The contraceptive effect of combined oral contraceptives (COCs) is based on the interaction of various factors, the most important of which are suppression of ovulation and changes in cervical secretion. In addition to preventing pregnancy, PDAs have a number of other positive properties that can be used when choosing a method of contraception. The menstrual cycle becomes more regular, menstruation becomes less painful, and blood loss decreases. The latter helps reduce the incidence of iron deficiency anemia. There is evidence of a reduced risk of endometrial and ovarian cancer. In addition, it has been proven that when using COCs in high doses (50 mcg ethinylestradiol), the risk of ovarian cysts, pelvic inflammatory diseases, benign breast diseases and ectopic pregnancy is reduced. It is necessary to find out whether this applies to low-dose COCs.
Gestoden
After oral administration, gestodene is quickly and completely absorbed. The maximum serum concentration of 4 ng/ml is achieved 1 hour after a single dose. Bioavailability is about 99%.
Gestodene binds to serum albumin and sex hormone binding globulin (SHBG). Only 1-2% of the total concentration of the substance in the blood serum is in the form of a free steroid, and 50-70% is specifically associated with SHBG. The increase in SHBG levels induced by ethinyl estadiol determines an increase in the gestodene fraction associated with SHBG and a decrease in the fraction associated with albumin.
The metabolism of gestodene occurs entirely through the known pathways of steroid metabolism. Serum clearance is 0.8 ml/min/kg body weight.
The level of gestodene in the blood serum decreases in two phases. Distribution in the final phase is characterized by a half-life of 12-15 hours. Gestodene is not excreted unchanged. Its metabolites are excreted from the body in urine and bile in a ratio of approximately 6:4. The half-life of metabolites is 1 day.
The pharmacokinetics of gestodene is affected by the level of SHBG, which increases 3 times while taking ethinyl estradiol. After daily administration, the level of gestodene in the blood serum increases approximately 4 times, reaching a state of equilibrium in the second half of the course of taking the pill.
Ethinyl estradiol
When taken orally, ethinyl estradiol is rapidly and completely absorbed. Peak serum concentrations of approximately 80 pg/ml are achieved within 1-2 hours.
Ethinyl estradiol binds tightly but not specifically to serum albumin (approximately 98%) and increases serum SHBG concentrations.
Ethinyl estradiol is metabolized mainly by aromatic hydroxylation, however, a large number of hydroxylated and methylated metabolites are additionally formed, including both free metabolites and conjugates with glucuronides and sulfates. Clearance is 2.3-7 ml/min/kg body weight.
The level of ethinyl estradiol in the blood serum decreases in 2 phases with half-lives of about 1 and 10-20 hours, respectively. The substance is not excreted from the body unchanged; ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6. The half-life of metabolites is approximately 1 day.
Based on variable serum half-life and daily dosing, steady-state serum concentrations of ethinyl estradiol are achieved in approximately 1 week.
Indications for use of the drug Logest
Contraception.
Use of the drug Logest
The pills should be taken daily according to the order indicated on the blister, at approximately the same time, with a small amount of liquid. The drug is taken 1 tablet per day for 21 days. Taking pills from each subsequent package must begin after the end of a 7-day break in taking the drug, during which, as a rule, menstrual-like bleeding occurs, which usually begins on the 2-3rd day after taking the last pill and may not end by the time you start taking it dragee from the next package.
If hormonal contraceptives were not used in the previous period (last month)
Taking the pills should start on the 1st day of the menstrual cycle. You can start taking it from the 2-5th day, but in this case, during the first cycle, it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the drug.
Switching from another combined oral contraceptive (COC)
It is advisable to start taking Logest the day after taking the last active tablet of the previous COC, at least no later than the next day after a break in taking pills or after taking placebo tablets of the previous COC.
Switching from a progestogen-only method (mini-pills, injections, implants) or a progestogen-containing intrauterine system
You can start taking Logest any day after you stop taking the mini-pill (in the case of implants or intrauterine system - on the day of their removal; in the case of injection - instead of the next injection). However, in all cases it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the pill.
After an abortion in the first trimester of pregnancy
You can start using Logest immediately. In this case, there is no need to use additional contraception.
After childbirth or abortion in the second trimester of pregnancy
If breastfeeding, see subsection "Pregnancy and breastfeeding"
It is recommended to start taking Logest from the 21st to 28th day after childbirth or abortion in the second trimester of pregnancy. If you start taking the pill later, you should additionally use a barrier method of contraception during the first 7 days of taking the drug. However, if sexual intercourse has already taken place, then before starting to use the PDA it is necessary to exclude a possible pregnancy or wait until menstruation.
What to do if you miss a pill dose
If the delay in taking the pill does not exceed 12 hours, the contraceptive effect of the drug is not reduced. The missed pill should be taken as soon as possible. The next pill from this package is taken at the usual time.
If the delay in taking the missed pill exceeds 12 hours, contraceptive protection may decrease. In this case, you can follow two basic rules:
- a break in taking pills should never exceed 7 days;
- Adequate suppression of the hypothalamus-pituitary-ovarian system is achieved by continuous intake of the pill for 7 days.
Accordingly, the following recommendations should be followed in daily life:
1st week
You should take the last missed pill as soon as possible, even if you have to take 2 pills at the same time. After this, continue to take the pills at the usual time. In addition, over the next 7 days you must use a barrier method of contraception, such as a condom. If sexual intercourse took place in the previous 7 days, the likelihood of pregnancy should be taken into account. The more pills you miss and the closer the break in taking the drug, the higher the likelihood of pregnancy.
2nd week
It is necessary to take the last missed pill as soon as possible, even if you have to take 2 pills at the same time. After this, continue to take the pills at the usual time. If you take the tablets correctly for 7 days before the first missed period, there is no need to use additional contraceptives. In another case or if more than 1 pill is missed, it is recommended to additionally use a barrier method of contraception for 7 days.
3rd week
The risk of decreased reliability increases as the break in taking the pill approaches. However, if you follow the regimen for taking pills, you can avoid a decrease in contraceptive protection. If you adhere to one of the following options, then there will be no need to use additional contraceptives, provided you take the tablets correctly for 7 days before the missed period. If this is not the case, you should stick to the first option below and use additional methods of contraception for the next 7 days.
It is necessary to take the last missed pill as soon as possible, even if you have to take 2 pills at the same time. After this, continue to take the pills at the usual time. The pills from the next package must be taken immediately after the end of the previous one, that is, there should be no breaks. It is unlikely that the patient will experience menstrual-like bleeding by the end of the second pack, although spotting or breakthrough bleeding may occur while taking the tablets.
You may also be advised to stop taking the tablets from the current package. In this case, the break in taking the drug should be up to 7 days, including days of missing pills; You should start taking the pills from the next package.
If you miss taking a pill and there is no menstrual-like bleeding during the first regular break in taking the pill, you need to exclude the possibility of pregnancy.
Recommendations in case of gastrointestinal disorders
In case of severe gastrointestinal disorders, incomplete absorption of the drug is possible; in this case, additional contraception should be used.
If vomiting occurs within 3-4 hours after taking the pills, it is advisable to use the recommendations regarding skipping pills. If the patient does not want to change her usual regimen of taking the drug, she needs to take additional pill(s) from a different package.
How to change the timing of your period or how to delay your period
To delay the appearance of menstruation, you should continue to take Logest tablets from a new package and not take a break from taking the drug. If desired, the period of administration can be continued until the end of the second package. In this case, the possibility of breakthrough bleeding or spotting cannot be excluded. The usual use of the drug Logest is restored after a 7-day break from taking the pill.
