Kimidess is a biphasic birth control pill containing a combination of 2 female hormones: ethinyl estradiol and desogestrel.
Indications for use
The use of Kimidess is indicated in women of childbearing age for oral contraception.
Mechanism of action
Kimidess is a combination oral contraceptive (COC). Its action is based on the interaction of various factors, including the change in cervical secretion and suppression of ovulation. In addition to contraceptive properties, the drug has a number of other actions that can be taken into account when choosing a method of contraception. Menstrual periods become more regular and less painful, which reduces the likelihood of developing iron deficiency anemia.
Dosage and mode of application
Each Kimidess pack contains:
- 21 white round tablets each containing 0.15 mg of desogestrel and 0.02 mg of ethinyl estradiol;
- 2 light-green inert tablets (no hormones);
- 5 yellow tablets containing 0.01 mg of ethinyl estradiol.
The tablets are taken orally with plenty of water. Take 1 tablet daily, always at the same time for 21 days, strictly following the specified order of priority on the blister. Begin taking tablets from the next blister as soon as the previous one is empty (even if the menstruation has not stopped).
If you did not use oral contraception in the previous month, Kimidess should be taken on the 1st day of the period. If you start taking tablets on day 2-5, you need to use barrier methods of contraception in the first 7 days of the period.
When switching from another combined hormonal contraceptive, you should start taking Kimidess the day after the last active tablet of the previous drug was taken.
When switching from the transdermal patch or vaginal ring, Kimidess should be taken on the day of their removal, but not later than the proposed next application or the introduction of a new ring.
When switching from drugs, mini-pills can be taken on any day of the menstrual period.
When switching from progestagen-releasing intrauterine system or implant, mini-pills can be taken on the day they are removed,
When switching from injection contraception, the pills can be taken on the day of the next procedure.
Each of these transitions should be accompanied by the use of an additional barrier method of contraception during the first 7 days.
After an abortion in the first trimester, taking tablets should begin on the day of surgery without the use of additional contraception.
You can start using Kimidess 21-28 days after an abortion in the second trimester or delivery. If the use is started in a later period, the first 7 days should be supplemented with non-oral contraceptives. If a woman had sexual intercourse after an abortion or childbirth, she should exclude pregnancy before using Kimidess or postpone its use until the first menstruation.
In some cases, Kimidess can cause the following side effects:
- Cardiovascular system: thromboembolism or thrombosis (including myocardial infarction, deep vein thrombosis, stroke, thromboembolism of retinal arteries, pulmonary artery, mesenteric, hepatic, renal arteries and veins), increased blood pressure;
- Digestive system: ulcerative colitis, Crohn’s disease, cholelithiasis, exacerbation or appearance of jaundice and / or skin itching caused by cholestasis, abdominal pain, nausea, vomiting, diarrhea;
- Skin: Chloasma, especially in women with chloasma in a history of pregnancy, skin rash, hives, erythema multiforme, erythema nodosum;
- Reproductive system: Acyclic bloody discharge (usually in the first months of use), soreness and / or breast enlargement, chest pain, discharge from the mammary glands, discharge from the vagina.
- Other: systemic lupus erythematosus, porphyria, hemolytic-uremic syndrome, herpes of pregnant women, minor chorea, allergic reactions, hearing loss on the background of otosclerosis.
- Nervous system: migraine, headache, depression, decreased libido, mood swings, increased libido;
- Metabolism and nutrition: fluid retention, weight gain, weight loss;
- Immune system: hypersensitivity;
- Eyesight: intolerance to contact lenses.
