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BELLMUNT 28 0.03 MG/3 MG FILM-COATED TABLETS

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PACKAGE LEAFLET: INFORMATION FOR THE USER
Bellmunt 28 0.03 mg / 3 mg film-coated tablets
Ethinylestradiol/Drospirenone
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”)

Read all of this leaflet carefully before you start taking this medicine because it contains
important information for you.





Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do no 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 or pharmacist. This includes any possible side
effects not listed in this leaflet.

What is in this leaflet:
1. What Bellmunt 28 is and what it is used for
2. What you need to know before you take Bellmunt 28
3. How to take Bellmunt 28
4. Possible side effects
5. How to store Bellmunt 28
6. Contents of the pack and other information

1

1. WHAT BELLMUNT 28 IS AND WHAT IT IS USED FOR


Bellmunt 28 is a contraceptive pill and is used to prevent pregnancy.



Each of the 21 yellow tablets contains a small amount of two different female hormones,
namely drospirenone and ethinylestradiol.



The 7 white tablets contain no active substances and are also called placebo tablets.



Contraceptive pills that contain two hormones are called “combination” pills.

2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE BELLMUNT 28
General notes
Before you start using Bellmunt 28 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”).
Before you can begin taking Bellmunt 28, your doctor will ask you some questions about your
personal health history and that of your close relatives. The doctor will also measure your blood
pressure, and depending upon your personal situation, may also carry out some other tests.
In this leaflet, several situations are described where you should stop using Bellmunt 28, or where
the reliability of Bellmunt 28 may be decreased. In such situations you should either not have sex
or you should take extra non-hormonal contraceptive precautions, e.g., use a condom or another
barrier method. Do not use rhythm or temperature methods. These methods can be unreliable
because Bellmunt 28 alters the monthly changes of the body temperature and of the cervical
mucus.
Bellmunt 28, like other hormonal contraceptives, does not protect against HIV infection
(AIDS) or any other sexually transmitted disease.

Do not take Bellmunt 28:
You should not use Bellmunt 28 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.
• 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);

2

• if you have any of the following diseases that may increase your risk of a clot in the arteries:



a very high level of fat in the blood (cholesterol or triglycerides)






very high blood pressure








severe diabetes with blood vessel damage

a condition known as hyperhomocysteinaemia

if you have (or have ever had) a type of migraine called ‘migraine with aura’;
if you have (or have ever had) a liver disease and your liver function is still not normal.
if your kidneys are not working well (renal failure)
if you have (or have ever had) a tumour in the liver
if you have (or have ever had) or if you are suspected of having breast cancer or cancer of the
genital organs
if you have any unexplained bleeding from the vagina
if you are allergic to ethinylestradiol or drospirenone, or any of the other ingredients of this
medicine (listed in section 6) This may cause itching, rash or swelling.

Warnings and precautions
Talk to your doctor or pharmacist before taking Bellmunt 28.
What to take special care with Bellmunt 28

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 clot’ (thrombosis) section below.

For a description of the symptoms of these serious side effects please go to “How to recognise a
blood clot”.
Tell your doctor if any of the following conditions apply to you.
If the condition develops, or gets worse while you are using Bellmunt 28, you should also tell your
doctor.
In some situations you need to take special care while using Bellmunt 28 or any other combination
pill, and your doctor may need to examine you regularly.









if a close relative has or has ever had breast cancer
if you have a disease of the liver or the gallbladder
if you have diabetes
if you have depression
if you have Crohn’s disease or ulcerative colitis (chronic inflammatory bowel disease)
if you have systemic lupus erythematosus (SLE –; a disease affecting your natural defence
system)
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)

3



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)



if you need an operation, or you are off your feet for a long time (see in section 2 ‘Blood
clots’)



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 can start taking Bellmunt 28



if you have an inflammation in the veins under the skin (superficial thrombophlebitis);








if you have varicose veins.
if you have epilepsy (see "Bellmunt 28 and using other medicines")
if you have a disease that first appeared during pregnancy or earlier use of sex hormones (for
example, hearing loss, a blood disease called porphyria, skin rash with blisters during
pregnancy (gestational herpes), a disease of the nerves in which sudden movements of the
body occur (Sydenham’s chorea)).
if you have or have ever had chloasma (a discolouration of the skin, especially of the face or
neck known as “pregnancy patches”). If so, avoid direct sunlight or ultraviolet light.
if you have hereditary angioedema, products containing estrogens may cause or worsen the
symptoms. You should see your doctor immediately if you experience symptoms of
angioedema such as swollen face, tongue and/or throat and/or difficulty swallowing, or hives
together with difficulty breathing.

