Cimizt Contraceptive Pill

The combined oral contraceptive pill is usually just called "the pill". It contains the female hormones oestrogen and progesterone, which women produce naturally in their ovaries. The Combined pill is over 99% effective at preventing pregnancy. The usual way to take the pill is to take one every day for 21 days, then stop for seven days, and during this week you have a period-type bleed. You start taking the pill again after seven days. You need to take the pill at around the same time every day. You could get pregnant if you don't do this, or if you miss a pill, or vomit or have severe diarrhoea. Some medicines may make the pill less effective. Check with your doctor if you're taking any other tablets. If you have heavy periods or painful periods, PMS (premenstrual syndrome) or endometriosis the combined pill may help. The pill does not protect against sexually transmitted infections (STIs), so using a condom as well will help to protect you against STIs. How the combined pill works 1) prevents the ovaries from releasing an egg each month (ovulation). 2)thickens the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg 3)thins the lining of the womb, so there is less chance of a fertilised egg implanting into the womb and being able to grow There are many different brands of pill, made up of three main types: Monophasic 21-day pills This is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then no pills are taken for the next seven days. Microgynon, Marvelon, Yasmin and Cilest are examples of this type of pill. Phasic 21-day pills Phasic pills contain two or three sections of different coloured pills in a pack. Each section contains a different amount of hormones. One pill is taken each day for 21 days and then no pills are taken for the next seven days. Phasic pills need to be taken in the right order. Logynon is an example of this type of pill. Every day (ED) pills There are 21 active pills and seven inactive (dummy) pills in a pack. The two types of pill look different. One pill is taken each day for 28 days with no break between packets of pills. Every day pills need to be taken in the right order. Microgynon ED is an example of this type of pill. Follow the instructions that come with your packet. If you have any questions, ask your GP, practice nurse or pharmacist. What to do if you miss a pill If you continue to be sick, keep using another form of contraception until you've taken the pill again for seven days without vomiting. Who can use the combined pill If there are no medical reasons why you cannot take the pill, and you don't smoke, you can take the pill until your menopause. However, the pill is not suitable for all women. To find out whether the pill is right for you, talk to your GP, practice nurse or pharmacist. You should not take the pill if you: are pregnant smoke and are 35 or older stopped smoking less than a year ago and are 35 or older are very overweight take certain medicines (ask your GP or a health professional at a contraception clinic about this) You should also not take the pill if you have (or have had): thrombosis (a blood clot) in a vein, for example in your leg or lungs stroke or any other disease that narrows the arteries anyone in your close family having a blood clot under the age of 45 a heart abnormality or heart disease, including high blood pressure severe migraines, especially with aura (warning symptoms) breast cancer disease of the gallbladder or liver diabetes with complications or diabetes for the past 20 years Risks of taking the combined pill There are some risks associated with using the combined contraceptive pill. However, these risks are small and, for most women, the benefits of the pill outweigh the risks. Blood clots The oestrogen in the pill may cause your blood to clot more readily. If a blood clot develops, it could cause: deep vein thrombosis (clot in your leg) pulmonary embolus (clot in your lung) stroke heart attack The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors that before prescribing the pill. The pill can be taken with caution if you have one of the risk factors below. It is unlikely you would be advised to take it if you have two or more risk factors. These include: being 35 years old or over being a smoker or having quit smoking in the past year being very overweight (in women with a BMI of 35 or over, the risks of using the pill usually outweigh the benefits) having migraines (you should not take the pill if you have severe or regular migraine attacks, especially if you get aura or a warning sign before an attack) having high blood pressure having had a blood clot or stroke in the past having a close relative who had a blood clot when they were younger than 45 being immobile for a long time – for example, in a wheelchair or with a leg in plaster Cancer Research is ongoing into the link between breast cancer and the pill. Research suggests that users of all types of hormonal contraception have a slightly higher chance of being diagnosed with breast cancer compared with women who do not use them. However, 10 years after you stop taking the pill, your risk of breast cancer goes back to normal. Research has also suggested a link between the pill and the risk of developing cervical cancer and a rare form of liver cancer. However, the pill does offer some protection against developing womb (endometrial) cancer, ovarian cancer and colon cancer.

