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MARVELON TABLETS

Active substance(s): DESOGESTREL / ETHINYLESTRADIOL / ETHINYLOESTRADIOL

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PACKAGE LEAFLET: INFORMATION FOR THE
USER
®
Marvelon Tablets
(desogestrel/ethinylestradiol)
This product will be referred to as Marvelon
throughout the remainder of this leaflet.

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”).
 Some women should not take the Pill because of
current medical problems or illnesses. Please
read this leaflet to make sure Marvelon is right for
you.
 To prevent pregnancy it is important to take
Marvelon as instructed and to start each pack on
time. Please make sure that you understand what
to do if you miss a pill or if you think you are
pregnant.
Read all of this leaflet carefully before you start
taking this medicine.
 Keep this leaflet. You may need to read it again.
 If you have any questions or need more advice,
ask your doctor, family planning nurse or
pharmacist.
 This medicine has been prescribed for you. Do
not pass it on to others. It may harm them.
 If any of the side effects gets severe, or if you
notice any not listed in this leaflet, please tell your
doctor, family planning nurse or pharmacist.
In this leaflet:
1. What Marvelon does
2. What you need to know before you use
Marvelon
3. Taking Marvelon
3.3 A missed Pill
4. Possible side effects
5. How to store Marvelon
6. What is in Marvelon and who makes it
1.

What Marvelon does

Marvelon is a combined oral contraceptive pill (‘the
Pill’). You take it to stop you getting pregnant.
This low-dose contraceptive contains two types of
female sex hormones, oestrogen and progestogen.
These hormones prevent an egg being released from
your ovaries so you can’t get pregnant.
Marvelon also makes the fluid (mucus) in your cervix
thicker which makes it more difficult for sperm to enter
the womb.
Marvelon is a 21-day pill – you take one each day for
21 days, followed by 7 days when you take no pills.
The benefits of taking the Pill include:
 it is one of the most reliable reversible methods
of contraception if used correctly
 it doesn’t interrupt sex
 it usually makes your periods regular, lighter and
less painful
 it may help with pre-menstrual symptoms.
Marvelon will not protect you against sexually
transmitted infections, such as Chlamydia or HIV. Only
condoms can help to do this.
Marvelon needs to be taken as directed to prevent
pregnancy.

2.

What you need to know before you use
Marvelon

General notes
Before you start using Marvelon 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”.
It’s important that you understand the benefits and risks
of taking the Pill before you start taking it, or when
deciding whether to carry on taking it. Although the Pill
is suitable for most healthy women it isn’t suitable for
everyone.
 Tell your doctor if you have any of the illnesses or
risk factors mentioned in this leaflet.
Before you start taking the Pill
 Your doctor will ask about you and your family’s
medical problems and check your blood pressure.
You may also need other checks, such as a breast
examination.
While you’re on the Pill
 You will need regular check-ups with your doctor
or family planning nurse, usually when you need
another prescription of the Pill.
 You should go for regular cervical smear tests.
 Check your breasts and nipples every month for
changes – tell your doctor if you can see or feel
anything odd, such as lumps or dimpling of the
skin.
 If you need a blood test tell your doctor that you
are taking the Pill, because the Pill can affect the
results of some tests.
 If you’re going to have an operation, make sure
your doctor knows about it. You may need to stop
taking the Pill about 4–6 weeks before the
operation. This is to reduce the risk of a blood clot
(see section 2.1). Your doctor will tell you when you
can start taking the Pill again.
2.1

When you should not use Marvelon

You should not use Marvelon 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. See also section
2.2 ‘When to take special care with Marvelon’.
 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 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)
 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 recently had a severe liver
disease
 If you have ever had a liver tumour
 If you have cancer affected by sex hormones –
such as some cancers of the breast, womb
lining or ovary
 If you have vaginal bleeding that has not been
explained by your doctor
 If you are allergic (hypersensitive) to any of the
ingredients in Marvelon.

 If you suffer from any of these, or get them for
the first time while taking Marvelon, contact your
doctor as soon as possible. Do not take Marvelon.
2.2

When to take special care with Marvelon

HOW TO RECOGNISE A BLOOD CLOT
Seek urgent medical attention if you notice any of the
following signs or symptoms.

Are you experiencing any of these
signs?

