Dienogest / Estradiol Dosage
Applies to the following strength(s): multiphasic
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Contraception
To prevent pregnancy and for the treatment of heavy menstrual bleeding in women without organic pathology who choose to use an oral contraceptive as their method of contraception:
One tablet taken orally, once a day, consecutively in the order directed on the package for 28 days with the next pack to be started the day after the last pack.
Dienogest-estradiol products are packaged in 28 day dosage preparations.
The cycle length for oral contraceptives is generally considered to be 28 days. (The first day of menstrual bleeding is counted as day 1).
Initiation of Oral Contraceptive Therapy:
This product can be started one of the following ways:
1. No preceding hormonal contraceptive use in the past month: Start on day 1 of the woman's natural cycle;
2. For postpartum women who do not breastfeed or after a second trimester abortion: Start on day 28 after delivery or abortion. The patient should be advised to use additional barrier methods for the first 9 days of tablet taking. However, if intercourse has already taken place, pregnancy should be excluded before use or the patient should wait until the first menstrual cycle.
3. Changing from a combined oral contraceptive, vaginal ring, or transdermal patch: Instruct her to take the first dark yellow pill on the first day of her withdrawal bleed. She should not continue taking the pills from her previous birth control pack. If she does not have a withdrawal bleed, rule out pregnancy before starting dienogest-estradiol. If she previously used a vaginal ring or transdermal patch, she should start using dienogest-estradiol on the day the ring or patch is removed. Instruct the patient to use a nonhormonal backup method such as a condom or spermicide for the first 9 days.
4. Changing from a progesterone only method: Instruct her to take the first dark yellow pill on the day she would have taken her next progestin only pill or on the day of removal of her implant or intrauterine system or on the day when she would have had her next injection. Instruct the patient to use a nonhormonal backup method such as a condom or spermicide for the first 9 days.
If a woman is less than 12 hours late for an active tablet, the missed dose should be taken as soon as it is remembered and the normal schedule should be resumed.
If a woman is more than 12 hours late for an active tablet, please follow the following principles:
Day 1 to 17: Take the missed tablet immediately and the rest as usual. Use backup contraception for the next 9 days.
Day 18 to 24: Discard the current cycle, start a new cycle immediately. Use backup contraception for the next 9 days.
Day 25 to 28: Take the missed tablet immediately and following tablets as usual. No backup contraception is required.
If a woman misses TWO PILLS in a row, please follow the following principles:
Days 1-17 (if she misses the pills for Days 17 and 18, follow the instructions for Days 17-25 instead):
Do not take the missed pills. Instead, take the pill for the day on which you first noticed you had missed pills. Use backup contraception for the next 9 days. Continue taking one pill each day at the same time for the rest of the cycle.
Days 17-25 (if she misses the pills for Days 25 and 26, follow the instructions for Days 25-28 instead):
Do not take any pills from the current blister pack and throw the pack away. Take Day 3 pill from a new blister pack. Use backup contraception for the next 9 days. Continue taking one pill from the new blister pack at the same time each day.
Do not take any pills from the current blister pack and throw the pack away. Start a new pack on the same day or start a new pack on the day you usually start a new pack. No backup contraception is needed. Continue taking one pill from the new pack at the same time each day, for the rest of the cycle.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
The efficacy of dienogest-estradiol in women with a body mass index (BMI) of greater than 30 kg/m2 has not been evaluated.
In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures should be taken. If vomiting or diarrhea occurs within 3 to 4 hours after taking a colored tablet, this can be regarded as a missed tablet.
Data not available
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