- Name: Jolessa
- Common brands: Altavera, Alysena, Amethyst, Aviane, Jolessa, Seasonale, Quasense, Introvale
- Active ingredient: Ethinyl Estradiol and Levonorgestrel
- Manufacturer: Teva Pharmaceuticals
- Hormonal component: progestin and estrogen
- Release form: pills
- Hormone dose: low dose
- Type: monophasic
- Dosage: 0.15mg/30mcg
- Quantity: 91 pills
- Age: 18 – 40 years
- Average price: $115
Jolessa is a 91-day cycle contraceptive containing a combination of 2 hormones: ethinyl estradiol and levonorgestrel, that prevent ovulation.
Indications for use
- Oral contraception;
- Functional menstrual disorders (including dysmenorrhea without an organic cause, dysfunctional metrorrhagia);
- Premenstrual tension syndrome.
Mechanism of action
Jolessa is a combined monophasic oral hormonal contraceptive. When ingested, the medication depresses the pituitary secretion of gonadotropic hormones. The contraceptive effect is associated with several mechanisms.
Levonorgestrel blocks the release of LH and FSH from the hypothalamus, oppresses the pituitary gland by gonadotropic hormones, which leads to inhibition of maturation and release of the ovum ready for fertilization (ovulation). The contraceptive effect is enhanced by ethinyl estradiol. The preparation reserves high viscosity of the cervical mucus (making it difficult for sperm to enter the uterine cavity). With regular use, the drug normalizes the menstrual period and helps prevent some gynecological diseases, including tumors.
Dosage and mode of application
Jolessa extended-cycle pack contains 91 tablets (a 13-week supply of tablets):
- 84 pink active tablets, each containing 0.15 mg of levonorgestrel and 0.03 mg of ethinyl estradiol;
- 7 white inert tablets without hormones.
Take 1 tablet orally at the same time of a day with a small amount of liquid for 91 days in a row.
If you did not use hormonal contraception during the previous menstrual period, you start taking Jolessa pills on the 1st day of your period, according to the instructions. Menstrual bleeding occurs 2-3 days after you start taking inert tablets. Start using a new pack of the medication without interruption, even if the bleeding did not stop.
When switching to Jolessa from another oral contraceptive, a similar scheme is used.
The drug is taken as long as you need contraception.
After an abortion: it is recommended to start taking the tablets on the day of abortion or the day after the operation.
After a childbirth: Start taking the pills on the 1st day of menstruation (the drug can only be used by women who are not breastfeeding).
Jolessa contraceptive is usually well tolerated. Possible side effects include:
- breast engorgement;
- weight change;
- libido change;
- mood changes;
- acyclic spotting;
- eyelid edema;
- visual impairment;
- discomfort when wearing contact lenses.
These phenomena are temporary and disappear after Jolessa withdrawal without any therapy.
With long-term use, the drug can cause the following adverse reactions (rarely):
- hearing loss;
- generalized pruritus;
- calf muscle cramps;
- increased frequency of epileptic seizures;
- decreased glucose tolerance;
- increased blood pressure;
- thrombosis and venous thromboembolism;
- skin rashes;
- a change in the nature of vaginal secretion;
Absolute contraindication for Jolessa tablets include:
- severe liver diseases (including congenital hyperbilirubinemia – syndromes Gilbert, Dubin-Johnson and Rotor);
- severe cardiovascular and cerebrovascular diseases (including in the anamnesis);
- thromboembolism and predisposition to it;
- malignant tumors (primarily breast cancer or endometrium);
- liver tumors;
- family forms of hyperlipidemia;
- severe forms of hypertension;
- endocrine diseases (including severe forms of diabetes mellitus);
- sickle cell anemia;
- chronic hemolytic anemia;
- vaginal bleeding of unknown etiology;
- bubble skidding;
- idiopathic jaundice of pregnancy in the anamnesis;
- severe itching of pregnancy;
- herpes gestationis;
- age over 40 years;
- lactation period (breastfeeding);
- hypersensitivity to the components of the drug (ethinyl estradiol and levonorgestrel).
- diseases of the liver and gallbladder;
- ulcerative colitis;
- myoma of the uterus;
- diseases of the kidneys;
- diabetes mellitus;
- diseases of the cardiovascular system;
- arterial hypertension;
- impaired renal function;
- varicose veins;
- multiple sclerosis;
- lesser choree;
- adolescence (without regular ovulatory periods).
Caution should be taken when using Jolessa in combination with the following drugs:
- barbiturates, some antiepileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives;
- some antimicrobial agents (including ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines);
- anticoagulants, coumarin or indanedione derivatives;
- tricyclic antidepressants, maprotiline, beta-blockers;
- oral hypoglycemic drugs and insulin;
- drugs with a potential hepatotoxic effect, for example, dantrolene.
Breastfeeding and pregnancy
Jolessa drug is contraindicated in pregnancy and lactation (breastfeeding).
What if I miss a pill?
The missed tablet should be taken within the next 12 hours. If 36 hours have elapsed since taking the last pill, contraception is considered unreliable. To avoid intermenstrual bleeding, continue taking Jolessa pills from the already started package, with the exception of the missed tablet (s). If you missed active tablets, it is recommended to use additional non-hormonal methods of contraception during the current period (for example, barrier birth control). If you missed an inert tablet, just throw it away since it contains no medication and act as a reminder.
A general medical and gynecological examination is required before starting the use of Jolessa and every 6 months during therapy. The examination includes cytological analysis of the smear from the cervix, assessment of the condition of the mammary glands, determination of blood glucose, cholesterol and other indicators of liver function, control of blood pressure, urinalysis.
The use of hormonal birth control pills by young women with thromboembolic disease is not recommended.
The use of oral contraception is allowed no earlier than 6 months after the transferred viral hepatitis, after hepatic functions are normalized.
If you have sharp pains in the upper abdominal areas, hepatomegaly and signs of intra-abdominal bleeding, you need to exclude a liver tumor. If necessary, the drug should be discontinued.
If you have a liver violation during the use of the drug, a consultation of the therapist is required.
When acyclic (intermenstrual) bleeding occurs, continue taking Jolessa. In most cases, these bleedings spontaneously cease. If acyclic (intermenstrual) bleeding does not disappear or recur, a medical examination should be performed to exclude the organic pathology of the reproductive system.
If you have vomiting or diarrhea, continue taking the pills and use another, non-hormonal method of contraception.
Smoking women taking hormonal contraceptives have an increased risk of developing cardiovascular diseases with serious consequences (myocardial infarction, stroke). The risk increases with age and depending on the number of cigarettes smoked (especially in women older than 35 years).
Jolessa tablets should be discontinued in the following cases:
- a first-time or increased migraine;
- an unusually strong headache;
- early signs of phlebitis or phlebothrombosis (unusual pain or bloating of the veins on the legs);
- jaundice or hepatitis;
- cerebrovascular disorders;
- stitching pains of unclear etiology with breathing or coughing, pain and a feeling of pressure in the chest;
- acute deterioration of visual acuity;
- a suspicion of thrombosis or a heart attack;
- a sharp increase in blood pressure;
- generalized itching;
- increased epileptic seizures;
- 3 months before the planned pregnancy;
- approximately 6 weeks before the planned surgical intervention;
- prolonged immobilization;
- the onset of pregnancy.
The drug does not affect the ability to drive vehicles and work with other mechanisms.