To shift the onset of menstruation to another day of the week, it is recommended to shorten the break in taking pills by the desired number of days. It should be noted that the shorter the break, the more often the absence of menstrual-like bleeding and breakthrough bleeding or spotting is noted while taking the pills from the second package (as in the case of a delay in the onset of menstruation).
Contraindications to the use of the drug Logest
PDAs should not be used if you have at least one of the following conditions or diseases. If any of these conditions or diseases occurs for the first time during the period of use of the COC, the drug should be stopped immediately.
Venous or arterial thrombotic/thromboembolic events (eg deep vein thrombosis, pulmonary embolism, myocardial infarction) or cerebrovascular disorders, current or in history.
The presence or history of prodromal symptoms of thrombosis (for example, transient cerebrovascular accident, angina pectoris).
History of migraine with focal neurological symptoms.
Diabetes mellitus with vascular damage.
The presence of severe or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see).
Current or history of pancreatitis if associated with severe hypertriglyceridemia.
Current or history of severe liver disease until liver function tests return to normal.
Diagnosed or history of liver tumors (benign or malignant).
Diagnosed or suspected malignant tumors (for example, genitals or mammary glands) that are dependent on sex hormones.
Vaginal bleeding of unknown etiology.
Diagnosed or suspected pregnancy.
Hypersensitivity to the active substances or to any of the components of the drug.
Side effects of the drug Logest
The most serious side effects associated with the use of COCs are described in the section.
Other undesirable effects have been reported with the use of COCs, but their connection with the use of COCs has been neither confirmed nor refuted:
Organs and systems |
Frequent (≥1/100) |
Uncommon (≥1/1000 and ≤/100) |
Single (≤1/1000) |
Contact lens intolerance |
|||
Nausea, abdominal pain |
Vomiting, diarrhea |
||
The immune system |
Hypersensitivity |
||
Study |
Weight gain |
Reducing body weight |
|
Metabolism and nutritional disorders |
Fluid retention |
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Mental disorders |
Depressed state, mood disturbance |
Decreased libido |
Increase libido |
Reproductive system and mammary glands |
Changes in vaginal secretion, the appearance of secretion from the mammary glands |
||
Skin and subcutaneous tissues |
Skin rashes, urticaria |
Erythema nodosum, exudative erythema multiforme |
Special instructions for the use of the drug Logest
If any of the following conditions/risk factors are present, the benefits of using COCs should be assessed against the possible risks, taking into account the individual characteristics of each patient and discussed with her before she decides to take COCs. If any of the following conditions or risk factors become worse, worse, or occur for the first time, it is recommended that you consult your doctor. The doctor must decide whether to stop using the COC.
Circulatory disorders
Based on the results of epidemiological studies, there is an association between the use of COCs and an increased risk of venous and arterial thrombotic and thromboembolic diseases, such as myocardial infarction, stroke, deep vein thrombosis and pulmonary embolism. These conditions occur rarely.
Venous thromboembolism (VTE), manifested as venous thrombosis and/or pulmonary embolism, can occur with the use of any COC. The risk of venous thromboembolism is highest during the 1st year of COC use. The incidence of VTE in women taking oral contraceptives with low doses of estrogens (≤0.05 mg ethinyl estradiol) is up to 4 cases per 10,000 women/year compared with 0.5-3 cases per 10,000 women/year in women not using oral contraceptives. The incidence of VTE associated with pregnancy is 6 cases per 10,000 women/year.
Thrombosis of other blood vessels, such as arteries and veins of the liver, kidneys, mesenteric vessels, cerebral or retinal vessels, has been extremely rarely reported in women using COCs. There is no consensus regarding the connection between these complications and the use of COCs.
Symptoms of venous or arterial thrombotic/thromboembolic events or stroke may include: unilateral lower extremity pain or swelling; sudden severe chest pain radiating to the left arm; sudden shortness of breath; sudden onset of cough; any unusual, severe, prolonged headache; sudden decrease or complete loss of vision; diplopia; speech impairment or aphasia; vertigo; collapse with or without partial epileptic seizure; weakness or very severe sudden numbness of one side or one part of the body; motor impairment; acute abdomen syndrome.
Factors that increase the risk of venous or arterial thrombotic/thromboembolic events or stroke:
- age;
- tobacco smoking (in combination with heavy smoking and with age, the risk increases, especially in women over 35 years of age);
- family history (for example, cases of venous or arterial thromboembolism in siblings or parents at a relatively early age).
If a hereditary tendency is suspected, before making a decision on the use of any PDA, the woman should be referred for consultation to an appropriate specialist:
- obesity (body mass index more than 30 kg/m2);
- dyslipoproteinemia;
- hypertension;
- heart valve pathology;
- atrial fibrillation;
- prolonged immobilization, radical surgical interventions, any surgical operations on the lower extremities, significant injuries.
In these cases, it is recommended to stop using the PDA (for planned operations at least 4 weeks before they are performed) and not restore it earlier than 2 weeks after complete remobilization.
There is no consensus regarding the possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism.
It is necessary to take into account the increased risk of thromboembolism in the postpartum period.
Other diseases that may be associated with serious circulatory disorders include diabetes mellitus; systemic lupus erythematosus; hemolytic uremic syndrome; chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis) and sickle cell anemia.
An increased incidence of migraine or its exacerbation during the period of use of COCs (which may be a harbinger of cerebrovascular accident) may require urgent cessation of COC use.
Biochemical indicators characteristic of a hereditary or acquired tendency to venous or arterial thrombosis include: resistance to CRP, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies).
When analyzing the risk/benefit ratio, the physician should take into account that adequate treatment for the conditions mentioned above can reduce the associated risk of thrombosis, and also that the risk of thrombosis associated with pregnancy is higher than with the use of COCs in low doses (≤0.05 mg ethinyl estradiol).
Tumors
The most important risk factor for the development of cervical cancer is the persistence of papillomavirus. Some epidemiological studies indicate an additional increase in this risk with long-term use of COCs, however, this statement is controversial because the extent to which the study results account for concomitant risk factors, such as cervical smears and sexual behavior, including the use of barrier methods of contraception, is not clear. .
The results of a meta-analysis based on data from 54 epidemiological studies indicate a slight increase in the relative risk (RR = 1.24) of developing breast cancer in women using COCs. This increased risk gradually disappears within 10 years of stopping taking COCs. Because breast cancer is rarely diagnosed in women under 40 years of age, the increase in breast cancer diagnosis among current or recent COC users is small relative to the overall risk of breast cancer. The results of these studies do not provide evidence of a causal relationship. The increased risk may be due to both earlier diagnosis of breast cancer in women using COCs, the biological effects of COCs, or a combination of both factors. There has been a tendency that breast cancer detected in women who have ever taken COCs is clinically less severe than in those who have never taken COCs.
In isolated cases, benign, and even less often, malignant liver tumors were noted in women using COCs, which sometimes led to the development of life-threatening intra-abdominal bleeding. If there are complaints of severe pain in the epigastric region, liver enlargement, or signs of intra-abdominal bleeding, the differential diagnosis should take into account the possibility of a liver tumor in women taking COCs.
Other conditions
Women with hypertriglyceridemia or a family history of this disorder are at risk of developing pancreatitis when using COCs.