BLOOD CLOTS
Using a combined hormonal contraceptive such as Bellmunt 28 increases your risk of developing a
blood clot compared with not using one. In rare cases a blood clot can block blood vessels and
cause serious problems.
Blood clots can develop


in veins (referred to as a ‘venous thrombosis’, ‘venous thromboembolism’ or VTE)



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 a harmful blood clot due to Bellmunt 28 is
small.
HOW TO RECOGNISE A BLOOD CLOT
Seek urgent medical attention if you notice any of the following signs or symptoms.

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What are you possibly
suffering from?

Are you experiencing any of these signs?


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



Deep vein thrombosis

change in colour of the skin on the leg e.g. turning pale,
red or blue



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;

Pulmonary embolism

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’).
Symptoms most commonly occur in one eye:


immediate loss of vision or



painless blurring of vision which can progress to loss of
vision



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

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Retinal vein thrombosis
(blood clot in the eye)

Heart attack

What are you possibly
suffering from?

Are you experiencing any of these signs?


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.

Stroke

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.


swelling and slight blue discolouration of an extremity;



severe pain in your stomach (acute abdomen)

Blood clots blocking other
blood vessels

BLOOD CLOTS IN A VEIN
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 thrombosis). However, these side effects are rare. Most
frequently, they occur in the first year of use of a combined hormonal contraceptive.



If a blood clot forms in a vein in the leg or foot it can cause a deep vein thrombosis (DVT).



If a blood clot travels from the leg and lodges in the lung it can cause a pulmonary embolism.



Very rarely a clot may form in a vein in another organ such as the eye (retinal vein thrombosis).

When is the risk of developing a blood clot in a vein highest?
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 time. The risk may also be higher if you restart taking a
combined hormonal contraceptive (the same product or a different product) after a break of 4 weeks
or more
After the first year, the risk gets smaller but is always slightly higher than if you were not using a
combined hormonal contraceptive.
When you stop Bellmunt 28 your risk of a blood clot returns to normal within a few weeks.

What is the risk of developing a blood clot?

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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 Bellmunt 28 is small.
-

Out of 10,000 women who are not using any combined hormonal contraceptive and are not
pregnant, about 2 will develop a blood clot in a year.

-

Out of 10,000 women who are using a combined hormonal contraceptive that contains
levonorgestrel, norethisterone, or norgestimate about 5-7 will develop a blood clot in a year.

-

Out of 10,000 women who are using a combined hormonal contraceptive that contains
drospirenone, such as Bellmunt 28, between about 9 and 12 women will develop a blood
clot in a year.

-

The risk of having a blood clot will vary according to your personal medical history (see
“Factors that increase your risk of a blood clot” below).

Risk of developing a blood clot
in a year
Women who are not using a combined hormonal
pill/patch/ring and are not pregnant

About 2 out of 10,000 women

Women using a combined hormonal contraceptive pill
containing levonorgestrel, norethisterone or
norgestimate

About 5-7 out of 10,000 women

Women using Bellmunt 28

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 Bellmunt 28 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);



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). In this case you could have a hereditary blood clotting
disorder;



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 a cast. The use of Bellmunt 28 may need to be stopped
several weeks before surgery or while you are less mobile. If you need to stop Bellmunt 28 ask
your doctor when you can start using it again.



as you get older (particularly above about 35 years);



if you gave birth less than a few weeks ago

The risk of developing a blood clot increases the more conditions you have.
Air travel (>4 hours) may temporarily increase your risk of a blood clot, particularly if you have
some of the other factors listed.

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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 Bellmunt 28 needs to be stopped.
If any of the above conditions change while you are using Bellmunt 28, for example a close family
member experiences a thrombosis for no known reason; or you gain a lot of weight, tell your
doctor.

