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To prevent unwanted pregnancy from occurring unexpectedly, contraceptive methods must be carefully considered. For these purposes, hormonal contraceptives are ideal. They have proven effectiveness. In addition to the main functions, these oral contraceptives have others. For example, against the background of their intake, the condition of the skin and hair improves, weight normalizes, and hormonal imbalance is eliminated.
In this article, we will consider the contraceptive pills "Silhouette". Feedback from patients and doctors will also be given.
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 part of 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 belongs to hormonal substances (progestane).
These components do the following:
They slow down peristalsis in the fallopian tubes, that is, muscle fibers do not contract so intensely, as a result, the egg cannot actively move through them;
Decreased sex drive;
Sleep problems.
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 passed within a month and a half after taking the first pill.
The negative impact of smoking is not excluded. Therefore, in order not to aggravate the side effect of "Silhouette", smoking must be quit, better - long before taking the drug.
To the drug "Silhouette" instruction (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 uncontrolled intake of hormones can harm the body.
After the drug is purchased, it is necessary to 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 menstruation.
If a woman has already taken another hormonal drug, then "Silhouette" can be drunk a day after the end of the course of the previous remedy.
It is necessary to drink a tablet at the same time every day. Drink a small amount of plain water. The dosage of one tablet should not be exceeded.
On each blister, arrows indicate the order of administration. It must be adhered to and in no case be 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.
In case of abortion or childbirth in the subsequent trimesters, the contraceptive must be used 28 calendar days after surgery or natural delivery.
No need to take breaks in taking hormonal contraceptives, this is not necessary. Thus, you can only harm your body by creating artificial hormonal surges.
In case of skipping the pill due to forgetfulness, it must be drunk immediately, as soon as the woman remembered it.
If there was vomiting a few hours after taking the drug, you need to take the pill again, because the previous one did not have time to digest.
This distinguishes contraceptive pills "Silhouette". Reviews about them are mostly positive.
Before starting the reception, you need not only a consultation with a specialist, but also a complete examination of the whole organism. This will help to identify existing pathologies that prevent the use of oral contraceptives. A woman may also be pregnant, which needs to be clarified in advance.
If you violate the procedure for taking Silhouette tablets, this can lead to a serious hormonal imbalance in the body.
Simultaneous reception with other means
Is the use of the drug "Silhouette" always allowed? The reviews confirm that the interaction of the drug with other hormonal agents is unacceptable. Also, some drugs during the period of treatment with the agent in question should not be taken. 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 medicines, the action of which is aimed at reducing the clearance of sex hormones, including those cannot be taken together with the "Silhouette".
special instructions
If any side effects occur while taking combined oral contraceptives, you should immediately see a gynecologist and inform him about it. Perhaps he will prescribe another drug that will provide the desired effect without a negative effect on the body.
Why does the condition of the skin and hair improve during the use of hormones? This question interests many. This is due to the decrease in sebum production. 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 about these contraceptives. Doctors prescribe them not only for protection, but also for the treatment of various women's problems. Tablets are generally well tolerated, side effects are extremely rare. Patient reviews confirm this.
Many women like the condition of the skin against the background of taking "Silhouette", as well as the fact that the pain has stopped during menstruation. Some have intensified headache but generally good reviews.
Oral contraceptives are used by many women to prevent unwanted pregnancies. There are several drugs with proven effectiveness. In addition to their main purpose, these products can improve skin condition, normalize weight and eliminate problems caused by hormonal imbalances. One of these medications is "Silhouette".
Action
The combination drug has a pronounced antiandrogenic effect. It contains two main and several auxiliary substances: ethinylestradiol - a hormonal agent of the estrogen series (acts as estrogen); dienogest - a hormonal drug (performs the functions of progestane); 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 muscle fiber contractions, which prevents the egg from moving).
- The mucus in the cervical canal thickens (which creates obstacles for the advancement of spermatozoa in the genitals).
- Due to the decrease in androgens, ovulation is suppressed, and folliculogenesis is also disturbed.
- 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 unwanted pregnancy.
- In the treatment of acne in girls and women 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 the growth of the endometrium in young girls and women. In the case when surgical intervention is contraindicated, Silhouette therapy is performed for endometriosis:
- Decreased estrogen synthesis.
- There is a blockage of the growth of the endometrium outside the uterus.
- Ovulation is suppressed.
- Regular intake contributes to the atrophy of endometriosis foci (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 contact and reduces pain during menstruation.
Contraindications
Since this is a fairly strong hormonal drug, there are a number of body conditions 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 dysfunction (failure, hepatitis).
- Malignant tumors (especially of the uterus, appendages and mammary glands).
- Diabetes.
- Epilepsy.
- sickle anemia.
- Pregnancy and lactation. If pregnancy was detected while taking the drug, it is canceled. The conducted studies did not reveal the effect on the fetus of contraceptives, which were taken through negligence. 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 drug is prohibited.
- Severe migraines, especially with neurological symptoms.
- Lactose intolerance.
- Vaginal bleeding (of unknown cause).
In addition, the contraceptive is forbidden to be taken by those who smoke and after the age of 35. If the disease was detected during the course of treatment with the drug, it should be canceled and immediately consult a doctor.
Side effects
When using Silhouette birth control pills, women may experience certain body reactions:
- Emotional changes.
- Headaches or migraines.
- Increased heart rate.
- Abdominal pain, nausea, diarrhea.
- Eruptions on the skin.
- Increase (or decrease) in appetite.
- Pain in the mammary glands.
- Lack of libido.
- Insomnia.