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’
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 Marvelon, you should also tell your doctor.
 If you have ever had problems with your heart,
circulation or blood clotting
 If you have diabetes
 If you have ever had kidney or liver problems
 If you have ever had severe depression
 If you have ever had migraines
 If you have had problems while pregnant or
while using the pill, like:
 itching of the whole body (pruritus)
 jaundice which was not caused by infection
 gall stones
 systemic lupus erythematosus (SLE)
 a blister-like rash, called herpes gestationis
 a hearing problem called otosclerosis
 other rare conditions called porphyria and
hereditary angiodema
 If you have brown patches on your face or
body (chloasma) – if so avoid too much
exposure to the sun or ultraviolet light
 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);
 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 Marvelon;
 if you have an inflammation in the veins under
the skin (superficial thrombophlebitis);
 if you have varicose veins;
2.2.1. The Pill and Thrombosis
BLOOD CLOTS
Using a combined hormonal contraceptive such as
Marvelon, 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 Marvelon is small.








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
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’).
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
 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
 swelling and slight blue
discolouration of an extremity;
 severe pain in your stomach
(acute abdomen)

What are
you possibly
suffering
from?
Deep vein
thrombosis

Pulmonary
embolism

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.

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

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 Marvelon your risk of a blood clot
returns to normal within a few weeks.
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.

Retinal vein
thrombosis
(blood clot in
the eye)
Heart attack

Stroke

Blood clots
blocking other
blood vessels

The overall risk of a blood clot in the leg or lung (DVT
or PE) with Marvelon 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 desogestrel
such as Marvelon 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
About 2 out of
combined hormonal
10,000 women
pill/patch/ring and are not
pregnant
Women using a combined
About 5-7 out of
hormonal contraceptive pill
10,000 women
containing levonorgestrel,
norethisterone or
norgestimate
Women using Marvelon
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 Marvelon 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
Marvelon may need to be stopped several weeks
before surgery or while you are less mobile. If you
need to stop Marvelon 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.
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 Marvelon needs to be stopped.

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 Marvelon is very small but can
increase:
 with increasing age (beyond about 35 years);
 if you smoke. When using a combined hormonal
contraceptive like Marvelon 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 than
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 Marvelon, 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.
2.2.2

The Pill and cancer

The Pill reduces your risk of cancer of the ovary and
womb if used in the long term. However, it also seems
to slightly increase your risk of cancer of the cervix –
although this may be due to having sex without a
condom rather than the Pill itself. All women should
have regular smear tests.
If you have breast cancer, or have had it in the past,
you should not take the Pill. The Pill slightly increases
your risk of breast cancer. This risk goes up the longer
you’re on the Pill, but returns to normal within about 10
years of stopping it. Because breast cancer is rare in
women under the age of 40 the extra number of cases
of breast cancer in current and recent users of the Pill
is small.
For example:
 Of 10,000 women who have never taken the
Pill, about 16 will have breast cancer by the time
they are 35 years.
 Of 10,000 women who take the Pill for 5 years
in their early twenties, about 17-18 will have
breast cancer by the time they are 35 years.

Of 10,000 women who have never taken the
Pill, about 100 will have breast cancer by the
time they are 45 years old.
Of 10,000 women who take the Pill for 5 years
in their early thirties, about 110 will have breast
cancer by the time they are 45 years old.

Your risk of breast cancer is higher:
 if you have a close relative (mother, sister or
grandmother) who has had breast cancer
 if you are seriously overweight
 See a doctor as soon as possible if you notice
any changes in your breasts, such as dimpling of
the skin, changes in the nipple or any lumps you
can see or feel.
Taking the Pill has also been linked to liver diseases,
such as jaundice and non-cancer liver tumours, but this
is rare. Very rarely, the Pill has also been linked with
some forms of liver cancer in women who have taken it
for a long time.
 See a doctor as soon as possible if you get
severe pain in your stomach, or yellow skin or
eyes (jaundice). You may need to stop taking
Marvelon.
2.3

Taking other medicines

If you ever need to take another medicine at the same
time as being on the Pill, always tell your doctor,
pharmacist or dentist that you’re taking Marvelon. Also
check the leaflets that come with all your medicines to
see if they can be taken with hormonal contraceptives.
Some medicines can stop Marvelon from working
properly – for example:
 some medicines used to treat epilepsy (primidone,
phenytoins, barbiturates, carbamazepine,
oxcarbazepine, topiramate, felbamate)
 medicine to treat tuberculosis (rifampicin)
 certain HIV medicines (ritonavir)
 certain antibiotics (penicillins, tetracyclines)
 St. John’s Wort (a herbal remedy)
 Griseofulvin (an antifungal drug).
If you do need to take one of these medicines,
Marvelon may not be suitable for you, or you may be
able to take Marvelon and use extra contraception for a
while. Your doctor, pharmacist or dentist can tell you if
this is necessary and for how long.
Marvelon can also affect how well other medicines
work. For example ciclosporin and lamotrigine. Remind
your doctor if you are taking these in case your
treatment needs to be adjusted.
2.4

