Pills silhouette method of administration. Silhouette: instructions for use. General concept of endometriosis

To prevent an unwanted pregnancy from unexpectedly occurring, contraceptive methods must be carefully considered. For these purposes, hormonal contraceptives are ideal. They have proven effectiveness. In addition to the basic functions, these oral contraceptives have others. For example, against the background of their intake, the condition of the skin, hair improves, weight normalizes, and hormonal imbalances are eliminated.

In this article, we will consider the silhouette contraceptive pills. Feedback from patients and doctors will also be provided.

The mechanism of action of the drug and its composition

The drug has a pronounced antiandrogenic effect due to the action of two main and several auxiliary substances that are included in its composition.

Below is the composition of the drug "Silhouette" (reviews confirm its high efficiency):

Dienogest;

Ethinylestradiol;

Corn starch;

Lactose monohydrate;

Magnesium stearate.

Ethinylestradiol is a hormonal agent of the estrogen series (estrogen), dienogest also refers to hormonal substances (progestogen).

These components have the following effect:

They slow down peristalsis in the fallopian tubes, that is, the muscle fibers do not contract so intensively, as a result, the egg cannot actively move along them;

Decreased sex drive;

Trouble falling asleep.

The most common unpleasant phenomenon is the occurrence of pulling pain in the lower abdomen, as well as nausea and headaches. But for most women, they disappeared within a month and a half after taking the first pill.

The negative impact of smoking is possible. Therefore, in order not to aggravate the side effect of "Siluet", smoking must be quit, preferably long before taking the drug.

The instruction for the drug "Silhouette" (reviews confirm this) indicates that there are certain features of taking combined oral contraceptives. First of all, they must be prescribed by a doctor. Self-administration is unacceptable, since the uncontrolled intake of hormones can harm the body.

After the drug is purchased, you must carefully study the instructions for use. It states the following:

If a woman is just planning to start taking this medication, then this should be done on the first day of her period.

If a woman has already taken another hormonal drug, then "Silhouette" can be drunk one day after the end of the course of the previous remedy.

You need to take a pill at the same time every day. Drink with a little plain water. The dosage of one tablet should not be exceeded.

The order of reception is indicated by arrows on each blister. It must be adhered to and in no case violated.

If a woman had an abortion in the first trimester of pregnancy, then the contraceptive must be taken on the same day that the operation is performed.

For abortion or childbirth in subsequent trimesters, the contraceptive must be used 28 calendar days after surgery or natural delivery.

There is no need to take breaks from taking hormonal contraceptives, it is not necessary. Thus, you can only harm your body by creating artificial jumps in the hormonal background.

If you miss taking a pill due to forgetfulness, you must immediately drink it as soon as the woman remembered about it.

If vomiting has occurred several hours after taking the drug, you need to take the pill again, since the previous one did not have time to be absorbed.

This is the difference between the Silhouette contraceptive pills. Most of the reviews about them are positive.

Before starting the appointment, you need not only a specialist consultation, but also a complete examination of the whole body. This will help to identify the existing pathologies that prevent the use of oral contraceptives. The woman may also be pregnant, which needs to be determined in advance.

If you violate the order of taking the Silhouette tablets, it can lead to a serious hormonal disruption in the body.

Simultaneous reception with other means

Is the use of the drug "Silhouette" always permitted? Reviews confirm that the interaction of the drug with other hormonal agents is unacceptable. Also, some medications cannot be taken during the period of treatment with the agent in question. These include:

- "Phenobarbital".

- "Tetracycline".

- "St. John's wort extract".

- "Ampicillin".

- "Carbamazepine".

- "Ritonavir".

- "Ribafutin".

These drugs lead to bleeding from the genital tract, and the effect of contraception may be reduced.

Some medications, the action of which is aimed at reducing the clearance of sex hormones, including those that cannot be taken together with Siluet.

special instructions

If any side effects occur while taking combined oral contraceptives, you should immediately see the gynecologist and inform him about it. Perhaps he will prescribe another drug that will provide the desired effect without negatively affecting the body.

Why does the condition of the skin and hair improve during the use of hormones? This question is of interest to many. The fact is that the production of sebum decreases. Hair becomes less oily as a result, and acne does not form on the skin. But you should not take the drug only for this. You should always remember about contraindications and side effects.

"Silhouette": reviews of doctors and patients

There are numerous reviews of these contraceptives. Doctors prescribe them not only for the purpose of protection, but also for the treatment of various female problems. The tablets are generally well tolerated, side effects are extremely rare. Patient reviews confirm this.

Many women like the condition of the skin while taking the "Siluet", as well as the fact that the pain has stopped during menstruation. Some had headaches worse, but overall the reviews are good.

Oral contraceptives are used by many women to avoid unwanted pregnancies. There are several drugs with proven effectiveness. In addition to their main purpose, these funds are able to improve skin condition, normalize weight and eliminate problems caused by hormonal imbalances. One of these medications is "Silhouette".

Act

This combined drug has a pronounced antiandrogenic effect. It contains two main and several auxiliary substances: ethinylestradiol - a hormonal agent of the estrogen series (performs the functions of estrogen); dienogest is a hormonal drug (it acts as a progestan); lactose monohydrate, corn starch, magnesium stearate.

Therapy with this drug leads to certain changes in the female body:

• Peristalsis in the fallopian tubes slows down (due to a decrease in the intensity of contractions of muscle fibers, which prevents the movement of the egg).
• Mucus in the cervical canal thickens (which creates obstacles to the advancement of sperm in the genitals).
• By reducing androgens, ovulation is suppressed, and folliculogenesis is also impaired.
• The structure of the endometrium in the uterus changes in such a way that the embryo cannot gain a foothold in it.

Taking dienogest in combination with ethinyl estradiol helps to reduce ovulation and the level of androgens in a woman's body.

Indications for use

• As an oral contraceptive to prevent an unplanned pregnancy.
• In the treatment of girls and women, acne caused by an increased level of androgens.
• For the treatment of endometriosis (thickening of the layer lining the uterus).

Each of the hormones contained in the tablets is used in the treatment of infertility, while their combined action has a contraceptive effect.

"Silhouette" for the treatment of endometriosis

This combination medicine is used to treat endometrial overgrowth in young girls and women. In the case when surgical intervention is contraindicated, therapy with the drug Silhouette is performed for endometriosis:

1. Decreased synthesis of estrogen.
2. There is a blockage of the proliferation of the endometrium outside the uterus.
3. Ovulation is suppressed.
4. Regular intake contributes to the atrophy of the foci of endometriosis (by reducing their blood circulation).

In addition to a complete cure for the disease, many women note that the remedy restores the menstrual cycle, removes pain during sexual intercourse and reduces pain during menstruation.

Contraindications

Since this is a fairly strong hormonal drug, there are a number of conditions in the body in which it is not recommended to use it:

• Cardiovascular diseases (angina pectoris, myocardial infarction, pulmonary embolism, thrombosis, severe arterial hypertension; hereditary tendency to form blood clots).
• Pancreatitis
• Liver dysfunctions (failure, hepatitis).
• Malignant tumors (especially of the uterus, appendages and mammary glands).
• Diabetes.
• Epilepsy.
• Sickle anemia.
• Pregnancy and breastfeeding. If pregnancy was detected while taking the drug, it is canceled. The studies did not reveal the effect on the fetus of contraceptives, which were taken inadvertently. The combination of the active ingredients of the drug can penetrate into the mother's milk and have a negative effect on the child, therefore, during lactation, the use of the drug is prohibited.
• Severe migraines, especially with neurological symptoms.
• Lactose intolerance.
• Vaginal bleeding (with an unexplained cause).

In addition, the contraceptive is prohibited for those who smoke and after 35 years of age. If the disease was detected during the course of treatment with the drug, it should be canceled and the doctor should be consulted immediately.

Side effects

When using the Silhouette birth control pill, women may experience certain body reactions:

• Changes in the emotional background.
• Headaches or migraines.
• Increased heart rate.
• Abdominal pain, nausea, diarrhea.
• Skin rashes.
• Increased (or decreased) appetite.
• Painful sensations in the mammary glands.
• Lack of libido.
• Insomnia.

Many women who have taken the Siluet note that the most common symptoms are pulling pain in the lower abdomen (as with menstruation), nausea and headaches. Typically, these symptoms go away within a month after starting the drug.

In addition, some of the side effects can arise from smoking, so a woman is advised to quit this habit before starting the contraceptive pill. The silhouette can cause dry eyes and decreased visual acuity in women who wear contact lenses.