Many women who have taken Siluet note that the most common symptoms are pulling pain in the lower abdomen (as with menstruation), nausea and headaches. As a rule, these symptoms disappear within a month after the start of the drug.
In addition, some of the side effects may occur due to smoking, so a woman is advised to quit this habit before starting to take a contraceptive. Silhouette can cause dry eyes and reduced visual acuity in women who wear contact lenses.
Peculiarities
Instructions for use indicate the following regimens:
- If the drug is used for the first time, it is necessary to start on the first day of menstrual bleeding.
- If Silhouette replaces another contraceptive, it should be taken 24 hours after the end of the course of the previous drug.
- It is necessary to use a contraceptive once a day, preferably at the same time, after meals, drinking plenty of water.
- You need to drink the product in accordance with the order indicated on the blister pack.
- If the contraceptive is taken after an abortion in the first trimester of pregnancy, it is prescribed on the day of the operation.
- In case of abortion or childbirth in the second and third trimesters, the drug is taken 21-28 days after the intervention or natural childbirth.
- Breaks during the course of taking are unacceptable, if a woman forgot to take a pill, it is necessary to resume taking it as soon as it became clear.
- If you experience side effects from the gastrointestinal tract (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 in which the use of the drug is prohibited. It is also necessary to exclude pregnancy.
The drug should be taken only as described in the instructions, since the deviation from specified order can cause hormonal changes in the body.
Interaction with other drugs
Taking Silhouette at the same time as other medicines can cause vaginal bleeding or reduce the contraceptive effect. This can happen when interacting with certain substances:
- Carbamazepine.
- Phenobarbital.
- Ribafutin.
- Ritonavir.
- Hypericum extract.
- Tetracycline.
- Ampicillin.
In addition, a decrease in the protective effect and vaginal bleeding may 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 condition of the skin and weight, problems with which were provoked by a violation of the hormonal balance. Silhouette is also used to treat endometriosis.
It should be remembered that by prescribing birth control pills for yourself, you can harm the body. Therefore, before starting the Silhouette course, it is imperative to consult a gynecologist and undergo a complete medical examination.
Flovit.ru
Siluette tablets (Siluette) - instructions for use of hormonal tablets reviews about Siluette, a contraceptive for endometriosis
Siluet is a contraceptive and antiandrogenic drug. It contains two substances: ethinyl estradiol and dienogest. The first component acts as estrogen, and the second - progesterone. The contraceptive effect of Siluet is based, like other drugs, on inhibition of ovulation, thickening of cervical mucus, and changes in the state of the endometrium. However, as a rule, Siluette 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 Janine medicine.
The silhouette is used for:
- Prevention of unwanted pregnancy;
- Elimination of acne (acne) in women, along with contraception;
Release form Silhouette - tablets. The blister contains twenty-one tablets with the same concentration of active ingredients. That is, it is a monophasic hormonal agent. The instructions for the drug Siluet contain recommendations for switching to it, after the abolition of various contraceptives (pills, implants, injections, and so on), as well as after abortions. It also details what to do if you miss a pill.
Like other hormonal drugs, Siluette should be taken on the first day of the menstrual cycle. Choose one time when it will be convenient for you to take pills and try not to deviate from this schedule. At the end of taking a pack of Siluet, you need to take a break, seven days long. At this time, as a rule, bleeding occurs. The next pack of Siluet should be used a week after the end of the previous one.
Siluet is contraindicated in:
- Various blood clotting disorders - a tendency to thrombosis, increased clotting, and even in the presence of factors predisposing to such pathologies;
- Pancreatitis and high cholesterol;
- Some liver diseases;
- epilepsy;
- Migraines with neurological symptoms;
- Disorders of carbohydrate metabolism;
- Vaginal bleeding of unknown origin;
- Pregnancy and lactation;
There are also a number of conditions that require special care when using Silhouette. If, when prescribing this contraceptive, the patient had no contraindications, but they arose in the process of taking the drug, you should immediately inform the doctor about this. Perhaps the specialist will consider it necessary to cancel the Silhouette.
Side effects
The drug instructions contain a detailed table of undesirable effects of Stluet. We will list here only those that occur frequently, that is, at least in one case out of a hundred. It:
- Headaches, cramps in the calf muscles;
- Body weight gain;
- breast engorgement;
- Nausea;
- Decreased libido and bad mood;
The risk of thrombosis, hypertension, 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 Silhouette
The reaction of the body to the use of various oral contraceptives is individual. Evidence of this is the reviews about Siluet, which can be found on various forums. There are opinions of those who feel great using this drug:
She underwent a complete examination - hormones, examination, ultrasound. Then the doctor prescribed Siluet for 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 I had 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-like bleeding during a week-long break. Others, on the contrary, are faced with the fact that "menstruation" does not end, even when a woman begins to drink the next package of the drug. But these things are possible. They are not undesirable and should not become a reason for canceling Silhouettes. 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 the reception of Siluet:
I've been nauseous all month, dizzy. I barely made it to the end of the pack. I will take Jeanine again, although it is more expensive.
I take Siluet as prescribed by the doctor, "so that the ovaries rest." I don’t know yet how my ovaries are, but my general health has not been very good: either my head hurts, or insomnia, or I feel sick, or depression ...
Indeed, hormone-based contraceptives can cause a range of side effects. Sometimes it takes several drugs to try to find the right drug. Such experiments must be carried out together with a competent doctor. This tactic will allow you to quickly opt for an effective tool.
zhivizdorovim.ru
Contraceptive pills Silhouette: description and treatment regimen of a contraceptive
Silhouette is a new generation drug belonging to the group of monophasic contraceptives. Available in the form of white biconvex tablets with G23 engraving. One blister contains 21 tablets.
