AKIZZA 75 MCG /20 MCG TABLETS
Active substance(s): ETHINYLESTRADIOL / GESTODENE
Some of the conditions listed below can be made worse by taking the Pill or they may mean it is less suitable for you. You may
Akizza 75 microgram / 20 microgram tablets
Akizza 75 microgram / 30 microgram tablets
Gestodene / Ethinylestradiol
still be able to take Akizza but you need to take special care and have check-ups more often.
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
• if you have systemic lupus erythematosus (SLE – a disease affecting your natural defence system);
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor, pharmacist or nurse.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the
same as yours.
- If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this
leaflet. See section 4.
Important things to know about combined hormonal contraceptives (CHCs)
• They are one of the most reliable reversible methods of contraception if used correctly.
• They slightly increase the risk of having a blood clot in the veins and arteries, especially in the first year or when restarting a
combined hormonal contraceptive following a break of 4 or more weeks.
• Please be alert and see your doctor if you think you may have symptoms of a blood clot (see section 2 ‘Blood Clots’).
What is in this leaflet
1. What Akizza is and what it is used for
2. What you need to know before you take Akizza
3. How to take Akizza
4. Possible side effects
5. How to store Akizza
6. Contents of the pack and other information
1. What Akizza is and what it is used for
Akizza is a combined oral contraceptive, “the Pill”. You take it to stop you getting pregnant.
This contraceptive contains two types of female sex hormones called ethinylestradiol and gestodene. Both hormones prevent the
monthly release of an egg from the ovaries and thicken the mucus in the neck of the womb thereby making it more difficult for the
Akizza 75 microgram / 20 microgram
Akizza 75 microgram / 30 microgram
Gestodene & Ethinylestradiol
sperm to reach the egg. Akizza also affects the lining of the womb to make it less likely to accept a fertilised egg.
Akizza will not protect you against sexually transmitted infections, such as AIDS. Only condoms can help to do this.
2. What you need to know before you take Akizza
Before you start using Akizza you should read the information on blood clots in section 2. It is particularly important to read the
symptoms of a blood clot – see section 2 ‘Blood Clots’.
Tell your doctor if any of the following conditions apply to you.
If the condition develops, or gets worse while you are using Akizza, you should also tell your doctor.
• if you have Crohn’s disease or ulcerative colitis (chronic inflammatory bowel disease);
BLOOD CLOTS IN A VEIN
Like all oral contraceptives Akizza does not protect against HIV infection (AIDS) and other sexually transmitted
diseases. Only condoms can help to do this.
What can happen if a blood clot forms in a vein?
• The use of combined hormonal contraceptives has been connected with an increase in the risk of blood clots in the vein (venous
Breast cancer has been observed slightly more often in women using oral contraceptives than in women of the same age who do
not use them. It is not known whether this difference is caused by oral contraceptives. For example it may be that more tumours
• If a blood clot forms in a vein in the leg or foot it can cause a deep vein thrombosis (DVT).
are detected in users of combined oral contraceptives because they tend to be examined more often. The occurrence of breast
• If a blood clot travels from the leg and lodges in the lung it can cause a pulmonary embolism.
tumours becomes gradually less after stopping the Pill. It is important to regularly check your breasts and you should contact your
• Very rarely a clot may form in a vein in another organ such as the eye (retinal vein thrombosis).
doctor if you feel any lump.
When is the risk of developing a blood clot in a vein highest?
The risk of cervical cancer of the uterus is higher in women taking oral contraceptives. The most important risk factor for cervical
The risk of developing a blood clot in a vein is highest during the first year of taking a combined hormonal contraceptive for the first
cancer is persistent infection with the human papillomavirus (HPV). These findings may also have something else in common other
• if you need an operation, or you are off your feet for a long time (see in section 2 ‘Blood Clots’);
time. The risk may also be higher if you restart taking a combined hormonal contraceptive (the same product or a different product)
than the use of oral contraceptives (e.g. differences in sexual behavior). In case of abnormal vaginal bleeding with unknown cause,
• if you have just given birth you are at an increased risk of blood clots. You should ask your doctor how soon after delivery you
after a break of 4 weeks or more.
consult your doctor.
