-inducer of microsomal enzymes and within 28 days after its cancellation.

If the use of the drug inducer of liver microsomal enzymes continues after taking the last tablet of Jaimiess from the current package, you should start taking the tablets from the new package without taking last 7 inert tablets. Continuous administration of the contraceptive should also be continued for 28 days after discontinuation of the drug-inducer of microsomal enzymes.

Absorption impairment:

The joint use with drugs that enhance the motility of the gastrointestinal tract (for example, metoclopramide) can affect the absorption of Jaimiess.

Substances that increase clearance of ethinyl estradiol and levonorgestrel:

Phenytoin, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John’s Wort. Hypericum perforatum drugs have an effect on the clearance of the contraceptive for another two weeks after the end of their use.

Substances with different effects on the clearance of ethinyl estradiol and levonorgestrel

When used together with COCs, many HIV protease inhibitors or hepatitis C virus and non-nucleicidal reverse transcriptase inhibitors can both increase and decrease the concentration of estrogens or progestins in the blood plasma. In some cases, this effect may be clinically significant.

Substances that reduce the clearance of COCs (enzyme inhibitors)

CYP3A4 inhibitors, such as azole antimycotics (itraconazole, voriconazole, fluconazole), verapamil, macrolides (clarithromycin, erythromycin), diltiazem, and grapefruit juice can increase plasma concentrations of estrogen or progestin.

It was revealed that etoricoxib in doses of 60 and 120 mg/day increases the concentration of ethinyl estradiol in plasma by 1.4 and 1.6 times, respectively, when taken together with the combined oral contraceptives.

Effect of Jaimiess on other drugs

COCs can affect the metabolism of other drugs, which leads to an increase (cyclosporine) or a decrease (lamotrigine) of their concentration in blood plasma and tissues.

In vitro, ethinyl estradiol is a reversible inhibitor of CYP2C19, CYP1A1 and CYP1A2, as well as an irreversible inhibitor of CYP3A4 / 5, CYP2C8 and CYP2J2. In clinical trials, the administration of a hormonal contraceptive containing ethinyl estradiol did not lead to any increase or resulted only in a slight increase in the concentrations of CYP3A4 substrates in the blood plasma (midazolam), while the concentrations of CYP1A2 substrates in blood plasma may increase slightly (theophylline) or moderately (melatonin and tizanidine).

Trolandomitsin may increase the risk of intrahepatic cholestasis when taken together with birth control pills.

Pregnancy and breastfeeding

The use of Jaimiess for birth control is contraindicated during pregnancy and breastfeeding. If the pregnancy is revealed when on birth control pills, the drug should be immediately canceled. But studies have shown that children do not have any risk of developing defects if the mother used oral combination contraceptives before pregnancy or in its early stages.

Taking pills can reduce the amount of breast milk and change its composition, therefore, in the period of breastfeeding, the use of combined contraceptives is also contraindicated.

What if I miss a pill?

Try not to skip doses of COCs since this increases the risk of pregnancy.

If you miss an active tablet and remember it on the same day, take it as soon as possible and continue taking tablets in your usual dosing schedule. If remember about the missed pill the next day or if you miss more than 2 active tablets in a row, see the additional information leaflet that comes with the contraceptive or consult your gynecologist for further instructions. It’s recommended to use additional birth control methods (for example, condoms). If you are not sure about how to act in the case of skipping pills, use an additional birth control method until you consult your doctor.

Precautions

If you have any of the conditions/risk factors listed below, the drug can be used with caution and only after consulting a doctor.

Diseases of the cardiovascular system:

The results of epidemiological studies indicate a relationship between the use of COCs and an increased incidence of venous and arterial thrombosis and thromboembolism (deep vein thrombosis, pulmonary thromboembolism, myocardial infarction, cerebrovascular disorders). These diseases are rare.

The risk of venous thromboembolism is maximum in the first year of taking birth control pills. The studies suggest that this increased risk is predominantly present during the first 3 months.

The overall risk of venous thromboembolism in patients taking low-dose COCs.

Venous thromboembolism can be life-threatening or fatal (1-2% of cases).