The drug contains two active ingredients: dienogest and ethinylestradiol.
Dienogest is a substance, otherwise called a 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 transformation in tissues, so dienogest can be used for long-term therapy.
Ethinylestradiol is a substance from the estrogen series, which is widely used in modern gynecology. The composition of the substance contains an ethyl radical, it provides excellent digestibility, and also makes the transformation into less active forms of female hormones slower and stops the decay processes of the substance. Due to this, ethinylestradiol acts much longer and is much more effective.
Silhouette birth control pills contain 30 micrograms of ethinyl estradiol and 2 micrograms of dienogest, as well as auxiliary components: lactose monohydrate, talc, starch, hypromellose, potassium polyarylate, magnesium stearate.
Action of tablets Silhouette and dosage
These pills perform the following number of functions in the female body:
- ovulation inhibition;
- increased viscosity of cervical mucus;
- change in the peristalsis of the fallopian tubes;
- 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 to overcome acne and seborrhea.
Tablets should be taken strictly following the instructions attached to them. It lists the regimen - one tablet once a day for twenty-one days.
You should take the contraceptive 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, the so-called "withdrawal bleeding" should occur. This bleeding should begin two or three days after the end of the pills, and its duration is 4-5 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. Such a 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 tablets after combined contraceptives, then, according to the instructions, the first application should be made at the usual time of the next day, that is, after the last tablet has been taken.
If a woman is switching from a progesterone-only medication, the switch can be made any day that is convenient. After removing the implants, you can take the pill on the same day. If at first the woman used contraceptives in injectable form, then in order to switch to the tablet form, she must take the first pill on the day of the planned injection.
In cases where a woman has had a miscarriage in the first trimester, neither the instructions nor the doctors forbid taking Silhouette as a hormonal remedy immediately. If the 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 must be used during sexual intercourse.
If a woman forgot to take the medicine on time, and less than twelve hours have passed since then, then the strength of the drug does not decrease. The tablet should be taken immediately, and the next one should be taken at the usual time. But when the reception delay exceeds twelve hours, then you need to follow some rules.
Firstly, in no case should you interrupt the reception 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 that in case of missing a dose in the first week of taking Silhouette tablets, immediately drink the missed dose and take the next tablet at the appointed time, as usual. And for a week, insure yourself with condoms.
If the pass happened in the second week of taking the drug, then the tablet should also be taken immediately, but there is no need for additional protective equipment. The failure that occurred during the third week must be corrected in the same way as in the case of 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.
Overdose with Silhouette
The toxicity of the hormone dosage in Silhouette is quite low. However, an 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 Silhouette
Since the Silhouette is, first of all, a hormonal remedy, you need to know that you cannot independently prescribe this medicine to yourself as a contraceptive. Doctors especially single out among the side effects the development of thrombosis in the arteries and veins. This effect can be exacerbated if a woman smokes, as well as in cases where she suffers from hypertension, pathology in the hemostasis system, varicose veins, obesity or thrombosis.
Among the side effects can also often be observed:
- 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;
- weight gain.
Less common are the following effects:
- arterial hypotension/hypertension;
- varicose veins;
- thrombophlebitis;
- pain in the abdomen;
- strong excitability;
- acne, dermatitis, itching;
- increased appetite;
- vaginitis;
- rapid fatigue, malaise;
- puffiness;
- painful bleeding;
- endometritis, salpingitis;
- allergic reactions;
- anemia, cardiovascular insufficiency;
- insomnia;
- depression and lethargy.
Contraindications to the use of 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:
- pregnant;
- breastfeed;
- suffer from lactose intolerance;
- are allergic to any of the components of the medicine.
Treatment of endometriosis 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 "Silhouette" is often prescribed by gynecologists. These tablets have received many positive reviews from gynecologists, who highlight its safety and effectiveness, and are used as an analogue of the drug "Janine".
Silhouette can be prescribed for endometriosis in the following cases:
- Empiric therapy for newly diagnosed endometriosis.
- Preoperative preparation with severe forms of the disease.
- 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 regimen. If a woman has been diagnosed with endometriosis, then she should seriously think about the issue of pregnancy, because the processes occurring during this action have a positive effect on the health of the patient. Changes in the hormonal background contribute to the atrophy of the focus of endometriosis and helps to extinguish inflammatory processes. The stable low concentration of estrogen that occurs when using Silhouette stimulates the degradation of ectopic formations.
Description of the action of Silhouette in the treatment of endometriosis
The pills gradually cause endometriosis foci, no matter where they are, to atrophy. Then Silhouette lowers estrogen synthesis, suppresses ovulation. After that, the proliferation of tissue cells outside the uterus is blocked. Also in the process of treatment, you can notice a good anti-inflammatory effect from taking the pills.
The drug is prescribed according to a cyclic scheme, if the patient wants to become pregnant or endometriosis was detected at an early stage of its development. The cyclic scheme is also called 21 + 7, which means that a woman should 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 cavity and small pelvis. Based on the results, the gynecologist develops further treatment. If a woman does not plan pregnancy, then after 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 tablets should be taken without interruption, otherwise the contraceptive effect and the specific therapeutic effect may be violated, and there is also a risk of unplanned bleeding and other negative consequences.
Also, the doctor should advise starting on the first day of the cycle, because if the patient starts using pills two to five days after the onset of menstruation, then within a week after the start of the intake, she will need to additionally protect herself with barrier contraception.
drlady.ru
Pill silhouette - Polismed
The silhouette of the pill is a contraceptive drug that affects the production of female hormones. 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. Auxiliary components include:
- magnesium stearate;
- corn starch;
- potassium polyacrylate;
- glucose monohydrate.