BLOOD CLOTS IN AN ARTERY
What can happen if a blood clot forms in an artery?
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.

Factors that increase your risk of a blood clot in an artery
It is important to note that the risk of a heart attack or stroke from using Bellmunt 28 is very small
but can increase:


with increasing age (beyond about 35 years);



if you smoke. When using a combined hormonal contraceptive like Bellmunt 28 you are
advised to stop smoking. If you are unable to stop smoking and are older than 35 your
doctor may advise you to use a different type of contraceptive;



if you are overweight;



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 could also have a higher risk of having a heart attack or
stroke;



if you, or someone in your immediate family, have a high level of fat in the blood
(cholesterol or triglycerides);



if you get migraines, especially migraines with aura;



if you have a problem with your heart (valve disorder, disturbance of the rhythm called
atrial fibrillation)



if you have diabetes.

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 increased even more.
If any of the above conditions change while you are using Bellmunt 28, 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.
Bellmunt 28 and cancer
Breast cancer has been observed slightly more often in women using combination pills, but it is not
known whether this is caused by the treatment. For example it may be that more tumours are
detected in women on combination pills because they are examined by their doctor more often. The
occurrence of breast tumours becomes gradually less after stopping the combination hormonal

8

contraceptives. It is important to regularly check your breasts and you should contact your doctor if
you feel any lump.
In rare cases, benign liver tumours, and in even fewer cases malignant liver tumours have been
reported in pill users. Contact your doctor if you have unusually severe abdominal pain.

Bleeding between periods
During the first few months that you are taking Bellmunt 28, you may have unexpected bleeding
(bleeding outside the week when you are taking the white tablets). If this bleeding occurs for more
than a few months, or if it begins after some months, your doctor must find out what is wrong.
What to do if no bleeding occurs during the placebo days
If you have taken all the yellow active tablets correctly, have not had vomiting or severe diarrhoea
and you have not taken any other medicines, it is highly unlikely that you are pregnant.
If the expected bleeding does not happen twice in succession, you may be pregnant. Contact your
doctor immediately. Do not start the next strip until you are sure that you are not pregnant.
Other medicines and Bellmunt 28
Always tell your doctor which medicines or herbal products you are already using. Also tell any
other doctor or dentist who prescribes another medicine (or the pharmacist) that you use Bellmunt
28. They can tell you if you need to take additional contraceptive precautions (for example
condoms) and if so, for how long.
Some medicines can make Bellmunt 28 less effective in preventing pregnancy, or can cause
unexpected bleeding. These include:
• medicines used for the treatment of
o epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine)
o tuberculosis (e.g. rifampicin)
o HIV infections (ritonavir, nevirapine) or other infections (antibiotics such as griseofulvin,
penicillin, tetracycline)
o high blood pressure in the blood vessels in the lungs (bosentan)
• the herbal remedy St John’s wort
Bellmunt 28 may influence the effect of other medicines, e.g.
o medicines containing ciclosporin
o the anti-epileptic lamotrigine (this could lead to an increased frequency of seizures)
Ask your doctor or pharmacist for advice before taking any medicine.
Bellmunt 28 with food and drink
Bellmunt 28 may be taken with or without food, if necessary with a small amount of water.

9

Laboratory tests
If you need a blood test, tell your doctor or the laboratory staff that you are taking the pill, because
hormone contraceptives can affect the results of some tests.
Pregnancy
If you are pregnant, do not take Bellmunt 28. If you become pregnant while taking Bellmunt 28
stop immediately and contact your doctor. If you want to become pregnant, you can stop taking
Bellmunt 28 at any time (see also "If you want to stop taking Bellmunt 28").
Ask your doctor or pharmacist for advice before taking any medicine.
Breast-feeding
Use of Bellmunt 28 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.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
There is no information suggesting that use of Bellmunt 28 affects driving or use of machines.
Important information about some of the ingredients of Bellmunt 28
Bellmunt 28 contains lactose.
If you have been told by your doctor that you have an intolerance to some sugars, contact your
doctor before taking this medicinal product.

