MARVELON 28 PILL (PACK)

Special Precautions: Increased risk of venous thromboembolism w/ increasing age, +ve family history of venous thromboembolism, obesity (BMI >30 kg/m2), prolonged immobilization, major surgery, any surgery to the legs or major trauma, superficial thrombophlebitis & varicose veins. Increased risk of arterial thromboembolic complications w/ increasing age, smoking, dyslipoproteinemia, obesity (BMI >30 kg/m2), HTN, migraine, valvular heart disease, atrial fibrillation, +ve family history of arterial thrombosis. Increased risk of thromboembolism in the puerperium. DM, SLE, hemolytic uremic syndrome, Crohn's disease or ulcerative colitis & sickle-cell disease. Increase in frequency or severity of migraine. Long-term use of combined OCs contributes to this increased risk of cervical cancer; slightly increased relative risk of breast cancer. Discontinue prior to starting therapy w/ the combination drug regimen ombitasvir/paritaprevir/ritonavir w/ or w/o dasabuvir. Women w/ hypertriglyceridemia or family history thereof may be at increased risk of pancreatitis when using combined OCs. Discontinue if a sustained clinically significant HTN develops during use of combined OCs. Jaundice &/or pruritus related to cholestasis; gallstone formation; porphyria; SLEs; haemolytic uraemic syndrome; Sydenham's chorea; herpes gestationis; otosclerosis-related hearing loss; (hereditary) angioedema have been reported w/ COC use. Discontinue if acute or chronic disturbances of liver function occur. Crohn's disease & ulcerative colitis. Avoid too much exposure to sun or UV radiation for women w/ tendency to chloasma. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Measure BP & perform physical exam prior to therapy. Irregular bleeding may occur during the 1st mth of use. Lactation. Side Effects / Adverse Reactions: Depressed mood, altered mood; headache; nausea, abdominal pain; breast pain, breast tenderness; increased wt. Dosage / Direction for Use: 1 tab daily for 21 consecutive days. Each subsequent pack is starting after a 7-day tab-free interval, during which time a w/drawal bleed usually occurs. Starts on day 2-3 after the last tab & may not have finished before the next pack is started. No hormonal contraceptive has been used in the past mth Start on the 1st day of menstrual bleeding. Use barrier method for the 1st 7 days of tab-taking during the 1st cycle. When changing from another combined hormonal contraceptive (combined OC, vag ring or transdermal patch) Start on the day after the last active tab of combined OC, or on the day of removal of vag ring or patch). When changing from progestogen-only method (minipill, inj, implant) or progestogen-releasing IUS May switch to Marvelon 28 right away but should use barrier method for the 1st 7 days of tab-taking. Following 1st-trimester abortion Start immediately. After delivery or 2nd-trimester abortion Start at day 21-28 after delivery or 2nd trimester abortion.