Tablets are coated, which dissolves in gastrointestinal tract. Shell composition:
- polyvinyl alcohol;
- talc;
- macrogol 6000;
- titanium dioxide.
Indications for use of Silhouette (tablets)
The silhouette of the pill is indicated for taking if you want to take contraceptive measures with regular sexual intercourse. In addition, the presented drug is often prescribed to women diagnosed with acne, if other treatments do not bring the desired result.
Please note: in the treatment of acne, the need for contraception must be taken into account.
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 "bleed with withdrawal", only after a week's break can you start drinking the next blister.
Important: if you are taking Silhouette for the first time, then you should take the first pill on the day your period starts.
Contraindications
Silhouette instructions for use categorically prohibits women who currently have or had a history of the following diseases:
- atrial fibrillation;
- angina;
- bacterial endocarditis;
- thrombosis of superficial and deep veins;
- ischemic disease hearts;
- hemorrhagic disorders;
- pulmonary embolism;
- congenital hyperbilirubinia;
- porphyria;
- diabetes;
- arterial hypertension;
- protein C deficiency;
- lupus anticoagulant;
- benign liver tumors;
- liver cancer;
- lactose intolerance;
- vaginal bleeding of unknown etiology;
- migraine;
- epilepsy.
Please note: diabetes 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.
Silhouette Special Instructions 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 fact of the onset of pregnancy, but only if the schedule for taking the pills has not been violated. If a woman missed taking 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;
- sharp pain in the legs and chest (short-term, but regularly recurring);
- visual impairment;
- dizziness and fainting;
- numbness of any part of the body.
When at least one of them appears, it should be the reason for a visit to the doctor. Some studies confirm an increased risk of developing malignant diseases with prolonged use of hormonal contraceptives - more than 5 years.
Pharmacological action of the drug
The silhouette of the tablet is a combination 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;
- changes in the peristalsis of the fallopian tubes.
Side effects
Taking Silhouette regularly can lead to the following side effects:
- dizziness and migraine;
- short-term vaginal bleeding;
- dry mouth;
- general weakness.
Similar 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 also recorded:
- pain along the veins;
- anemia;
- bradycardia;
- disorders of cerebral circulation;
- visual impairment;
- dry mucous membranes;
- development of bronchial asthma;
- sinusitis;
- diarrhea;
- exacerbation chronic stage gastritis;
- insomnia;
- fatigue syndrome.
If any health problems appear, even small changes in well-being should alert a woman - a full examination and consultation with a gynecologist will be required.
Interactions of Silhouette with other drugs
It is believed that taking hormonal contraceptives affects the effectiveness of antibiotics, antiviral and antifungal drugs. 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 Silhouette tablets.
Interaction with alcohol
Taking the presented drug simultaneously with the use alcoholic beverages does not reduce its effectiveness.
Overdose
Cases of overdose with Silhouette tablets have not been recorded.
Silhouette pills during pregnancy and lactation
During pregnancy, it is forbidden to take any hormonal drug - it can provoke spontaneous abortion, negatively affects the intrauterine development of the fetus. While breastfeeding, the Silhouette is prohibited for use.
Conditions and terms of storage of the Silhouette
The drug should be stored in a dry, dark place and out of the reach of children. Shelf life - 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 side (21 pcs. in a blister of PVC / PE / PVDC-aluminum foil, in a carton 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; shell: Opadry II white 85F18422 (talc, macrogol 3350, titanium dioxide, polyvinyl alcohol).
Indications for use
- Contraception;
- Therapy of moderate and mild acne (acne) in case of ineffective local treatment in women who need contraception.
Contraindications
Absolute:
- Venous and arterial thromboembolic diseases in history or at present: pulmonary embolism, deep vein thrombosis, etc.;
- Conditions preceding thrombosis: atrial fibrillation, valvular heart disease with complications, angina pectoris, transient ischemic attacks, extended surgery with prolonged immobilization, subacute bacterial endocarditis, extensive trauma;
- Thrombosis (venous and arterial) and thromboembolism, including history 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, present or in history;
- Expressed or multiple risk factors for arterial or venous thrombosis (including risk factors for arterial thrombosis indicated in the anamnesis): uncontrolled arterial hypertension, diabetes mellitus with vascular damage (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, existing antibodies to phospholipids (including lupus anticoagulant, antibodies to cardiolipin);
- sickle cell anemia;
- Severe liver disease, incl. in history (before normalization of liver function tests);
- Benign or malignant neoplasms of the liver, including indications in history;
- Bleeding from the vagina of unknown nature;
- Epilepsy;
- Migraine with local neurological symptoms, incl. in history;
- Glucose-galactose malabsorption, lactose intolerance, lactase deficiency;
- Smoking over the age of 35;
- The period of breastfeeding and pregnancy;
- Hypersensitivity to the components of the drug.
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 benefits of using the remedy):
- Controlled arterial hypertension;
- Diabetes mellitus without vascular complications;
- Dyslipoproteinemia;
- Fibrocystic mastopathy;
- Endometriosis, uterine fibroids;
- History of severe depression;
- Multiple sclerosis;
- Intolerance to contact lenses;
- Ulcerative colitis, Crohn's disease;
- Violations of the kidneys;
- Thromboembolism, phlebitis of superficial veins;
- Chronic heart failure;
- Myocardial infarction at a young age;
- Acute violation of cerebral circulation;
- Violation of the function of vision (threat of thrombosis of the retina);
- Breast cancer in close relatives;
- Hypokalemia, hypercalcemia;
- Tetany;
- Hereditary angioedema;
- Bronchial asthma;
- Idiopathic jaundice/herpes during a previous pregnancy;
- Liver diseases.