Taking Marvelon with food and drink

There are no special instructions about food and drink
while on Marvelon.
2.5

Pregnancy and breast-feeding

Do not use Marvelon if you are pregnant. If you think
you might be pregnant, do a pregnancy test to confirm
that you are before you stop taking Marvelon.
Marvelon is not recommended for use during breastfeeding. Ask your doctor or family planning nurse about
alternative contraception.
Breast-feeding may not stop you getting pregnant.
2.6

Driving and using machines

Marvelon has no known effect on the ability to drive or
use machines.
2.7

Marvelon contains lactose

If you have been told by your doctor that you have an
intolerance to some sugars, contact your doctor before
using Marvelon.
2.8

Use in adolescents

No clinical data on efficacy and safety are available in
adolescents below 18 years.
3.

Taking Marvelon

3.1

How to take it

To prevent pregnancy, always take Marvelon exactly as
described below.
Check with your doctor or family planning nurse if you
are not sure.
Take Marvelon every day for 21 days
Marvelon comes in strips of 21 pills, each marked with
a day of the week.
 Take your pill at the same time every day.
 Start by taking a pill marked with the correct day of
the week.
 Follow the direction of the arrows on the strip. Take
one pill each day, until you have finished all 21
pills.
 Swallow each pill whole, with water if necessary.
Do not chew the pill.
Then have seven pill-free days
After you have taken all 21 pills in the strip, you have
seven days when you take no pills. So if you take the
last pill of one pack on a Friday, you will take the first
pill of your next pack on the Saturday of the following
week.

Changing to Marvelon from a progestogen-only
injection, implant of progestogen releasing
intrauterine device (IUD)
Start taking Marvelon when your next injection is due or
on the day that your implant or IUD is removed. Make
sure you also use an additional contraceptive method,
such as a condom, for the first 7 days that you are
taking Marvelon.
Starting Marvelon after a miscarriage or abortion
If you have had a miscarriage or an abortion, your
doctor may tell you to start taking Marvelon straight
away. This means that you will have contraceptive
protection with your first pill.

3.5

If you are sick or have diarrhoea

A missed pill

If you miss a pill, follow these instructions:
START HERE

When were you due to take the missed Pill?

If you vomit within 3 to 4 hours after taking your pill,
this is like missing a pill. You must follow the advice for
missed pills – see section 3.3, A missed pill.
If you have severe diarrhoea for more than 12 hours
after taking Marvelon follow the instructions for if you
are more than 12 hours late – see section 3.3, A
missed pill.

Less than 12 hours ago

More than 12 hours ago, or you have missed more
than one Pill

 Talk to your doctor if your stomach upset
carries on or gets worse. He or she may
recommend another form of contraception.
3.6

 Take the delayed pill straight away, and further pills as
usual. This may mean taking two pills in one day.
 Don't worry your contraceptive protection should not be
reduced.

Or if your period has already begun start taking
Marvelon on day 5 (counting the first day of your period
as day 1) whether or not your bleeding has stopped.
You must also use extra contraception, such as
condoms, until you have taken the first seven pills
correctly.
Changing to Marvelon from another contraceptive
Pill
 If you are currently on a 21-day Pill: start
taking Marvelon the next day after the end of the
previous strip. You will have contraceptive
protection with your first pill but you will not have
a bleed until after you finish your first strip of
Marvelon.
 If you are currently on a 28-day Pill: start
taking Marvelon the day after your last active pill.
You will have contraceptive protection with your
first pill. You will not have a bleed until after you
finish your first strip of Marvelon.
 Or if you are taking a progestogen-only Pill
(mini-Pill or POP): start Marvelon on the first day
of bleeding, even if you have already taken the
POP for that day. You will have contraceptive
cover straight away. If you don’t usually have any
bleeding while you are taking a progestogen-only
Pill, you can stop taking it any day and start
Marvelon the next day. You will need to use extra
contraception, such as a condom, for seven
days.

