(dye EN oh jest and ESS tra Paint ole) Brand: Natazia
• Do not use dienogest and estradiol if you are pregnant or if you have recently had a baby.
• You must not take dienogest and estradiol if you have any of the next conditions: uncontrolled tall blood pressure, heart malady, a blood-clotting mess, circulation problems, diabetic problems with your eyes or kidneys, unusual vaginal bleeding, liver malady or liver cancer, severe migraine headaches, if you smoke and are over 35, or if you have ever had breast or uterine cancer, jaundice caused by birth control pills, a heart onslaught, a stroke, or a blood clot.
• You may need to use back up birth control, such as condoms or a spermicide, when you first start using this medicine or if you miss a doze. Follow your doctor's instructions.
• Missing a pill increases your risk of becoming pregnant. Carefully follow the "missed dose" instructions if you forget to take your medication.
• Some drugs can create dienogest and estradiol smaller effective in preventing pregnancy, including antibiotics, hepatitis C medications, HIV/AIDS medications, seizure medications, or barbiturate sedatives. Speak your doctor about all another medications you use.
• Dienogest and estradiol is a combination drug that contains female hormones that prevent ovulation (the release of an egg from an ovary). This medicine also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
• Dienogest and estradiol is used as contraception to prevent pregnancy. Dienogest and estradiol is also used to treat hard menstrual bleeding that is not caused by any medical condition of the uterus.
• Dienogest and estradiol may also be used for purposes not listed in this medicine guide.
• This medicine can reason birth defects. Do not use if you are pregnant. Speak your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a child, wait at least 4 weeks till taking dienogest and estradiol.
• You must not take dienogest and estradiol if you have:
· untreated or uncontrolled tall blood pressure;
· heart malady (coronary artery malady, uncontrolled heart valve mess, history of heart onslaught, stroke, or blood clot);
· a blood-clotting mess or circulation problems;
· problems with your eyes, kidneys or circulation caused by diabetes;
· a history of hormone-related cancer such as breast or uterine cancer;
· unusual vaginal bleeding that has not been checked by a doctor;
· liver malady or liver cancer;
· severe migraine headaches (with aura, numbness, weakness, or vision changes), especially if you are older than 35;
· a history of jaundice caused by pregnancy or birth control pills; or
· if you smoke and are over 35 years old.
• To create certain you can safely take dienogest and estradiol, speak your doctor if you have any of these another conditions:
· tall blood pressure, tall cholesterol or triglycerides, or if you are overweight;
· a history of depression;
· underactive thyroid, diabetes;
· gallbladder disease;
· seizures or epilepsy; or
· a history of fibrocystic breast malady, lumps, nodules, or an emergency mammogram.
• The hormones in dienogest and estradiol can pass into breast milk and may harm a nursing child. This medicine may also slow breast milk manufacture. Do not use if you are breast feeding a baby.
• This medicine contains 5 various colors of pills. Take 1 pill every day in the exact order directed on the blister pack. Use a back-up birth control, such as condoms or a spermicide, for the first 9 days when you first start using this medicine. Do not take two various kinds of birth control pills at the same time.
• If you are switching from other birth control pill, start taking dienogest and estradiol on the first day of your withdrawal bleeding. If you were taking progestin-only pills, start taking dienogest and estradiol on the day you would have taken your following pill.
• If you are switching from a birth control implant, intrauterine device (IUD), vaginal ring, or skin patch, start taking dienogest and estradiol on the day the another birth control device is removed.
• If you are switching from a birth control injection, start taking dienogest and estradiol on the day you would have received your following scheduled injection.
• You may have breakthrough bleeding. Speak your doctor if this bleeding continues or is very hard. You may also have very few or no bleeding during your periods.
• If you need surgery or medical trials or if you will be on bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you must know that you are using dienogest and estradiol.
• Store this medicine at room temperature away from moisture and heat.
• Follow the patient instructions provided with your medication. Ask your doctor or pharmacist if you do not understand these instructions. Missing a pill increases your risk of becoming pregnant.
• If you miss one pill:
· During Days 1 through 17, take the missed pill as soon as you remember, then take your following pill at the normal time. Use back-up birth control for at least 9 days.
· During Days 18 through 24, throw out the rest of the pack and start a new one the same day. Take the Day 1 pill from the new pack and then take one pill for day in the order directed on the pack. Use back-up birth control for at least 9 days.
· During Days 25 through 28, take the missed pill as soon as you remember, then take your following pill at the normal time. You do not need back-up birth control if you miss one pill during Days 25 through 28.
• If you miss two pills:
· During Days 1 through 16, skip the missed pills and start with the pill that corresponds to the day you remember you missed your doses. Then take one pill for day in the order directed on the pack. Use your back up birth control for at least 9 days
· During Days 17 through 24, throw out the rest of the pack and start a new one the same day. Take the Day 3 pill from the new pack and then take one pill for day in the order directed on the pack. Use your back up birth control for at least 9 days.
· During Days 25 through 28, throw out the rest of the pack. Start a new pack on the same day or on the day you would normally start a new pack. Take one pill for day in the order directed on the pack. No back up birth control is needed.
• If you miss a period for two months in a row, call your doctor because you might be pregnant.
• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.
• Smoking can magnify your risk of blood clots, stroke, or heart onslaught caused by dienogest and estradiol, especially if you are older than 35.
• This medicine will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.
• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.
• Stop using dienogest and estradiol and call your doctor at once if you have a serious side effect such as:
· sudden numbness or weakness, especially on one side of the body;
· sudden and severe headache, confusion, problems with vision, speech, or balance;
· chest pain or hard feeling, pain spreading to the hand or shoulder, nausea, sweating, common ill feeling;
· sudden cough, wheezing, rapid breathing, coughing up blood;
· pain, swelling, warmth, or redness in one or both legs;
· a change in the pattern or severity of migraine headaches;
· nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
· swelling in your hands, ankles, or feet;
· a breast lump; or
· symptoms of depression (sleep problems, weakness, weary feeling, mood changes).
• Smaller serious side effects may include:
· mild nausea (especially when you first start taking this medicine), vomiting, bloating, stomach cramps;
· breast pain or tenderness;
· freckles or darkening of facial skin, acne;
· weight gain;
· problems with contact lenses;
· vaginal itching or discharge, very easy menstrual periods; or
· decreased sex drive.
• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.
• Some drugs can create dienogest and estradiol smaller effective, which may result in pregnancy. Speak your doctor if you are using any of the next drugs:
· bosentan (Tracleer);
· an antibiotic or tuberculosis medication;
· drugs to treat hepatitis C, HIV, or AIDS;
· phenobarbital (Solfoton) and another barbiturates;
· St. John's wort; or
· seizure medication.
• Speak your doctor about all another medicines you use, especially:
· dantrolene (Dantrium);
· tizanidine (Zanaflex); or
· tranexamic acid (Cyklokapron, Lysteda).
• This list is not complete and another drugs may interact with dienogest and estradiol. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.
• Your pharmacist can provide more information about dienogest and estradiol.
Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.
Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.