In the presence of risk factors (blood clotting disorders, overweight, heart disease, varicose veins), a thorough study is necessary before starting a COC course.
If a woman under the age of 35 cannot stop smoking, it is recommended to use another method of contraception (especially if there are other risk factors).
Method of application and dosage
Siluet is taken orally, 1 tablet daily at about the same time, with a small amount of liquid if necessary. 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, a break is made during which withdrawal bleeding occurs (usually on days 2-3). After the break is over (on the eighth day), they start taking the pills from the next package, regardless of whether the bleeding has stopped or not.
If you have previously used pills containing only progesterone, you can switch to taking the drug on any day.
In the case when hormonal contraception was not used a month before the start of the course, you should start taking the pills on the first day of the menstrual cycle.
After taking a COC, it is recommended to switch to the use of Siluette the next day after the usual interval in taking or after finishing taking the tablets from the current package of the previous drug.
If you have an implant, you should start using Siluette on the day of its removal, and when switching from an injectable form, on the day the next injection is scheduled.
After an abortion in the first trimester of pregnancy, the drug is recommended to be taken immediately after surgery, without the use of additional contraceptives.
After an abortion in the II 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 there was sexual intercourse before using the product, 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 tablet 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, it is recommended to follow two basic rules:
- The use of the tool cannot be interrupted for more than 7 days;
- The drug should be taken for 7 days and be continuous (for adequate suppression of the hypothalamic-pituitary-ovarian regulation).
If the delay in taking the next dose of Siluet exceeds 12 hours, depending on the missed period, the following recommendations should be followed:
- I 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 at the usual time. Additionally, for the next 7 days, you must 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 probability of which is the higher, the more doses are missed and the closer the skip is to a week-long break in admission;
- II week. It is necessary to take the last missed tablet as soon as possible (even if you have to take 2 at once), then continue taking the remedy according to the usual method. If a woman missed 1 tablet, there is no need to use additional contraception, if the missed amount was more than 1 tablet, condoms should be used for 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 proposed 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. Further, continue the application according to the usual scheme, but without the usual weekly break (after the completion of the previous blister, they immediately begin taking the next one). The appearance of menstruation before the end of the second package is unlikely, but breakthrough uterine bleeding or spotting may occur. According to the second scheme, you can stop taking the pills from the current package, take a break for 7 days (which should include skip days), and then start taking the drug from the 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, it is necessary to take a new pill as soon as possible (within 12 hours after the usual time of admission). If the interval between doses was more than 12 hours, the same recommendations should be followed as for the missed tablets.
In order to delay the onset of menstruation after completing the use of the product from the previous blister pack, it is required to immediately start taking the pills from the new blister without a break. In this case, breakthrough uterine bleeding or spotting may occur. You can resume taking the usual scheme after the next week break.
In the case when it is necessary to transfer the day of the start 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 more likely there will be no withdrawal bleeding, and the greater the risk of spotting and breakthrough bleeding during the second pack.
The following serious undesirable effects have also been noted with the use of Siluet:
- Tumors of the liver;
- Hypertension;
- Venous/arterial thromboembolic disorders;
- Chloasma;
- Ulcerative colitis, Crohn's disease, systemic lupus erythematosus, porphyria, Sydenham's chorea, herpes in pregnancy, cholestatic jaundice, hemolytic uremic syndrome (the relationship between the occurrence and aggravation of these conditions with the use of PDA 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 relative to the overall risk of developing breast cancer.
Epidemiological studies have identified a possible causal relationship between 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 COC use is only one of many risk factors.
special instructions
Before starting or resuming the use of Siluette, and then 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 the reception.
It must be remembered that oral contraceptives do not protect against contracting HIV (AIDS) and any other sexually transmitted infections.
Against the background of the use of the drug (especially in the first three cycles), irregular bleeding may occur / spotting from the vagina. Evaluation of such reactions should be carried out after an adaptation period (approximately 3 months later). 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 adhered to the recommended instructions, the presence of pregnancy is unlikely.
When using COCs, the risk 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 (possibly radiating to the left arm);
- Unilateral unusual leg pain and/or swelling;
- Respiratory failure;
- A sudden attack of coughing;
- unusually long, severe headache;
- Complete or partial sudden loss of vision;
- Aphasia or slurred speech;
- Diplopia;
- Dizziness;
- Movement disorders;
- Loss of consciousness (with possible partial epileptic seizure);
- Sharp weakness or severe numbness of one side or one part of the body;
- Sharp belly.
If any of the above conditions occur, stop taking the remedy 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 disease, atrial fibrillation, smoking.
The 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.
Very rarely, the development of liver tumors (benign or malignant) has been reported with the use of COCs. 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 liver enlargement.
drug interaction
With the combined use of Siluet with drugs that can activate microsomal liver enzymes, it is possible to reduce the effectiveness of contraception and / or develop breakthrough bleeding. These drugs include: rifampicin, carbamazepine, primidone, phenobarbital, hydantoin, oxcarbazepine, nevirapine, efavirenz, rifabutin, griseofulvin, ritonavir, felbamate, topiramate and drugs containing St. John's wort (Hypericum perforatum).
According to clinical observations, the simultaneous use of Siluet with certain antibiotics (tetracycline, ampicillin) may also help reduce the contraceptive effect. As a result, during the period of use of any of the above drugs and for 7 days after the withdrawal of concomitant therapy, barrier methods of protection are required in addition to CPC.