Features:

The instructions for use indicate the following reception schemes:

1. If the drug is used for the first time, it should be started on the first day of menstrual bleeding.
2. If the Silhouette replaces another contraceptive, it should be taken 24 hours after the end of the course of the previous drug.
3. It is necessary to use a contraceptive once a day, preferably at the same time, after meals, with plenty of water.
4. You need to drink the product in accordance with the order indicated on the blister pack.
5. If the contraceptive is taken after an abortion in the first trimester of pregnancy, it is prescribed on the day of surgery.
6. For abortion or childbirth in the second and third trimesters, the drug is taken 21-28 days after the intervention or natural childbirth.
7. Breaks during the course of admission are unacceptable, if a woman has forgotten to take a pill, it is necessary to resume taking it as soon as it becomes clear.
8. If side effects from the gastrointestinal tract occur (vomiting 3-4 hours after ingestion), you must take the remedy again.

Before prescribing a course of oral contraceptives, a complete examination of the body should be carried out to identify possible diseases for which the drug is prohibited. It is also necessary to exclude pregnancy.

The drug should be taken only as described in the instructions, since a deviation from the specified order can cause hormonal changes in the body.

Interaction with other drugs

Taking Siluet at the same time as other medicines can cause vaginal bleeding or a decrease in the contraceptive effect. This can happen when interacting with certain substances:

• Carbamazepine.
• Phenobarbital.
• Ribafutin.
• Ritonavir.
• St. John's wort extract.
• Tetracycline.
• Ampicillin.

In addition, a decrease in the protective effect and vaginal bleeding can occur while taking a contraceptive with drugs that increase the clearance of sex hormones.

Oral contraceptives are used by women to protect against unwanted pregnancies. These drugs allow you to normalize the skin condition and weight, problems with which were provoked by a hormonal imbalance. The silhouette is also used to treat endometriosis.

It should be remembered that by prescribing yourself to take birth control pills yourself, you can harm the body. Therefore, before starting the course of the Silhouette, it is imperative to consult with a gynecologist and undergo a complete medical examination.

Flovit.ru

Siluette tablets - instructions for use of hormonal tablets reviews about Siluette, a contraceptive for endometriosis

Siluet is a contraceptive and antiandrogenic drug. It contains two substances: ethinylestradiol and dienogest. The first component acts as estrogen, and the second as progesterone. The contraceptive effect of Siluet is based, like other drugs, on inhibition of ovulation, thickening of cervical mucus, changes in the state of the endometrium. However, as a rule, Siluet provides not only the prevention of unwanted pregnancy, but also the treatment of conditions associated with an increased concentration of "male" hormones - androgens. Symptoms of this condition include acne, oily seborrhea. This drug is a generic (copy) of the original drug Janine.

Siluet is used for:

• Prevention of unwanted pregnancy;
• Elimination of acne (acne) in women, along with contraception;

Release form Siluet - tablets. The blister contains twenty-one tablets with the same concentration of active ingredients. That is, it is a monophasic hormonal agent. The instruction of the drug Siluet contains recommendations for switching to it, after the abolition of various contraceptives (pills, implants, injections, etc.), as well as after abortions. It also tells you in detail what to do if you miss a pill.

Like other hormonal drugs, Siluet should be taken on the first day of the menstrual cycle. Pick one time when you are comfortable with taking your pills and try to stay on that schedule. At the end of taking a pack of Siluet, you need to take a break of seven days. At this time, bleeding usually occurs. The next pack of Siluet should be used a week after the end of the previous one.

Siluet is contraindicated for:

• Various blood clotting disorders - a tendency to thrombosis, increased coagulability and, even, in the presence of factors predisposing to such pathologies;
• Pancreatitis and increased cholesterol concentration;
• Certain liver diseases;
• Epilepsy;
• Migraines with neurological symptoms;
• Disorders of carbohydrate metabolism;
• Vaginal bleeding of unexplained origin;
• Pregnancy and lactation;

There are also a number of conditions that require special care when using Siloet. If, when prescribing this contraceptive, the patient did not have contraindications, but they arose in the process of taking the drug, you must immediately inform the doctor about this. The specialist may consider it necessary to cancel Silouette.

Side effects of Siluet

The instructions for the drug contain a detailed table of undesirable effects of Stluet. We will list here only those that are common, that is, at least in one case out of a hundred. It:

• Headaches, cramps in the calf muscles;
• Weight gain;
• Breast engorgement;
• Nausea;
• Decreased libido and bad mood;

The risk of thrombosis, hypertension, and tumor processes in the liver also increases. Other pathologies are possible, the development of which is associated with the use of oral contraception.

Reviews about Siluet

The body's response to the use of different oral contraceptives is individual. This is evidenced by the reviews about Siluet, which can be found on various forums. There are opinions of those who feel great using this drug:

Passed a full examination - hormones, examination, ultrasound. Then the doctor prescribed Siluet to me. I have no side effects - no nausea, no chest pain, and so on. I advise everyone to be examined first, and then choose contraceptives.

Once a month there was severe dizziness. But I can't find any more complaints. I will continue to drink Simluet.

Often, patients worry that they do not have menstrual bleeding during the week's break. Others, on the contrary, are faced with the fact that "menstruation" does not end even when a woman starts drinking the next pack of the drug. But these phenomena are possible. They are not undesirable and should not constitute a reason for canceling Siloet. Such drugs cause some shifts in the hormonal regulation of the body - hence the interruptions in the cycle.

There are a lot of negative reviews about taking Siluet:

I was nauseated all month, dizzy. Barely endured until the end of the pack. I will take Janine again, although it is more expensive.

I accept the Silo as prescribed by the doctor, "to rest the ovaries." I don’t know how my ovaries are, but my overall health has become not very good: now my head hurts, then insomnia, then I feel sick, then depression ...

Indeed, hormone-based birth control can cause a variety of side effects. Sometimes, to find the right drug, you need to try several drugs. It is imperative to conduct such experiments together with a competent doctor. Such tactics will allow you to quickly choose an effective means.

zhivizdorovim.ru

Contraceptive pills Silhouette: description and treatment regimen of the contraceptive

Silhouette is a new generation drug belonging to the group of monophasic contraceptives. Available in white biconvex tablets with G23 engraving. One blister contains 21 tablets.

The preparation contains two active ingredients: dienogest and ethinylestradiol.

Dienogest is a substance otherwise called hybrid progestogen. It does not have an androgenic or mineralocorticoid effect on the body, but gives a pronounced progestogenic effect. Also, this substance is safe for metabolic conversion in tissues, due to which dienogest can be used for long-term therapy.

Ethinylestradiol is an estrogenic substance that is widely used in modern gynecology. The substance contains an ethyl radical, it provides excellent digestibility, and also makes the transformation into low-active forms of female hormones slower and stops the decomposition of the substance. Thanks to this, ethinyl estradiol acts much longer and much more effectively.

The silhouette contraceptive pills contain 30 mcg of ethinylestradiol and 2 mcg of dienogest, as well as auxiliary components: lactose monohydrate, talc, starch, hypromellose, potassium polyarylate, magnesium stearate.

Action of pills Silhouette and dosage

These pills have the following functions in the female body:

1. inhibition of ovulation;
2. increased viscosity of cervical mucus;
3. change in the peristalsis of the fallopian tubes;
4. transformation of endometrial structures.

The active ingredients of the tablets, in combination with each other, effectively reduce the level of androgens in plasma. For some women, Silhouette helps fight acne and seborrhea.

The tablets should be taken strictly following the instructions attached to them. It describes the dosage regimen - one tablet once a day for twenty-one days.

The contraceptive should be taken regularly, at the same time.

After the twenty-first day, a week break is taken before starting a new course. In this seven-day period, what is called withdrawal bleeding should occur. This bleeding should begin two or three days after the end of taking the pills, and its duration is 4 to 5 days. By the time it ends, it becomes necessary to start taking pills from the next blister.

However, there is one important nuance that characterizes the first use of the Silhouette. The instructions for use say that it is necessary to start using a contraceptive on the first day of menstruation. This condition is mandatory only for those women who have not previously taken any hormonal contraceptives or have not used them for more than a month.

Features of taking contraceptive pills Silhouette

If it was decided to use Silhouette pills after combined contraceptives, then, according to the instructions, the first use should be made at the usual time of the next day, that is, after the last pill has been taken.

If a woman switches from a medication that consists only of progesterone, then the switch can be made any day when it is convenient. After removing the implants, you can take the pill on the same day. If at first the woman used injectable contraceptives, then in order to switch to the pill form, she must take the first pill on the day of the planned injection.