A lost pill

If you are sick (vomit) or have very bad diarrhoea your
body may not get its usual dose of hormones from that
pill.

Starting Marvelon

As a new user or starting the Pill again after a break
Either take your first Marvelon pill on the first day of
your next period. By starting in this way, you will have
contraceptive protection with your first pill.

Like all medicines, Marvelon 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
Marvelon, please talk to your doctor.

Or if you do not want to change the starting day of your
cycle, take a pill from a spare strip. Then take all the
other pills from your current strip as usual. You can
then keep the opened spare strip in case you lose any
more pills.

As long as you take Marvelon correctly, you will always
start each new strip on the same day of the week.
3.2

If you start a new strip of pills late, or make your “week
off” longer than seven days, you may not be protected
from pregnancy. If you had sex in the last seven days,
ask your doctor, family planning nurse or pharmacist for
advice. You may need to consider emergency
contraception. You should also use extra contraception,
such as a condom, for seven days.

If you lose a pill,
Either take the last pill of the strip in place of the lost
pill. Then take all the other pills on their proper days.
Your cycle will be one day shorter than normal, but
your contraceptive protection won’t be affected. After
your seven pill-free days you will have a new starting
day, one day earlier than before.

Then start your next strip
Start taking your next strip of Marvelon after the seven
pill-free days – even if you are still bleeding. Always
start the new strip on time.

However, it will not cause you or the baby any harm if
you get pregnant straight away.

3.4

Contraception after having a baby
If you have just had a baby, ask your doctor for advice
about contraception.
If you are not breast-feeding:
 you can start taking Marvelon three weeks after
the birth or,
 you can start taking Marvelon more than three
weeks after the birth but you need to use extra
contraception, such as a condom until you
have taken the first seven pills correctly.
 If you have had sex since the birth there is a
chance that you could be pregnant, you should
therefore use another form of contraception,
such as a condom. In this case, take your first
Marvelon pill on the first day of your next
period.
3.3

Within a few days of taking the last pill from the strip,
you should have a withdrawal bleed like a period. This
bleed may not have finished when it is time to start your
next strip of pills. You don’t need to use extra
contraception during these seven pill-free days – as
long as you have taken your pills correctly and start the
next strip of pills on time.

If you have missed any of the pills in a strip, and
you do not bleed in the first pill-free break, you may
be pregnant. Contact your doctor or family planning
clinic, or do a pregnancy test yourself.

 Take the most recently missed pill straight away.
 Leave any earlier missed pills in the strip
 Take your further pills as usual. This may mean taking
two pills in one day.
 Use extra precautions (condoms for instance) for the
next 7 days.
 Check how many pills are left in the strip after the most
recently missed pill.

Missed a period – could you be pregnant?

Occasionally, you may miss a withdrawal bleed. This
could mean that you are pregnant, but that is very
unlikely if you have taken your pills correctly. Start your
next strip at the normal time. If you think that you might
have put yourself at risk of pregnancy (for example, by
missing pills or taking other medicines), or if you miss a
second bleed, you should do a pregnancy test. You can
buy these from the chemist or get a free test at your
family planning clinic or doctors surgery. If you are
pregnant, stop taking Marvelon and see your doctor.
3.7
Taking more than one pill should not cause
harm

7 or more pills left in the pack

Fewer than 7 pills left in the pack

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. Talk to your doctor if you have any of
these symptoms.
3.8

 Don't forget to use extra precautions for the next 7 days.
 When you have finished the strip. Leave the usual 7-day
break before starting the next strip
 If you have missed one or more pills from the first week
of your strip (days 1 to 7) and you had sex in that week,
you could become pregnant. Contact your doctor,
family planning nurse or pharmacist for advice as soon
as possible. They may recommend you use emergency
contraception.

 Don't forget to use extra precautions for the next 7 days.
 When you finish the strip of pills, start the next strip the
next day without a break.
 If you do not have a withdrawal bleed after you have
finished the second strip, do a pregnancy test before
starting another strip.
 If you have missed one or more pills from the first
week of your strip (days 1 to 7) and you had sex in
that week, you could become pregnant. Contact your
doctor, family planning nurse or pharmacist for advice as
soon as possible.