Do not use Kimidess contraceptive if you have any of the following conditions:
- angina pectoris, transient attack of coronary heart disease and other harbingers of thrombosis;
- arterial or venous thrombosis and / or thromboembolism, including pulmonary embolism, deep vein thrombosis, stroke, myocardial infarction (including in the anamnesis);
- migraine with focal neurologic symptoms in the anamnesis;
- severe or multiple risk factors for arterial or venous thrombosis, including arterial hypertension with arterial pressure (BP) 160/100 mm Hg or higher;
- pronounced liver disease, including anamnesis;
- pancreatitis, which occurs with severe hypertriglyceridemia (including anamnesis);
- benign and malignant liver tumors, including in the anamnesis;
- diabetes mellitus, complicated by vascular lesions;
- vaginal bleeding of unknown etiology;
- hormone-dependent malignant neoplasms of the mammary glands and genitals;
- glucose-galactose malabsorption, lactose intolerance, lactase deficiency;
- children’s age (no data on the safety and efficacy of Kimidess in women under 18 years of age);
- the period of breastfeeding;
- smoking more than 15 cigarettes a day over the age of 35;
- hypersensitivity to the components of the drug (ethinyl estradiol and desogestrel).
If these pathologies develop during the period of Kimidess use, the drug must be canceled.
With caution: women over the age of 35; smoking, thromboembolic diseases in a family history at a relatively early age (in parents, brothers or sisters), dyslipoproteinemia, obesity (body weight index more than 30 kg / m2), arterial hypertension, valvular heart disease, migraine, atrial fibrillation, varicose veins, superficial thrombophlebitis, prolonged immobilization after extensive surgery, operation on the lower extremities or severe trauma (birth control pills should be discontinued 4 weeks before the scheduled operation and resumed after a full remobilization), diabetes mellitus, hemolytic-uremic syndrome, systemic lupus erythematosus, sickle-cell anemia, acute and chronically (including congenital hyperbilirubinemia such as Gilbert’s syndrome, Rotor, Dabin-Johnson syndrome), hypertriglyceridemia (including family history), chronic inflammatory bowel diseases (ulcerative colitis or Crohn’s disease), biochemical changes (including hyperhomocysteinemia, resistance to activated protein C, deficiency of antithrombin III, deficiency of protein C, deficiency of protein S, antiphospholipid antibodies (including antibodies to cardiolipin), lupus anticoagulant), the postpartum period.
If you need to use other medicines together with this contraceptive, you should first get a doctor’s consultation to avoid a decrease in the drug’s contraceptive effectiveness and the development of unwanted side effects.
Possible Kimidess interactions with other drugs:
- Inducers of microsomal liver enzymes (primidone, hydantoins, rifampicin, barbiturates, felbamate, bosentan, oxcarbazepine, ritonavir, modafinil, topiramate, griseofulvin, rifabutin, preparations containing St. John’s wort). In case of simultaneous use of these drugs, it is necessary to use an additional barrier method of contraceptive protection (for example, a condom) throughout the course of therapy and for 4 weeks after its completion. If there is a need for long-term use of induction drugs, you need to consider alternative non-hormonal contraceptive options;
- Ampicillin, tetracycline may reduce a contraceptive effect of Kimidess. In case of simultaneous use of antibiotics (except griseofulvin and rifampicin) and birth control pills, a barrier method of contraception should be used throughout the course of therapy and for a week after its completion;
- Atorvastatin and some combination oral contraceptives containing ethinylestradiol: the ethinyl estradiol AUC is increased by approximately 20%;
- Cyclosporine: ethinyl estradiol and desogestrel can increase its concentration of in blood plasma and tissues;
- Lamotrigine, morphine, salicylic acid: ethinyl estradiol and desogestrel can reduce its concentration in blood plasma and tissues;
- Indirect anticoagulants, tricyclic antidepressants, caffeine, clofibrate, anxiolytics (diazepam), theophylline, hypoglycemic drugs, glucocorticosteroids: their effectiveness decreases;
- Ascorbic acid can increase the concentration of ethinyl estradiol in the blood plasma (due to inhibition of conjugation).
Breastfeeding and pregnancy
Kimidess is contraindicated in pregnancy. The intake of oral contraceptives, which preceded pregnancy, does not increase the risk of various fetal defects. Unintentional use of hormonal contraceptives in the early stages of pregnancy does not have a teratogenic or mutagenic effect, does not affect the sex of the fetus. When pregnancy is established or suspected, the drug should be canceled.