In cases where a woman suffered a miscarriage in the first trimester, neither the instructions nor the doctors prohibit the intake of Siluet as a hormonal agent immediately. If a miscarriage or abortion occurred at a later date, then before you start taking the pills, you need to wait a short time - 21 - 28 days. During this period, condoms should be used during sexual intercourse.

If a woman forgot to drink the medicine on time, and less than twelve hours have passed since that moment, then the strength of the drug's action does not decrease. The tablet should be taken immediately, and the next should be taken at the usual time. But when the reception delay exceeds twelve hours, then you need to adhere to some rules.

Firstly, in no case should you interrupt the intake of funds for more than one week. In order for the drug to have its effect on the female body, it must be consumed for at least seven days continuously. Therefore, gynecologists recommend in case of missing a dose in the first week of using the Silhouette tablets, immediately drink the missed dose, and take the next tablet at the appointed time, as usual. And insure yourself with condoms for a week.

If the pass occurred in the second week of using the drug, then the pill should also be taken immediately, but there is no need for additional protection. A failure that occurs during the third week should be corrected in the same way as in the first week. And after that, the next package of the drug is started immediately, without a seven-day break. However, “withdrawal bleeding” in this case can not be expected, but small spotting is quite possible.

Drug overdose Silhouette

The dosage toxicity of the hormones in the silhouette is quite low. However, overdose is quite possible. In this case, the woman will feel nausea, vomiting is possible. Vaginal discharge and even bleeding are also possible. But with all this, there is absolutely no need for therapy.

Side effects of the drug Silhouette

Since Silhouette is, first of all, a hormonal agent, you need to know that you cannot independently prescribe this medicine to yourself as a contraceptive. Doctors especially distinguish among the side effects the development of thrombosis in the arteries and veins. This effect can be aggravated if a woman smokes, as well as in cases when she suffers from hypertension, pathology in the hemostatic system, varicose veins, obesity or thrombosis.

Among the side effects, you can also often observe:

• migraines and headaches;
• nausea, vomiting;
• cramps of the calf muscles;
• emotional imbalance;
• an increase in the size of the mammary glands;
• pain in the mammary glands;
• back pain;
• increase in body weight.

Such effects are less common:

• arterial hypotension / hypertension;
• varicose veins;
• thrombophlebitis;
• abdominal pain;
• severe excitability;
• acne, dermatitis, itching;
• increased appetite;
• vaginitis;
• rapid fatigue, malaise;
• swelling;
• painful bleeding;
• endometritis, salpingitis;
• allergic reactions;
• anemia, cardiovascular failure;
• insomnia;
• depression and lethargy.

Contraindications to the use of the Silhouette

For some diseases, the drug is strictly prohibited. Among them:

• disease of the veins and arteries;
• pancreatitis;
• porphyria;
• jaundice;
• hyperbilirubinemia;
• severe liver disease;
• epilepsy.

Also, the drug should not be taken by women who:

• are pregnant;
• breastfeeding;
• suffer from lactose intolerance;
• are allergic to any of the components of the medicine.

Endometriosis treatment with silhouette

Endometriosis is a fairly common disease among the female population, which, depending on the degree, can be treated both conservatively and surgically. Treatment of endometriosis with Siluet is often prescribed by gynecologists. These pills have received many positive reviews from gynecologists, who emphasize its safety and effectiveness, and is used as an analogue of the drug "Janine".

The silhouette can be prescribed for endometriosis in cases of:

1. Empiric therapy for newly diagnosed endometriosis.
2. Preoperative preparation with severe forms of the disease.
3. Postoperative therapy as a way to prevent relapse.

Depending on whether a woman plans to become pregnant in the near future, the gynecologist must select an individual dosage and explain to the patient her personal pill-taking regimen. If a woman has been diagnosed with endometriosis, then she should seriously think about the question of pregnancy, because the processes occurring during this action have a positive effect on the patient's health. Changes in the hormonal background contribute to the atrophy of the endometriosis focus and helps to fade inflammatory processes. The stable low concentration of estrogen that occurs when using Siluet stimulates the degradation of ectopic formations.

Description of the action of the Silhouette in the treatment of endometriosis

The tablets gradually cause the foci of endometriosis, no matter where they are, to atrophy. Then Silhouette lowers estrogen synthesis, suppresses ovulation. After this, the proliferation of tissue cells outside the uterus is blocked. Also, during treatment, you can notice a good anti-inflammatory effect from taking the pills.

The drug is prescribed on a cyclical basis if the patient wants to become pregnant or endometriosis was detected at an early stage of her development. The cyclic pattern is also called 21 + 7, which means that the woman must take the medicine for twenty-one days, and then take a week off. Most often, the gynecologist prescribes a course for a period of three to six months. The term varies depending on the general condition of the patient. After the end of the course, the patient is prescribed tests, including a blood test, an analysis of the activity and level of thrombin, ultrasound of the abdominal and pelvic organs. Given the results, the gynecologist is developing further treatment. If a woman does not plan a pregnancy, then after a laparoscopic intervention, taking pills is prescribed according to a prolonged scheme - 42 + 7, 63 + 7 - for a period of several years.

Important information

The attending gynecologist is obliged to warn his patient that the pills should be taken without interruption, otherwise the contraceptive effect and specific therapeutic effect may be violated, and there is also a risk of unplanned bleeding and other negative consequences.

Also, the doctor should advise you to start taking it on the first day of the cycle, because if the patient starts taking pills two to five days after the onset of menstruation, then within a week after the start of taking it will need to be additionally protected with barrier contraception.

drlady.ru

Pill silhouette - Polismed

The silhouette of a pill is a contraceptive drug that affects the production of female hormones. It directly corrects ovulation and is one of the most reliable means of preventing unwanted pregnancy.

Composition and form of release

The presented drug is produced in the form of tablets, biconvex and engraved with G53. Silhouette tablets contain two main active ingredients - dienogest and ethinyl estradiol. The auxiliary components include:

• magnesium stearate;
• corn starch;
• potassium polyacrylate;
• glucose monohydrate.

The tablets are coated with a film that dissolves in the gastrointestinal tract. Shell composition:

• polyvinyl alcohol;
• talc;
• macrogol 6000;
• titanium dioxide.

Indications for use of Siluet (tablets)

The silhouette of the pill is indicated for admission if you wish to take contraceptive measures with regular intercourse. In addition, the presented drug is often prescribed to women diagnosed with acne if other methods of treatment do not bring the desired result.

Please note: when treating acne, the need for contraception must be considered.

Silhouette - instructions for use

The presented contraceptive drug should be taken daily, preferably at the same time. The order of taking the tablets is indicated on the blister pack. Drinking the first package (blister), the pills are stopped for 7 days - the woman begins to "withdrawal bleeding", only after a week's break can you start drinking the next blister.

Important: if Siluet's intake is primary, then the first pill should be taken on the day of the onset of menstruation.

Contraindications

Silhouette instructions for use categorically prohibit admission to women who currently have or have had a history of the following diseases:

• atrial fibrillation;
• angina pectoris;
• bacterial endocarditis;
• superficial and deep vein thrombosis;
• coronary heart disease;
• hemorrhagic disorders;
• pulmonary embolism;
• congenital hyperbilirubia;
• porphyria;
• diabetes;
• arterial hypertension;
• lack of protein C;
• lupus anticoagulant;
• benign liver tumors;
• liver cancer;
• lactose intolerance;
• vaginal bleeding of unexplained etiology;
• migraine;
• epilepsy.

Please note: diabetes mellitus in some cases may be a conditional contraindication. The doctor must exclude vascular disorders against the background of this disease, and only in such a situation can Silhouette tablets be taken.

Special instructions for using the Silhouette and warnings

In the first three months of taking the presented contraceptive, there may be short-term vaginal bleeding (acyclic) - this is considered the norm and refers to the period of adaptation of the body. But if such a phenomenon is regular, then you should consult a doctor - you will need to change the drug.

If there is no "withdrawal bleeding", then this does not mean the onset of pregnancy, but only if the schedule for taking the pills was not violated. If a woman missed the next Silhouette pill, then you should contact a gynecologist to confirm or exclude pregnancy.

Regular use of hormonal contraceptives increases the risk of developing thromboembolic diseases. A woman should pay attention to the following symptoms:

• shortness of breath and coughing fits;
• severe pain in the legs and chest (short-term, but recurring regularly);
• visual impairment;
• dizziness and fainting;
• numbness of any part of the body.

If at least one of them appears, it should be the reason for a visit to the doctor. Some studies confirm an increase in the risk of developing malignant diseases with prolonged use of hormonal contraceptives - more than 5 years.