3. HOW TO TAKE BELLMUNT 28
Each blister contains 21 active yellow tablets and 7 white placebo tablets.
The two differently coloured tablets of Bellmunt 28 are arranged in order. A strip contains 28
tablets.
Take one tablet of Bellmunt 28 every day, if necessary with a small amount of water. You may take
the tablets with or without food, but you should take the tablets every day around the same time.
One strip contains 28 tablets, each marked with a day of the week. Start by taking a tablet marked
with the correct day of the week. If, for example, you start on Wednesday, you should take a tablet
with “WED” at the side. Take one tablet each day. Follow the direction of the arrows on the strip
until you have taken the 28 tablets. Do not confuse the tablets: take a yellow tablet once per day
for the first 21 days, and then one white tablet per day for the last 7 days. Then you should start a
new strip (21 yellow tablets and 7 white tablets). Consequently there is no drug-free interval
between strips.

10

During the 7 days when you are taking the white placebo tablets (the placebo days), bleeding should
begin (so-called withdrawal bleeding). This usually starts on the 2nd or 3rd day after the last yellow
active tablet of Bellmunt 28. Once you have taken the last white tablet, you should start with the
following strip, whether your bleeding has stopped or not. This means that you should start every
strip on the same day of the week, and that the withdrawal bleed should occur on the same days each
month.
If you use Bellmunt 28 in this manner, you are protected against pregnancy also during the 7 days
when you are taking a placebo tablet.
When can you start with the first strip?


If you have not used a contraceptive with hormones in the previous month
Begin with Bellmunt 28 on the first day of the cycle (that is, the first day of your period). If you
start Bellmunt 28 on the first day of your period you are immediately protected against
pregnancy. You may also begin on day 2-5 of the cycle, but then you must use extra protective
measures (for example, a condom) for the first 7 days.



Changing from a combination hormonal contraceptive, or combination contraceptive vaginal
ring or patch
You can start Bellmunt 28 preferably on the day after the last active tablet (the last tablet
containing active substances) of your previous pill, but at the latest on the day after the tabletfree days of your previous pill (or after the last inactive tablet of your previous pill). When
changing from a combination contraceptive vaginal ring or patch, follow the advice of your
doctor.



Changing from a progestogen-only-method (progestogen-only pill, injection, implant or a
progestogen-releasing IUD)
You may switch any day from the progestogen-only pill (from an implant or an IUD on the day
of its removal, from an injectable when the next injection would be due) but in all of these cases
use extra protective measures (for example, a condom) for the first 7 days of tablet-taking.



After a miscarriage
Follow the advice of your doctor.



After having a baby
You can start Bellmunt 28 between 21 and 28 days after having a baby. If you start later than
day 28, use a so-called barrier method (for example, a condom) during the first seven days of
Bellmunt 28 use.
If, after having a baby, you have had sex before starting Bellmunt 28 (again), be sure that you
are not pregnant or wait until your next period.



If you are breastfeeding and want to start Bellmunt 28 (again) after having a baby
Read the section on "Breast-feeding".

Ask your doctor what to do if you are not sure when to start.
If you take more Bellmunt 28 than you should
There are no reports of serious harmful results of taking too many Bellmunt 28 tablets.

11

If you take several tablets at once then you may have symptoms of nausea or vomiting. Young girls
may have bleeding from the vagina.
If you have taken too many Bellmunt 28 tablets, or you discover that a child has taken some, ask
your doctor or pharmacist for advice.
If you forget to take Bellmunt 28
The tablets in the 4th row of the strip are the placebo tablets. If you forget one of these tablets, this
has no effect on the reliability of Bellmunt 28. Throw away the forgotten placebo tablet.
If you miss a yellow, active tablet from the 1st, 2nd or 3rd row, do as follows:


If you are less than 12 hours late taking a tablet, the protection against pregnancy is not
reduced. Take the tablet as soon as you remember and then take the following tablets again at
the usual time.
• If you are more than 12 hours late taking a tablet, the protection against pregnancy may be
reduced. The greater the number of tablets that you have forgotten, the greater is the risk of
becoming pregnant.
The risk of incomplete protection against pregnancy is greatest if you forget a yellow tablet at the
beginning or at the end of the strip. Therefore, you should keep to the following rules (see the
diagram below):