Although slight increases in blood pressure have been reported in many women taking COCs, clinically significant increases in blood pressure are rare. However, if prolonged clinically significant hypertension (arterial hypertension) occurs during the period of taking COCs, then sometimes it is more appropriate to discontinue the COC and direct treatment to hypertension (arterial hypertension).
The occurrence or exacerbation of the following diseases has been reported during pregnancy and with the use of COCs, but their relationship with the use of COCs has not been conclusively established: jaundice and/or itching associated with cholestasis, gallstone formation, porphyria, systemic lupus erythematosus, hemolytic-uremic syndrome, Sydenham's chorea, herpes of pregnancy, hearing loss associated with otosclerosis.
In acute or chronic liver dysfunction, it may be necessary to stop taking COCs until liver function tests return to normal. If cholestatic jaundice relapses, which first occurred during pregnancy or previous use of sex hormones, taking COCs should be discontinued.
Although COCs may affect peripheral insulin resistance and glucose tolerance, there are no data regarding the need to change the therapeutic regimen in women with diabetes mellitus taking low-dose COCs (containing ≤0.05 mg ethinyl estradiol). However, women with diabetes should be closely monitored while taking COCs.
Crohn's disease and ulcerative colitis may be associated with COC use.
Chloasma can sometimes occur, especially in women with a history of chloasma during pregnancy. Women prone to chloasma should avoid exposure to direct sunlight or ultraviolet radiation while taking COCs.
Medical examination
Before starting or resuming taking the drug Logest, you should conduct a full medical examination and study the patient’s medical history in detail, taking into account contraindications (see) and warnings (see). When using COCs, it is recommended to conduct periodic examinations, which is very important, since contraindications (transient circulatory disorders, etc.) or risk factors (for example, a family history of venous or arterial thrombosis) may first appear during the period of taking COCs. The frequency and nature of these examinations should be based on the standards of medical practice, taking into account the individual characteristics of each woman, however, special attention is paid to examination of the pelvic organs, including a standard analysis of cytology of the cervix, abdominal organs, mammary glands, determination of blood pressure.
The patient must be warned that oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Reduced efficiency
The effectiveness of combined oral contraceptives may be reduced if you miss a pill, have gastrointestinal problems, or use other medications.
Cycle control
When taking oral contraceptives, intermenstrual bleeding (spotting or breakthrough bleeding) may occur, especially during the first few months of treatment. Taking this into account, examination in the event of any intermenstrual bleeding should be carried out only after a period of adaptation of the body to the drug, which is approximately 3 cycles.
If menstrual irregularities continue or recur after several normal cycles, non-hormonal causes of bleeding should be considered and appropriate investigations should be carried out to exclude the presence of tumors and pregnancy. Diagnostic measures can include curettage.
Some women may not experience menstrual bleeding during a break from taking the drug. There is a low chance of pregnancy when you take COCs as directed. However, if the contraceptive was taken irregularly or if menstrual-like bleeding is absent for 2 cycles, pregnancy must be excluded before continuing to take the COC.
During pregnancy and breastfeeding
The drug is contraindicated for use during pregnancy. If pregnancy occurs during the use of the drug Logest, it is necessary to stop taking it. However, research results do not indicate an increased risk of congenital pathologies in children born to mothers who took COCs during pregnancy, nor do they indicate the existence of a teratogenic effect when unintentionally taking COCs in early pregnancy.
PDAs can affect lactation, since under their influence the amount of breast milk can decrease and also change its composition. With this in mind, COCs are not recommended for use while breastfeeding.
The active substances that make up the drug and/or their metabolites are excreted in small quantities in breast milk, but there is no data on their negative effect on the health of the infant.
Impact on the ability to drive vehicles and operate machinery
No effect noted.
Interactions of the drug Logest
Interactions between oral contraceptives and other drugs may result in breakthrough bleeding and/or decreased contraceptive effectiveness. The following interactions have been reported in the literature.
Hepatic metabolism: possible interaction with drugs that induce microsomal enzymes, which can cause an increase in the clearance of sex hormones (for example, phenytoin, barbiturates, primidone, carbamazepine, rifampicin and possibly also oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin and drugs containing St. John's wort).
Interaction with the enterohepatic circulation: The results of some clinical studies suggest that the enterohepatic circulation of estrogens may be reduced when taking certain antibiotics that reduce ethinyl estradiol concentrations (for example, penicillin and tetracycline antibiotics).
When treating any of the above drugs, a woman should temporarily use a barrier method in addition to taking COCs or choose another method of contraception. When treating with drugs that induce microsomal enzymes, the barrier method must be used throughout the entire period of treatment with the corresponding drug and for another 28 days after stopping its use. When treating with an antibiotic (with the exception of rifampicin and griseofulvin), the barrier method should be used for another 7 days after discontinuation of the antibiotic. If the barrier method is still being used, and the tablets in the PDA package have already run out, taking the tablets from the next package should be started without the usual break.
Oral contraceptives may affect the metabolism of other drugs. Taking this into account, the concentrations of active substances in blood plasma and tissues (for example, cyclosporine) may change.
Note. To determine the potential for interaction with drugs that are prescribed concomitantly with COCs, it is recommended that you read the instructions for medical use of these drugs.
Impact on laboratory results
Taking contraceptives may affect the results of certain laboratory tests, including biochemical parameters of liver, thyroid, adrenal and kidney function, plasma levels of proteins (carriers), such as sex hormone binding globulin and lipid/lipoprotein fractions, parameters carbohydrate metabolism, as well as parameters of coagulation and fibrinolysis.
Logest overdose, symptoms and treatment
No serious adverse effects due to overdose have been reported. The following symptoms of overdose are possible: nausea, vomiting, and in young patients - slight bleeding from the vagina. There are no specific antidotes; treatment should be symptomatic.
Storage conditions for the drug Logest
At room temperature not higher than 30 °C.
List of pharmacies where you can buy Logest:
- Saint Petersburg
21 tablets for oral administration in a package
pharmachologic effect
Logest is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.
The contraceptive effect of Logest is carried out through complementary mechanisms, the most important of which include suppression of ovulation and changes in the state of cervical mucus.
In women taking combined oral contraceptives, the cycle becomes more regular, the pain and intensity of menstrual bleeding decreases, resulting in a reduced risk of iron deficiency anemia. In addition, there is evidence that the risk of developing endometrial and ovarian cancer is reduced.
Indications for use
Oral contraception.
Directions for use and doses
The tablets should be taken orally in the order indicated on the package, every day at approximately the same time, with a small amount of water. Take one tablet per day continuously for 21 days. The next package begins after a 7-day break from taking pills, during which withdrawal bleeding usually develops. Bleeding usually begins 2-3 days after taking the last tablet and may not stop until you start taking a new pack.
Contraindications
Logest should not be used if you have any of the conditions/diseases listed below. If any of these conditions/diseases develop for the first time while taking the drug, the drug should be discontinued immediately:
- thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular disorders;
- conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history;
- the presence of pronounced or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see section “Special instructions”);
- migraine with focal neurological symptoms currently or in history;
- diabetes mellitus with vascular complications;
- pancreatitis with severe hypertriglyceridemia currently or in history;
- liver failure and severe liver disease (until liver tests return to normal);
- liver tumors (benign or malignant) currently or in history;
- identified or suspected hormone-dependent malignant neoplasms (including genital organs or mammary glands);
- bleeding from the vagina of unknown origin;
- pregnancy or suspicion of it;
- breast-feeding;
- hypersensitivity to any of the components of the drug Logest.
special instructions
Before starting or resuming the use of the drug Logest, it is necessary to familiarize yourself with the woman’s life history, family history, conduct a thorough general medical examination (including measuring blood pressure, determining body mass index) and gynecological examination (including examination of the mammary glands and cytological examination of the cervical epithelium), and exclude pregnancy. The scope of additional studies and the frequency of follow-up examinations are determined individually. Typically, follow-up examinations should be carried out at least once every 6 months.