• if you have haemolytic uraemic syndrome (HUS - a disorder of blood clotting causing failure of the kidneys);
• if you have sickle cell anaemia (an inherited disease of the red blood cells);
• if you have elevated levels of fat in the blood (hypertriglyceridaemia) or a positive family history for this condition.
Hypertriglyceridaemia has been associated with an increased risk of developing pancreatitis (inflammation of the pancreas);
After the first year, the risk gets smaller but is always slightly higher than if you were not using a combined hormonal contraceptive.
can start taking Akizza;
• if you have an inflammation in the veins under the skin (superficial thrombophlebitis);
• if you have varicose veins; if you have diabetes mellitus (diabetes) or susceptibility to its creation;
• if you or your close family have ever had problems with your heart, or circulation such as high blood pressure;
• if you or your close family have ever had problems with blood clotting;
• if you have the inherited disease called porphyria;
• if you are overweight (obese);
What is the risk of developing a blood clot?
The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking.
The overall risk of a blood clot in the leg or lung (DVT or PE) with Akizza is small.
blood clot in a year.
• if you have any illness that worsened during pregnancy or previous use of the Pill.
one. In rare cases a blood clot can block vessels and cause serious problems.
Blood clots can develop:
- Out of 10,000 women who are using a combined hormonal contraceptive that contains levonorgestrel, norethisterone,
- Out of 10,000 women who are using a combined hormonal contraceptive that contains gestodene such as Akizza between
about 9-12 women will develop a blood clot in a year.
• in the arteries (referred to as an ‘arterial thrombosis’, ‘arterial thromboembolism’ or ATE).
Recovery from blood clots is not always complete. Rarely, there may be serious lasting effects or, very rarely, they may be fatal.
It is important to remember that the overall risk of having a harmful blood clot due to Akizza is small.
HOW TO RECOGNISE A BLOOD CLOT
Seek urgent medical attention if you notice any of the following signs or symptoms.
What are you possibly suffering from?
Deep vein thrombosis
especially when accompanied by:
your risk of a blood clot” below).
Women who are not using a combined hormonal pill/patch/
Risk of developing a blood clot in a year
About 2 out of 10,000 women
ring and are not pregnant
Women using a combined hormonal contraceptive pill
About 5-7 out of 10,000 women
containing levonorgestrel, norethisterone or norgestimate
Women using Akizza
About 9-12 out of 10,000 women
Factors that increase your risk of a blood clot in a vein
The risk of a blood clot with Akizza is small but some conditions will increase the risk. Your risk is higher:
• if you are very overweight (body mass index or BMI over 30kg/m2);
In this case you could have a hereditary blood clotting disorder;
standing or walking;
• if you need to have an operation, or if you are off your feet for a long time because of an injury or illness, or you have your leg in
o increased warmth in the affected leg;
a cast. The use of Akizza may need to be stopped several weeks before surgery or while you are less mobile. If you need to stop
blood pressure and make sure you are not pregnant. Your doctor may also give you a comprehensive medical examination.
o change in colour of the skin on the leg e.g. turning pale,
Akizza ask your doctor when you can start using it again.
request an additional prescription.
You should not use Akizza if you have any of the conditions listed below. If you do have any of the conditions listed below, you
must tell your doctor. Your doctor will discuss with you what other form of birth control would be more appropriate.