Thrombosis of other blood vessels, such as the hepatic, mesenteric, renal, cerebral veins and retinal arteries or vessels, is extremely rare with this contraceptive.

Symptoms of deep vein thrombosis include unilateral swelling of the lower limb or along the vein, pain or discomfort only in an upright position or when walking, a local increase in temperature, redness or discoloration of the skin in the affected lower limb.

The symptoms of pulmonary thromboembolism (pulmonary embolism) are difficulty breathing or rapid breathing; a sudden cough, including hemoptysis; acute pain in the chest, which may increase with a deep breath; a sense of anxiety; severe dizziness; tachycardia or arrhythmia. Some of these symptoms (shortness of breath, cough) are nonspecific and may be misinterpreted as signs of other more or less severe conditions/diseases (respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. The symptoms of a stroke include sudden weakness or loss of sensation in the face, limbs, especially on one side of the body, sudden confusion, disorientation and dysarthria; sudden one or two-sided vision loss; sudden gait disturbance, dizziness, loss of balance or coordination of movements; sudden severe or prolonged headache for no apparent reason; loss of consciousness or fainting, epileptic seizures. Other signs of vascular occlusion include sudden pain, swelling and weak blueing of the extremities, “acute” stomach.

Symptoms of myocardial infarction include pain, discomfort, pressure, heaviness, feeling of compression or distension in the chest or behind the sternum, radiating to the back, jaw, upper limb, epigastrium; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety, or shortness of breath; tachycardia or arrhythmia. Arterial thromboembolism can be life-threatening or fatal.

In women with a combination of several risk factors or a high severity of one of them, the possibility of their mutual reinforcement should be considered. In such cases, the degree of risk increase may be higher than with a simple summation of factors. In this case, taking Jaimiess drug is contraindicated (see the “Contraindications” section).

The risk of thrombosis (venous and/or arterial) and thromboembolism or cerebrovascular disorders increases in the presence of multiple or pronounced risk factors for venous or arterial thrombosis:

  • a family history. Some blood counts may indicate susceptibility to the development of venous or arterial thrombosis, namely, resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant). In the case of hereditary or acquired predisposition, a woman should be examined by an appropriate specialist to decide on the possibility of taking birth control pills;
  • obesity;
  • elevated concentrations of fat metabolism products – cholesterol and triglycerides in the blood (dyslipoproteinemia);
  • subacute bacterial endocarditis;
  • arterial hypertension;
  • migraine without concomitant neurological symptoms;
  • valvular heart disease;
  • atrial fibrillation;
  • prolonged immobilization, serious surgery, any surgery on the lower limbs or extensive trauma. In these situations, it is necessary to stop taking the drug (in the case of a planned surgery – at least 4 weeks before it.

Temporary immobilization (for example, air travel over 4 hours) may also be a risk factor for developing VTE, especially if other risk factors exist: with age, smoking (with an increase in the number of cigarettes or an increase in age, the risk increases in women over 35 years of age).

The question of the possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial.

The increased risk of developing thromboembolism in the postpartum period should be considered.

Peripheral circulatory disorders can also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic-uremic syndrome, chronic inflammatory bowel disease (Crohn’s disease or ulcerative colitis), and sickle cell anemia.

An increase in the frequency and severity of a migraine during the use of COCs (which may precede cerebrovascular disorders) may be grounds for immediate discontinuation of the medication.

When assessing the relationship between risk and benefit, bear in mind that adequate treatment of the relevant diseases can reduce the risk associated with it. Bear in mind that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (

Tumors:

The most significant risk factor for developing cervical cancer is persistent papillomavirus infection. There are reports of some increase in the risk of developing cervical cancer with prolonged use of COCs. The connection with the reception of the drug has not been proved. There are contradictions regarding the extent to which these findings are associated with screening for cervical pathology or with the characteristics of sexual behavior (more rare use of barrier methods of contraception).

Peripheral circulatory disorders can also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic-uremic syndrome, chronic inflammatory bowel disease (Crohn’s disease or ulcerative colitis), and sickle cell anemia.