A woman should be warned that drugs like Logest do not protect against HIV infection (AIDS) and other sexually transmitted diseases!
Storage conditions
Store at a temperature not exceeding 25°C in a place protected from light. Keep out of the reach of children.
LogestCompound
Active ingredients (in 1 tablet): ethinyl estradiol - 0.02 mg, gestodene - 0.075 mg.Others: polyethylene glycol 6000, lactose, povidone 25,000, corn starch, calcium carbonate, magnesium stearate, sucrose, povidone 700,000, talc, montanglicol wax E.
pharmachologic effect
Logest is an oral hormonal combined contraceptive. The action of the drug is based on the interaction of various factors, the main of which are changes in the properties of cervical mucus and suppression of ovulation. In addition to the contraceptive effect, hormonal combined oral contraceptives have other positive properties that are decisive when choosing a particular method of contraception: restoration of the normal menstrual cycle, reduction of symptoms of dysmenorrhea, reduction of the intensity of bleeding during menstruation (prevention of iron deficiency anemia in menstruating women), reducing the likelihood of developing ovarian and endometrial cancer. The effect of reducing the risk of developing benign breast diseases, inflammatory diseases of the female reproductive system, ectopic pregnancy and ovarian cysts when taking high-dose oral combined contraceptives (containing ethinyl estradiol 50 mg) has been proven. A similar effect for low-dose drugs has not yet been confirmed.The active ingredients of Logest are gestodene and ethinyl estradiol.
Gestaden after internal administration is completely and quickly absorbed. After 60 minutes, the maximum content of gestodene is observed in the blood plasma (4 ng/ml). Bioavailability – 99%. In the blood, gestodene is bound by proteins: SHBG (sex hormone binding globulin) and albumin. Approximately 1-2% of gestodene introduced into the body in the blood serum is represented by a free steroid. 50-70% of gestaden is bound by SHBG in a specific way. Clearance of gestodene in blood serum is 0.8 ml/min/kg body weight. Ethinyl estradiol provides an increase in SHBG content, which leads to an increase in the level of the SHBG + gestodene fraction and a decrease in the albumin + gestodene fraction.
The metabolism of gestodene in the body follows the pathway of steroid metabolism. The decrease in serum gestodene occurs in two phases. In the final phase, a half-life of 12-15 hours is observed. There is no elimination of gestodene in its pure form. Metabolites of the substance are excreted in bile and urine in a ratio of 4:6. The half-life of gestodene metabolites is 24 hours.
The pharmacokinetic parameters of gestodene depend on the level of SHBG, which, when combined with ethinyl estradiol, increases 3 times. As a result of daily intake, the content of gestogen in the blood serum increases approximately 4 times. During the period of taking the second half of the package of Logest tablets, a state of equilibrium in the level of gestodene is observed.
Ethinyl estradiol, when taken internally, is absorbed from the intestine quickly and completely. The peak content of ethinyl estradiol in the blood serum is reached after 1-2 hours (80 pkg/ml). Binds to blood albumin 98% tightly and nonspecifically. Increases serum SHBG. Metabolized mainly by aromatic hydroxylation. Additional metabolites are also formed in the form of methylated and hydroxylated complexes (including free metabolites, conjugates with sulfates and glucuronides). Ethinyl estradiol clearance is 2.3–7 ml/min/kg body weight. The decrease in the level of the substance in the blood serum occurs in two phases, the half-life for each phase is 1 hour and 10-20 hours, respectively. Ethinyl estradiol is not eliminated unchanged; the resulting metabolites are excreted in bile and urine in a ratio of 6:4. The period of elimination of metabolites is 24 hours. Steady-state concentrations of ethinyl estradiol are achieved in approximately 7 days, due to the variable half-life of the substance.
Indications for use
Prescribed as a contraceptive.Mode of application
Logest tablets must be taken once a day for 21 days in accordance with the order of administration indicated on the blister. It is recommended to take the dragee at the same time, with a small amount of liquid. The next package of tablets should be taken 7 days after the end of the tablet from the previous package. During the 7-day break between taking tablets from the blister, a menstrual-like reaction (bleeding) is observed. Usually bleeding begins on days 2-3 of a 7-day break. In some cases, bleeding does not stop by the time you take Logest tablets from the next blister.Starting hormonal contraceptives
Taking Logest starts on the 1st day of the menstrual cycle (on the 1st day of menstruation). If reception is used from 2-5 days, then additional prescription of other methods of contraception (for example, barrier method) is necessary during the first 7 days of using Logest.
Switching to Logest from another hormonal contraceptive
It is recommended to take Logest on the next day of using the last active (containing hormonal substances) tablet/dragée of the previous hormonal oral contraceptive. In exceptional cases, Logest may be taken after a 7-day break from taking previous hormonal contraceptives (or at the time of taking the last placebo of the previous contraceptive).
Switching to Logest from an intrauterine system containing progestogen, mini-pills, implants and injections
Logest tablets are taken any day after the previous use of mini-pills is discontinued. If injections or implants were used, then the first pill is taken on the day the implant is removed or the injection ends (on the day when the next portion of the injectable hormonal contraceptive was to be administered). In all these cases, it is necessary to prescribe additional contraception during the first 7 days of taking Logest (for example, a barrier method).
After artificial termination of pregnancy in the first trimester
It is recommended to start taking the drug immediately after an abortion. Additional contraception is not needed.
After childbirth or late abortion
You can start taking Logest on days 21-28 of the postpartum period or after an abortion in the second trimester of pregnancy. If admission is used at a later date, it is necessary to prescribe an additional method of birth control (for example, a barrier method). If sexual activity has already begun before taking Logest, you should wait for menstruation or exclude an already developed pregnancy.
Precautions if you miss a dose of Logest tablets
If the delay in using the pill is no more than 12 hours, then there is no decrease in the contraceptive effectiveness of the drug. You should take the next (missed) tablet as quickly as possible. After this, the next tablet from the blister must be taken at the usual time.
If the delay is more than 12 hours, then a decrease in contraceptive effectiveness may be observed. It is especially dangerous when the break is more than 7 days, since adequate suppression of the hypothalamic-pituitary-ovarian system is observed only in the case of continuous use of Logest for 7 days.
When skipping Logest tablets, you need to remember a few rules:
1. Dragee was missed during the 1st week of administration. It is necessary to take the missed pill as quickly as possible. It is allowed to take 2 tablets if it is time to take the next one after the missed tablet. Then Logest is taken as usual. During the next 7 days after missing a pill, additional contraception (for example, a barrier method) is required. It is necessary to take into account that if 7 days before missing the pill there was coitus without additional precautions, then conception is likely. The probability of conception is higher, the greater the number of pills missed and the closer the temporary break in taking the contraceptive is.
2. Dragee was missed during the 2nd week of administration. It is necessary to take the missed pill as quickly as possible. It is allowed to take 2 tablets if it is time to take the next one after the missed tablet. Then Logest is taken as usual. If the instructions are strictly followed for the next 7 days before potentially missing the next pill, there is no need for additional contraception. Otherwise, as well as if more than 1 tablet is missed, additional use of other contraceptive measures (for example, barrier contraception) is necessary for 7 days after the miss.