Do not use Akizza:
• if you have (or have ever had) a blood clot in a blood vessel of your legs (deep vein thrombosis, DVT), your lungs (pulmonary
embolus, PE) or other organs;
• if you know you have a disorder affecting your blood clotting – for instance, protein C deficiency, protein S deficiency,
antithrombin-III deficiency, Factor V Leiden or antiphospholipid antibodies;
• if you need an operation or if you are off your feet for a long time (see section ‘Blood Clots’);
• if you have ever had a heart attack or a stroke;
• if you have (or have ever had) angina pectoris (a condition that causes severe chest pain and may be a first sign of a heart
attack) or transient ischaemic attack (TIA – temporary stroke symptoms);
• if you have any of the following diseases that may increase your risk of a clot in the arteries:
– severe diabetes with blood vessel damage,
– very high blood pressure,
– a very high level of fat in the blood (cholesterol or triglycerides),
red or blue.
• Sudden unexplained breathlessness or rapid breathing;
• as you get older (particularly above about 35 years);
• Sudden cough without an obvious cause, which may bring
• Sharp chest pain which may increase with deep breathing;
• Severe light headedness or dizziness;
• Rapid or irregular heartbeat;
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
Retinal vein thrombosis (blood clot in the eye)
• Immediate loss of vision or;
• Painless blurring of vision which can progress to loss of vision
• Chest pain, discomfort, pressure, heaviness;
While using Akizza, blood clots have been observed in the blood vessels of the eye (ocular vascular thrombosis), which may lead to
vision, you should inform your doctor immediately.
The Pill and migraine / headache
If you feel the onset or worsening of migraine or development of headache with new symptoms that recur, persist or are severe,
contact your doctor immediately. During the use of Akizza, if you have a migraine (particularly migraine with aura), you may be
subject to an increased risk of stroke.
Changes in glucose tolerance are observed in women using Akizza. If you have diabetes, your doctor should carefully monitor the
use of Akizza.
If you have high triglycerides (fat) levels, your doctor should carefully monitor the use of Akizza, since there have been rare cases
where a massive increase in triglycerides leads to pancreatitis (inflammation of the pancreas).
The Pill and depression
If you have ever had depression and this depression recurs while you are using Akizza, you should discontinue use and tell your
The Pill and its effects on immunity
Use of the product may cause or worsen the symptoms of angioedema (rapid swelling of the tissues which is caused by a problem
with the immune system. In some cases, this causes problems with breathing, swallowing, and rash).
Other medicines and Akizza:
It is also important to tell your doctor or dentist that you are taking Akizza because taking certain other medicines could alter the
effectiveness of Akizza or the other medicines.
known reason, or you gain a lot of weight, tell your doctor.
During use of Akizza with certain other medicines, it is recommended to use additional non-hormonal methods of contraception
BLOOD CLOTS IN AN ARTERY
method for at least another 7 days after stopping certain other medicines while using Akizza.
(such as condoms with spermicide) along with the use of Akizza. It is recommended to use additional non-hormonal contraceptive
Like a blood clot in a vein, a clot in an artery can cause serious problems. For example, it can cause a heart attack or a stroke.
Medicines that can make Akizza less effective in preventing pregnancy include:
Factors that increase your risk of a blood clot in an artery
• Medicines for psychological disorders or epilepsy, such as barbiturates, phenytoin, primidone, topiramate, modafinil,
• with increasing age (beyond about 35 years);
stop smoking and are older than 35 your doctor may advise you to use a different type of contraceptive;
The Pill and eye disorders
Akizza needs to be stopped.
• if you smoke. When using a combined hormonal contraceptive like Akizza you are advised to stop smoking. If you are unable to
• Sensation of squeezing or fullness in the chest, arm or below
bleeding. The risk of liver cancer is extremely low.
Tell your doctor if you are taking, have recently taken or might use any other medicine.
It is important to note that the risk of a heart attack or stroke from using Akizza is very small but can increase:
Very rarely the use of oral contraceptives causes benign liver tumors, which may rupture and cause life-threatening internal
It is important to tell your doctor if any of these conditions apply to you, even if you are unsure. Your doctor may decide that
What can happen if a blood clot forms in an artery?
a milder condition such as a respiratory tract infection
pregnancy, you are more likely to develop the disorder when taking Akizza. You should therefore be carefully monitored while taking
Air travel (>4 hours) may temporarily increase your risk of a blood clot, particularly if you have some of the other factors listed.