Pharmacological action of the drug

The silhouette of a tablet is a combined drug with an antiandrogenic effect. The contraceptive effect is due to the following factors:

• the viscosity of cervical mucus increases;
• the structure of the endometrium changes;
• ovulation is inhibited;
• the peristalsis of the fallopian tubes changes.

Side effects

Regular use of Siluet can lead to the following side effects:

• dizziness and migraine;
• short-term vaginal bleeding;
• dry mouth;
• general weakness.

Such effects disappear after a few days of taking the drug and refer to the period of adaptation of the body. Rarely, but more severe side effects are recorded:

• pain along the veins;
• anemia;
• bradycardia;
• disorders of cerebral circulation;
• visual impairment;
• dry mucous membranes;
• development of bronchial asthma;
• sinusitis;
• diarrhea;
• exacerbation of the chronic stage of gastritis;
• insomnia;
• fatigue syndrome.

If any health problems appear, even small changes in well-being should alert the woman - a full examination and consultation of a gynecologist will be required.

Interaction of the silhouette with other medicines

It is believed that taking hormonal contraceptives affects the effectiveness of antibiotics, antivirals and antifungals. In turn, the latter reduce the contraceptive effect. Therefore, when prescribing any course of therapy, it is necessary to warn the attending physician about taking the Siluet tablets.

Interaction with alcohol

Reception of the presented drug simultaneously with the use of alcoholic beverages does not entail a decrease in its effectiveness.

Overdose

No cases of overdose by Siluet in tablets were recorded.

Silhouette of a pill during pregnancy and lactation

During pregnancy, it is forbidden to take any hormonal drug - it can provoke a spontaneous abortion, negatively affects the intrauterine development of the fetus. While breastfeeding, the Silhouette is prohibited.

Storage terms and conditions of the Silhouette

Store the drug in a dry, dark place out of the reach of children. The shelf life is 3 years.

Siluet is a monophasic combined oral contraceptive (CPC) with an antiandrogenic effect.

Release form and composition

Siluet is produced in the form of film-coated tablets: biconvex, round, white or almost white, engraved with "G53" on one of the sides (21 pcs. In a blister of PVC / PE / PVDC-aluminum foil, in a cardboard box 1 or 3 blisters together with a flat cardboard storage case).

Composition of 1 tablet:

• Active ingredients: dienogest - 2 mg, ethinylestradiol - 0.03 mg;
• Additional components: magnesium stearate, potassium polacrilin, talc, hypromellose 2910, corn starch, lactose monohydrate; cover: Opadry II white 85F18422 (talc, macrogol 3350, titanium dioxide, polyvinyl alcohol).

Indications for use

• Contraception;
• Therapy for moderate to mild acne (acne) in the case of ineffective local treatment in women who need contraception.

Contraindications

Absolute:

• History of venous and arterial thromboembolic diseases: pulmonary thromboembolism, deep vein thrombosis, etc .;
• Conditions preceding thrombosis: atrial fibrillation, lesions of the heart valve apparatus with complications, angina pectoris, transient ischemic attacks, extended surgery with prolonged immobilization, subacute bacterial endocarditis, extensive trauma;
• Thrombosis (venous and arterial) and thromboembolism, including a history of data, including hemorrhagic or ischemic cerebrovascular disorders, myocardial infarction, deep vein thrombophlebitis, thrombosis, pulmonary embolism;
• Congenital hyperbilirubinemia (Rotor, Dubin-Johnson, Gilbert syndromes), jaundice, porphyria;
• Pancreatitis with severe hypertriglyceridemia, current or history;
• Severe or multiple risk factors for arterial or venous thrombosis (including risk factors for arterial thrombosis indicated in the history): uncontrolled arterial hypertension, diabetes mellitus with vascular lesions (retinopathy, angiopathy), severe dyslipoproteinemia;
• Predisposition to arterial thrombosis (acquired or congenital), for example, protein C, S deficiency, hyperhomocysteinemia, antithrombin III deficiency, resistance to activated protein C, antibodies to phospholipids (including lupus anticoagulant, antibodies to cardiolipin);
• Sickle cell anemia;
• Severe liver disease, incl. history (before normalization of liver function tests);
• Benign or malignant neoplasms of the liver, including a history of indications;
• Vaginal bleeding of unknown nature;
• Epilepsy;
• Migraine with local neurological symptoms, incl. in the anamnesis;
• Glucose-galactose malabsorption, lactose intolerance, lactase deficiency;
• Smoking over the age of 35;
• Breastfeeding and pregnancy;
• Hypersensitivity to drug components.

At the first manifestations of any of the above diseases during the period of taking oral contraceptives, the use of the latter must be stopped immediately.

Relative (it is necessary in each individual case to carefully weigh the possible risk and the expected benefit from the use of the drug):

• Controlled arterial hypertension;
• Diabetes mellitus without vascular complications;
• Dyslipoproteinemia;
• Fibrocystic breast disease;
• Endometriosis, uterine fibroids;
• A history of severe depression;
• Multiple sclerosis;
• Intolerance to contact lenses;
• Ulcerative colitis, Crohn's disease;
• Kidney dysfunction;
• Thromboembolism, phlebitis of superficial veins;
• Chronic heart failure;
• Myocardial infarction at a young age;
• Acute violation of cerebral circulation;
• Visual impairment (threat of retinal thrombosis);
• Breast cancer in close relatives;
• Hypokalemia, hypercalcemia;
• Tetany;
• Hereditary angioedema;
• Bronchial asthma;
• Idiopathic jaundice / herpes during a previous pregnancy;
• Liver disease.

In the presence of risk factors (bleeding disorders, overweight, heart disease, varicose veins), a thorough examination is necessary before starting the course of the CPC.

If a woman under the age of 35 is unable to quit smoking, it is recommended to resort to another method of contraception (especially if other risk factors are present).

Method of administration and dosage

Siluet is taken orally, 1 tablet daily at approximately the same time, with a small amount of liquid if necessary. The tablets are used in the sequence indicated on the blister pack for 21 days. Then, in the next 7 days after taking the last tablet from the blister, take a break, during which there is (usually 2-3 days) withdrawal bleeding. After the end of the break (on the eighth day), they begin to take the pills from the next package, regardless of whether the bleeding has stopped or not.

If you have previously used progesterone-only pills, you can switch to the drug any day.

In the case when hormonal contraception was not used a month before the start of the course, pills should be started on the first day of the menstrual cycle.

After taking the PDA, it is recommended to switch to using Siluet the next day after the usual interval in taking or after you have finished taking the tablets from the current package of the previous drug.

If you have an implant, you should start using Siluet on the day of its removal, and when switching from an injection form, on the day of the appointment of the next injection.

After an abortion performed in the first trimester of pregnancy, the drug is recommended to be taken immediately after surgery, without the use of additional contraception.

After an abortion in the second trimester or childbirth, the drug is allowed to be taken after 21-28 days. In the case when the reception is started later, it is required to use barrier methods of contraception during the first 7 days. If, before using the product, there was sexual contact, you must wait for the first menstruation or exclude pregnancy.

If you are late in taking the next pill, which is less than 12 hours, the contraceptive effect of Siluet does not decrease. The missed pill should be taken as soon as possible, and the next one should be taken as usual.

If you are late in taking the next pill, which is more than 12 hours, the contraceptive effect may be reduced, as a result of which it is recommended to adhere to two basic rules:

1. The use of the product must not be interrupted for more than 7 days;
2. The drug should be taken for 7 days and be continuous (for adequate suppression of the hypothalamic-pituitary-ovarian regulation).

If you are late in taking the next dose of Siluet for more than 12 hours, depending on the skip period, you should be guided by the following recommendations:

• 1st week. The last missed tablet should be taken as soon as possible (even if you need to take 2 tablets at the same time), the next dose should be taken at the usual time. Additionally, for the next 7 days, it is necessary to use a barrier method of contraception (for example, a condom). If sexual intercourse took place in the previous 7 days before the skip, the possibility of pregnancy should be taken into account, the likelihood of which is higher, the more doses are missed and the closer the pass is to a weekly break in admission;
• II week. It is necessary to take the last missed pill as early as possible (even if you have to use 2 at once), then continue taking the drug as usual. If a woman missed 1 pill, there is no need to use additional contraception; if the pass was more than 1 pill, condoms should be used within 7 days;
• III week. Due to the upcoming interruption in reception, a decrease in the reliability of the PDA is inevitable. But if one of the two schemes suggested below is observed, the need to use barrier methods of protection can be avoided. According to the first scheme, the last missed tablet should be taken as soon as possible, even if the simultaneous use of 2 tablets is required. Then continue the application in the usual way, but without the usual weekly break (after the completion of the previous blister, they immediately start taking from the next one). It is unlikely that menstruation occurs before the end of the second pack, but breakthrough uterine bleeding or spotting spotting may occur. According to the second scheme, you can stop taking pills from the current package, take a break for 7 days (which should include the days of skipping), and then start taking the drug from a new blister. In the absence of withdrawal bleeding in the first subsequent interval between doses, it is necessary to exclude the possibility of pregnancy.

