Wera is a low dose monophasic birth control. It contains 2 female hormones: progestin and estrogen to prevent pregnancy.
Indications for use
Mechanism of action
Wera relates to a contraceptive means. It is a combined low dose drug containing estrogen and progestin. It is devoted to inhibits pituitary secretion of gonadotropic hormones. The main mechanism for achieving a contraceptive effect includes due to the blocking effect of the gestagen and estrogenic drug components influencing the hypothalamic-pituitary-ovarian system.
Ethinyl estradiol is the estrogen component which is known as a synthetic analog of the follicular hormone – estradiol, which takes part in the formation of the hormone of the corpus luteum (progestin) in the menstrual cycle regulation and even formation. The progestin component is norethisterone acetate, which suppresses LH and FSH synthesis by the pituitary gland (preventing follicle maturation). It results in blocking ovulation. Due to the combination of estrogen with progestin, Wera when taking correctly can both stimulate and delay menstruation and help arrest acyclic uterine bleeding.
Mode of application and dosage
Wera is a birth control containing estrogen and progestin. The duration of the regimen is 28 days. 21 pills of Wera contains the definite hormone dosage when the latest 7 are considered to be placebo containing no hormone. A pill should be taken daily at one and the same time. The daily regimen allows regulating the hormone level in the female body to proper suppression of ovulation. A pill should be washed down with water. The second third days of placebo application will bring menstruation.
Wera is contraindicated in the following cases:
- hypersensitivity to norethindrone and ethinyl estradiol;
- venous and arterial thrombosis/thromboembolism diagnosed currently or transferred prior;
- conditions ongoing to thrombosis inclusively of angina pectoris;
- congenital or gained predisposition to arterial or venous thrombosis;
- currently diagnosed or prior transferred cerebrovascular disease (stroke, transient ischemic attacks);
- multifold or severe risk factors for venous or arterial thrombosis;
- dyslipoproteinemia of severe form;
- uncontrolled high blood pressure;
- severe surgical intervention;
- immobilization for a long period of time;
- air flight lasting more than 4 hours;
- surgery on the lower limbs and pelvic organs;
- neurosurgical interventions;
- smoking over the age of 35;
- migraine complicated by focal neurological signs diagnosed or found in the medical history;
- diabetes exacerbated by vascular dysfunctions;
- diagnosed or transferred pancreatitis with severe hypertriglyceridemia;
- hepatic failure and severe hepatic disease, including Dubin-Johnson and Rotor syndromes;
- hepatic tumors (benign or malignant): diagnosed or transferred;
- determined hormone-dependent malignant neoplasms (including genitals or mammary glands);
- children and adolescents (until 18 age);
- vaginal bleeding of unknown origin;
- obesity (body mass index more than 30 kg/m2);
- major injury;
- intolerance to galactose, lactase deficiency or malabsorption of glucose-galactose, fructose intolerance or deficiency of sucrase-isomaltase;
- diagnosed or suggested pregnancy;
- breastfeeding period.
- Infectious and parasitic diseases: vulvovaginitis/vaginitis, vaginal candidiasis or other fungal vulvovaginal infections; adnexitis, urinary tract infections, cystitis, mastitis, cervicitis, candidiasis, herpes of oral cavity, fungal infections, influenza, sinusitis, upper respiratory infections, bronchitis, viral infection.
- Benign, malignant and unspecified neoplasms: uterine fibroids, breast lipoma.
- Immune system: allergic reactions.
- Endocrine system: virilism.
- Hematopoietic system: anemia.
- Metabolism and nutrition: increase in appetite, anorexia.
- Nervous system: headache, dizziness, migraine, ischemic stroke, cerebrovascular disorders, dystonia.
- Organ of vision: dryness of the mucous membrane of the eyes, irritation of the mucous membrane, oscillopsia, visual impairment; intolerance to contact lenses.
- Organ of hearing and labyrinth disorders: sudden hearing loss, tinnitus, dizziness, hearing loss.
- Mental disorders: decrease in mood; depression, mental disorders, insomnia, sleep disorders, aggression, mood change, decrease in libido, increase in libido.
- Cardiovascular system: “hot flashes”, increase in blood pressure, decrease in blood pressure, cardiovascular dysfunctions, tachycardia, venous and arterial thromboembolic complications, thrombophlebitis, diastolic hypertension, orthostatic circulatory dystonia, varicose veins, venous pathology.
- Respiratory system: bronchial asthma, hyperventilation.
- Gastrointestinal tract: abdominal pain, including pain in the upper and lower abdomen, discomfort/bloating, nausea, vomiting, diarrhea, gastritis, enteritis, dyspepsia.
- Skin and subcutaneous tissues: acne, alopecia, rash (including macular rash), pruritus, allergic dermatitis, eczema, psoriasis, hyperhidrosis, chloasma, pigmentation disorder/hyperpigmentation, seborrhea, dandruff, hirsutism, skin pathology, skin reactions, orange peel, spider veins, urticaria, erythema nodosum, erythema multiforme.
- Musculoskeletal system: back pain, discomfort in the muscles and skeleton, myalgia, pain in the limbs.
- Genital organs and the mammary gland: pain in the mammary gland, discomfort, changes in the volume, duration and interval of menstrual bleeding, secretions from the genital tract, ovarian cyst, pain in the pelvic area, cervical dysplasia, uterine appendage cysts, cysts of the mammary glands, fibrocystic mastopathy, dyspareunia, galactorrhea, menstrual disorders, mammary glands secretions.
- General disorders and disorders at the injection site: fatigue, asthenia, feeling unwell; chest pain, peripheral edema, influenza symptoms, fever, irritability, fluid retention.
Barbiturates, antiepileptic drugs (carbamazepine, phenytoin) magnify steroid hormones’ metabolism. Antibiotics (ampicillin, rifampicin), changing the intestinal microflora, decrease the reliable concentration. Means for local anesthesia, narcotic analgesics, anxiolytics, antiepileptic drugs, some antihypertensive drugs, ethanol reduces the contraceptive reliability. The correction of the dosing regimen of hypoglycemic drugs may be required if taken together with Wera.
What if I miss a dose?
If a woman is late in taking the pill for less than 12 hours, there is no effect on the contraceptive reliability. The pill must be taken immediately, as soon as the woman understands the pill is missed. The next tablet should be applied at a common time.
If a woman is late in taking the tablet for more than 12 hours, there is a dramatic effect on the contraceptive reliability. The risk to become pregnant is higher than average. In this case, you must follow the basic regulations and apply proper measures:
- the tablets’ application should never be interrupted for more than 7 days;
- it is required a 7-day period of continuous administration of pills to reach the mandatory suppression of the hypothalamic-pituitary-ovarian system.
Wera and pregnancy
Wera is prescribed as a means to prevent pregnancy but contraindicated during pregnancy. It is a confirmed fact that the application of birth control pills at the early stages of pregnancy may provoke developmental defects in the fetus. When the diagnosis “Pregnancy” is established any hormonal contraception should be withdrawn.
Breastfeeding is also a period during which it is banned to take Wera. It is necessary to discontinue the preparation while breastfeeding as breast milk composition may be influenced by hormones.