More than one tablet forgotten in this strip
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. Continue taking the tablets at the usual time and use extra precautions
for the next 7 days, for example, a condom. If you have had sex in the week before forgetting
the tablet you may be pregnant. In that case, 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 to take two
tablets at the same time. Continue taking the tablets at the usual time. The protection against
pregnancy is not reduced, and you do not need to take extra precautions.
• One tablet forgotten in week 3
You can choose between two possibilities:
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. Continue taking the tablets at the usual time. Instead of taking
the white placebo tablets on this strip, throw them away, and start the next strip.
Most likely, you will have a period at the end of the second strip - while taking the white
placebo tablets - but you may have light or menstruation-like bleeding during the second
strip.

12

2. You can also stop the active yellow tablets and go directly to the 7 white placebo tablets
(before taking the placebo tablets, record the day on which you forgot your tablet). If
you want to start a new strip on the day you always start, take the placebo tablets for less
than 7 days.
If you follow one of these two recommendations, you will remain protected against pregnancy.
• If you have forgotten any of the tablets in a strip, and you do not have a bleeding during the
normal placebo days, you may be pregnant. Contact your doctor before you start the next strip.
More than varios
Olvido de 1
yellow tablet del
comprimidos
forgotten in 1
mismo blister
strip

Ask your doctorsu médico
Pida consejo a for advice


Yes
En la
In week 1
semana 1

Had sex in relaciones sexuales la semana anterior?
¿Mantuvo the previous week before forgetting?

No

Only 1 yellow
Olvido de 1 sólo
tablet forgotten
comprimido
(taken more than
(tomado más de
12 hours late)
12 horas tarde)

En la
In week 2
semana 2

- - Tome thecomprimido olvidado
Take el forgotten tablet
- - Utilice un método de barrera (preservativo) durante
Use a barrier method (condom) for the following 7
days and
los 7 días siguientes
- - Y finalice el blister
Finish the strip
-- Tome the forgotten tablet
Take el comprimido olvidado y
-- Finalice el blister
Finish the strip
- - Tome thecomprimido olvidado y
Take el forgotten tablet and
- - Finalice el blister yellow tablets
Finish taking the
- - En lugar de la semana de descanso comience de
Throw away the 7 white tablets
- forma seguida con el siguiente blister
Start the next strip
or
o

En la
In week 3
semana 3

- - Pare de tomar los comprimidos del blister
Stop the yellow tablets immediately
- inmediatamente the 7 white tablets
Go on directly to
- -Then start the next strip
Inicie la semana de descanso (no más de 7 días,
incluyendo el comprimido olvidado)
- Después, continúe con el siguiente blister

What to do in the case of vomiting or severe diarrhoea
If you vomit within 3-4 hours after taking an active yellow tablet or you have severe diarrhoea,
there is a risk that the active substances in the pill will not be fully taken up by your body. The
situation is almost the same as forgetting a tablet. After vomiting or diarrhoea, take another yellow
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 possible or 12 hours have passed, you should follow the advice
given under “If you forget to take Bellmunt 28”.
Delaying your period: what you need to know
Even though it is not recommended, you can delay your period by not taking the white placebo
tablets from the 4th row and going straight to a new strip of Bellmunt 28 and finishing it. You may
experience light or menstruation-like bleeding while using this second strip. Finish this second strip
by taking the 7 white tablets from the 4th row. Then start your next strip.

13

You might ask your doctor for advice before deciding to delay your menstrual period.
Changing the first day of your period: what you need to know
If you take the tablets according to the instructions, then your period will begin during the placebo
week. If you have to change this day, reduce the number of placebo days – when you take the white
placebo tablets – (but never increase them – 7 is the maximum!). For example, if you normally start
taking the placebo tablets on a Friday, and you want to change this to a Tuesday (3 days earlier)
start a new strip 3 days earlier than usual. If you make the placebo interval very short (for example,
3 days or less) you may not have any bleeding during these days. You may then experience light or
menstruation-like bleeding.
If you are not sure what to do, consult your doctor.
If you want to stop taking Bellmunt 28
You can stop taking Bellmunt 28 whenever you want. If you do not want to become pregnant, ask
your doctor for advice about other reliable methods of birth control. If you want to become
pregnant, stop taking Bellmunt 28 and wait for a period before trying to become pregnant. You will
be able to calculate the expected delivery date more easily.
If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS
Like all medicines, Bellmunt 28 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 Bellmunt 28, please talk to your doctor.
An increased risk of blood clots in your veins (venous thromboembolism (VTE)) or blood clots in
your arteries (arterial thromboembolism (ATE)) is present for all women taking combined hormonal
contraceptives. For more detailed information on the different risks from taking combined hormonal
contraceptives please see section 2 “What you need to know before you use Bellmunt 28”.