If any of the above conditions change while you are using Akizza, for example a close family member experiences a thrombosis for no
• Severe pain in your stomach.
(e.g. a ‘common cold’).
Symptoms most commonly occur in one eye:
• if you gave birth less than a few weeks ago.
The risk of developing a blood clot increases with the more conditions you have.
If you have or ever had cholestasis (accumulation of bile in the gallbladder) while using hormonal contraceptives or during
The Pill and diabetes
• if one of your immediate family has had a blood clot in the leg, lung or other organ at a young age (e.g. below the age of about 50).
o pain or tenderness in the leg which may be felt only when
The Pill and diseases of the gallbladder and liver
partial or complete loss of vision. If you experience sudden partial or complete loss of vision, or a sudden onset of abnormal
- The risk of having a blood clot in a vain will vary according to your personal medical history (see paragraph, “Factors that increase
• in veins (referred to as a ‘venous thrombosis’, ‘venous thromboembolism’ or VTE);
The increase in blood pressure was observed in women taking oral contraceptives. Tell your doctor if you have or had hypertension
or norgestimate about 5-7 will develop a blood clot in a year.
Using a combined hormonal contraceptive such as Akizza increases your risk of developing a blood clot compared with not using
The Pill and blood pressure
(high blood pressure).
- Out of 10,000 women who are not using any combined hormonal contraceptive and are not pregnant, about 2 will develop a
• if you have migraines;
Are you experiencing any of these signs?
• Swelling of one leg or along a vein in the leg or foot
When you stop Akizza your risk of a blood clot returns to normal within a few weeks.
Before you start using Akizza, your doctor is likely to take a full medical history of you and members of your family, check your
Once you have started using Akizza, your doctor or prescriber may carry out regular check-ups, usually this will occur when you
The Pill and cancer
thrombosis). However, these side effects are rare. Most frequently, they occur in the first year of use of a combined hormonal
• Medicines for digestive problems (e.g. laxatives);
dexamethasone and hypericum perforatum (St. John’s wort);
• Medicines for infections such as ritonavir, rifampicin, rifabutin, tetracycline, ampicillin and other penicillins;
• Antifungal medicines (griseofulvin);
• Medicines for pain and anti-inflammatory drugs (e.g. phenylbutazone);
• Drugs used after transplant (cyclosporin);
• Fullness, indigestion or choking feeling;
• if you are overweight;
• Upper body discomfort radiating to the back, jaw, throat,
• if you have high blood pressure;
• if a member of your immediate family has had a heart attack or stroke at a young age (less then about 50). In this case you
• if you have (or have ever had) breast cancer;
arm and stomach;
• Sweating, nausea, vomiting or dizziness;
• if you have ever had a severe liver disease, and you have been told by your doctor that your liver function test results are not yet
• Extreme weakness, anxiety, or shortness of breath;
• if you, or someone in your immediate family, have a high level of fat in the blood (cholesterol or triglycerides);
Medicines containing troleandomycin may increase the risk of cholestasis (accumulation of bile in the gallbladder) when taken
• Rapid or irregular heartbeats.
• Sudden weakness or numbness of the face, arm or leg,
• if you get migraines, especially migraines with aura;
with the Pill.
– a condition known as hyperhomocysteinaemia;
• if you have (or have ever had) a type of migraine called ‘migraine with aura’;
back to normal;
• if you have ever had liver tumours;
• if you have hepatitis C and are taking the medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir (see
also in section Other medicines and Akizza).
• if you are allergic to gestodene, ethinylestradiol, or to any of the other ingredients of this medicine (listed in section 6).
Akizza should not be used by children or after menopause.
Warnings and precautions
When should you contact your doctor?