If you are planning a pregnancy, the medication should be discontinued 3 months before the intended date of conception.
If you need no scheduled menstrual bleeding, you need to exclude pregnancy.
The drug is contraindicated during breastfeeding. If you need to use the drug during this period, you should stop breastfeeding. Ethinyl estradiol and desogestrel suppress lactation and affect the quality of milk. A small amount of active substances can be excreted in breast milk.
What if I miss a pill?
Delay in taking a dose of Kimidess can reduce the effectiveness of contraception. If a delay is less than 12 hours and the woman took the pill in this time interval, contraception is not violated, the use should be continued as usual. If a delay exceeds 12 hours, the following rules should be followed:
- If a delay occurred in the first week of the drug’s use, it is necessary to take the missed pill right away, as soon as you remember it, even if it means the simultaneous intake of 2 tablets, and to continue reception in the established mode. Use additional barrier contraception within the next 7 days. If a delay occurred at week 2, you should take the missed pill right away, as soon as you remember it, even if it means the simultaneous intake of 2 tablets, and continue taking the tablet according to the common scheme;
- If a delay occurred at week 3 of the course, the reliability of contraception may be reduced. You need to continue taking the tablets while applying additional barrier methods of contraception;
- If you missed inert tablets, discard them and continue taking the tablets according to the usual schedule.
If you have severe gastrointestinal disorders accompanied by vomiting and diarrhea, the absorption of the drug may be incomplete and cause a decrease in the reliability of contraception. If you have vomiting and diarrhea during the first 3-4 hours after taking a tablet, you need to take an additional tablet of Kimidess.
The use of birth control pills should be started only after consultation with a gynecologist, who will weigh the desired effect and the possible risk of the therapy.
A doctor should prescribe the drug on the basis of a detailed medical history and conduct a thorough examination based on common practice, including the measurement of blood pressure, examination of the abdominal cavity organs, mammary glands and pelvis (including cervical examination). A doctor may recommend additional examinations. During oral contraception, such examinations should be conducted at least once every 6 months.
The patient should be informed about the need to seek immediate medical attention if his condition worsens or when signs of risk factors appear.
A woman should know that Kimidess tablets can increase the risk of developing venous and arterial thrombotic and thromboembolic pathologies, such as deep vein thrombosis, myocardial infarction, pulmonary embolism, stroke, sometimes with a fatal outcome. These diseases occur extremely rarely and often in the first year of taking combined oral contraceptives.
If you develop thrombosis or have symptoms of cerebrovascular disorders, you need to stop taking contraceptive tablets.
Consider the possible impact of the prolonged use of the drug on the increased risk of cervical and breast cancer.
With hypertriglyceridemia, including a family history, there is a risk of developing pancreatitis.
With the development of persistent arterial hypertension on the background of hormonal contraception, Kimidess should be canceled and hypertension therapy should be prescribed.
You can resume oral contraception only after reaching a normal stable blood pressure.
In case of recurrence of cholestatic jaundice, acute or chronic functional disorders, the drug should be canceled before the liver function is normalized.
Women with diabetes need regular medical examinations.
Patients predisposed to chloasma should avoid ultraviolet irradiation and direct sunlight.
The contraceptive effect of the preparation can be disturbed by missing tablets, gastrointestinal disorders, or combined use of certain medicines.
The average adaptation period to taking Kimidess tablets lasts three months.
If you have a continuing irregular bleeding, you need to exclude pregnancy and tumors. For this, it is necessary to conduct appropriate studies, which may include diagnostic scraping.
If you have no menstrual bleeding, you need to see a doctor to exclude pregnancy.
The drug does not protect against sexually transmitted infections (including HIV (AIDS).
Hormonal contraceptives can influence the results of laboratory tests (the changes are usually within the limits of normal values).
Each tablet contains a small amount of lactose. The drug represents an unlikely threat of complications in women with lactose intolerance.
The use of Kimidess does not affect the ability of a patient to drive vehicles and work with mechanisms.
The drug is not prescribed for patients under the age of 18 since its safety and effectiveness in adolescent girls have not been studied.