Traditional medicine

Mechanism of action Combined oral contraceptives: principle of action

Active ingredient

Vaccine for the prevention of viral hepatitis B, diphtheria, whooping cough and tetanus (diphtheria, tetanus, pertussis and hepatitis B (rDNA) vaccine (adsorbed))

Release form, composition and packaging

0.5 ml - ampoules (10) - contour cell packaging (1) - cardboard packs.

Pharmacological action

Administration of the drug in accordance with the approved regimen causes the formation of specific immunity against whooping cough, diphtheria, tetanus, etc.

Indications

— prevention of whooping cough, diphtheria, tetanus and hepatitis B in children.

Contraindications

Progressive diseases of the nervous system, a history of afebrile convulsions, allergic reactions to yeast, severe reactions and post-vaccination complications following the administration of a previous dose of DPT vaccine, hepatitis B vaccine, Bubo-Kok vaccine.

The presence of febrile convulsions during the administration of the previous dose of the vaccine is not a contraindication to the administration of Bubo-Kok; after its administration, it is advisable to prescribe paracetamol (10-15 mg/kg 3-4 times a day) for 1-2 days.

Children who have suffered acute diseases are vaccinated no earlier than four weeks after recovery; for mild forms of respiratory diseases (rhinitis, mild hyperemia of the pharynx, etc.), vaccination is allowed 2 weeks after recovery.

Patients with chronic diseases are vaccinated no earlier than four weeks after achieving stable remission.

Stable manifestations of an allergic disease (localized skin manifestations, latent bronchospasm, etc.) are not contraindications to vaccination, which can be carried out against the background of appropriate therapy.

In order to identify contraindications, the doctor (paramedic at the FAP) on the day of vaccination conducts a survey of parents and examines the child with mandatory thermometry. Children temporarily exempt from vaccination must be monitored and registered and vaccinated in a timely manner.

Dosage

Vaccinations against Bubo-Kok are carried out for children up to the age of 4 years.

The vaccine is administered in accordance with the national calendar of preventive vaccinations at a time that provides for simultaneous vaccinations against hepatitis B, whooping cough, diphtheria and tetanus.

Children who are not vaccinated against hepatitis B before 3 months of age receive the vaccine three times according to the schedule of 3 months, 4.5 months and 6 months.

Reducing intervals is not allowed. If it is necessary to increase the intervals, the next vaccination should be carried out as soon as possible, determined by the state of health of the children. If there are one or two vaccinations with the LKDS vaccine in children who have not been vaccinated against hepatitis B, the missing number of vaccinations up to 3 can be carried out with the Bubo-Kok vaccine. In this case, the missing number of vaccinations against hepatitis B, up to 3, is carried out with a monovaccine against hepatitis B.

Revaccination against whooping cough, diphtheria and tetanus is carried out with DTP vaccine once at the age of 18 months (if the vaccination schedule is not met - 12-13 months after the completed course of vaccination). If revaccination against whooping cough, diphtheria and tetanus coincides in time with vaccination against hepatitis B, it can be carried out with the Bubo-Kok vaccine.

Note: If a child, upon reaching 4 years of age, has not received revaccination with the DTP vaccine or the Bubo-Kok vaccine, then it is carried out with LDS toxoid for the ages of 4 years - 5 years 11 months. 29 days or for ages 6 years and older with ADS-M toxoid vaccine. If revaccination against diphtheria and tetanus coincides in time with vaccination against hepatitis B, it can be carried out with the vaccine.

The drug is administered intramuscularly into the upper outer quadrant of the buttock or into the anterior outer region of the thigh in a dose of 0.5 ml (single dose). Before vaccination, the ampoule must be thoroughly shaken until a homogeneous suspension is obtained.

The opening of ampoules and the vaccination procedure are carried out in strict compliance with the rules of asepsis and antiseptics. The drug cannot be stored in an opened ampoule.

The drug is not suitable for use in ampoules with damaged integrity, lack of labeling, changes in physical properties (change of color, presence of non-developing flakes), expired expiration date, or improper storage.

The administration of the drug is registered in the established accounting forms, indicating the batch number, expiration date, manufacturer, date of administration, and the nature of the reaction to the administration of the drug.

Side effects

Some vaccinated people may develop short-term general (fever, malaise) and local (pain, hyperemia, swelling) reactions in the first two days. In rare cases, complications may develop: convulsions (usually associated with fever), episodes of high-pitched screaming, allergic reactions (urticaria, polymorphic rash).

Considering the possibility of developing immediate allergic reactions in particularly sensitive children, vaccinated children must be provided with medical supervision for 30 minutes. Vaccination sites must be provided with anti-shock therapy.

Note: If a child develops a strong general reaction (increase in temperature in the first two days above 40°C, swelling and hyperemia of more than 8 cm in diameter at the site of vaccine administration) or a post-vaccination complication, further vaccinations with the Bubo-Kok vaccine are stopped. If the child has been vaccinated twice, the course of vaccination against diphtheria and tetanus is considered completed, and vaccination against hepatitis B is completed with a single vaccine one month after the second Bubo-Kok vaccination. If the child has received one vaccination, vaccination can be continued with Bubo-M, which is administered once no earlier than after 3 months. In this case, vaccination against hepatitis B is completed with a single vaccine after a month. In both cases, the first revaccination is carried out with ADS-M toxoid 9-12 months after the last vaccination with Bubo-Kok or Bubo-M. If a complication develops after the third Bubo-Kok vaccination, the first revaccination is carried out with ADS-M toxoid after 12-18 months. Subsequent revaccinations are carried out at decreed ages with ADS-M toxoid.