Seek urgent medical attention
- if you notice possible signs of a blood clot that may mean you are suffering from a blood clot in the leg (i.e. deep vein thrombosis),
a blood clot in the lung (i.e. pulmonary embolism), a heart attack or a stroke (see ‘Blood Clots’ (thrombosis) section below).
For a description of the symptoms of these serious side effects please go to the paragraph “How to recognise a blood clot”.
especially on one side of the body;
If you have more than one of these conditions or if any of them are particularly severe the risk of developing a blood clot may be
• Sudden trouble seeing in one or both eyes;
increased even more.
• Sudden trouble walking, dizziness, loss of balance or
If any of the above conditions change while you are using Akizza, for example you start smoking, a close family member experiences
a thrombosis for no known reason, or you gain a lot of weight, tell your doctor.
• Sudden, severe or prolonged headache with no known cause;
• Loss of consciousness or fainting with or without seizure.
What to do if you experience irregular bleeding / spotting
• 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
• Severe pain in your stomach (acute abdomen).
• if you have a problem with your heart (valve disorder, disturbance of the rhythm called atrial fibrillation);
• if you have diabetes.
• Sudden confusion, trouble speaking or understanding;
• Swelling and slight blue discolouration of an extremity;
could also have a higher risk of having a heart attack or stroke;
• Cholesterol-lowering drugs (atorvastatin);
• Medicines such as asthma medications (theophylline).
If you are taking a medication containing flunarizine at the same time as Akizza, this may cause production of breast milk in
women who have not yet had children.
Do not use Akizza if you have Hepatitis C and are taking the medicinal products containing ombitasvir/ paritaprevir/ ritonavir
and dasabuvir as this may cause increases in liver function blood test results (increase in ALT liver enzyme). Your doctor will
prescribe another type of contraceptive prior to start of the treatment with these medicinal products. Akizza can be restarted
approximately 2 weeks after completion of this treatment. See section “Do not use Akizza”.
During the use of Akizza, if you observe irregular bleeding or spotting, especially during the first three months and if bleeding
Akizza with food and drink
continues or repeats, stop taking Akizza, use a non-hormonal method of contraception and consult your doctor.
Akizza may be taken with or without food, if necessary with a small amount of water.
What to do if there is no regular bleeding
Pregnancy, breast-feeding and fertility
Some women may not experience regular bleeding during the tablet-free break. If there is failure of two consecutive regular
Blood clots blocking other blood vessels
• Vitamin C or paracetamol;
bleedings, or if the product is not used according to directions before the first regular bleeding that fails, you should discontinue use
of Akizza and use any non-hormonal method of contraception to prevent pregnancy.
There is no evidence that the use of the Pill in early pregnancy leads to increased neonatal defects. Nevertheless, the Pill should
not be used during pregnancy and the possibility of pregnancy should first be taken into account if you fail to bleed regularly.
The use of oral contraceptives should be stopped until pregnancy is ruled out.
The use of Akizza is generally not advisable when a woman is breast-feeding. If you want to take the pill while you are breast feeding,
you should contact your doctor.
• One tablet forgotten in week 3
- heart attack,
You have two options:
1. Take the forgotten tablet as soon as you remember (even if this means taking two tablets at the same time) and take the tablets
- mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic attack (TIA),
at the usual time. Start the next pack as soon as the previous pack is completed, so no break between packs. You may not
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for
have menstrual period until the end of the second pack, but you may have spotting or breakthrough bleeding during the days of
advice before taking this medicine.
Driving and using machines
There is no information suggesting that the use of Akizza affects driving or use of machines.
Akizza contains lactose
If you have been told by your doctor that you have an intolerance to lactose, contact your doctor before using Akizza.
3. How to take Akizza
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no
• Signs of a severe allergic reaction or worsening of hereditary angioedema:
longer use. These measures will help to protect the environment.
With the above two recommendations, you will remain protected against pregnancy if you forgot one pill in week 3.