3. The pill was missed during the 3rd week of taking it. As the break in the use of Logest tablets approaches, the risk of a decrease in the contraceptive effect of the drug increases. However, if you follow the instructions below, then additional contraceptive measures are not necessary (provided there is no missed pill intake 7 days before the actual missed dose). Otherwise, additional backup with other methods of contraception (for example, barrier methods) is necessary. It is necessary to take the missed pill as quickly as possible. It is allowed to take 2 tablets if it is time to take the next one after the missed tablet. Then Logest is taken as usual. Immediately after finishing taking the last Logest tablet, it is recommended to immediately (without a 7-day break) start taking the tablet from the next blister. In this case, a menstrual-like reaction is unlikely, but breakthrough bleeding or spotting may occur while taking the pill from the next package.
If a woman does not have a menstrual-like reaction while taking Logest tablets as usual, it is necessary to conduct additional examination methods to exclude pregnancy.
Taking pills for gastrointestinal disorders
In case of severe gastrointestinal disorders, insufficient absorption of the active components of the drug may occur, so additional contraceptive measures (for example, barrier methods) should be prescribed. If vomiting develops 3-4 hours after taking Logest, use recommendations on the rules for taking pills if you miss them.
Changing the date of the next menstruation
In order to delay menstruation, it is necessary to continue taking Logest from the next blister; in this case, a 7-day break is not taken. At the request of the woman, you can extend the intake of the next package of pills until it is finished. Breakthrough bleeding or spotting is possible with this use of the drug. You can resume taking Logest by taking a break of 7 days after using the next blister.
In order to change the time of the next menstruation to another day, it is necessary to reduce the break in taking Logest by the amount required to shift the date of menstruation. It is important to know that the shorter the interval between taking pills from different blisters, the more likely it is that bleeding or breakthrough bleeding will occur while taking Logest from the next blister.
Side effects
There are reports of side effects associated with taking hormonal oral combined contraceptives, but there has been no confirmation or refutation of the fact that these side effects are related to their use.From the gastrointestinal tract: vomiting, diarrhea, nausea, abdominal pain.
From the senses: intolerance to contact lenses.
From the side of metabolism and nutritional disorders: change in body weight (decrease or increase), fluid retention in the body.
From the central nervous system: headaches, migraines, depressed mood, decreased or increased libido, depressed state.
From the genital organs and mammary glands: a feeling of engorgement of the mammary glands, enlargement of the mammary glands, changes in vaginal secretion, mastalgia, the appearance of discharge from the nipples.
From the skin and subcutaneous fat: rash, urticaria, exudative erythema multiforme, erythema nodosum.
Others: allergic reactions.
Contraindications
A combined hormonal contraceptive (including Logest) should not be prescribed if the patient has at least one of the following diseases or conditions:· Arterial or venous thromboembolic or thrombotic signs (myocardial infarction, pulmonary embolism, deep vein thrombosis of the extremities, etc.);
· anamnestic indication of cerebrovascular disorders (or similar disorders currently);
· indication of precursors of thrombosis in history or currently (angina pectoris, transient cerebrovascular accidents);
· migraine with the presence of focal symptoms in the past;
· diabetes mellitus of any type, which is complicated by vascular damage;
· the patient has multiple or several severe risk factors for thrombosis;
pancreatitis with severe hypertriglyceridemia in history or currently;
· severe liver diseases with severe liver dysfunction (until liver function indicators return to normal);
· malignant or benign liver diseases (currently diagnosed or in history);
· hormone-dependent malignant tumor diseases of the mammary glands and reproductive system (suspected or diagnosed);
· bleeding from the genital tract of unknown etiology;
suspected or diagnosed pregnancy;
· hypersensitivity reactions to gestodene, ethinyl estradiol or other components of Logest.
If any of these diseases or conditions develops for the first time since taking the Logest contraceptive, stop taking it immediately.
Pregnancy
Logest is contraindicated for pregnant patients. If pregnancy develops while taking Logest, the contraceptive should be stopped. Studies have not revealed an increased risk of developing congenital malformations in fetuses when taking hormonal oral contraceptives. Also, no teratogenic effect of hormonal oral contraceptives was detected when they were unintentionally used during pregnancy.Logest is not recommended for lactating women, since its influence may change the composition of milk and its quantity. The active substances of Logest and their metabolites pass into breast milk in small concentrations, but studies have not revealed any negative effects on the infant.
Drug interactions
When Logest interacts with other drugs, breakthrough bleeding may occur, as well as a decrease in the effectiveness of the drug. The following interactions are currently known:1. Hepatic metabolism– there is an interaction with drugs that induce microsomal liver enzymes - this can provoke an increase in the clearance of reproductive hormones (for example, primidone, phenytoin, carbamazepine, barbiturates, rifampicin and probably topiramate, oxcarbazepine, felbamate, griseofulvin, ritonavir and drugs that have contains extract from St. John's wort). If such drugs are prescribed while taking Logest, additional protection against unwanted pregnancy by other methods (for example, barrier) is necessary. In this case, the barrier method should be used for the entire period of prescription of microsomal enzyme inducers, as well as for the next 28 days after their discontinuation.
2. Enterohepatic circulation: Some clinical studies have shown that the enterohepatic circulation of estrogens is reduced when combined with antibacterial drugs (for example, tetracycline and penicillin antibiotics). If a patient is prescribed such antibacterial drugs while taking Logest, additional use of other methods of contraception (for example, a barrier method) is necessary. In this case, the barrier method should be used for the entire period of prescription of these antibacterial drugs, as well as for the next 7 days after their discontinuation. If the time for using the barrier method has not yet expired, and the tablets in the blister have already run out, it is recommended to take the tablets from the next package without a 7-day break.
3. The effect of Logest on the metabolism of other drugs. It is likely that an interaction between a hormonal oral contraceptive and other drugs may occur in combination with a change in the concentration of the latter in the blood plasma (for example, cyclosporine). To establish the likelihood of an interaction, it is necessary to read the instructions for medical use of drugs that are prescribed while taking Logest.
4. The effect of Logest on some laboratory parameters. When taking Logest, the following indicators may change: kidney function, adrenal glands, thyroid gland, liver, blood protein composition, lipid/lipoprotein ratio, blood coagulation parameters, carbohydrate metabolism and fibrinolysis.
Overdose
There are no known serious health or life-threatening conditions for the patient due to an overdose of the drug. If the dose is exceeded, nausea, mild bleeding from the genital tract, and vomiting are possible. Treatment of overdose is symptomatic; there are no specific antidotes.Release form
Dragees in a blister of 21 pieces. Blister in cardboard packaging.Storage conditions
Store at room temperature (30°C). Do not use after the expiration date indicated on the package. Keep away from children.Active ingredients:
ethinylestradiol, gestodeneAdditionally
A thorough analysis of the benefits/harms of taking the hormonal oral contraceptive Logest is necessary in the following cases:1. Circulatory disorders
As a result of epidemiological studies, it was established that there is a possibility of a connection between taking hormonal contraceptives and an increased risk of developing thromboembolic and thrombotic diseases in the patient (pulmonary embolism, myocardial infarction, deep vein thrombosis, stroke). The above clinical situations occur rarely. The likelihood of developing venous thromboembolism increases especially when taking a hormonal oral contraceptive during the first year. It has been noted that venous thromboembolism can develop when taking any of the oral hormonal contraceptives.
