Portia is a monophasic birth control preparation containing ethinyl estradiol and levonorgestrel. It is prescribed for the ovulation suppression as one of the means for pregnancy prevention.
Indications for use
- Oral contraception;
- Functional disorders of the menstrual cycle (including dysmenorrhea without an organic cause, dysfunctional metrorrhagia, premenstrual syndrome).
Mechanism of action
Portia is a medicinal product of the group of combined oral contraceptives. It is a monophasic drug, each tablet contains the same amount of estrogen and progestin components.
The mechanism of action is based on the pharmacological properties of the active components that make up its composition. So the drug blocks release substances of the hypothalamus (luteinizing and follicle-stimulating hormone), inhibits the secretion of gonadotropic hormones by the pituitary gland, which slows the maturation of the follicle and its rupture.
Thus, the drug active components depress ovulation, preventing fertilization and the onset of pregnancy.
In addition, the gestagen component – levonorgestrel – increases the viscosity of the cervical secretion, which makes it difficult to penetrate the spermatozoa into the uterine cavity. By changing the structure of the endometrium the implantation of a fertilized egg is prevented.
Mode of application and dosage
Oral administration. Portia is taken daily 1 tablet preferably at the same time.
If the woman in the previous cycle did not take the contraceptive and the doctor did not appoint otherwise: 1st pill should be taken on the 1st day of menstruation, and the tablets’ application continue for the 21st day. Then therapy is recommended to continue taking placebo pills for 7 days, during which menstrual bleeding occurs. After this, continue to take the next package containing 21 active tablets, and then 7 placebo pills – without breaks. Each cycle of admission begins on the same day of the week.
- Severe hepatic disorders inclusively of congenital hyperbilirubinemia – Gilbert’s, Dubin-Johnson’s and Rotor’s syndromes );
- Severe cardiovascular and cerebrovascular disorders;
- Thromboembolism and predisposition to it;
- Malignant tumors (primarily breast or endometrium cancer);
- Hepatic tumors;
- Familial hyperlipidemia;
- Severe forms of hypertension;
- Endocrine disorders inclusively of severe forms of diabetes mellitus;
- Sickle-cell anemia;
- Chronic hemolytic anemia;
- Vaginal bleeding of unclear etiology;
- Vesicular mole;
- Idiopathic jaundice of pregnant women in the medical history;
- Severe pruritus of the pregnant woman;
- Herpes during pregnancy;
- Age over 40 years;
- Hypersensitivity to the drug components.
Caution should be taken when Portia is used in the following cases:
- hepatic and gallbladder dysfunctions;
- ulcerative colitis;
- uterine myoma;
- renal disorders;
- diabetes mellitus;
- disorders of the cardiovascular system;
- arterial hypertension;
- disordered renal function;
- varicose veins;
- multiple sclerosis;
- rheumatic chorea;
- adolescent age (without regular ovulatory cycles).
Portia is usually well tolerated provoking few side effects.
Possible transient side effects spontaneously occurring:
- breast tenderness;
- weight and libido changes;
- mood changes;
- acyclic spotting.
There are some cases of:
- eyelid edema;
- visual impairment;
- discomfort when wearing contact lenses (these phenomena are temporary and disappear after withdrawal without prescribing any therapy).
In the case of the long-lasting administration there are observed:
- hearing loss;
- generalized pruritus;
- calf muscle cramps;
- increased frequency of epileptic seizures.
Such side effects are observed rarely.
There are absolutely rare cases of negative reactions such as:
- decreased glucose tolerance;
- increased blood pressure (BP);
- thrombosis and venous thromboembolism;
- skin rashes;
- changes in the nature of vaginal secretion;
- vaginal candidiasis;
- increased fatigue;
- Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives are capable to improve the metabolism of the used hormones.
- Reduction of contraceptive effect can be observed in the case of simultaneous administration with some antimicrobial agents (including ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines), which is associated with the intestinal microflora changes.
- When used simultaneously with anticoagulants, coumarin or indanedione derivatives, it may be mandatory to get an additional prothrombin index and dose’s change of the anticoagulant.
- With the use of tricyclic antidepressants, maprotiline, beta-blockers their bioavailability and toxicity may be increased.
- When using oral hypoglycemic drugs and insulin, it may be necessary to change their dose.
- When combined with bromocriptine, its effectiveness decreases.
- When combined with drugs with a potential hepatotoxic effect, for example, with dantrolene, there is an increase in hepatotoxicity, especially in women older than 35 years.
What if I miss a dose?
If the tablet was skipped within the prescribed period of time:
- the missed tablet should be taken within the next 12 hours. In this case, there is no need for additional methods of contraception. The remaining tablets are recommended at the usual time.
- if more than 12 hours have passed, the last missed tablet should be taken and continue taking the drug in the usual pattern. In this case, additional methods of contraception (barrier methods, spermicides) should be used within the next 7 days.
Portia and pregnancy
Portia is contraindicated in pregnancy and lactation.