If a woman vomits within 4 hours after taking Siluet, this may lead to incomplete absorption of the drug. In such cases, you need to take a new pill as soon as possible (within 12 hours after the usual time of administration). If the interval between doses is more than 12 hours, you must follow the same recommendations as for the missed pills.

In order to delay the onset of menstruation after the end of the use of the product from the previous blister pack, it is required to immediately start taking the tablets from the new blister without taking a break. In this case, the appearance of breakthrough uterine bleeding or spotting discharge is possible. You can resume taking the usual scheme after the next week break.

In the case when it is necessary to postpone the day of the onset of menstruation to another day of the week, it is recommended to reduce the next interval in taking the tablets by the desired number of days. The shorter the break, the higher the likelihood of no withdrawal bleeding during it, and the higher the risk of smearing discharge and breakthrough bleeding during the second pack.

The following serious undesirable effects have also been reported with Siluet:

• Liver tumors;
• Hypertension;
• Venous / arterial thromboembolic disorders;
• Chloasma;
• Ulcerative colitis, Crohn's disease, systemic lupus erythematosus, porphyria, Sydenham's chorea, herpes of pregnancy, cholestatic jaundice, hemolytic uremic syndrome (the relationship between the occurrence and aggravation of these conditions with the use of PDAs has not been proven).

The incidence of breast cancer while taking Siluet is slightly increased. Since the disease is rarely seen in women younger than 40, this increase is very small in relation to the overall risk of developing breast cancer.

Epidemiological studies have identified a possible causal relationship between the long-term use of oral contraceptives started at a young age and the development of breast cancer in middle age. However, it should be borne in mind that the use of PDAs is only one of many risk factors.

special instructions

Before starting or resuming the use of Siluet, and in the future at least once every six months during the period of its use, a complete medical examination (gynecological and general) should be carried out to identify possible contraindications to admission.

It must be remembered that oral contraceptives do not protect against HIV (AIDS) and any other sexually transmitted infections.

With the use of the drug (especially in the first three cycles), the occurrence of irregular bleeding / spotting from the vagina may occur. Evaluation of such reactions should be carried out after the adaptation period (after about 3 months). If acyclic bleeding recurs or occurs after previous normal regular cycles, an examination is required to exclude possible pregnancy or malignant neoplasms.

In some cases, withdrawal bleeding may not occur in the interval between doses, if the woman strictly adheres to the recommended instructions, pregnancy is unlikely.

When using PDAs, the threat of venous thromboembolism increases, especially in the first year of admission. Symptoms of arterial or venous thrombotic / thromboembolic events may include:

• Sudden severe chest pain (with possible radiation to the left arm);
• Unilateral unusual leg pain and / or swelling;
• Breathing disorder;
• A sudden onset of coughing;
• An unusually long, severe headache;
• Complete or partial sudden loss of vision;
• Aphasia or slurred speech;
• Diplopia;
• Dizziness;
• Movement disorders;
• Loss of consciousness (with a possible partial epileptic seizure);
• Severe weakness or severe numbness of one side or one part of the body;
• Sharp abdomen.

If any of the above conditions occur, you need to stop taking the drug and consult a doctor.

Factors leading to an increased risk of venous thromboembolic complications and arterial thrombosis are: hereditary predisposition, age, prolonged immobilization (after major surgery), high obesity, hypertension, dyslipoproteinemia, heart valve damage, atrial fibrillation, smoking.

Aggravation of the severity and increase in the frequency of migraine attacks while taking Siluet may be a harbinger of cerebrovascular accident, which requires immediate discontinuation of the drug.

The development of liver tumors (benign or malignant) has been reported extremely rarely with the use of PDAs. In some cases, these tumors have caused life-threatening intra-abdominal bleeding. When conducting differential diagnosis, it is required to take into account the appearance of severe pain in the abdomen, symptoms of intra-abdominal bleeding and enlargement of the liver.

Drug interactions

With the combined use of Siluet with drugs that can activate microsomal liver enzymes, a decrease in the effectiveness of contraception and / or the development of breakthrough bleeding is possible. These drugs include: rifampicin, carbamazepine, primidone, phenobarbital, hydantoin, oxcarbazepine, nevirapine, efavirenz, rifabutin, griseofulvin, ritonavir, felbamate, topiramate, and drugs with the inclusion of St. John's wort.

According to clinical observations, the simultaneous use of Siluet with certain antibiotics (tetracycline, ampicillin) can also reduce the contraceptive effect. As a result, during the period of use of any of the above drugs and for 7 days after discontinuation of concomitant therapy, in addition to COC, barrier methods of protection are required.

During the entire course of treatment with rifampicin, as well as 28 days after its completion, additional methods of contraception should be used. If the concomitant agent is used during the period of completion of taking the tablets from the blister, they begin to take them from the next package without taking a 7-day break.

In the case of long-term therapy with the drugs listed above, an increase in the doses of CPC may be required. If undesirable reactions occur against the background of this measure (irregular bleeding, etc.), it is necessary to use another method of contraception.

When using drugs that enhance the clearance of sex hormones, breakthrough uterine bleeding and a decrease in the contraceptive effect of Siluet may occur.

Terms and conditions of storage

Store in a place protected from light and out of reach of children, at a temperature not exceeding 25 ° C.

Shelf life is 2 years.

Silhouette is a hormonal drug related to monophasic oral contraceptives. One of the indications for admission endometriosis.

Composition and form of release

The drug contains dienogest weighing 2 mg... It is a substance derived from natural progesterone, by its mechanism of action contributes to the provision of antiandrogenic activity, in addition, dienogest affects progesterone receptors.

Ethinylestradiol weighing 0.03 mg... Synthetic analogue of estrogen.

These substances act as the main active components of the drug, it is they who have all the effects.

Insignificant amounts of starch, lactose, talc should be allocated as auxiliary substances.

The package consists of 21 tablets, the dosage of the drug in each of which is the same. The tablet has a film coating, white or almost white color, round or biconvex shape. On one side, you can find the engraving G53.

The cost

The average price for a Silhouette is from 1200 to 1400 rubles.

pharmachologic effect

Pharmacodynamics

The silhouette manifests its effect by influencing several links. Prevention of pregnancy occurs after the influence on the hormonal background, stabilizing it.

The follicles in the organ stop developing and maturing. Ovulation does not occur and the eggs do not come out of water. In many ways, a similar effect helps to eliminate cystic formations on the ovaries within a short time or to preserve ovarian reserve. This can delay the onset of menopause for some time.

Due to a change in the composition of mucus in the cervix, it thickens. As a result, a mechanical obstacle is created in the cervical canal for the passage of the sperm.

Due to its composition, Silhouette interferes with the processes aimed at transforming the endometrium. As a result, the endometrial tissue does not reach a great thickness, which reduces the volume of blood lost during menstruation.

This is especially important for women with hyperpolymenorrhea and anemic syndrome.

The silhouette also has a low antiandrogenic effect. Due to this, the work of the ovaries is normalized, by the transformation of androgens into estrogens. Signs of excessive hair growth are eliminated. The silhouette helps to cope with such manifestations of hyperandrogenism as the hirsutism clinic.

Pharmacokinetics

It should be noted that the drug is combined, therefore, the pharmacokinetics of each component should be taken into account separately. Among the main points are:

• Ethinyl estradiol is absorbed quickly enough... The drug reaches its maximum serum concentration in an average of 1.5 to 4 hours. The absorption process takes place in the intestinal cavity. The percentage of bioavailability is high and can reach 45%. The binding of the main active substance occurs with blood plasma albumin. It reaches its equilibrium concentration during the second half of the cycle. Metabolism is carried out in liver cells. The average elimination half-life is about an hour. Full elimination is up to a day. Excretion of metabolites occurs through the urinary system and kidneys.
• Dienogest is also rapidly absorbed... It reaches its maximum concentration for about 2-3 hours. The bioavailability of dienogest reaches about 100%. Achievement of equilibrium concentration appears about 4 days. Binding occurs with albumin in the blood. Metabolism is carried out by hydroxylation. Inactive metabolites achieve rapid excretion. The half-life of the average concentration of the substance is carried out after 9 hours. Excretion is carried out through the kidneys in the maximum amount.

Indications for use of the Silhouette

The main purpose of prescribing the drug is to prevent unwanted pregnancy, especially in cases where alternative methods are contraindicated.

