TriNessa Lo is a combination of female hormones (norgestimate and ethinyl estradiol) used as a contraceptive to prevent ovulation and pregnancy.
- Indications for use
- Mechanism of action
- Dosage and mode of application
- Side effects
- Pregnancy and breastfeeding
- What if I miss a pill?
- Oral contraception.
The active components of the drug suppress the release of gonadotropins, prevent the maturation of eggs in the ovaries and ovulation. In addition, the drug increases the viscosity of cervical mucus, which complicates the penetration of sperm into the uterus, and acts on the endometrial epithelium, reducing the likelihood of implantation.
Each pack of TriNessa Lo contains 28 tablets: active tablets are white (Day 1-Day 7), light blue (Day 8-Day 14) and dark blue (Day 15-Day 21). Inactive tablets are dark green (Day 22-Day 28).
The drug is taken orally. Take 1 tablet every day for 28 days in a row, without breaks. The interval between doses of the drug should not exceed 36 hours. Contraceptive pills are most effective when taken at the same time of day, for example, in the evening. Once you’ve finished the pack, start a new one immediately.
An overdose of TriNessa Lo (norgestimate and ethinyl estradiol) can cause vomiting, nausea, and vaginal bleeding. There is no specific antidote. In case of overdose, it is necessary to do a gastric lavage (within the first hour after taking the active pill) and to receive symptomatic therapy.
TriNessa Lo tablets can cause the following side effects:
- Cardiovascular system: arterial hypertension, myocardial infarction, cerebrovascular accident, deep vein thrombosis, arterial thromboembolism, pulmonary or other thromboembolism, edema;
- Tumors: benign and malignant tumors of the liver, cervical cancer and breast cancer.
- Hepatobiliary system: cholestatic jaundice, Budd-Chiari syndrome, intrahepatic cholestasis, cholelithiasis;
- Gastrointestinal tract: nausea, vomiting, abdominal pain, flatulence, colitis, anorexia.
- Genital organs: intermenstrual bleeding, spotting, amenorrhea, changes in the menstrual cycle, increase in the size of uterine fibroids, vaginal candidiasis, increase in cervical secretion, erosion of the cervix, decreased libido, premenstrual syndrome, temporary infertility after the end of the drug;
- Breast glands: soreness and sensation of tension, galactorrhea, engorgement, increase in size, decrease in lactation when taken immediately after birth;
- Skin: erythema nodosum, skin rash, chloasma, exudative erythema, acne, seborrhea, alopecia, hirsutism, pigment spots on the face, hypertrichosis, pemphigoid (gestational herpes), melasma with a tendency to persist;
- Organs of vision: cataract, lesion of the optic nerve, change in the curvature of the cornea, discomfort when wearing contact lenses;
- CNS: headache, mood changes, irritability, depression, chorea, dizziness, migraine,
- Metabolism: fluid retention, changes in body weight (decrease or increase), decreased glucose tolerance, changes in appetite;
- Kidneys: reduced kidney function, hemolytic-uremic syndrome;
- Others: kidney disease, decreased libido, depression, decreased glucose tolerance, changes in body weight.
With the onset of menstrual bleeding, the drug should be continued. If the bleeding does not stop, it is necessary to conduct an examination to eliminate organic causes. Similar recommendations also apply to vaginal bleeding that may occur irregularly over several cycles of the drug or for the first time after prolonged use of the drug. If bleeding does not occur at the end of the pack, it is necessary to exclude pregnancy before starting a new contraceptive pack.
- Venous thrombosis, including a history (deep vein thrombosis, pulmonary thromboembolism);
- Arterial thrombosis, including a history (acute cerebrovascular accident, myocardial infarction, retinal artery thrombosis) or precursors of thrombosis (angina pectoris or transient ischemic attack);
- The presence of serious or multiple risk factors for arterial thrombosis;
- Arterial hypertension (persistent increase in blood pressure above 160/100 mm Hg);
- Diabetes mellitus vascular disease;
- Hereditary dyslipoproteinemia;
- Hereditary susceptibility to venous or arterial thrombosis, for example, antithrombin-lll deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia, antiphospholipid antibodies (antibodies against cardiolipin, a group of antibodies against negatively charged phospholipids);
- Migraine with aura;
- Cerebrovascular disorders;
- Carcinoma of the breast and endometrium, other estrogen-dependent formations;
- Liver failure;
- Hemolytic anemia;
- Benign or malignant liver tumors;
- Cholestatic jaundice during pregnancy, including a history;
- Sickle cell anemia;
- Coronary heart disease;
- Bleeding from genitals of unknown etiology;
- Postmenopausal period;
- Age under 18 years;
- Postpartum period (4 weeks);
- Pregnancy and breastfeeding.
- Ulcerative colitis;
- Venous or arterial embolism in siblings or parents at a relatively young age;
- Prolonged immobilization or extensive surgery;
- Risk factors for coronary heart disease, such as smoking, hyperlipidemia, hypertension, or obesity;
- Arterial hypertension (persistent blood pressure levels 140-159 / 90-99 mm Hg);
- Thrombophlebitis of the superficial veins and varicose veins;
- Uterine fibroids;
- Diseases of the liver and gallbladder;
- Lesions of the valvular apparatus of the heart with complications (mitral stenosis with atrial fibrillation);
- Crohn’s disease;
- Hypertriglyceridemia, including a family history;
- Systemic lupus erythematosus;
- Kidney disease;
- Acute abnormal liver function during a previous pregnancy or prior use of sex hormones;
- Violations of the menstrual cycle.
- The metabolism of norgestimate and ethinyl estradiol is enhanced by Hypericum perforatum, barbiturates, carbamazepine, phenytoin, sulfonamides, derivatives of pyrazolone, rifampicin;
- When taken together with some antibiotics (for example, ampicillin or tetracycline), there is insufficient cleavage of estrogen conjugates and fatty acids by intestinal bacteria;
- Some protease inhibitors and some antiretroviral drugs (indinavir, ritonavir) can increase or decrease the concentration of combined hormonal contraceptives in the blood;
- When taken with hypoglycemic drugs, a patient may require their dose adjustment.
TriNessa Lo is contraindicated for use in pregnant women.
Epidemiological studies did not reveal an increase in the risk of birth defects in children whose mothers took norgestimate and ethinyl estradiol tablets before pregnancy. In most modern studies, the teratogenic effects, in particular, heart abnormalities and shortening of the extremities, were not found in the offspring of women who mistakenly took COCs during pregnancy.
The medication can affect lactation (reduce the amount and change the composition of breast milk). In addition, a small portion of the drug components can penetrate into breast milk. In this regard, TriNessa Lo is contraindicated for use during breastfeeding.
If you miss 1 active tablet in Week 1, 2 or 3, take the tablet as soon as you remember. If you miss 2 active tablets in Week 1 or Week 2, take 2 tablets the day you remember and 2 tablets the next day; and then take 1 tablet per day until you finish the pack. In addition, you should use a non-hormonal method of contraception such as a condom or spermicide if you have sexual intercourse in the next 7 days. If you miss 2 active tablets in Week 3 or miss 3 or more active tablets in a row, continue taking 1 tablet per day until Sunday. On Sunday, throw out the rest of the tablets and start a new pack that same day. In addition, you should use a non-hormonal method of contraception such as a condom or spermicide if you have sexual intercourse in the next 7 days.
Oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Before taking birth control pills, it is recommended that you conduct a thorough physical examination. Examinations should be periodically repeated in accordance with the standards of quality gynecological care.
Efficiency decreases with regular use of ethanol.
Impact on the ability to drive vehicles and control mechanisms have not been identified.