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 drug is used during the period of completion of taking the tablets from the blister, the reception from the next package is started without a 7-day break.
In the case of long-term therapy with the drugs listed above, it may be necessary to increase the dose of COC. If against the background of this measure there are undesirable reactions (irregular bleeding, etc.), it is necessary to use another method of contraception.
When using drugs that increase 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 the reach of children, at a temperature not exceeding 25 °C.
Shelf life - 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 preparation contains dienogest weighing 2 mg. It is a substance derived from natural progesterone, according to the mechanism of its action, it 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.
As auxiliary substances, small amounts of starch, lactose, talc should be distinguished.
The package contains 21 tablets, the dosage of the drug in each of which is the same. The tablet has a film shell, white or almost white color, round or biconvex shape. On one side you can find the engraving G53.
Price
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 influencing the hormonal background, stabilizing it.
The follicles in the organ stop developing and maturing. Ovulation does not occur and the water of the egg does not come out. In many ways, this effect helps to eliminate cystic formations on the ovaries in a short time or maintain the ovarian reserve. Thus, for some time, you can delay the onset of menopause.
Due to a change in the composition of the mucus in the cervix, it thickens. As a result, a mechanical obstacle is created in the cervical canal for the passage of the spermatozoon.
Due to its composition, Silhouette interferes with the processes aimed at the transformation of the endometrium. As a result, the endometrial tissue does not reach a large thickness, which reduces the amount 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. Eliminates signs of excess hair growth. The silhouette helps to cope with such manifestations of hyperandrogenism as a hirsutism clinic.
Pharmacokinetics
It should be noted that the drug is combined, so the pharmacokinetics of each component should be taken into account separately. Among the main points should be highlighted:
- Absorption of ethinylestradiol occurs quite quickly. The drug reaches its maximum concentration in the blood serum on average from 1.5 to 4 hours. The process of absorption takes place in the intestinal cavity. The percentage of bioavailability is high and can reach 45%. Linking the main active substance occurs with plasma albumin. It reaches its equilibrium concentration during the second half of the cycle. Metabolism is carried out in the liver cells. The average half-life is about an hour. Complete elimination is up to a day. Excretion of metabolites occurs through the urinary system and kidneys.
- Absorption of dienogest is also rapid.. It reaches its maximum concentration in about 2-3 hours. The bioavailability of dienogest reaches about 100%. Achievement of equilibrium concentration appears about 4 days. Binding occurs to albumin in the blood. Metabolism is carried out by hydroxylation. Metabolites in an inactive form 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 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.
Silhouette can also be taken against endometriosis.
Instructions for use
Silhouette provides for regular use of the drug. The dosage regimen is the use of 1 table. in a day. Drink Silhouette should be regularly, preferably at the same time.
The duration of the course is 21 days, after which a 7-day break is held, and then the course is resumed again from a new package.
Treatment should begin on the first day of menstruation. After 21 days of taking Silhouette, a menstrual-like reaction appears.
If Silhouette is prescribed to women after childbirth, then use begins no earlier than 21 days from the date of birth. Conducted course will be no different from the recommended as the main.
Instructions for use for endometriosis provides that treatment is carried out without interruption.
Silhouette, prescribed after a diagnostic curettage of the uterine cavity or termination of pregnancy, is recommended to be taken from the first day after the procedure. The first tablet is taken on the day of the procedure.
If you miss taking the Silhouette tablet, which will not exceed 12 hours, no additional measures are taken. If the break was more than 12 hours, it is also worth taking the missed pill and resuming the use of the next ones according to the usual pattern, but protective equipment must be used within 7 days.
Contraindications
The drug has absolute and relative contraindications, which 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 history;
- a history of thrombosis, thrombophlebitis or other acute pathologies from the venous system. Identified 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 vascular region. 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 in the biochemical study and clinically defined dyslipoproteinemia;
- epilepsy or other neurological pathologies accompanied by convulsive syndrome;
- uterine bleeding in history with an unexplained cause;
- pregnancy at any gestational age;
- lactation.
Side effects
When taking Silhouette, 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 common:
- the development of headache, which is spasmodic in nature;
- attacks of nausea or vomiting that occur regardless of food intake;
- the appearance of loading in the mammary glands, simultaneously with an increase in size and the development of pain. Pain in this case can be dull in nature, occurring on the 7-10th day from the reception;
- pain syndrome in the region of the spine according to the type of lumbalgia;
- 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 appearance of a tendency to depressive disorders due to a decrease in 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:
- development of pain in the abdomen. It proceeds differently, in some cases simulating the clinic of gastritis or colitis;
- interruptions in the work of the heart with a clinic of tachycardia and pain by the type of angina pectoris;
- manifestation of increased excitability, frequent mood swings, irritability;
- impaired visual acuity or constant dryness of the mucous membranes, including in 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 Silhouette, one should carefully monitor the state of health, if any pathologies are detected, it is necessary to consult a specialist.
drug interaction
Care should be taken when taking Silhouette with other drugs. 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 is reduced when taking ampicillin, rifampicin, tetracycline. For the entire duration of administration and the half-life should be applied barrier contraception.
Rifampicin enhances the drug effect on the body for an average of about 28 days.
Simultaneous use phenobarbital, rifampicin, carbamazepine, griseofulvin and other potent drugs that affect nervous system, as well as St. John's wort may cause breakthrough bleeding.
Silhouette analogues for the treatment of endometriosis
Silhouette is currently 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 include:
- Byzanne
The drug has a similar mechanism of action against 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 course treatment, it contributes to the decidualization of endometrial foci, as a result, 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 relapse. It can be used for prophylactic purposes after surgery to remove endometriotic lesions. Byzanne should be taken without interruption.
