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Combined oral contraceptives

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VOL: 101, ISSUE: 33, PAGE NO: 31

Generic and proprietary names


Generic and proprietary names
First generation



- Norinyl-1.



Second generation



- BiNovum.



- Brevinor.



- Cilest.



- Loestrin-20 and Loestrin-30.



- Logynon and Logynon ED.



- Microgynon-30 and Microgynon-30 ED.



- Norimin.



- Ovranette.



- Ovysmen.



- Synphase.



- Trinordiol.



- TriNovum.



Third generation



- Femodene and Femodene ED.



- Femodette.



- Marvelon.



- Mercilon.



- Minulet.



- Triadene.



- Tri-Minulet.



- Yasmin.



- Synthetic oestrogen suppresses ovulation while synthetic progesterone (progestogen) thickens the cervical mucus, reducing sperm access, and changes the uterus lining.



- Combined hormonal contraceptives.



- Prevention of pregnancy.



- Menstrual symptoms.



- Smoking 40 or more cigarettes a day.



- Pregnancy.



- History of thrombosis.



- History of migraines.



- Liver disease.



- Breast, gynaecological or any oestrogen-dependent cancer.



- Risk factors for venous thromboembolism.



- Arterial disease.



- History of severe depression particularly hormone contraceptive-induced.



- Sickle cell disease.



- Inflammatory bowel disease.



- Obesity.



- Diabetes.



- Raised blood pressure.



- Smoking.



- Age 35 years or more.



Common side-effects
- Headache.



- Breast tenderness.



- Nausea.



- Changes in body weight.



- Fluid retention.



- Changes in libido.



- Depression.



- Increased risk of DVT.



- Drugs that cause gastric upset, alter bowel flora or induce hepatic enzyme activity can reduce effectiveness.



- Start on the first day of menstruation and take daily for 21 days, then seven days without taking any tablets.



- ED or ‘Every Day’ preparations are available and contain non-active tablets to take instead of having a seven day break.



Nursing considerations
- Choose the COC with the lowest hormone content that gives good cycle control and minimal side-effects.



- COC should be stopped if BP rises above systolic 160mmHg and diastolic 100mmHg.



Patient teaching
- COCs do not protect from sexually transmitted diseases.



- Missed doses or gastric upsets, especially at the start and end of cycles, may lower protection.



- Take forgotten pills as soon as remembered and use alternative contraception if appropriate.



- Stop treatment in the event of: sudden severe chest pain; sudden breathlessness; unexplained pain in one calf; severe stomach pain or serious neurological problems such as prolonged headaches or visual disturbance.



Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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