The incidence of venous thromboembolism in patients who use contraceptives with a low dose of estrogen (ethinyl estradiol ≤0.05 mg) is up to 4 cases per 10,000 patients/year compared with women who did not use contraceptives (0.5-3 cases per 10,000 patients /year). The frequency of venous thromboembolism that develops during pregnancy is 6 cases per 10,000 patients/year. Very rarely, cases of thrombosis of other vessels (mesenteric, retinal and cerebral vessels, kidneys and liver) have been reported. There is no consensus on the reliability of the relationship between these conditions and the use of hormonal oral combined contraceptives.
Signs of a developing thrombotic or thromboembolic complication in a patient taking Logest may be: severe sudden pain in the chest, radiating to the left arm; speech impairment or aphasia; collapse with partial epileptiform seizure (or without it); any severe, unusual for a woman, prolonged headache; unilateral leg pain or swelling; sudden onset of cough; sudden shortness of breath; sudden decrease (or complete) loss of visual acuity; diplopia; vertigo; general weakness; sudden severe numbness of one part or one side of the body; motor dysfunction; acute abdomen syndrome.
Risk factors for the development of arterial or venous thromboembolic/thrombotic complications or stroke:
· Tobacco smoking (the risk increases with age (over 35 years) and the number of cigarettes smoked);
· age;
dyslipoproteinemia;
· obesity (with a body mass index over 30 kg/m2);
heart valve pathology;
· family history (for example, cases of arterial or venous thromboembolism in sisters, brothers or parents at a fairly early age). If there is a suspicion of a hereditary tendency to such conditions, then consultation with an appropriate specialist is necessary to decide on the possibility of using Logest even before its prescription;
· arterial hypertension;
· atrial fibrillation;
· the need for long-term immobilization or radical surgery, any surgical interventions on the lower extremities, extensive trauma. It is recommended to stop using Logest: in the case of planned surgery, at least 4 weeks before it is performed. You cannot take the contraceptive Logest again in these cases if less than 14 days have passed since complete remobilization;
· migraine.
If the patient has one or more of the above conditions, then a careful analysis of the benefit/risk ratio is necessary, taking into account the individual characteristics of the patient, before prescribing Logest. In case of deterioration of the condition, exacerbation of one or more diseases from the above list, or development of any of these conditions, it is necessary to consult a doctor, who will decide whether to continue or discontinue taking Logest.
In the case of thrombophlebitis of superficial veins or varicose veins, there is no consensus regarding the possibility of developing venous thromboembolism. However, it is recommended to take into account the increased risk of thromboembolic complications during the postpartum period.
Other diseases associated with changes in circulation include: chronic inflammatory bowel disease (ulcerative colitis or Crohn's disease); systemic lupus erythematosus; diabetes; uremic hemolytic syndrome; sickle cell anemia.
It is necessary to urgently stop taking a hormonal oral contraceptive if an exacerbation of migraine occurs while taking Logest, since this may indicate a prodromal period of cerebral circulatory disorders.
There are a number of biochemical tests that can identify an acquired or hereditary tendency to arterial or venous thrombosis: hyperhomocysteinemia, CRP resistance, protein C deficiency, antithrombin III deficiency, antiphospholipid (anticardiolipin) antibodies, protein S deficiency.
When analyzing the benefit/risk ratio, the physician should take into account that proper treatment of the above conditions may reduce the likelihood of developing thrombosis, as well as the fact that thrombosis associated with pregnancy is more common than when taking low-dose hormonal oral contraceptives (ethinyl estradiol ≤ 0.05 mg).
2. Tumors
The main predisposing factor to cervical cancer is the persistence of highly oncogenic strains of human papillomavirus. According to some epidemiological studies, the risk of cervical cancer increases when the combination of infection with the human papillomavirus and the use of hormonal contraceptives. However, this statement is controversial because this study did not include examination of other precipitating factors (frequency of cervical smears, use of barrier methods of contraception, sexual behavior).
According to the results of a meta-analysis of data from 54 epidemiological studies, the risk of developing breast cancer in women using hormonal oral combined contraceptives as a method of contraception increases slightly (RR = 1.24). The increased risk of breast cancer gradually disappears after stopping contraceptives for 10 years. Breast cancer is quite rare in patients under 40 years of age. And the increased incidence of breast cancer in patients taking hormonal contraceptives (or who have recently stopped taking them) may be associated with regular examinations of these women.
There is no evidence of a cause-and-effect relationship between contraceptive use and the development of breast cancer. A tendency has been noted that in women who took hormonal contraceptives, breast cancer is less clinically pronounced compared to women who have never used this method of contraception.
There have been isolated cases of malignant and benign processes in the liver in women who used hormonal contraception. In some cases, such tumors led to intra-abdominal bleeding, which was life-threatening for the patient. If a woman, while taking Logest, develops liver enlargement, intense abdominal pain, signs of bleeding into the abdominal cavity, then a differential diagnosis of a liver tumor is necessary.
3. Other conditions
If hypertriglyceridemia is present, the patient is at risk of developing pancreatitis while taking hormonal medications (including a hereditary history of hypertriglyceridemia).
Hormonal oral combination contraceptives may slightly increase blood pressure, but clinically significant hypertension has been observed in isolated cases. It is advisable to discontinue Logest if a woman develops a clinically significant increase in blood pressure and provide her with appropriate treatment.
In the literature there are indications of the development or exacerbation of the following diseases while taking hormonal oral combination drugs:
itching and/or jaundice associated with cholestasis,
hemolytic-uremic syndrome,
· formation of gallstones,
hearing loss associated with otosclerosis,
Sydenham's chorea
systemic lupus erythematosus,
· porphyria,
· herpes of pregnant women.
These same diseases also occur during pregnancy. It has not been definitively established that the cause of the development of the above diseases was the use of hormonal contraceptive drugs.
If liver dysfunction develops while taking Logest, the drug should be discontinued.
Hormonal oral combined contraceptives can affect glucose tolerance and insulin resistance of peripheral tissues, however, recommendations on the advisability of changing the dose of insulin in women with diabetes have not yet been formed.
The connection between the development of ulcerative colitis and Crohn's disease and the use of hormonal contraceptives is indicated. Patients prone to the appearance of facial skin pigmentation (chloasma) should avoid exposure to insolation while taking Logest.
Medical examination
Before prescribing Logest (including re-prescribing), a thorough medical examination of the patient is necessary, taking into account warnings and contraindications. While taking Logest, it is recommended to periodically conduct a medical examination to exclude possible risk factors and contraindications (since they may arise after the patient began taking the hormonal oral combined contraceptive Logest).
The nature and frequency of medical examination are determined individually. The list of studies includes: examination of the pelvic organs, mammary glands and abdominal cavity, standard cytological analysis of the cervix and determination of blood pressure.
The patient is warned that Logest does not protect against HIV infection (AIDS) and other transmissible sexual infections.
Reduced efficiency
The effectiveness of Logest decreases with gastrointestinal diseases, taking other medications, or skipping pills.
There was no effect of Logest on the ability to drive vehicles or work with high-precision mechanisms.
Authors
Links
- Official instructions for the drug Logest.
Description of the drug " Logest"on this page is a simplified and expanded version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and read the instructions approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
Release form, composition and packaging
Dragee white, round in shape.