In addition, it can be the restoration of the hormonal background and its stabilization, with manifestations of its violation in the form of an irregular menstrual cycle or functional cysts.

Elimination of manifestations of acne or excessive hair growth, which is based on the primary mechanism of hyperandrogenism.

Also, Silhouette can be taken against endometriosis.

Instructions for use

The silhouette provides for the regular use of the drug. The dosage regimen is the use of 1 table. in a day. Silhouette should be drunk regularly, preferably at the same time.

The duration of the course is 21 days, after which a 7-day break is taken, and then the course is resumed from a new package.

Treatment should be started on the first day of your period. After the end of 21 days of Siluet's intake, a menstrual reaction appears.

If the Silhouette is assigned to women after childbirth, then use begins no earlier than 21 days from the date of birth. The course conducted will be no different from the one recommended as the main one.

Instructions for use for endometriosis provides that the treatment is carried out without interruption.

The silhouette prescribed after diagnostic curettage of the uterine cavity or termination of pregnancy is recommended to be taken from the first day after the procedure. The first pill is taken on the day of the procedure.

If you skip taking the Silhouette pill, which will not exceed 12 hours, no additional measures are taken. If the break is more than 12 hours, it is also worth taking the missed pill and resuming the use of the following in the usual way, but within 7 days it is necessary to use protective equipment.

Contraindications

The drug has absolute and relative contraindications that should be considered before taking the drug. Among them should be highlighted:

• revealed hypersensitivity to the components that make up the composition, as well as the development of allergic reactions that occur in the history;
• a history of thrombosis, thrombophlebitis or other acute pathologies from the venous system. Revealed hypercoagulability or a tendency to develop thrombosis, an unsatisfactory result of a coagulogram;
• acute diseases of the cardiovascular system, the presence of angina attacks and ischemic attacks in history. The presence of high risk factors for the development of myocardial infarction or cerebral stroke;
• arterial hypertension with high rates;
• identified diabetes mellitus with high blood glucose levels and complications diagnosed with it, especially in the area of \u200b\u200bblood vessels. These include diabetic microangiopathy, retinopathy, nephropathy, etc.
• acute inflammatory diseases in the pancreas;
• acute inflammatory and chronic pathologies of the liver, gallbladder and biliary system;
• revealed during biochemical research and clinically determined dyslipoproteinemia;
• epilepsy or other neurological pathologies accompanied by convulsive syndrome;
• a history of uterine bleeding with an unexplained cause;
• pregnancy at any gestational age;
• lactation.

Side effects

When taking Siluet, as well as many other drugs from the group of combined oral contraceptives, all side effects have a similar manifestation, and they are divided into two main groups, these are often found:

• the development of a headache, which is spasmodic;
• bouts of nausea or vomiting that occurs regardless of food intake;
• the appearance of a load in the mammary glands, simultaneously with an increase in size and the development of pain. In this case, the pain can be dull in nature, arising on the 7-10th day from admission;
• pain syndrome in the spine like lumbodynia;
• convulsive syndrome in the calf muscles;
• the development of menstrual bleeding, regardless of the amount of the previously taken drug;
• development of venous thromboembolism, aggravation of varicose veins and the appearance of telangiectasias;
• an increase in body weight associated with an increase in appetite and the development of fluid retention in soft tissues;
• the emergence of a tendency to depressive disorders due to decreased mood.

Less commonly, the following conditions can be identified, which should also be attributed to the manifestation of side effects. These are states such as:

• the development of pain in the abdomen. It proceeds unevenly, in some cases mimicking the clinic of gastritis or colitis;
• interruptions in the work of the heart with a clinic of tachycardia and pain like angina pectoris;
• manifestation of increased excitability, frequent mood swings, irritability;
• impaired visual acuity or persistent dryness of the mucous membranes, including the vagina;
• anemic syndrome;
• skin reactions in the form of the appearance of inflammatory elements or acne;
• flu-like condition with constant weakness, exercise intolerance, etc.;
• an allergic reaction to the components of the drug;
• sleep disturbance with insomnia;
• the appearance of myalgia and arthralgia;
• the development of vaginitis and the addition of a fungal infection.

When treating with Siluet, you should carefully monitor your health status, if you identify any pathologies, you should consult a specialist.

Drug interactions

Care should be taken when taking the Silhouette with other means. Before using the drugs, you should consult a specialist in order to determine whether it is possible to simultaneously combine the means and possible contraception at the time of admission.

So, the effectiveness of the silhouette decreases when receiving ampicillin, rifampicin, tetracycline... For the entire time of admission and half-life should be applied barrier contraception.

Rifampicin enhances the medicinal effect on the body for an average of about 28 days.

Simultaneous use phenobarbital, rifampicin, carbamazepine, griseofulvin and other potent drugs that affect the nervous system, as well as st. John's wort can cause breakthrough bleeding.

Analogs of the Silhouette for the treatment of endometriosis

Currently, the silhouette is recommended for women with signs of endometriosis. In addition, there are a fairly large number of drugs that can replace it, showing a similar effect. The most popular are:

• Byzanne

The drug has a similar mechanism of action for endometriosis and is currently one of the most popular. It contains only dienogest in a volume of 2 mg. Due to it, a progestogenic and antiandrogenic effect is achieved. During the course of treatment, it promotes decidualization of endometrial foci, as a result of which the ectopically located endometrium, which is the main cause of the development of endometriosis, is rejected.

The duration of its reception should not be less than six months. An incomplete course can provoke a second relapse. It can be used prophylactically after surgery to remove endometriotic lesions. Visanne should be taken without taking breaks.

• Janine, Yarina

Preparations related to combined oral contraceptives. The composition contains several main components, it includes progestogen and estrogen. After taking it, the production of its own hormones is replaced and the hormonal balance is adjusted.

Reception should be carried out for a long time, the minimum course is use within 6 months. Regular use should be considered a special point. With endometriosis, a continuous course of treatment is prescribed. At this time, menstruation will be absent, only in some cases breakthrough bleeding will develop. In this case, this will be considered acceptable, but for some women it may be necessary to change the treatment with a higher dosage of the drug for the treatment of endometriosis.

Yarina and Zhanin also have an antiandrogenic effect in combination with a contraceptive.

The choice of such funds should be carried out with endometriosis at the initial stage of development, as well as in limited areas.

• Jess and Jess plus

The drugs, like Silhouette, belong to combined oral contraceptives. Their composition contains a gestagenic and estrogenic component, but their dosage is somewhat lower, which allows them to be taken by female representatives with unrealized reproductive function. This provides better tolerance and fewer side effects.

Reception should be carried out according to the indicated scheme. It will show its maximum effectiveness with long-term continuous use for several years, in addition, the appointment can be carried out for a prophylactic purpose. It manifests its effect only at the first stage of internal endometriosis, it is almost impossible to improve the condition with a more pronounced process or the presence of ectopic foci.

• Novinet

Microdose, which belongs to combined oral contraceptives. Due to the content of ethinyl estradiol, there is a positive effect on the female genital organs, endometrium, lipid spectrum.

Desogestrel, which is part of the composition, acts like levonorgestrel. The main effect is on the state of the endometrium. It has an insignificant effect on androgen levels, helping to cope with hyperandrogenism. It can be used for endometriosis. It prevents the growth of endometrioid foci, but a significant effect is only at the initial stage of the pathological process.

Few facts about the product:

Instructions for use

Online pharmacy price website: from 667

Release form, composition and packaging

The medication contains a combination of two active components - ethinylestradiol and dienogest. Also, the medicine contains stearic acid, talc, corn-based starch, lactate, hypromellose, potassium polacrilin. The film frame of the tablet is white opadry II, consists of talc, titanium white, ethylene oxide, PVA carbon chain polymer. The drug Siluet is made in the form of white round tablets. There are 21 tablets in one blister pack - this amount is calculated for 1 month of admission, packaging assumes 1-3 packs in a cardboard box.

pharmachologic effect

Siluet is distinguished by a low ratio of doses of progestogen and estrogen, which, in combination, perform several functions when performing the main task - preventing conception:

• prevent the development of the female reproductive cell, so that it does not stand out from the ovarian follicles;
• make the cervical fluid thicker, which provides a barrier to the advancement of sperm in an effort to enter the uterus;
• due to the effect of hormones, the endometrial tissue becomes thinner, and this prevents the embryo from fixing in the uterine cavity.

By reducing the amount of male steroids in the blood, the working components of the drug help to improve the condition:

• relieve premenstrual syndrome;
• reduce pain and excruciating cramps during menstruation;
• reduce the amount of bleeding during menstruation.