You can delay a period

If you want to delay having a period, finish the strip of
pills you are taking. Start the next strip the next day
without a break. Take this strip the usual way. After the
second strip, leave seven pill-free days as usual, then
start your next strip of pills in the normal way. When
you use the second strip, you may have some
unexpected bleeding or spotting on the days that you
take the pill, but don’t worry.
3.9

When you want to get pregnant

If you are planning a baby, it’s best to use another
method of contraception after stopping Marvelon until
you have had a proper period. Your doctor or midwife
relies on the date of your last natural period before you
get pregnant to tell you when your baby is due.

4.

Possible side effects

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
Marvelon”.
4.1
away

Serious side effects – see a doctor straight

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 Marvelon
 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
Marvelon.
4.2

Possible side effects

Common (more than 1 in 100 people who take
Marvelon are affected)
 Migraine or headache (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)
 Putting on weight or losing weight
 Breast problems, such as painful or tender
breasts; producing a milky fluid from the nipples
 Depression or mood changes
 Changes in sexual desire
 Heart or circulation problems, such as increased
blood pressure, swollen hands, ankles or feet– a
sign of fluid retention
 Changes in vaginal secretions
 Irregular vaginal bleeding -see section 4.3,
Bleeding between periods should not last long
 Skin problems, such as rash; bruise-like swelling
to the shins (erythema nodosom)
 Stomach problems, such as nausea; vomiting
 Discomfort of the eyes if you wear contact lenses
Rare (less than 1 in 1000 people who take Marvelon
are affected)
 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.)
 Severe allergic reaction to Marvelon
 Breast cancer
 Cancer of the cervix
 Severe liver problems
 High blood pressure
 Gall stones
 Chorea (a problem with the nervous system
causing jerky movements that you can’t control)
 Worsening of systemic lupus erythematosus
(SLE; when your immune system attacks your body
causing, for example, joint ache and tiredness)
 Stomach and intestine problems such as
pancreatitis; Crohn’s disease; ulcerative colitis
 Worsening of otosclerosis (a hearing problem)





Problems with blood sugar
Worsening of a rare condition called porphyria
Worsening of skin problems, such as brown
patches on your face or body (chloasma) blisterlike rash, (herpes gestationis)

 Tell your doctor, pharmacist or family planning
nurse if you are worried about any side effects
which you think may be due to Marvelon. Also tell
them if any existing conditions get worse while you
are taking Marvelon.
4.3
long

Bleeding between periods should not last

A few women have a little unexpected bleeding or
spotting while they are taking Marvelon, especially
during the first few months. Normally, this bleeding is
nothing to worry about and will stop after a day or two.
Keep taking Marvelon as usual; the problem should
disappear after the first few strips.
You may also have unexpected bleeding if you are not
taking your pills regularly, so try to take your pill at the
same time every day. Also, unexpected bleeding can
sometimes be caused by other medicines.
 Make an appointment to see your doctor if you
get breakthrough bleeding or spotting that:
 carries on for more than the first few months
 starts after you’ve been taking Marvelon for a
while
 carries on even after you’ve stopped taking
Marvelon.
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. You can also report side
effects directly via the Yellow Card Scheme at:
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 Marvelon

KEEP OUT OF THE SIGHT AND REACH OF
CHILDREN.
Do not store above 30°C.
Store in the original package to protect from light and
moisture.
Do not use after the expiry date which is stated on the
label. The expiry date refers to the last day of that
month
Medicines should not be disposed of via wastewater or
household waste. These measures will help protect the
environment. Return any leftover tablets to your
pharmacist
6.

Further Information

What Marvelon contains:
 Each tablet contains: 150 micrograms of the
progestogen desogestrel, and 30 micrograms of
the oestrogen ethinyl estradiol.
 Marvelon also contains the inactive ingredients:
dl-alpha-tocopherol, potato starch, povidone,
stearic acid, silica colloidal anhydrous and lactose.
What Marvelon contains and the contents of the
pack:
Each tablet is round, measures 6mm across, has TR5
marked on one side and ORGANON * on the other
side. Each box of Marvelon contains three strips of 21
tablets. Each strip of contains 21 white tablets.
Manufacturer
Manufactured by Organon Ireland, Ltd. Drynam Road,
Swords, 2857 County Dublin, Ireland.
Or
NV Organon, Kloosterstraat 6, 5349 AB Oss, Holland.
Procured from within the EU and repackaged by the
product licence holder: G Pharma Ltd., Salford M50
2PU.
POM
PL 16369/1530
th
Leaflet Revision: 19 August 2015

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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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