Excipients: lactose monohydrate 37.155 mg, corn starch 15.5 mg, polyvidone 25,000 1.7 mg, magnesium stearate 550 mcg, sucrose 19.66 mg, polyvidone 700,000 171 mcg, macrogol 6000 2.18 mg, calcium carbonate 8.697 mg, talc 4.242 mg, mountain glyco wax Liium 50 mcg .
21 pcs. - blisters (1) - cardboard packs.
21 pcs. - blisters (3) - cardboard packs.
Clinical and pharmacological group
Monophasic oral contraceptivepharmachologic effect
Monophasic combined gestagen-estrogen contraceptive drug. Inhibits the secretion of gonadotropic hormones of the pituitary gland, inhibits the maturation of follicles and prevents the ovulation process. Increases the viscosity of cervical mucus, which makes it difficult for sperm to penetrate the uterus.
With the use of the drug, the menstrual cycle becomes more regular, painful menstruation is less common, the intensity of menstrual flow decreases, resulting in a reduced risk of iron deficiency anemia.
Pharmacokinetics
Gestoden
Suction
After taking the pills orally, gestodene is quickly and completely absorbed from the gastrointestinal tract. C max of gestodene is reached after 1 hour and is (after taking 1 Logest tablet) 3.5 ng/ml. The bioavailability of gestodene is 99%.
Distribution
Gestodene mainly (about 69%) binds to globulin (GSBG - sex steroid-binding globulin). With daily use of Logest, accumulation of gestodene in the blood serum is observed, while the average level of gestodene in the second half of the cycle (after 2 weeks of use) is approximately 4 times higher than at the beginning of taking the drug. Due to the specific binding of gestodene to GSPS, an increase in the level of GSPS is accompanied by an almost parallel increase in the level of gestodene in the blood serum. After 3 cycles of taking the drug, the degree of SHB induction in the cycle no longer changes.
Vd is 0.7 l/kg.
Metabolism and excretion
The pharmacokinetics of gestodene is biphasic.
T1/2 for the terminal phase is about 12 hours. Gestodene is excreted from the body only in the form of metabolites. The rate of metabolic clearance from serum is 0.8 ml/min/kg. Metabolites are excreted by the kidneys and through the intestines in a ratio of 6:4. T1/2 of gestodene metabolites is 24 hours.
Ethinyl estradiol
Suction
After taking the pills orally, ethinyl estradiol is quickly and completely absorbed from the gastrointestinal tract.
Cmax of ethinyl estradiol is achieved after 1.7 hours and is (after taking 1 Logest tablet) 65 pg/ml. As a result of intensive metabolism during absorption and primary passage through the liver, its bioavailability is approximately 45% and is characterized by significant individual variability.
Distribution
An equilibrium state is achieved after 5-6 days of regular use, with C ss being 40-60% higher than the concentration of ethinyl estradiol after a single dose of Logest. The binding of ethinyl estradiol to plasma proteins (mainly albumin) is more than 90%.
Vd is 5 l/kg.
About 0.02% of the daily dose of ethinyl estradiol is excreted in breast milk.
Metabolism and excretion
Ethinyl estradiol is biotransformed in the body. It is excreted in the form of metabolites in urine and bile in a ratio of 4:6. T1/2 is about 24 hours.
Indications for use of the drug
- contraception.
Dosage regimen
The drug is taken 1 tablet/day for 21 days at the same time.
Taking Logest begins on the 1st day of the cycle, using a pill from the cell marked with the corresponding day of the week. After finishing taking all 21 tablets from the calendar pack, there is a 7-day break in taking the drug, during which menstrual-like bleeding occurs. Each subsequent package should be started after a 7-day break from taking the drug (regardless of whether menstrual bleeding has stopped by this time or not).
When switching from combined oral contraceptives It is preferable to start taking Logest the day after taking the last active tablet from the previous package, but in no case later than the next day after the usual 7-day break in taking (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets per package).
If a woman used contraceptives containing only gestagen (“mini-pill”), then she can switch to Logest any day (without a break).
When using injectable forms of contraceptives containing only gestagen, Logest should be taken from the day when the next injection is due.
When switching from implants - on the day of its removal. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill.
After abortion in the first trimester of pregnancy the woman can start taking the drug immediately. In this case, the woman does not need additional contraceptive measures.
After childbirth or abortion in the second trimester of pregnancy Taking the drug should start on days 21-28. If use is started later, then it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill. If a woman was sexually active in the period between childbirth or abortion and the start of taking Logest, then pregnancy should first be excluded or you must wait until the first menstruation.
If the patient for any reason didn’t take the pills at the usual time and less than 12 hours have passed since the scheduled time of administration, the contraceptive effect of the drug is still ongoing and the missed pill should be taken as soon as possible. The next pill must be taken at the prescribed time. Thus, it is possible to take 2 tablets per day. If more than 12 hours have passed since the scheduled time of administration, you should immediately take the missed tablet. Then continue the course as usual. In this case, it is necessary to use additional barrier methods of contraception in the next 7 days, since in this case the contraceptive effect of the drug is weakened. If there are less than 7 tablets left in the package, taking the drug from the next package begins without interruption.
Side effect
From the digestive system: sometimes - nausea, vomiting.
From the reproductive system: sometimes - intermenstrual bleeding (during the first few months of use), changes in vaginal secretion.
From the endocrine system: sometimes - a feeling of tension and enlargement of the mammary glands, changes in body weight, changes in libido.
From the side of the central nervous system: sometimes - decreased mood, headaches, migraines.
Others: Poor tolerance to contact lenses, fluid retention in the body, and allergic reactions are possible.
Contraindications to the use of the drug
- presence of thrombosis (venous and arterial) currently or in history (for example, deep vein thrombosis of the lower extremities, thromboembolism of the branches of the pulmonary artery, myocardial infarction, cerebrovascular disorders);
- the presence or history of conditions preceding thrombosis (for example, transient ischemic attacks, angina pectoris);
— diabetes mellitus with vascular complications;
- the presence of severe or multiple risk factors for venous or arterial thrombosis;
- current or history of jaundice or severe forms of liver disease (until liver tests return to normal);
- presence or history of liver tumors (benign or malignant);
— migraine with focal neurological symptoms (including a history);
- pancreatitis with severe hypertriglyceridemia (including a history);
- identified hormone-dependent malignant diseases of the genital organs or mammary glands (including a history);
- vaginal bleeding of unknown origin;
— pregnancy or suspicion of it;
- lactation;
- hypersensitivity to the components of the drug.
Use of the drug during pregnancy and lactation
Logest is contraindicated for use during pregnancy.
If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided. The active substances included in the drug are excreted in small quantities in breast milk.
Use for liver dysfunction
The drug is contraindicated if you currently have or have a history of jaundice or severe liver disease (until liver tests return to normal).
Use for renal impairment
The drug should be prescribed with caution to patients with impaired renal function.
special instructions
Before starting to use the drug, a woman should undergo a thorough general medical and gynecological examination (including examination of the mammary glands and cytological examination of cervical mucus), exclude pregnancy and blood clotting disorders.
The drug is prescribed with caution to patients with diabetes mellitus, arterial hypertension, varicose veins, impaired renal function, uterine fibroids, otosclerosis, migraine, multiple sclerosis, epilepsy, porphyria, systemic lupus erythematosus, overweight, fibrocystic mastopathy, severe depression in medical history; if there is a family history of thromboembolism, chronic heart failure, stroke, or breast cancer.