Side Effects

Serious side effects – see a doctor straight away Signs of deep vein thrombosis include:

• swelling of one leg or along a vein in the leg or foot especially when accompanied by:

• pain or tenderness in the leg which may be felt only when standing or walking;

• increased warmth in the affected leg;

• change in colour of the skin on the leg e.g. turning pale, red or blue. Signs of a pulmonary embolism:

• sudden unexplained breathlessness or rapid breathing;

• sudden cough without an obvious cause, which may bring up blood;

• sharp chest pain which may increase with deep breathing;

• severe light headedness or dizziness;

• rapid or irregular heartbeat;

• severe pain in your stomach. If you are unsure, talk to a doctor as some of these symptoms such as coughing or being short of breath may be mistaken for a milder condition such as a respiratory tract infection (e.g. a ‘common cold’). Signs of retinal vein thrombosis (blood clot in the eye):

• symptoms most commonly occur in one eye:

• immediate loss of vision or

• painless blurring of vision which can progress to loss of vision. Signs of heart attack:

• chest pain, discomfort, pressure, heaviness;

• sensation of squeezing or fullness in the chest, arm or below the breastbone;

• fullness, indigestion or choking feeling;

• upper body discomfort radiating to the back, jaw, throat, arm and stomach;

• sweating, nausea, vomiting or dizziness;

• extreme weakness, anxiety, or shortness of breath;

• rapid or irregular heartbeats. Signs of a stroke:

• sudden weakness or numbness of the face, arm or leg, especially on one side of the body;

• sudden confusion, trouble speaking or understanding;

• sudden trouble seeing in one or both eyes;

• sudden trouble walking, dizziness, loss of balance or coordination;

• sudden, severe or prolonged headache with no known cause;

• loss of consciousness or fainting with or without seizure. Sometimes the symptoms of stroke can be brief with an almost immediate and full recovery, but you should still seek urgent medical attention as you may be at risk of another stroke. Signs of blood clots blocking other blood vessels:

• swelling and slight blue discolouration of an extremity;

• severe pain in your stomach (acute abdomen). Signs of a severe allergic reaction to Cimizt

• swelling of the face, lips, mouth, tongue or throat. Signs of breast cancer include:

• dimpling of the skin;

• changes in the nipple;

• any lumps you can see or feel. Signs of cancer of the cervix include:

• vaginal discharge that smells and contains blood;

• unusual vaginal bleeding;

• pelvic pain;

• painful sex. Signs of severe liver problems include:

• severe pain in your upper abdomen;

• yellow skin or eyes (jaundice). →If you think you may have any of these, see a doctor straight away. You may need to stop taking Cimizt. Possible side effects Common (may affect up to 1 in 10 people):

• Headache;

• Putting on weight;

• Breast problems, such as painful or tender breasts;

• Depression or mood changes;

• Stomach problems, such as nausea; abdominal pain; Uncommon (may affect up to 1 in 100 people):

• Migraine (see a doctor as soon as possible if this is your first migraine or it’s worse than usual, or if the headache is severe, unusual or long lasting);

• Fluid retention (swollen hands, ankles or feet – a sign of fluid retention);

• Decreased sexual desire;

• Vomiting;

• Diarrhoea;

• Skin problems, such as rash or hives;

• Breast enlargement; Rare (may affect up to 1 in 1000 people):

• Changes in vaginal secretions–Irregular vaginal bleeding

• see section 4.3, Bleeding between periods should not last long;

• Breasts producing a milky fluid from the nipples;

• Hypersensitivity reactions;

• Discomfort of the eyes if you wear contact lenses;

• Erythema nodosum (bruise-like swelling to the shins);

• Erythema multiforme (this is a skin condition);

• Decreased weight;