Ethinylestradiol+dienogest

Dienogest+ethinylestradiol is not recommended for use in women over 35 who smoke. Dienogest+ethinylestradiol should not be used in case of any known allergy to either of the components. Dienogest+ethinylestradiol is not advisable for use in case of high risk or previous history of any mental health disorders, arterial or thrombotic disorders, cardiovascular health disorders, liver disease, gallbladder disease, history of breast/uterine/cervical cancer or any hormone-sensitive cancer. Women with a history of angioedema should exercise caution while taking Dienogest+ethinylestradiol as it may worsen the angioedema. Please consult the doctor before using Dienogest+ethinylestradiol during pregnancy or breastfeeding. It is advisable not to consume Dienogest+ethinylestradiol with alcohol. Inform the doctor right away if you notice any dark urine, yellowing of the eyes/skin, severe mood changes or any sudden heavy bleeding. Women with a tendency for chloasma/melasma (a skin condition commonly seen in middle-aged women) should avoid sun exposure after taking Dienogest+ethinylestradiol.

Drug-Drug Interactions:  Dienogest+ethinylestradiol is known to interact with antiepileptics (carbamazepine, phenytoin, felbamate, topiramate), antidepressants (St. John’s wort) and antibiotics (rifampicin, rifabutin), anti-fungal (griseofulvin) and anti-HIV drugs (nelfinavir, ritonavir). 

Drug-Food Interactions: Grapefruit juice may interfere with the absorption of Dienogest+ethinylestradiol. Proceed with caution.

Drug-Disease Interactions: Dienogest+ethinylestradiol may interact with blood clotting disorders, hypertension, breast disorders, cancer, depression, diabetes, angioedema, heart problems, cardiovascular disease, kidney disease, liver disease, stroke, unexplained vaginal bleeding and or thyroid issues.

• As nausea and vomiting may occur with the use of Dienogest+ethinylestradiol, make sure to take it on light, small meals. 
• Let your doctor know if you are planning to get pregnant. 
• After starting Dienogest+ethinylestradiol, use another alternative non-hormonal contraceptive for at least ten days.
• Maintaining a healthy weight can go a long way in promoting healthy female reproductive health. Make sure you exercise for at least 30 minutes every day. However, do not engage in very strenuous physical exercise as this can worsen bleeding. 
• Regularly working night shifts can affect hormone production. Try to avoid night shifts. 
• Maintain good sexual hygiene and prevent any sexually transmitted diseases by practising only safe sex.
• Limit your intake of caffeine and alcohol. 
• Avoid smoking. 
• Avoid grapefruit juice while taking Dienogest+ethinylestradiol as this may interact with Dienogest+ethinylestradiol and affect its absorption. 
• Increase your intake of red vegetables, fruits, dry fruits, spinach, nuts and beans as these help in new blood formation. 
• Keeping your skin hydrated by drinking enough water can also do wonders for the overall quality of your skin. 
• Always wash your makeup before sleeping. Never go to bed with makeup on.
• Exfoliate your skin lightly but regularly. This helps wash away dry and dead cells, cleansing the skin. 
• Severe nausea or vomiting following the use of the tablet can be considered a missed dose. In this case, additional contraceptive measures are advised. 

• Do not skip tablets or delay intake by more than 12 hours. In case of a missed dose, try to catch up as early as possible. However, if the time for the second dose has come too close, revert to your original schedule. 
• Chart your menstrual cycle and take Dienogest+ethinylestradiol on Day 1 of your cycle, i.e. Day 1 of your period. 
• Use a condom or any non-hormonal contraceptive for the first ten days after starting Dienogest+ethinylestradiol.
• Please inform the doctor immediately if you notice any breast lump, dark urine, yellowing of the skin, mood changes, headache, palpitations, severe fatigue or any alarming changes in vaginal bleeding. 
• Call for the doctor right away in case of any stroke symptoms such as breathlessness, confusion, dizziness, left arm pain, jaw pain or sudden vision changes or any pulmonary embolism symptoms such as cough, leg pain and warmth, pain in calf etc.