In order to move the first day of bleeding menstrualnopodobnoe on another day of the week, a woman can be recommended to shorten the next break in taking the tablets for as many days, as much as she wants. The shorter the interval, the higher the risk that there will be bleeding, “cancel” and later, during the reception of the following packages will be spotting and breakthrough bleeding (as well as when she wanted to delay the onset of bleeding menstrualnopodobnoe).
In women who use the drug testosterone blend, the following serious adverse events were noted:
- Venous thromboembolic disorders;
- Arterial thromboembolic disorders;
- Arterial hypertension;
- Tumors of the liver;
- The emergence or worsening of conditions for which communication with the technique is not proven: Crohn’s disease, ulcerative colitis, porphyria, systemic lupus erythematosus, herpes gestationis, Sydenham’s chorea, haemolytic-uraemic syndrome, cholestatic jaundice;
The incidence of breast cancer in women taking the increases very slightly. Because breast cancer rarely occurs in women younger than 40 years, this excess is very small relative to the overall risk of developing breast cancer.
Breast cancer is a hormone-dependent tumor. Known breast cancer risk factors such as early menarche, late menopause (after 52 years), lack of birth, presence of anovulatory cycles, etc., indicate the role of hormones in the development of this disease. Receptors for hormones play a key role in the cell biology of breast cancer, estrogen can enhance the effects of growth factors .
Epidemiological studies have shown the existence of a possible causal relationship between prolonged use of the CPC, launched at a young age, and the development of breast cancer in middle age.However, the use of the PDA is only one of many risk factors.
Acute toxicity after oral administration of the combined preparation testosterone blend in overdose is low. In these cases, you may experience nausea, vomiting and bleeding / bleeding from the vagina. It needs no special treatment. If required, the treatment should be symptomatic.
Interaction with other drugs
Interactions related to activation of microsomal enzymes, between oral contraceptives and other drugs may lead to breakthrough bleeding and / or reduce the effectiveness of contraception. These effects have been shown to hydantoin, phenobarbital, primidone, carbamazepine and rifampicin. Such effects are also possible for rifabutin, efavirenz, nevirapine, oksikarbazepina, topiramate, felbamate, ritonavir, griseofulvin and the herbal remedy St. John’s wort (Hypericum perforatum). The mechanism of these interactions is based on the ability of these drugs to activate the microsomal liver enzymes.
According to clinical observations of co-administration with certain antibiotics (such as ampicillin and tetracycline) may reduce the effectiveness of birth control, the cause of this phenomenon is unknown.
Women taking the above drugs for a short testosterone blend period of time (up to weeks), in addition to the need to temporarily use a barrier methods of contraception, such as during the period of receiving one of these drugs, and after 7 days.
Women taking rifampicin barrier methods must use during the time of rifampicin, and 28 days after closure. If receiving a concomitant medication is necessary at the end of the pills from the package, taking the next pack should be started immediately, without the usual interval.
With long-term appointment of the concomitant drug having the ability to activate liver enzymes, your doctor may consider the need to increase the doses of hormonal contraceptives. If this approach results in the emergence of adverse events (eg, irregular bleeding) or a decrease in efficiency, it is necessary to use another method of contraception.
Based on in vitro studies have shown that when using conventional concentrations did not inhibit cytochrome P450 is therefore not expected to detect the nature of such interactions.
Drug interactions that increase clearance of sex hormones can lead to breakthrough uterine bleeding and reducing contraceptive efficacy.
Before the start or resumption , tablet film-coated, it is necessary to gather medical history (including family history), as well as the need to exclude pregnancy. It is necessary to measure blood pressure and to carry out a general inspection, taking into account contraindications and warnings. It is necessary to explain to the woman the need to carefully read the instructions for use and follow the recommendations set out therein. The nature of medical examinations, including general medical and gynecological examination is determined by the attending gynecologist individually for each woman and carried out with varying frequency, but not less than 1 time in 6 months. It should warn the woman that oral contraceptives do not protect against infection or any other disease transmitted through sexual contact.
Reduced efficacy of a combination testosterone blend is the case, for example, a missed reception in the gastro-intestinal disorders or receiving concomitant therapy.