The relative risk of developing arterial thrombosis increases when the use of combined hormonal contraceptives is combined with risk factors such as age over 35 years and smoking. In this regard, women over 35 years of age who smoke are advised to quit smoking if they intend to take Logest for contraception.
The risk of thrombosis is also increased in the presence of a family history, obesity, dyslipoproteinemia, arterial hypertension, heart valve disease, and atrial fibrillation.
The drug should be stopped 6 weeks before planned surgery, as well as if long-term immobilization is necessary, and resumed 2 weeks after the end of immobilization due to the increased risk of thrombosis.
If pain appears in the lower extremities along the veins, swelling of the extremities, acute pain or a feeling of tightness or heaviness in the chest, sudden shortness of breath, the drug should be discontinued and examinations should be carried out to identify possible thrombosis or thromboembolism.
When using Logest, it should be taken into account that while taking hormonal contraceptives, the normal course of the menstrual cycle, rectal temperature and the properties of cervical mucus may change.
If persistent skin itching, severe pain in the lower abdomen, severe headaches and migraines, severe depression, a significant increase in blood pressure, increased frequency of seizures, or sudden changes in vision, hearing or speech occur, the drug should be discontinued and additional examination should be performed.
Intermenstrual bleeding may occur during the first few months of use and stops after the body adapts to Logest. If such discharge reoccurs or increases in intensity, an additional examination of the patient should be performed.
If during a 7-day break from taking the pill there is no menstrual-like bleeding, it is necessary to examine the patient without resuming taking the drug.
At vomiting, diarrhea within 3-4 hours from the moment of taking the drug, its contraceptive effect may decrease. In this case, you should continue taking Logest and simultaneously use additional non-hormonal methods of contraception.
In the case of combined use of Logest and rifampicin, the contraceptive effect of Logest is reduced, so additional methods of contraception should be used for 4 weeks after stopping the antibiotic.
Women receiving short-term medications that affect the effectiveness of Logest should temporarily use a barrier method of contraception while taking the appropriate medications and for 7 days after their discontinuation.
Patients who experience chloasma should avoid exposure to the sun while using the drug.
Overdose
Symptoms: nausea, vomiting, uterine bleeding.
Treatment: carry out symptomatic therapy. There is no specific antidote.
Drug interactions
With simultaneous use, rifampicin, ampicillin, tetracyclines, griseofulvin, NSAIDs, phenytoin, phenobarbital, carbamazepine reduce the effectiveness of Logest.
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug should be stored at room temperature. Shelf life - 4 years.
"Name
Trade name - Logest (rus); Logest (latin).
International name - Ethinylestradiol+Gestodene
Release form Logest tablets
The blister contains 21 tablets.
The package contains 21 or 63 tablets (1x21 tablets or 3x21 tablets).
Logest indications for use
Logest is prescribed as a means of oral contraception.
The drug is used to restore hormonal levels and the menstrual cycle after miscarriage or abortion.
Logest, as a drug containing an estrogen and gestagen component, can be prescribed in the complex treatment of gynecological diseases (there is evidence of the effectiveness of the drug for ovarian cysts, endometriosis, uterine fibroids, mastopathy, endometritis and polycystic disease).
Logest can be prescribed to normalize the menstrual cycle, disturbances of which are caused by changes in hormonal levels.
Logest is prescribed for some forms of infertility.
The drug can also be prescribed during menopause due to a lack of female sex hormones.
Logest - description of the properties of the drug
Logest is a hormonal contraceptive pill containing a combination of estrogen and progestogen components. The drug contains synthetic analogues of the female hormones estrogen and progesterone. Logest is effective protection against pregnancy. Its action is based on its influence on the functioning of the ovaries, in particular the inhibition of follicle maturation. In addition, Logest increases the thickness of cervical mucus (which prevents sperm from penetrating into the uterine cavity) and reduces susceptibility to endometrial blastocysts (which prevents the fertilized egg from attaching to the uterine wall). The contraceptive effectiveness of Logest, like other combined oral contraceptives, reaches 99% and is maintained after a 7-day break.
Logest contains low doses of hormones and is well tolerated by patients, so it can be taken for a long time without taking so-called “rest” breaks.
After stopping taking Logest, ovulation (and therefore the ability to get pregnant) is restored within 1-3 months. In some forms of infertility, taking Logest and its subsequent withdrawal may increase the likelihood of pregnancy (due to the so-called rebound effect).
When starting to take Logest, some women experienced an increase in breast size and some weight gain, which is usually associated with fluid retention. In most cases, weight dropped to normal levels within 1-3 menstrual cycles.
Logest, by normalizing hormonal levels, improves the condition of the skin (including if there were acne and pimples before taking it) and reduces the manifestations of hirsutism (excessive hair growth), which is associated with its antiandrogenic effect and a decrease in the activity of the sebaceous glands. The drug can be used as a prophylaxis for a number of gynecological diseases, as it supports normal hormonal levels.
Logest - instructions for use
Taking Logest should begin on the first day of the cycle (1st day of menstruation). If it was not possible to take the drug on the first day, then you can start taking it on the 5th day of the cycle.
Logest should be taken at the same time of day (morning or evening), regardless of meals. Take 1 tablet per day. After finishing taking 1 package (21 tablets), take a break for 7 days, after which they begin taking the next package (21 tablets). During the 7-day break, menstrual-like bleeding should begin. The next package is started regardless of the bleeding (even if it has not ended or was completely absent).
Special instructions: if 1 tablet is missed, you should take it as soon as possible. If less than 12 hours have passed since the planned time of administration, no additional measures are required, but if more than 12 hours have passed, contraception is considered unreliable and the use of an additional method of contraception (for example, barrier) is required.
If 2 or more tablets were missed during the cycle (more than 12 hours passed after the planned time of taking each time), then additional contraception is required during the entire cycle.
If vomiting begins within 1 hour after taking the tablet, contraception is considered unreliable and additional contraception should be used for 7 days (the following tablets are taken according to the usual schedule).
Some medications may reduce the effectiveness of estrogens, which should be taken into account when prescribing treatment for women taking Logest. If the prescription of such drugs cannot be avoided, then additional contraceptives should be used.
Logest - side effects of the drug
Sometimes unusual vaginal discharge, intermenstrual bleeding, aggression, effects on weight (increase or decrease), dizziness, itching and decreased libido were noted.
Side effects such as changes in psychoemotional state, development of candidiasis, swelling of the extremities, and thrombosis are also possible. It is also possible to develop undesirable effects on the heart, blood vessels, digestive tract and hematopoietic system.
Logest - contraindications for use
Intolerance to the ingredients of the drug, severe dysfunction of the liver, kidneys and cardiovascular system, thrombophlebitis. Vaginal bleeding of unknown cause, migraine, diabetes mellitus, active smoking (especially for women over 35 years of age), hormone-dependent malignant neoplasms, pregnancy or suspected pregnancy.
Prescribe antibiotics (including azalides) with caution while taking Logest. You should not drink alcohol while taking Logest.
The drug should not be taken if a woman is breastfeeding, since the components of Logest pass into breast milk.
Logest - composition
1 tablet contains:
Active ingredients:
Ethinyl estradiol - 0.02 mg;
Gestodene - 0.075 mg.
Additional ingredients.
Logest - analogues
Drugs with similar effects: Yarina, Lindinet, Novinet, Janine, Regulon, Jess. Oral contraceptives are selected only by a doctor after a face-to-face consultation.
Storage
Logest is good for 4 years when stored at room temperature.