• If you forgot one of the tablets in a strip and no bleeding occurs during the tablet-free gap period, you may be pregnant.
Then consult your doctor before starting the next strip.
Ask your doctor for advice
in week 1
Wednesday, take a tablet where “Wednesday” is stated. Follow the direction of the arrow on the strip until all 21 tablets have been
Had sex in the previous week before
After you have taken all 21 pills in the strip, you have a seven day break during which you take no pills. In the course of these 7 pillfree days, bleeding should begin, so called ‘withdrawal bleeding’. Usually bleeding starts on the second or third day of the gap week.
On the eighth day i.e. after the seven-day gap you should start the next strip of tablets, whether your bleeding has stopped or not.
This means that each strip begins on the same day of the week and withdrawal bleeding every month coincides.
Correct use of your tablets will ensure protection against pregnancy whilst you take the tablets and also during the 7 days break.
Only 1 tablet
(taken more than
12 hours late)
When can you start with the first strip of Akizza
in week 2
You can start taking Akizza on the first day of your menstrual cycle and you immediately get protection against pregnancy. You may
also start taking Akizza on 2nd to 5th day of the menstrual cycle, but in this case, an additional contraceptive method (e.g. condom)
is recommended for the first 7 days.
previous pill, but not later than the day following the tablet-free days of your previous pill (or after the last inactive-tablet of your
previous pill). If you switch from a combined contraceptive vaginal ring or patch, follow the advice given by your doctor.
Follow the advice given by your doctor.
• After childbirth:
You can start taking Akizza after 21 to 28 days of childbirth. If you start taking pill after 28 days, an additional contraceptive method is
recommended for the first seven days. After childbirth, if you have had sex before starting Akizza, you must first be sure that you are
not pregnant or wait until your next period.
• If you are breast-feeding:
Read the section ‘Pregnancy, breast - feeding and fertility’.
Ask your doctor what to do if you are not sure when to start Akizza.
Use in children and adolescents
There is no data available for use in adolescents below 18 years.
If you take more Akizza than you should
It is unlikely that taking more than one pill will do you any harm, but you may feel sick, vomit or have some vaginal bleeding.
What Akizza contains
Signs of breast cancer:
The active substances are gestodene and ethinylestradiol.
• dimpling of the skin,
Each tablet contains either
• changes in the nipple,
Gestodene 75 mcg and Ethinylestradiol 20 mcg or
• any lumps you can see or feel.
Gestodene 75 mcg and Ethinylestradiol 30 mcg
Signs of cancer of the cervix:
The other ingredients are:
• vaginal discharge that smells and/or contains blood,
• unusual vaginal bleeding,
• pelvic pain,
• painful sex.
• severe pain in your upper abdomen,
• yellow skin or eyes (jaundice),
Composition of Opadry white 03F58750:
• inflammation of the liver (hepatitis),
HPMC 2910/Hypromellose (E464)
• your whole body starts itching.
Titanium dioxide (E171)
Akizza may cause some other side effects and these are shown below:-
• stomach ache,
Round, white to off white, biconvex, film-coated tablet debossed ‘A’ on one side and other side plain.
• depressive moods or mood swings,
• sore or painful breasts.
If you vomit within 3-4 hours of taking a tablet or you have severe diarrhea, there is a risk that the active substances in the pill will
Uncommon side effects (between 10 and 100 in every 10,000 users may be affected)
not be fully taken up by your body. The situation is almost the same as forgetting a tablet. After vomiting or diarrhea, take another
• being sick and stomach upsets,
Each carton contains blister packed in a sealed tri-laminated pouch.
Morningside Healthcare Ltd
Postponing your period:
• loss of interest in sex,
115 Narborough Road
Although it is not recommended, you can postpone your period by directly consuming Akizza without taking a break from the next
• breast enlargement,
• skin rash, which may be itchy.
blister and continue this till the end. During the administration of the second blister you can experience minor or menstrual-like
bleeding. Begin by following the regular 7-day rest as usual with your next blister.