An increase in the frequency and severity of a migraine during the use of COCs (which may precede cerebrovascular disorders) may be grounds for immediate discontinuation of Jaimiess.

When assessing the relationship between risk and benefit, bear in mind that adequate treatment of the relevant diseases can reduce the associated risk. Bear in mind that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (

Other conditions:

Women with hypertriglyceridemia (or the presence of this condition in the family history) may have an increased the risk of developing pancreatitis. Although a slight increase in blood pressure has been described in many women taking COCs, a clinically significant increase was rarely observed. However, if a persistent, clinically significant increase in blood pressure develops while taking Jaimiess tablets, they should be discontinued. You can resume taking the drug if normal blood pressure values are achieved with the help of antihypertensive therapy. The following conditions have been reported during both pregnancy and use of combination oral contraceptives: cholestatic jaundice, itching; the formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis, Crohn’s disease and ulcerative colitis.

In women with hereditary forms of angioedema, exogenous estrogens can cause or worsen the symptoms of angioedema.

Acute or chronic liver dysfunction may require the withdrawal of the contraceptive until the liver function returns to normal. Relapse of cholestatic jaundice, which developed for the first time during a previous pregnancy or previous intake of sex hormones, requires discontinuation of the preparation.

Although COCs based on ethinyl estradiol and levonorgestrel may affect insulin resistance and glucose tolerance, there is usually no need to adjust the dose of hypoglycemic drugs in diabetic patients using low-dose combined oral contraceptives (

Chloasma can sometimes develop, especially in women with a history of pregnant chloasma. Women with a tendency to chloasma should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

Laboratory tests:

The use of birth control pills may affect the results of some laboratory tests, including biochemical parameters of the liver, thyroid gland, kidney and adrenal function, the concentration of transport proteins in plasma (globulin, binding corticosteroids, lipid/lipoprotein fractions, parameters of carbohydrate metabolism coagulation and fibrinolysis). These changes, as a rule, remain within normal physiological values.

Decreased efficiency:

The effectiveness of Jaimiess can be reduced in the following cases: when skipping pills, with vomiting and diarrhea, or as a result of drug interactions.

Effect on the nature of menstrual bleeding:

While taking oral hormonal contraceptives, irregular bleeding can occur (“spotting” or “breakthrough” bleeding), especially during the first months of use. Therefore, assessment of any irregular bleeding should be carried out only after a period of adaptation of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, a thorough examination should be performed to exclude malignant neoplasms or pregnancy.

Some women may not develop “withdrawal” bleeding during the phase of taking 7 inert tablets. If the contraceptive was taken as directed, it is unlikely that the woman is pregnant. Nevertheless, if the preparation was taken irregularly and if a woman did not have two “cancellation” bleedings in a row, pregnancy should be excluded before starting a new package of the contraceptive.

Medical examinations:

Before starting or resuming the use of Jaimiess, it is necessary to undergo a thorough general medical and gynecological examination, examination of the mammary glands. It’s also necessary to exclude pregnancy. The additional research and the frequency of control examinations is determined individually. Usually, control examinations are carried out at least once in 6 months.

A woman should be warned that COCs do not protect against HIV infection (AIDS) and other sexually transmitted diseases!

Conditions requiring urgent medical advice:

  • Any changes in the state of health, especially the occurrence of conditions listed in the sections “Contraindications” and “With caution”;
  • Local consolidation in the mammary gland;
  • Simultaneous intake of other drugs (see “Interactions”);
  • If prolonged immobility is expected, hospitalization or surgery is planned (at least 4-6 weeks before the intended operation);
  • Unusually heavy vaginal bleeding;
  • The pill was missed in the first week and you had sexual intercourse seven or fewer days before it;
  • You have no menstrual-like bleeding twice in a row or suspect that you are pregnant (do not start taking the tablets from the next package before consulting a doctor).

A woman should stop taking birth contral pills and immediately consult a doctor if there are possible signs of thrombosis, myocardial infarction or stroke.

Impact on the ability to drive vehicles and operate mechanisms:

  • Not found.

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