Janine

Among all the pharmacological agents currently used for pregnancy prevention, birth control pills with hormones are considered by experts to be the most effective.

The contraceptive hormone preparation Jeanine (Jeanine) is manufactured by the famous German pharmaceutical company Bayer Schering Pharma, GmbH AG.

Indications Janine

Indications for use of Jeanine - prevention of unwanted pregnancy. In addition, this drug can be prescribed as a hormonal contraceptive for those women who suffer from acne, seborrhea, hirsutism (excessive growth of hard male type) or androgenic alopecia (male pattern baldness).

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Release form

The form of the preparation is white color dragee; one dragee contains 30 mcg of ethinyl estradiol, 2 mg of dienogest, and also auxiliary substances (lactose monohydrate, potato starch, gelatin, talc, magnesium stearate).

Pharmacodynamics

The contraceptive effect of Jeanine, like most contraceptives of the new generation, is based on a dual effect on the hormonal sphere of a woman. In one sense, this is suppression of ovulation, on the other - a change in the degree of viscosity of mucus in the cervix (cervical mucus). The contraceptive mechanism of Jeanine is strengthened by the third component due to changes in the inner mucosa of the uterus (endometrium), which makes it impossible to introduce a fertilized egg into it.

[4], [5], [6], [7]

Pharmacokinetics

Pharmacodynamics Zhanina due to the combined action of ethinyl estradiol and dienogest. Ethinyl estradiol is a synthetic estrogen, that is, a hormone that is naturally produced by female ovaries. Ethinyl estradiol causes the synthesis of binding sex steroids - blood plasma proteins that are involved in the transport of sex hormones in the body.

Dienogest is the newest synthetic progestin, which is analogous to the action of the natural female hormone progesterone. By the time of ovulation, the viscosity of the mucus decreases, and this is favorable for the passage of spermatozoa. A dienogest increases the viscosity of mucus in the cervical canal so much that it becomes an insurmountable barrier to sperm. In addition, dienogest has an antiandrogenic effect (suppresses the production of male hormones) and progestagenic effect (does not allow ripening of follicles and thereby prevents the onset of ovulation).

Zhanin's pharmacokinetics is due to the fact that the active substances of this drug bind to blood plasma proteins, which affects their distribution. Ethinyl estradiol for a short time is completely absorbed in the gastrointestinal tract, and more than 98% of the substance binds to the albumen blood albumin, the rest is in the blood in a free form. Absolute bioavailability of this synthetic hormone is low - no more than 44%. It is transformed by hydrooxidation into the mucosa of the small intestine and the liver, the products of its metabolism are excreted in the urine and bile.

Dienogest is also rapidly absorbed, but its bioavailability is much higher - 96%. Almost 90% of the synthetic progestin binds to albumin, and about 10% remains in the blood in a free form. In the course of chemical processes in the body, it is almost completely metabolized. Only a very small part of the dienogast is excreted by the kidneys unchanged, and the intermediate products of its chemical changes in the cells of the body (metabolites) are also excreted together with urine and bile.

[8], [9], [10], [11], [12]

Dosing and administration

Dragee Janine is taken orally, with a small amount of water. On the packaging, the manufacturer specified the order of reception exactly: for 21 days, one tablet a day - at about the same time. You need to start taking Jeanine on the first day of the menstrual cycle.

And before the start of each next package, you need to take a break for seven days. During this break, bleeding similar to menstrual bleeding is observed. As a rule, it begins on the second-third day after the last dragee is received from the package. And before the start of taking a new package may not end.

If the woman before Zhanin used other hormonal contraceptive pills or patches, then you should start taking Jeanine the day after taking the last pill of the previous drug. And if you used a transdermal contraceptive in the form of a patch, then Janine should be taken on the same day when the band-aid was removed.

As already noted, taking Jeanine should be at the same time. If the woman did not take the pills in time, then she should take it at the first opportunity. The fact is that the contraceptive protection of the drug is reduced when the delay in its regular application is 12 hours or more.

If within 7 days before the first missed reception the woman took the pills in the due time, you do not need to use additional measures of protection. However, serious consideration should be given to additional protection when the woman did not take two or more pills.

[18], [19], [20], [21], [22]

Use Janine during pregnancy

Use of Zhanin during pregnancy and during lactation is unacceptable. In cases where pregnancy is detected during the use of Zhanin, the drug must be immediately canceled. Breastfeeding should be borne in mind that combined contraceptives in tablets can significantly reduce the amount of breast milk, and sex hormones and "waste" of contraceptive oral products fall into the milk.

Contraindications

Contraindications Zhanina concern the following diseases: venous and arterial thrombosis; pulmonary embolism; angina pectoris; myocardial infarction; diseases of the coronary arteries of the heart; diabetes; systemic lupus erythematosus; angioedema; Migraine with focal neurological symptoms; cerebrovascular disease; hepatic insufficiency and severe liver disease; pancreatitis; tumors of genital organs or mammary glands (including suspicion of them); vaginal bleeding.

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Side effects Janine

Side effects of Zhanin can be in the form of irregular bleeding (from small bloody discharge to sudden severe bleeding), especially in the first months of taking the drug.

The most frequent side effects of Zhanin are pain in the abdomen, nausea, vomiting, pain in the mammary glands, as well as their swelling and feeling of bursting. In addition, there is often increased appetite and weight fluctuations (upward), headache, tinnitus, tachycardia, edema, diarrhea, skin rash, skin pigmentation disorder, sleep disturbance, depressive condition.

In some women, prolonged use of hormonal contraceptives can lead to infection of the urinary tract, cystitis, mastitis, cervicitis, fungal infections, candidiasis, uterine myoma, breast lipoma.

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Overdose

An overdose of Janine can be manifested in the form of nausea, vomiting, spotting spotting or not associated with the menstrual cycle of uterine bleeding (metrorrhagia).

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Interactions with other drugs

The interaction of Jeanine with other drugs can lead to breakthrough bleeding and a decrease in the reliability of contraceptive protection. And the parallel use of drugs such as phenytoin, primidone and carbamazepine (antiepileptic drugs), barbiturates (hypnotics and anticonvulsants) and anti-tuberculosis antibiotic rifampicin, can lead to an increase in the rate of clearance (clearance) of body tissues from sex hormones and impaired hepatic metabolism. The same interaction of Zhanin with other drugs is possible with the use of oxcarbazepine, topiramate, felbamate, griseofulvin, as well as medicines, which contain a medicinal plant St. John's Wort (hypericin, deprim, deprim forte, neustin, turyneurin).

Due to the fact that some antibiotics - including the penicillin and tetracycline groups - are able to reduce the circulation of estrogen, their intake with dragee Jannin reduces the concentration of the synthetic hormone ethinyl estradiol in the gastrointestinal tract.

[24], [25], [26],

Storage conditions

In accordance with the instructions attached to the drug, it must be stored out of the reach of children at a temperature of not more than + 25 ° C.

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Special instructions

It must be remembered that any hormone-containing medications should be taken as prescribed by the doctor. If the doctor does not find contraindications to the use of Zhanin, then during her admission the woman needs to undergo a control examination at least once every 12 months.

Shelf life

The shelf life of the drug Zhanin since its release is 3 years.