So Siluet tablets can be prescribed not only as a contraceptive, but also to regulate the monthly cycle. Moreover, they are able to prevent too long and heavy menstruation, which often causes a decrease in hemoglobin and the development of anemia. It has been proven that, in addition, the threat of the appearance of epithelial growths of the inner uterine layer is reduced - thus, endometriosis, which is often the culprit of female infertility, and malignant ovarian tumors are prevented. In addition, in the course of therapeutic and prophylactic therapy, it was found that the combination of two hormones in the composition of Siluet has a beneficial effect on the state of the epidermis in patients - the pathological manifestations of seborrhea and acne vulgaris are noticeably smoothed, with the exception of severe stages of dermatological ailment. And a substance such as dienogest is able to improve the biochemical parameters of the blood, increasing the level of good cholesterol, which includes a significant percentage of protein. Pharmacokinetics of the working component of Siluet - ethinyl estradiol, provides:

• accelerated absorption into the small intestine, which occurs within an interval of 1.5 to 4 hours, the main stages of the biotransformation of the substance are carried out in the liver tissues (up to 44%);
• binding to protein fractions of albumin, ethinyl estradiol raises the level of globulins, and this leads to inhibition of sex hormones;
• in the intestine, the component forms metabolites in the form of sulfates and glucuronides with a clearance of 2.3-7 ml / min / kg, the decay products are excreted by the renal system and intestines per day.

Dienogest in the composition of Siluet, completely absorbed in the intestine, reaches a maximum level after 2.5 hours, it does not bind to SHBG, but binds to blood albumin. If the medicine is used regularly, then after 4 days the substance reaches a stable state, increasing in the body by one and a half times. The main part of the transformed element is excreted through the intestines, and only a small amount is excreted in the urine. The hormonal drug can be purchased at any pharmacy, one package of Siluet is sold at a price of 650-750 rubles.

Indications

The doctor prescribes Siluet tablets for two, main, indications:

• prevention of pregnancy;
• acne therapy in the absence of a therapeutic effect in patients who need oral contraception.

The medicine is prescribed only in the case of a complete collection of information about the state of the body, a general visual and gynecological examination, measurement of blood pressure, and also, the exclusion of such a factor as pregnancy. In some situations, the drug is prescribed for endometriosis of the uterus. Reviews about Siluet are quite ambiguous. The following advantages of the drug are noted:

• improving hair condition, slowing down hair loss;
• no changes in weight and blood composition;
• increased libido;
• normalization of the menstrual cycle;
• the effectiveness of treatment of the residual effects of endometriosis (cessation of discharge).

In addition, the drug helps to get rid of severe pain during ovulation and menstruation; in many patients, the effect of the medication solved the problem of skin rashes (when taken, the production of sebum decreases). Negative reviews regarding Siluet tablets are mostly associated with side effects. Unfortunately, this remedy is not suitable for some, and then there may be a worsening of the condition, the occurrence of pain in the area of \u200b\u200bthe liver, mammary glands, stomach, vomiting, and blurred consciousness. Patients and doctors emphasize that the medicine cannot be used with contraindications, and there are quite a few of them.

Contraindications

An obstacle to taking Siluet can be the presence of various painful conditions, inflammations and serious pathologies:

• temporary acute circulatory disorders of the brain of an ischemic nature, transferred and present;
• pathological disorders of blood coagulability with the formation of blood clots - pulmonary embolism, ischemic myocardial necrosis, cerebral paralysis, cerebral atherosclerosis;
• increased threat of thrombosis - arterial and venous due to genetic and acquired predisposition, as well as resistance to coagulation factor XIV (protein C), increased concentration of homocysteine, lack of natural anticoagulant - antithrombin III;
• resistant arterial hypertension with persistent high blood pressure;
• familial chylomicronemia of severe course - a violation of lipid metabolism;
• migraine-like pains provoked by vertebral artery syndrome with focal neurological localization;
• a complicated condition with pancreatitis with an increase in the concentration of triglycerides;
• history of benign and malignant growths of the liver or in the present;
• violation of several functions of the liver in severe form, irreversible, structural changes in the parenchyma of the organ;
• damage to large vessels against the background of diabetes mellitus with the risk of developing a heart attack and acute circulatory disorders of the brain;
• hormone-dependent oncology - malignant tumors of the genital area and breast;
• uterine bleeding of unexplained etiology;
• diseases of the digestive function - fermentopathy, lactase deficiency, hereditary syndrome of impaired absorption of monosaccharides in the small intestine (malabsorption);
• increased sensitivity to the drug composition;
• lactation period, bearing the fetus.

Medicine Siluet is contraindicated in case of injuries and injuries at the time of bone fusion and for another 14 days after complete regeneration and restoration of motor function. If surgery is to be done, then the drug is canceled a month before the proposed surgery. When prescribing a steroid, the doctor must be careful about cases of potential threat of thrombosis and thromboembolism, additional prerequisites for which are:

• overweight patient;
• acquired heart defects such as arrhythmia, poor conduction, insufficiency of pumping function, inflammatory and infectious endocarditis;
• essential hypertension with an increase in diastolic and systolic pressure;
• use of cigarettes;
• lipoprotein imbalance;
• neurological headache attacks;
• a genetic disease caused by a C1 inhibitor deficiency, characterized by periodic swelling of the facial skin and mucous tissues (HAO);
• the recovery period after labor;
• any disturbances in the liver;
• diseases that manifested themselves during pregnancy or while taking steroids - rheumatic chorea, porphin disease, cholestasis with stagnation of the liver, gallbladder, otospongiosis with overgrowth of bone tissue in the middle ear and impaired auditory function;
• diseases against the background of pathologies of the peripheral circulation - ulcerative inflammation of the walls of the colon, damage to the digestive tract in Crohn's disease, a combination of azotemia, thrombocytopenia and microangiopathic anemia (HUS), hemoglobinopathy, superficial phlebitis, diabetes, autoimmune systemic disease - lupus erythematosus.

In situations where the deterioration of well-being is associated with taking Siluet tablets, you should immediately refuse to use the product.

Dosage

Taking Siluet tablets is not associated with any difficulties, since they are all marked with the day of the week, so it remains to "move" in the direction of the arrow until the package is finished. If the medication is prescribed for the first time, then you need to start taking it on the first day of your period. In accordance with the instructions for use, Siluet is used every day at one hour, one tablet for exactly three weeks. After that, you need to pause for 7 days, and resume taking the medicine from a new blister. If, before the appointment, the patient drank similar contraceptive medications, she can continue the course, taking the usual weekly break. In the absence of contraindications and the doctor's recommendation, it is possible to start taking it, almost immediately after labor (after three weeks). In the case of an artificial termination of pregnancy, at the beginning of gestation, pills are started to drink immediately after the abortion. You can not interrupt the use of the contraceptive drug for more than 7 days, as this will mean a complete lack of protection against conception. It is allowed to skip a dose for half a day, but it is necessary to take the next portion as soon as possible. In the first week of use, in addition, you will need to use alternative methods of contraception, for example, a condom, a diaphragm for the vagina or spermicidal creams, ointments. If a dose is missed in the second week, then such measures are not necessary. In the third week of admission, you will again have to think about barrier contraceptive aids. If you interrupt the use of Siluet for a week, you need to resume taking it using a new package. You can stop using the drug simultaneously with the end of the tablets in the blister. After this, other methods of protection against pregnancy can be used, but if a decision is made about its onset, it is necessary to wait for the onset of menstruation. During an unsatisfactory state of the intestine and its disorders, it makes sense to postpone the intake of hormones for 12 hours, especially since the effect of the intake decreases due to insufficient absorption. But then you need to take care of the auxiliary contraceptive methods of protection. Under specific circumstances and with the participation of a gynecologist, Siluet's drug can be replaced with analogues. There are several such tools:

• in terms of composition and indications, the closest are such medicines as Klayra, Dieziklen, Luvina, Klimodien;
• according to the method of use and indications - Angelique, Fkmoston, Femoston conti, Femoston conti mini;
• the preparations Klimonorm and Klioges coincide with Siluet in terms of the method of application and indications, but have a different composition.

