Alesse contraindications are diverse:
- pregnancy, lactation;
- hepatitis, jaundice, decompensated liver cirrhosis, liver failure, constitutional hyperbilirubinemia (Gilbert’s syndrome, Dubin-Johnson syndrome), liver tumors (hemangioma, liver cancer, including in anamnesis), or expressed itching during previous pregnancy; porphyria;
- herpes infection during pregnancy in anamnesis;
- otosclerosis (aggravated in course of previous pregnancies);
- thrombosis and thromboembolism (deep vein thrombosis, pulmonary embolism, including in anamnesis), coagulopathy with tendency to thrombosis;
- severe diseases of cardiovascular system (coronary heart disease, angina, myocardial infarction, hypertension, atherosclerosis, heart disease, myocarditis);
- cerebrovascular diseases; cerebrovascular accidents (in anamnesis – ischemic stroke, hemorrhagic stroke);
- lipid storage disease, hyperlipidemia, severe obesity;
- choledocholithiasis, cholecystitis, pancreatitis, accompanied by severe hypertriglyceridemia;
- chronic colitis;
- sickle cell anemia, chronic hemolytic anemia;
- hormone-dependent tumors, including breast cancer or endometrial (including in anamnesis); endometrial hyperplasia;
- diabetes complicated by microangiopathy, retinopathy;
- uterine bleeding of unknown etiology;
- epilepsy (increased frequency of seizures), apyretic tetanus, migraine with focal neurological symptoms;
- severe renal impairment;
- smoking women older than 35 years;
- hypersensitivity to drug and its components.
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Pregnancy and Lactation
Alesse is contraindicated during pregnancy. Oral contraceptives, which preceded pregnancy does not increase the risk of a variety of fetal disorders. The use of hormonal contraceptives in the early stages of pregnancy has no teratogenic or mutagenic effects, does not affect the sex of a future fetus. At the same time, it should be remembered that FDA classification of estrogens and progestins on the degree of pregnancy risk are classified as X. The possible risks associated with taking hormonal contraceptives, in this case far exceed the benefit; when established pregnancy steroid hormones should be discontinued.
In case of planned pregnancy, it should be discontinued the application 3 months prior to its expected date and time for use of different, non-hormonal contraception. In case of pregnancy, the drug should be discontinued. In the absence of continued bleeding, reception of Alesse is allowed after excluding pregnancy.
Birth Control pills are contraindicated during lactation. If necessary, you may take Alesse but stop breastfeeding. Combined oral contraceptives suppress lactation and affect the quality of breast milk.
Special Instructions and Preventive Measures
Before starting drug intake it is necessary to exclude the presence of pregnancy, undergo general medical and gynecological examination (blood pressure measurement, determination of glucose in urine, liver function tests, breast exams, cytologic analysis).
The birth control effect from the beginning of reception is fully manifested by 14 days and persists during a 7-day pause while using Alesse. In this regard, in the first 2 weeks, it is recommended to use additional non-hormonal methods of contraception.
It is recommended to undergo the general medical and gynecological examination (including breast examination) every 6 months of application. In case of long-term use, it must be an annual gynecological examination.
In absence of bleeding, continued Alesse reception is allowed only after the pregnancy is excluded.
Particular attention is required when women over 40 apply it, in presence of varicose veins, phlebitis, hypertension, non-severe diabetes mellitus, renal dysfunction, uterine fibroids or mastitis, mental disorders accompanied by depression, epilepsy, otosclerosis, scattered sclerosis, chorea minor, intermittent porphyria, latent tetany, asthma.
Birth control drugs’ use is not allowed for women with a thromboembolic disease at the young age, or bleeding disorders in a family history.
Alesse should be discontinued and it is appropriate to undergo a medical examination in case of:
- thrombosis, thrombophlebitis or thromboembolic development;
- hepatitis, development of jaundice, generalized itching;
- cerebrovascular disorders;
- myocardial infarction, a significant increase in blood pressure;
- retinal thrombosis, worsening of visual acuity or hearing, ophthalmoptosis, diplopia;
- frequent seizures;
- repeated migraine, persistent or unusually severe headache;
- acute pain in upper abdomen;
- prolonged immobilization;
- any chronic serious diseases.
You should stop taking Alesse before scheduled surgery (6 weeks).
The use of oral contraceptives may be no earlier than 6 months after suffering viral hepatitis, after full normalization of liver function. If an abnormal liver function is observed, its function should monitor every 2-3 months.
With prolonged use of sex hormones, which are a part of Alesse, in some cases, it is noted the development of benign formations, in rare cases – malignant liver tumors. For acute pain in the abdomen or in the case of bleeding it should be excluded hepatocellular adenomas presence. When there is an acute pain in upper abdomen, hepatomegaly or symptoms of intra-abdominal hemorrhage may be suspected of liver tumor.
In case of diarrhea or vomiting due to deterioration of drug absorbability contraceptive (birth control) effect may temporarily disappear. Therefore, when the drug is appointed, comorbidities presence should be taken into account, which may be accompanied by vomiting or diarrhea.
Smoking can increase side effects’ frequency and severity. Women older than 35 years, receiving hormonal birth control medications, are recommended to stop smoking completely, because smoking while taking hormonal contraceptives increases the risk of cardiovascular system diseases, particularly thrombosis and thromboembolism.
When inter-menstrual bleeding is present you should continue taking Alesse, as in most cases, bleeding stops spontaneously. If intermenstrual bleeding persists or recurs, it is required a medical examination to rule out any pathology of internal organs.
While the use of anticoagulants, coumarin derivatives or indandiones may be necessary to determine prothrombin time and change the anticoagulant dose.
Low-dose estrogen-progestogen contraceptives do not affect the course of puberty, during normal menstrual cycle formation. In this regard, young women can use oral contraceptives of this type, if necessary.