Rare side effects (between 1 and 10 in every 10,000 users may be affected)
You should ask your doctor for advice before you decide to postpone your menstrual period.
• poor tolerance of contact lenses,
Change in first day of bleeding:
If you take the tablets as directed, your period / withdrawal bleeding starts during the week off between taking tablets. If you need
to change that day, you can do shorter (but never stretching!) rest interval between taking tablets. For example, if your rest interval
between taking tablets starts on Friday, and you want to change to Tuesday (3 days earlier), you should start a new pack 3 days
earlier than usual. If you make the rest interval between taking tablets very short (for example, 3 days or less) bleeding may not
occur during this period. You can then experience spotting (drops or flecks of blood) or breakthrough bleeding.
• increase of interest in sex,
5 Pavilion Way
• vaginal or breast discharge.
Other side effects reported
• Bleeding and spotting between your periods can sometimes occur for the first few months but this usually stops once your body
has adjusted to Akizza. If it continues, becomes heavy or starts again, contact your doctor (see section 4.3).
- kidney or liver problems,
- gall stones,
• If you are less than 12 hours late taking a tablet, the protection against pregnancy is not reduced. Take the tablet as soon as
If you have any questions on the use of this medicine, ask your doctor or pharmacist or nurse.
the strip. Therefore, you must follow the following rules:
• More than one tablet forgotten in this strip
Please contact your doctor.
• One tablet forgotten in week 1
Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Take the
tablets again at the usual time and for the next seven days use an additional contraceptive method such as a condom.
If you had sex in the week prior to the missed tablet, you may be pregnant. In this case please contact your doctor.
• One tablet forgotten in week 2
Take the forgotten tablet as soon as you remember, even if that means that you have two tablets at the same time. Take the
tablets again at the usual time. Contraceptive protection is not reduced and you need not take extra contraceptive precautions.
This leaflet was last revised in June 2017.
Chloasma may be reduced by avoiding too much sunlight and/or UV lamps.
If you are unsure how to do this, ask your doctor for advice.
before trying to get pregnant. You can then easily calculate the expected date of birth.
The risk of incomplete protection against pregnancy is greatest if you forget a tablet at the beginning or at the end of
• Chloasma (yellow brown patches on the skin). This may happen even if you have been using Akizza for a number of months.
If you forget to take Akizza
tablets you have forgotten, the greater is the risk of becoming pregnant.
Morningside Pharmaceuticals Ltd
- persistent itching (pruritus),
• If you are more than 12 hours late taking a tablet, the protection against pregnancy may be reduced. The greater the number of
• losing weight,
reliable methods of birth control. If you want to become pregnant, stop using Akizza and wait until you have a menstrual period,
you remember and then take the following tablets again at the usual time.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
• fluid retention,
You can stop taking Akizza whenever you want. If you do not want to become pregnant, ask your doctor for advice about other
some, ask your doctor or pharmacist for advice.
Each carton contains 1, 3, or 6 blister strips of 21 tablets each.
What to do in case of vomiting or severe diarrhoea
Conditions that may worsen during pregnancy or previous use of the Pill:
Talk to your doctor if you have any of these symptoms. If you have taken too many tablets, or you discover that a child has taken
For Akizza 75 microgram / 30 microgram tablets
For Akizza 75 microgram / 20 microgram tablets
• putting on weight,
possible or 12 hours have passed, you should follow the advice given under section ‘What to do if you forget to take Akizza’.
Round, white to off white, biconvex, film-coated tablet debossed ‘B’ on one side and other side plain.
• feeling sick,
tablet from a reserve strip as soon as possible. If possible take it within 12 hours of when you normally take your pill. If that is not
What Akizza looks like and contents of the pack
Common side effects (between 100 and 1000 in every 10,000 users may be affected)
If you stop using Akizza:
Other symptoms may include tender breasts, dizziness , stomach pain, drowsiness and feeling tired.