- Jeanine, Yarina
Preparations related to combined oral contraceptives. The composition contains several main components, it includes a progestogen and estrogen. After the intake, 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 the use within 6 months. A special point should be considered regular use. With endometriosis, a continuous course of treatment is prescribed. At this time, menstruation will be absent, only in some cases breakthrough bleeding will develop. AT this case this would be considered acceptable, but some women may need to change their treatment to a higher dose of the drug in 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 limited areas.
- Jess and Jess Plus
Drugs, like Silhouette, are combined oral contraceptives. Their composition contains a gestagenic and estrogen component, but their dosage is somewhat lower, which allows them to be taken by female representatives with an unrealized reproductive function. This provides better tolerability and fewer side effects.
Reception should be carried out according to the specified scheme. It will show its maximum effectiveness with long-term continuous use for several years, in addition, the appointment can be carried out for prophylactic purposes. It shows 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
Microdosed agent, which refers to combined oral contraceptives. Due to the content of ethinyl estradiol, it has a positive effect on the female genital organs, endometrium, and lipid spectrum.
Desogestrel, which is part of the composition, acts like levonorgestrel. The main effect is on the state of the endometrium. To a small extent, it has an effect on the level of androgens, helping to cope with hyperandrogenism. 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.
Some facts about the product:
Instructions for use
Price in the online pharmacy site: from 667
Release form, composition and packaging
As part of the drug - a combination of two active ingredients - ethinyl estradiol 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, it consists of talc, titanium white, ethylene oxide, PVA carbon chain polymer. The drug Siluet is made in the form of round tablets of white color. There are 21 tablets in one blister pack - this amount is calculated for 1 month of taking, packaging involves 1-3 packs in a cardboard box.
pharmachologic effect
Silhouette is distinguished by a low ratio of dosages of gestagen and estrogen, which in combination perform several functions in performing the main task - preventing conception:
- prevent the development of the female reproductive cell, so that it is not released from the ovarian follicles;
- make the cervical fluid thicker, which provides a barrier to the movement of sperm in an effort to penetrate the uterus;
- due to the influence of hormones, endometrial tissues become thinner, and this prevents the embryo from fixing in the uterine cavity.
- relieve premenstrual syndrome;
- reduce pain and painful cramps during menstruation;
- reduce the amount of bleeding during menstruation.
- accelerated absorption in small intestines, occurring within a period 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, ethinylestradiol raises the level of globulins, and this leads to the 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.
Indications
The doctor prescribes Silute tablets for two main indications:
- prevention of pregnancy;
- acne therapy in the absence therapeutic effect in patients requiring oral contraception.
- improving the condition of the hair, slowing down their loss;
- no changes in weight and blood composition;
- increased libido;
- normalization of the menstrual cycle;
- the effectiveness of the treatment of residual effects of endometriosis (cessation of discharge).
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 real;
- pathological disorders of blood clotting with the formation of blood clots - pulmonary embolism, myocardial necrosis of the ischemic type, cerebral palsy, cerebral atherosclerosis;
- increased risk of thrombosis - arterial and venous due to genetic and acquired predisposition, as well as resistance to coagulation factor XIV (protein C), an increase in the concentration of homocysteine, a lack of a natural anticoagulant - antithrombin III;
- resistant arterial hypertension with persistent high blood pressure;
- severe familial chylomicronemia - 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;
- benign and malignant growths of the liver in history or in the present;
- violation of several functions of the liver in severe form, irreversible, structural changes in the parenchyma of the organ;
- lesion of large vessels against the background diabetes with the risk of developing a heart attack and acute circulatory disorders of the brain;
- hormone-dependent oncology - malignant tumors of the organs of the genital area and the mammary gland;
- uterine bleeding of unknown etiology;
- diseases of the digestive function - fermentopathy, lactase deficiency, hereditary syndrome of malabsorption of monosaccharides in the small intestine (malabsorption);
- increased sensitivity to the medicinal composition;
- lactation period, gestation.
- overweight patient;
- acquired heart defects, such as arrhythmia, poor conduction, insufficient pumping function, inflammatory and infectious endocarditis;
- essential hypertension with increased diastolic and systolic pressure;
- cigarette use;
- lipoprotein imbalance;
- attacks of a headache of a neurological nature;
- a genetic disease caused by a deficiency of the C1 inhibitor, characterized by periodic swelling of the skin of the face and mucous tissues (HAO);
- recovery period after childbirth;
- any disturbances in the liver;
- diseases manifested during pregnancy or while taking steroids - rheumatic chorea, porphine disease, cholestasis with stagnation of the liver, gallbladder, otospongiosis with bone growth 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.
