Marvelon

Marvelon belongs to the category of hormonal contraceptives used for oral administration.

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Indications Marvelona

It is used as a means of preventing the possibility of unwanted pregnancy.

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Release form

The release is carried out in the form of tablets, 21 pieces inside a blister plate. Inside a separate pack there are 1, 3 or 6 blister packs.

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Pharmacodynamics

The drug's constituent components - desogestrel (used as a progestin element) and ethinyl estradiol (used as an estrogen substance) - allow it to exert a strong contraceptive effect of the estrogen-progestogen type, thereby preventing unwanted pregnancy.

Along with this, the drug has many other positive effects:

• stabilizes the menstrual cycle and reduces the pain of menstruation, as well as its severity;
• reduces the likelihood of developing iron deficiency anemia;
• reduces the possibility of developing fibroadenomatosis;
• prevents the occurrence of cysts, and in addition, the development of inflammation in the pelvis;
• prevents ectopic pregnancy;
• reduces the risk of developing cancer.

The contraceptive effect of the drug develops due to the ability of the active components to suppress the ovulation process and increase the volume of cervical mucus produced.

The progestogen element desogestrel helps to slow down the production of luteinizing hormone and follicle-stimulating hormone (FSH) through the gonadotropic cells of the anterior pituitary lobe, which makes natural maturation of the follicle impossible. As a result, the ovulation process is blocked.

Among other properties of desogestrel:

• affecting the composition of the mucus that passes through the cervical canal, which leads to its thickening. As a result, it becomes a serious obstacle to the penetration of sperm;
• facilitating a reduction in estradiol levels to the level observed in the early follicular stage;
• does not cause any significant disturbances in the metabolic processes of lipids with carbohydrates. On the contrary, after the use of desogestrel, the level of HDL in the blood plasma increases, and the LDL indicators remain at the same level;
• does not affect hemostasis values;
• reduces the volume of blood lost during menstruation in women who previously experienced menorrhagia (heavy menstrual bleeding), which was accompanied by severe blood loss exceeding physiological norms;
• improving the condition of the skin surface if acne is present;
• stabilization of the menstrual cycle;
• prevention of the occurrence of certain gynecological pathologies, including tumor-type diseases.

Ethinyl estradiol is an artificially created hormonal component from the estrogen category. In its medicinal properties, it is similar to the main, most active female sex hormone - the substance estradiol.

When ethinyl estradiol is consumed inside the body, the following occurs:

• an increase in endometrial tissue, which is caused by an increase in the activity of endometrial cell division processes;
• stimulation of uterine development, and in addition to this, the development of underdeveloped female sexual characteristics of a secondary type;
• reduction or complete elimination of complications associated with poor functioning of the sex glands;
• lowering cholesterol levels in the blood;
• stimulation of an increase in the level of β-lipoproteins in the blood;
• increased sensitivity to insulin;
• stabilization of the processes of utilization of the element glucose occurring in the body.

The use of large doses of ethinyl estradiol reduces the activity of pituitary FSH production, while small doses, on the contrary, increase it.

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Pharmacokinetics

Desogestrel is completely and fairly quickly absorbed from the gastrointestinal tract after oral administration. Inside the body, the component undergoes biotransformation, transforming into etonogestrel.

The bioavailability of desogestrel ranges from 62-81%. With daily use of the substance, serum levels of etonogestrel increase approximately 2-3 times.

Desogestrel, as well as the products of its decay formed during biotransformation, are excreted in the urine and through the kidneys.

Etonogestrel is capable of 40-70% synthesis with the SHBG element, and in addition with albumin. Only 2-4% of the component has a free form.

Ethinylestradiol stimulates a threefold increase in SHBG values, which causes an increase in the SHBG-associated fraction of the etonogestrel element. At the same time, a decrease in the fraction associated with albumin occurs.

Ethinyl estradiol undergoes complete biotransformation inside the body, and its absorption in the gastrointestinal tract after oral administration of the tablet is complete and rapid. The bioavailability values of the element reach approximately 60%.

The main process in the metabolism of ethinylestradiol is aromatic hydroxylation. The decay products formed during biotransformation are excreted through the kidneys, and also with urine and bile (in a ratio of 4 to 6).

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Dosing and administration

Marvelon must be taken orally - 1 tablet at the same time of day, without chewing it, and with water.

The treatment course usually lasts for 3 weeks. The subsequent use of the drug occurs 1 week after the completion of the 1st course. The break is due to the fact that during these 7 days the woman should have her period.