If you think you may have any of these, see a doctor straight away. You may need to stop taking Akizza.
Take the forgotten tablet and
Finish the strip
Instead of the gap week
Go straight on to the next strip
6. Contents of the pack and other information
• a red bumpy rash (hives) and itching.
- Take the forgotten tablet and
- Finish the strip
- Stop the strip immediately
- Begin the gap week (not longer than
7 days, including the forgotten tablet)
- Then go on to the next strip
You can start the use of Akizza on the day after the last active tablet (the last tablet containing the active substances) of your
Signs of severe liver problems:
in week 3
• Changing from a combined hormonal contraceptive, combined vaginal ring or patch:
• swelling of the hands, face, lips, mouth, tongue or throat. A swollen tongue/throat may lead to difficulty swallowing and
- Take the forgotten tablet
- Use a barrier method (condom) for the
following 7 days
- And finish strip
• No hormonal contraceptive has been taken in the previous menstrual cycle:
• After a miscarriage or abortion:
Signs of a blood clot (see section 2 ‘Blood Clots’)
Each strip contains 21 tablets. At each tablet, the day of the week is printed on the back of the blister. For example, if you start on a
first 7 days of taking Akizza is recommended.
The chance of having a blood clot may be higher if you have any other conditions that increase this risk (see section 2 ‘Blood
tablet) and continue with the next pack. With this method you can always start your next pack on the same day of the week as
tablets every day around the same time.
when the next injection would be due) but in all of these cases the use of extra protective measures (for example, a condom) for the
Do not use this medicine after the expiry date stated on the blister / carton after EXP. The expiry date refers to the last day of the
- blood clots in the liver, stomach/intestine, kidneys or eye.
This medicinal product does not require any special storage conditions. Keep in the original package.
Take one tablet (Akizza) daily with a little water if necessary. You may take the tablets with or without food, but you should take the
You may switch any day from the progestogen-only pill (from an implant or an IUS on the day of its removal, from an injectable
Keep this medicine out of the sight and reach of children.
Clots’ for more information on the conditions that increase risk for blood clots and the symptoms of a blood clot).
2. Stop taking the pills from your current pack, leave an interval of 7 tablet-free days or less (count also the day when you forget a
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
• Changing from a progestogen-only pill (also called “mini-pill”) or injection or implant or a progestogen-releasing IUS:
5. How to store Akizza
- yellowing of the skin (jaundice),
- certain rare medical conditions such as systemic lupus erythematosus,
- occurrence or deterioration of the movement disorder chorea,
- blister-like rash (herpes gestationis) whilst pregnant,
4. Possible side effects
Like all medicines, Akizza can cause side effects, although not everybody gets them. If you get any side effect, particularly if
severe and persistent, or have any change to your health that you think may be due to Akizza, please talk to your doctor.
- an inherited form of deafness (otosclerosis),
- Crohn’s disease,
- ulcerative colitis,
An increased risk of blood clots in your veins (venous thromboembolism (VTE)) or blood clots in your arteries (arterial
- a personal or family history of a form of sickle cell disease,
thromboembolism (ATE)) is present for all women taking combined hormonal contraceptives. For more detailed information on
- swelling of body parts (hereditary angioedema),
the different risks from taking combined hormonal contraceptives please see section 2 ‘What you need to know before you use
- an inherited disease called porphyria,
- cancer of the cervix.
Serious side effects
Tell your doctor, pharmacist or family planning nurse if you are worried about any side effects which you think may be due to
Tell your doctor straight away if you get any of these symptoms after taking your tablets.
Akizza. Also tell them if any existing conditions get worse while you are taking Akizza.
Rare side effects (between 1 and 10 in every 10,000 users may be affected):
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.
• harmful blood clots in a vein or artery, for example:
You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.
- in a leg or foot (i.e. DVT),
By reporting side effects you can help provide more information on the safety of this medicine.
- in a lung (i.e. PE),
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