Dosage
Taking the Siluette 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 over. If the medication is prescribed for the first time, then you need to start taking it on the first day of menstruation. In accordance with the instructions for use, Silute 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 recommendation of a doctor, it is possible to start taking it almost immediately after labor (in three weeks). In the case of artificial termination of pregnancy at the beginning of gestation, the pills begin to be drunk immediately after the abortion. Do not interrupt the use of the contraceptive 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 vaginal diaphragm 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 auxiliary barrier contraceptives. 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 the unsatisfactory condition of the intestines and its disorders, it makes sense to delay the intake of hormones for 12 hours, especially since the effect of the intake is reduced due to insufficient absorption. But then you need to take care of auxiliary contraceptive methods of protection. Under specific circumstances and with the participation of a gynecologist, Siluette can be replaced by analogues. There are several such tools:
- in terms of composition and indications, medicines such as Qlaira, Diecyclen, Luvina, Klimodien are closest;
- according to the method of use and indications - Angelik, Fkmoston, Femoston conti, Femoston conti mini;
- preparations Klimonorm and Clioges 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 remedy Siluet relate to thrombosis already transferred and manifested in the present, because the use of combined oral contraceptives is associated with the risk of their progression, as well as blockage of the bloodstream due to thromboembolism. If at the same time the patient smokes, she has varicose veins, stable high blood pressure, the presence of large fat accumulations and disturbances in the hemocoagulation system, then the tablets can aggravate the situation and cause complications of these pathologies. Regarding spotting, they are not observed regularly, but, as a rule, in the first few months of admission. Unpleasant symptoms were revealed in the work of life-supporting systems and internal organs:
- Quite rarely, against the background of the use of the Silhouette, there are deviations in the mental area - sleep disturbance, 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 indicators, signs of neurocirculatory dystonia, increased contractions of the heart muscle, a feeling of heat in the upper body, exacerbation varicose veins on parts of the body, upper and lower extremities.
- side effect the drug rarely becomes anemia.
- Abrupt changes sometimes affect the visual organs, this is an illusory rotation of stationary 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 the use of glasses.
- Some patients showed signs of dysfunction of the respiratory system in the form of hyperventilation and bronchial asthma.
- No less unpleasant are the signs of a hearing disorder - in addition to extraneous sounds and noises, episodes of a sharp hearing loss have been recorded.
- Among the inadequate reactions of the digestive organs are loss and increased appetite, exacerbation of gastritis, flatulence, inflammation of the membranes of the small intestine, pain in the lower and upper abdomen, liquid stool, vomit.
- Under "favorable" conditions, the combined hormonal drug can lead to the development of secondary male characteristics in a woman. True, such a disease as the viril syndrome, associated with a malfunction in the endocrine glands, is very rare.
- During the reception, muscle and joint pain, pain in the spine area may occur.
- In the work of the reproductive organs, there are also violations. This is an increase and soreness of the breast, failures in the monthly cycle, heavy or scanty menstruation, ovarian cysts, pain in the uterus and its appendages, cystic proliferation of breast tissue, transient release of milk-like fluid from the mammary glands in the absence of pregnancy and postpartum feeding, pain in the external sexual organs.
- fast fatiguability;
- lethargy and loss of strength;
- rise in temperature;
- pain in the area chest;
- increased irritability;
- limb edema.
Overdose
The drug Siluet does not cause significant deterioration in well-being and serious violations in the functionality of the body, if the established 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.
drug interaction
Contraceptive The silhouette influences therapeutic effect other drugs, at the same time, its effectiveness can also increase and decrease due to joint use with other drugs:
- So, in combination with tranquilizers, hypnotics, some antibiotics, the rate of purification of sex hormones increases, which causes heavy intrauterine bleeding. Provoking drugs include agents that induce liver fermentation activity, Primidon, Rifampicin, Fenitol, Bosentan. The same effect is produced by formulations intended for the treatment of immunodeficiency conditions and drugs based on St. John's wort. In addition, the effect of contraception is sometimes reduced. In this regard, it is recommended to use additional methods of non-steroidal contraceptive protection.
- Potent and moderately moderate stimulators of the CYP3A4 isoenzyme of cytochrome P450 (antifungal agents) - Fluconazole, Itraconazole, Voriconazole - are capable of raising the level of progestin, estrogen and reducing the clearance of Silhouette. This is due to the fact that dienogest is a derivative of cytochrome P450 CYP3A4. A similar effect is noted 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, grapefruit juice can also contribute to the increase in plasma hormone levels.
- With special care, it is necessary to combine the medicine with medicines aimed at treating hepatitis and HIV infection, since the latter can both increase and decrease the effectiveness of contraception.
special instructions
There are certain risks when using the Siluet contraceptive in patients with certain categories of diseases, so 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 admission. Cases of a fatal outcome (1-2%) have been recorded. Arterial thromboembolism is quite capable of leading to such serious consequences as acute cerebrovascular accident and heart attack. The risk group includes patients of mature age:
- suffering from nicotine addiction;
- with a genetic predisposition to the manifestation of thrombosis and thromboembolism;
- after surgery, serious injuries;
- with diseases of the heart muscle;
- during the recovery period after childbirth.
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 when accidentally taking 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 Siluette contraceptive reduces the production of mother's milk and is able to change its composition, adversely affecting the condition of the baby, therefore its intake is limited until the complete cessation of natural feeding.
Application in childhood
For children, the medicine Siluet is contraindicated. In adolescence, use is possible as prescribed by a doctor after the establishment of a monthly cycle and the first menstruation.
For impaired renal function
According to the results of some studies, there is no direct connection between disorders in the functioning of the kidneys and the use of the Siluette contraceptive. Existing data do not provide a basis for dose adjustments or other changes in the treatment of such patients.
For impaired liver function
Based on the instructions for use, Siluette has contraindications for tumor growths of the liver, both in the past and in the present. In case of insufficiency of 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 normalize during a biochemical blood test. You should also pay attention to the development of cholestatic jaundice at the time of a previous pregnancy or with a previous course of hormonal agents - in this case, the medication is canceled.
Use in the elderly
During the period of slowing down the work of the ovaries with the onset of menopause, the contraceptive medicine Siluette is not used.
Terms and conditions of storage
The medicine provides for storage for two years, in a place protected from light penetration with ordinary temperature conditions(up to 25 degrees). In pharmacies, Siluette can only be bought with a prescription issued by a doctor after taking an anamnesis and a thorough examination.
