Marvelon

What is Marvelon?

Marvelon is a combined oral contraceptive pill (‘the Pill’).

You take it to prevent pregnancy.

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:

1. it is one of the most reliable reversible methods of contraception if used correctly
2. it doesn’t interrupt sex
3. it usually makes your periods regular, lighter and less painful
4. 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

How does Marvelon work?

This low-dose contraceptive contains two types of female sex hormones, oestrogen and progestogen.

These hormones prevent an egg from being released from your ovaries so you can’t get pregnant.

Marvelon also makes the fluid (mucus) in your cervix thicker, this makes it more difficult for sperm to enter the womb.

How to take Marvelon

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.

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.

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

When were you due to take the missed pill?

Less than 12 hours ago · 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.

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

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.

A lost pill 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.

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.

If you are sick or have diarrhoea If you vomit within 3 to 4 hours after taking your pill, or have severe diarrhoea, this is like missing a pill. You must follow the advice for missed pills in the patient information leaflet on, “A missed pill”.

Side effects & precautions

Precautions with Marvelon Like all medicines, Marvelon can cause side effects, although not everybody gets them. If you get any side effects, 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.

An increased risk of blood clots (thrombosis) can happen in all women taking combined hormonal contraceptives.

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).

The Pill and Thrombosis Blood Clots Using a combined hormonal contraceptive such as Marvelon increase 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).

It is important to remember that the overall risk of a harmful blood clot due to Marvelon is small.

How to recognise a blood clot:

Seek urgent medical attention if you notice any of the following signs or symptoms.

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 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 another 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.

Some medicines may stop Marvelon from working properly. These include medicines used for the treatment of:

Epilepsy (primidone, phenytoins, phenobarbital, carbamazepine, oxcarbazepine, topiramate, felbamate, modafinil)

Tuberculosis (rifampicin)

HIV infection (ritonavir, nelfinavir, nevirapine, efavirenz) Hepatitis C virus infection (e.g., boceprevir, telaprevir) another infectious disease (e.g., griseofulvin) high blood pressure in the blood vessels of the lungs (bosentan)

Depressive moods (the herbal remedy St. John’s wort)

Your doctor will prescribe another type of contraceptive prior to the start of the treatment with these medicinal products.

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 from getting pregnant.

Possible side effects

Common side effects include:

• Headache
• Putting on weight
• Breast problems, such as painful or tender breasts
• Depression or mood changes
• Stomach problems, such as nausea; abdominal pain

Uncommon side effects include:

• Migraine (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)
• Fluid retention (swollen hands, ankles or feet – a sign of fluid retention) · Decreased sexual desire
• Vomiting
• Diarrhoea
• Skin problems, such as rash or hives
• Breast enlargement

Documentation