It usually starts on the 2nd-3rd day after taking the last tablet, and sometimes it may not end until the start of the next course of Marvelon.

If hormonal contraception was not used during the previous menstrual cycle, you should start taking the pills on the 1st day of the new cycle.

In addition, it is allowed to start using the drug between days 2-5 of the cycle. But it is necessary to take into account that the contraceptive effect of the drug manifests itself only after 7 days. Because of this, in the 1st week of use, it is necessary to combine the drug with some non-hormonal contraceptives.

In case of switching to Marvelon after using other hormonal contraceptives, the most optimal option would be to start taking it the next day after using the last tablet of the previously taken medication.

When switching from progestogen-only drugs (injectable contraceptives, mini-pills and implants) to estrogen-progestogen-only contraceptives, it is necessary to start using the drug:

• after using the mini-pill, any day is suitable for starting therapy;
• when using an implant, you need to start taking it immediately on the day of its removal;
• for the injection method - start on the day when the next injection is expected.

It is also necessary to take into account that in all these cases, during the first week of the course, it is necessary to supplement the drug with other contraceptives.

Women who have had an abortion in the first trimester are allowed to start taking the medication immediately without using additional contraception.

Women who have given birth or after an abortion in the 2nd trimester are required to start the course on the 21st or 28th day. When starting to use Marvelon at later stages, barrier contraception is required in the 1st week of this course.

Moreover, if a woman who has given birth or had an abortion has already had sexual intercourse before starting to use the drug, it is necessary to first exclude the possibility of a new pregnancy.

The instructions indicate that if a dose is missed, the contraceptive effect remains reliable for the next 12 hours. The woman should take the pill as soon as she remembers about it, and take all subsequent pills as usual at the same time.

If the 12-hour interval between drug intakes is exceeded, its contraceptive effect is weakened.

If you miss a dose during the first 7 days of the course, it is recommended to take the required dose immediately after being told to do so (even if it is necessary to take 2 tablets of the drug at the same time).

The course then continues in the above-mentioned regimen, but the intake of the drug is supplemented by the use of barrier contraception. In situations where a woman has had unprotected sexual intercourse in the previous 7 days, the possibility of conception in this period must be taken into account. In this case, the greater the number of missed pills, and the longer the break between taking the drug and the moment of sexual intercourse, the higher the risk of pregnancy for a woman.

If a dose is missed during the 2nd week of therapy, a new tablet must be taken immediately after this fact is remembered, and then continue using the drug according to the above rules of administration.

If the medicine was taken daily during the 7 days before the missed tablet, there is no need to use additional contraceptive methods. If there are any missed tablets during this period or if more than 1 tablet has been missed at the moment, it is necessary to use barrier contraception for 7 days.

If a dose is missed during the 3rd week of use, the level of reliability of the contraceptive effect may be weakened - this is caused by the subsequent pause in the use of the drug. To avoid such an effect and the need to use barrier contraception, it is necessary to change the regimen of use of the drug.

It is mandatory for the patient not to miss doses of the medication during the previous week. If this condition is not met, after resuming the use of the drug, it is necessary to combine it with other contraceptives.

The missed dose must be taken as soon as the missed dose is discovered, even if this means taking 2 tablets at once. After this, the dose is taken as normal.

A new pack should be started at the end of the previous one, without taking breaks between different packs. The risk of vaginal bleeding in this case (before the end of the 2nd pack) is considered unlikely. But it cannot be ruled out that some patients may experience light spotting or (sometimes) very heavy discharge while still taking the medicine.

Another option for changing the pill regimen is to stop taking the medicine from the current pack, and then wait 7 days before starting a new pack. In this case, you should also take into account the days when you missed taking the medicine.

If a woman misses a dose and her period is missed, this may be a sign of pregnancy. Therefore, before resuming the medication, it is necessary to exclude the possibility of conception.

If the patient vomits after taking Marvelon, the absorption of the drug may decrease. In this case, it is necessary to follow the recommendations regarding skipping the next dose.

If a woman refuses to change her usual regimen, it is recommended to take an additional tablet (or several) from another pack of medication.

If it is necessary to postpone the onset of menstruation, the product is continued to be used without maintaining the standard 7-day pause between individual packs. The delay of menstruation can last the entire period until the end of the tablets in the 2nd pack. During this period, weak or heavy bloody discharge from the vagina may appear. The usual mode of use involves starting to take the tablets after maintaining an interval of 7 days.