The following is a list of the side effects that have been linked with the use of Bellmunt 28.
Common side effects (between 1 and 10 in every 100 users may be affected):
• depressive mood
• headache
• migraine
• nausea
• menstrual disorders, bleeding between periods, breast pain, breast tenderness
• thick, whitish vaginal discharge and vaginal yeast infection.
Uncommon side effects (between 1 and 10 in every 1,000 users may be affected):
• high blood pressure, low blood pressure
• vomiting, diarrhoea
• acne, skin rash, severe itching hair loss (alopecia)
• breast enlargement, changes in interest in sex, infection of the vagina

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fluid retention and body weight changes.

Rare side effects (between 1 and 10 in every 10,000 users may be affected):
• allergic reactions (hypersensitivity), asthma
• hearing impairment
• the skin conditions erythema nodosum (characterized by painful reddish skin nodules) or
erythema multiforme (characterized by rash with target-shaped reddening or sores).
• breast secretion


harmful blood clots in a vein or artery for example:
o in a leg or foot (i.e. DVT)
o in a lung (i.e. PE)
o heart attack
o stroke
o mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic
attack (TIA)
o blood clots in the liver, stomach/intestine, kidneys or eye.

The chance of having a blood clot may be higher if you have any other conditions that increase this
risk (See section 2 for more information on the conditions that increase risk for blood clots and the
symptoms of a blood clot)
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme,
Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more
information on the safety of this medicine.

5.

HOW TO STORE BELLMUNT 28

Keep Bellmunt 28 out of the reach and sight of children.
This medicinal product does not require any special storage conditions.
Expiry date
Do not use Bellmunt 28 after the expiry date which is stated on the blister and package after the
phrase "Do not use after:" or "EXP:"
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These measures will help protect the environment.
6.

CONTENTS OF THE PACK AND OTHER INFORMATION

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What Bellmunt 28 contains:
A strip of Bellmunt 28 contains 21 yellow active tablets in the 1st, 2nd and 3rd rows of the strip and 7
white placebo tablets in row 4.
Active tablets
The active ingredients are ethinylestradiol 0.03 mg and drospirenone 3 mg.
The other ingredients are:
Tablet core: lactose monohydrate, maize starch, pregelatinised starch (maize), crospovidone,
povidone, polysorbate 80, magnesium stearate.
Coating: Polyvinyl alcohol partial hydrolyzed, titanium dioxide (E171), macrogol 3350, talc, yellow
iron oxide (E172).
Placebo tablets
Tablet core: lactose anhydrous, povidone, magnesium stearate.
Coating: Polyvinyl alcohol partial hydrolized, titanium dioxide (E171), macrogol 3350, talc.
What Bellmunt 28 looks like and contents of the package
Active tablets are yellow, round film-coated tablets.
Placebo tablets are white, round film-coated tablets.
Bellmunt 28 is available in boxes of 1, 2, 3, 6 and 13 blisters, each one containing 28 tablets (21
active plus 7 placebo tablets).
Not all package sizes may be marketed
This medicinal product is authorised in the Member States of the EEA under the following names:
This leaflet was last approved in:
Marketing Authorisation Holder
Laboratorios León Farma, S.A.
Pol. Ind. Navatejera.
C/ La Vallina s/n
24008 - Villaquilambre, León.
Spain
Manufacturer
Laboratorios León Farma, S.A.
Pol. Ind. Navatejera.
C/ La Vallina s/n
24008 - Villaquilambre, León.
Spain

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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