Side effects

It is not in vain that many contraindications of the steroid Siluet relate to thrombosis already transferred and manifested in the present, because the use of combined oral contraceptives is associated with the danger of their progression, as well as with blockage of the bloodstream due to thromboembolism. If at the same time the patient smokes, she has varicose veins, persistent high blood pressure, the presence of large fat accumulations and disturbances in the hemocoagulation system, then the pills can aggravate the situation and cause complications of these pathologies. Regarding bleeding, they are not observed regularly, but, as a rule, in the first few months of admission. Unpleasant symptoms were detected in the work of life-supporting systems and internal organs:

• Quite rarely, while using Siluet, there are deviations in the mental area - sleep disturbances, episodes of depression, aggressive states, mood swings, instability of sexual desire.
• In relation to blood vessels and the heart, there is an increase in diastolic parameters, signs of neurocirculatory dystonia, increased heart muscle contractions, a feeling of heat in the upper body, exacerbation of varicose veins in parts of the body, upper and lower extremities.
• Anemia is rarely a side effect of the drug.
• Abrupt changes sometimes affect the visual organs, this is an illusory rotation of fixed objects, discomfort due to dryness and increased irritation of the mucous tissues of the eyes. A number of patients develop intolerance to lenses, which is why they have to switch to using glasses.
• Some patients showed signs of dysfunction of the respiratory system in the form of hyperventilation and bronchial asthma.
• Signs of hearing impairment are no less unpleasant - in addition to extraneous sounds and noises, episodes of severe hearing loss have been recorded.
• Among the inadequate reactions of the digestive organs - loss and increased appetite, exacerbation of gastritis, flatulence, inflammation of the membranes of the small intestine, pain in the lower and upper abdomen, loose stools, vomiting.
• Under "favorable" conditions, the combined hormonal drug can lead to the development of secondary male characteristics in a woman. True, a disease such as viril syndrome associated with a malfunction in the endocrine glands is very rare.
• During the reception, muscle and joint pains, painful sensations in the spine may occur.
• In the work of the reproductive organs, violations are also traced. This is an increase and soreness of the breast, interruptions in the monthly cycle, heavy or scanty menstruation, ovarian cysts, pain in the uterus and its appendages, cystic proliferation of breast tissue, transient discharge of milk-like fluid from the mammary glands in the absence of pregnancy and postpartum feeding, pain in the external genitals.

In some cases, negative symptoms were revealed concerning the epidermis, its superficial and deep layers. When using the contraceptive Siluet, acne and macular rashes appear on the skin, itching is noted, local areas are prone to the development of eczema, excessive pigmentation, seborrheic dermatitis, and excessive hair growth. In addition, the manifestation of neurogenic dermatoses, neurodermatitis, atopic eczema, cellulite, nettle fever, and exudative erythema multiforme is possible. Infectious lesions - cervicitis, cystitis, adnexitis, fungal diseases - vaginal candidiasis, vaginitis, herpes infections of the mouth and respiratory organs can also become complications when taking contraceptive pills. The most common undesirable symptoms noted during the period of use of Siluet tablets are:

• fast fatiguability;
• lethargy and loss of strength;
• temperature rise;
• painful sensations in the chest area;
• increased irritability;
• swelling of the limbs.

The most rare manifestations of the effect of Siluet include fluctuations in body weight, breast and liver tumors.

Overdose

The drug Siluet does not cause significant deterioration in well-being and serious disorders in the functionality of the body if the prescribed dose is increased. But some unwanted symptoms may be present:

• nausea;
• mucous discharge with blood;
• bouts of vomiting;
• violation of the monthly cycle with the appearance of unplanned blood secretion.

More often, such manifestations concern young, sexually active patients. To eliminate unpleasant effects, you should consult a gynecologist and undergo symptomatic therapy.

Drug interactions

The contraceptive Siluet has an effect on the therapeutic effect of other drugs, at the same time, its effectiveness can also increase and decrease due to coadministration with other drugs:

• So, in combination with tranquilizers, sleeping pills, some antibiotics, the rate of cleansing of sex hormones increases, which is why profuse intrauterine bleeding is caused. The provocative agents include agents that induce liver fermentation activity, Primidon, Rifampicin, Fenitol, Bosentan. The same effect is produced by compositions intended for the treatment of immunodeficiency conditions and drugs based on St. John's wort. In addition, the effect of contraception sometimes decreases. In this regard, it is recommended to use additional methods of non-steroidal contraceptive protection.
• To raise the level of progestin, estrogen and reduce the clearance of Siluet, powerful and moderate stimulants of the CYP3A4 isoenzyme of cytochrome P450 (antifungal agents) - Fluconazole, Itraconazole, Voriconazole are capable of. This is due to the fact that dienogest is a derivative of the cytochrome P450 CYP3A4. A similar effect is observed when taken simultaneously with such compounds as calcium channel blockers Diltiazem and Verapamil, antibacterial drugs Erythromycin, Clarithromycin and other macrolides. During the period of taking the tablets, the used grapefruit juice can also help to increase the plasma levels of hormones.
• With extreme caution, it is necessary to combine a medicine with medicines aimed at treating hepatitis and HIV infection, since the latter can both increase and decrease the effectiveness of contraception.

Before using Siluet, the patient must inform the doctor about all the drugs taken in order to adjust their dose or cancel at the time of taking the contraceptive. Using the Internet, tablets can be ordered on many pharmacological sites. In such chain stores, the hormonal drug is sometimes cheaper than in a pharmacy, in addition, you can arrange for delivery to a pharmacy located near your home. Prices for Siluet are strikingly different on various resources, but you should not place an order at the lowest cost, since the original product may turn out to be a real fake for the products of Gedeon Richter OJSC.

special instructions

There are certain risks when using the Siluet contraceptive in patients with certain categories of diseases, therefore, pills are prescribed taking them into account. In diseases of the heart and vascular system, the threat of thromboembolism is highest during the first 12 months of administration. Cases of fatal outcome were recorded (1-2%). Thromboembolism of the arteries is quite capable of leading to such serious consequences as acute circulatory disorders of the brain and heart attack. The risk group includes patients of mature age:

• suffering from nicotine addiction;
• with a genetic tendency to manifest thrombosis and thromboembolism;
• after undergoing surgery, serious injuries;
• with diseases of the heart muscle;
• during the recovery period after childbirth.

The risk of progression of thromboembolism increases if the woman is obese with a mass index greater than 30 kg per m2. The drug will also have to be abandoned if the frequency and intensity of migraine attacks increases - this can lead to impaired cerebral circulation. Against the background of the use of Siluet, with the defeat of the papillomavirus, the development of a malignant tumor of the cervix, cancer of the breast, liver, as well as benign growths of hepatic tissues is possible. With an increased level of triglycerides in the blood, cases of the development of inflammatory processes of the pancreas have been reported. Some excess blood pressure does not give a reason to generalize this for all patients using the drug Siluet, but with a steady increase in blood pressure, it must be canceled. The condition of patients with stones in the gallbladder, cholestasis, epilepsy and endogenous depression may worsen during the use of the drug. In women diagnosed with chloasma during pregnancy, the corresponding symptoms may develop and they are advised to avoid exposure to direct sunlight. The first three months, admission, as a rule, is accompanied by a change in the nature of uterine bleeding, but this should not cause concern, since such signs indicate the adaptation of the body to new conditions. In any case, with the appointment of Siluet, a complete examination, information on the anamnesis and a study of laboratory tests are required.

Pregnancy and lactation

The tests carried out have shown that there is no risk for the embryonic development of children when using the drug before conception, or with the occasional intake of a hormonal agent in the first trimester. Siluet is not able to have a teratogenic effect on the future functionality of the child's body, but it is contraindicated to take it. With regard to lactation, it has been proven that the Siluet contraceptive reduces the production of breast milk and is able to change its composition, adversely affecting the baby's condition, therefore, its intake is limited until the complete cessation of natural feeding.

Pediatric use

For children, the medicine Siluet is contraindicated. In adolescence, use is possible as directed by a doctor after the establishment of the monthly cycle and the first menstruation.

With impaired renal function

According to the results of some studies, there is no direct link between disorders in kidney function and the use of the contraceptive Siluet. The existing information does not provide grounds for dose adjustments or other changes in the treatment of such patients.

For violations of liver function

Based on the instructions for use, the drug Siluet has contraindications for tumor growth of the liver, both in the past and in the present. In case of insufficient organ function and serious diseases, it also cannot be used until the work of liver enzymes is fully stabilized. To start or resume taking pills, it is necessary that the results of biomaterial samples are normalized during a biochemical blood test. You should also pay attention to the development of cholestatic jaundice at the time of the last pregnancy or with a previous course of hormonal drugs - in this case, the medication is canceled.

Use in the elderly

During the period of slowing down of the ovaries with the onset of menopause, the contraceptive medicine Siluet is not used.

Storage conditions and periods

The medicine provides for storage for two years, in a place protected from light penetration with normal temperature conditions (up to 25 degrees). In pharmacies, Siluet can be bought only with a prescription issued by a doctor after taking a history and a thorough examination.