If it is necessary to change the day of the beginning of the menstrual cycle from the one assumed when following the standard scheme to some other day, the interval between packs specified in the recommendations is reduced by the required number of days.

The shorter the interval between using tablets from different packs, the higher the probability of missing menstruation during this period and the risk of heavy vaginal discharge when using the medicine from the 2nd pack.

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Use Marvelona during pregnancy

It is prohibited to prescribe Marvelon in case of pregnancy (both diagnosed and suspected).

Contraindications

Among the main contraindications:

• the presence in the woman’s medical history or at the time of the decision to use the drug of thrombosis in the area of large blood vessels (such as arteries and veins);
• clinical symptoms present in the medical history or at the time of the proposed use of the drug that develop against the background of thrombosis (including coronary heart disease or angina pectoris);
• diabetes mellitus with vascular lesions;
• pronounced or present in large quantities risk factors for the development of arterial or venous thrombosis in a woman;
• history of or current severe liver disease (in situations where liver function tests are not within normal limits);
• the presence of tumor pathologies in the patient (or existing ones in the anamnesis) - formations of both malignant and benign nature;
• malignant tumor (developed due to hormones) in the mammary glands or genitals (in addition to this, if its presence is suspected);
• vaginal bleeding of unknown etiology;
• lactation period;
• migraine attacks accompanied by focal neurological symptoms;
• elevated plasma triglyceride levels (development of triglyceridermia);
• the presence of intolerance to any of the components of the drug.

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Side effects Marvelona

The use of tablets can sometimes lead to various side effects, including:

Lesions of the reproductive system: intermenstrual bloody discharge from the vagina, disorder of the cervical discharge process, swelling and engorgement of the mammary glands, as well as amenorrhea;

Disorders in the functioning of the gastrointestinal tract: the appearance of vomiting with nausea;

The main manifestations from the central nervous system: unstable mood, headaches with dizziness, as well as migraine attacks;

Other disorders: weight changes and fluid retention in the body. In addition, a rash on the skin surface, erythema nodosum, melasma may appear, the tolerance of contact lenses may worsen (or complete intolerance may develop), and the likelihood of acute thrombosis in the blood vessels may increase.

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Overdose

Desogestrel and ethinyl estradiol are elements with low toxicity, so the risk of health-threatening symptoms in case of overdose of tablets is considered very low. If the patient accidentally takes several tablets together, she may experience nausea with vomiting, as well as slight bloody vaginal discharge (in young women).

The drug has no antidote. If signs of intoxication are observed, the victim should be given symptomatic therapy.

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Interactions with other drugs

Suppression of the contraceptive effect of the drug is observed when combined with such drugs: hydantoin derivatives, rifampicin with griseovulfin and carbamazepine, and in addition isoniazid with primidone and oxcarbazepine, as well as topiramate and barbiturates with felbamate. In addition to weakening the properties of Marvelon, profuse vaginal bleeding may occur.

The contraceptive effect is also suppressed when the drug is used in combination with penicillins, as well as tetracyclines, chloramphenicol, neomycin, laxatives and activated carbon.

Marvelon is able to weaken the medicinal effect of the following drugs: oral coagulants, tricyclics, theophylline with caffeine, as well as anxiolytics, clofibrate, hypoglycemic drugs and GCS.

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Storage conditions

Marvelon should be kept in a place protected from sunlight and moisture, inaccessible to small children. The most optimal temperature range is considered to be within 2-30°C.

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Special instructions

Reviews

According to doctors, Marvelon is considered a fairly effective hormonal contraceptive. In addition, taking the drug helps eliminate symptoms of hormonal imbalance in the body, which results in such positive reactions as stabilization of menstruation, improvement of the skin condition, and disappearance of acne.

But at the same time, the drug can sometimes cause such a negative effect as weight gain. In addition, there are reviews from women who noticed that the drug reduces libido.

Patients leave many positive reviews about the drug - the absence of any negative reactions, excellent tolerability of the drug and a decrease in the abundance of discharge, as well as pain during menstruation are emphasized. Sometimes the patient's body adapts to taking the drug within 2-3 months from the start of use.

Because the drug has such rather contradictory reviews, before choosing it as a contraceptive, it is necessary to consult with your doctor about the advisability of this option.

Shelf life

Marvelon is allowed to be used for a period of 3 years from the date of manufacture of the drug.