If the temperature rises above 38.5°C in more than 1% of vaccinated people or the occurrence of pronounced local reactions (swelling of soft tissues with a diameter of more than 5 cm, infiltration with a diameter of more than 2 cm) in more than 4% of vaccinated people, as well as the development of post-vaccination complications, vaccination with the drug of this series stop. The issue of its further use is decided by the Federal State Institution GISK named after. L.L. Tarasevich Rospotrebnadzor.

Every woman who has regular sex life thinks about how to prevent unwanted pregnancy. Today there are many methods of contraception, but one of the most popular is taking birth control pills. How combined oral contraceptives work and how they should be taken so as not to harm the body is a question that worries many young ladies.

Contraceptive pills (OC) refer to the oral method of contraception. Regardless of the type of hormonal contraceptives, the basis of such pills is female sex hormones that regulate estrogen levels and block ovulation, as a result of which fertilization of the egg becomes impossible.

The contraceptive effect is also achieved due to a specific effect on the uterine mucosa; it begins to produce more thick mucus, which prevents sperm from penetrating the fallopian tube. If you take COCs for a long time, the ovaries begin to work in a different mode, creating an artificial feeling of pregnancy.

Many girls are afraid to take such contraceptives, because there is an opinion that they often provoke side effects and cause multiple complications. It is immediately worth noting that modern drugs have a gentle effect on the body; if they are selected correctly, the risk of side effects will be minimized.

The undoubted advantage of oral contraceptives is that they help normalize hormonal levels, which improves the condition of the skin (fights), hair and nails. Currently, doctors around the world prescribe COCs not only as a contraceptive, but also as a means to help regulate hormone production and normalize the menstrual cycle. Also, numerous clinical studies have confirmed that taking birth control reduces the likelihood of ovarian and cervical cancer.

Important to know! You cannot select a product in this pharmaceutical category on your own. They should be prescribed by a gynecologist after taking hormones and a physical examination. If the drug is selected properly, taking into account the individual characteristics of the body, it will not only not provoke complications, but, on the contrary, will have a positive effect on the functioning of the female body.

Many girls mistakenly believe that COCs are taken only to prevent pregnancy, but in fact the range of use of these pills is much wider. Main indications for their use:

Both microdosed COCs and high-hormone birth control pills help women get rid of many diseases. If the drug was prescribed by a gynecologist to combat the above pathologies after undergoing tests, you should not be afraid to drink it, the risk of complications will be minimized.

According to statistics, birth control pills provide a 99% guarantee of preventing unwanted pregnancy, but, unfortunately, not everyone can take them. You should stop taking COCs in the following cases:

the formation of neoplasms of a benign or malignant nature on the reproductive organs;
kidney and liver diseases;
bearing a child and lactation period;
presence of cardiovascular diseases;
migraine;
high blood pressure;
tendency to form blood clots;
diabetes mellitus;
3 and 4 degrees of obesity.

Take note! If the likelihood of complications is minimal, you should refuse birth control pills, since taking them can provoke irreversible reactions and cause irreparable harm to health.

Instructions for taking COC tablets

Regardless of the type, drugs of this pharmaceutical category begin to be taken on the first day of menstruation. Experts advise taking multiphase medications in a certain sequence, which is indicated on the package, and after that taking a week's break. On break days (or when taking inactive pills), menstruation begins, after which they begin to drink a new pack. It should be noted that some COCs contain 28 tablets per package (active and dummy), and there is no need to take breaks when taking them. The next pack is started after the last tablet in the previous pack runs out.

Attention! Before taking OK, in any case, you must read the accompanying instructions completely (each drug has its own characteristics and specific administration).

Most gynecologists advise drinking OK at night, so the restructuring of the body will be less noticeable. For 7 days after taking the first tablet from the first pack, it is recommended to use a barrier method of contraception, since the effect of the drug has not yet taken full effect.

Many people know that women taking COCs can easily postpone their menstruation to a more favorable time. At least 70% of them are aware of the option to delay their periods, and 30% have already used this option 1 .

You don’t want to ruin your long-awaited vacation or romantic date with bloody discharge. A business trip, sporting competition, upcoming exam, or some important event may also be reasons for a postponement.

Gynecologists, in turn, successfully use a prolonged regimen of COCs for medicinal purposes. It is necessary for women with chronic anemia, menstrual migraine, after treatment of abnormal uterine bleeding, endometriosis and severe PMS to live for some time without monthly bleeding.

A prolonged regimen of COCs should be recommended if treatment is carried out with drugs that reduce the effectiveness of COCs (antiretrovirals, phenytoin, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort).

Most patients easily agree to “postpone” menstruation for therapeutic purposes.

- It must be so. Nothing can be done...

The question is, how right are women who seek to avoid menstrual-like reactions due to COCs because of a whim: a desire to swim in the sea, meet a loved one, enter a tiger cage, or take part in a bicycle race?

- Drink two packs without a break? But this is scary, harmful and dangerous! Is it possible to interfere with the natural cycle?

What about cycle disruption?

The menstrual cycle is called a cycle because the body of a healthy woman undergoes daily changes that are repeated cyclically. Approximately every 28 days. The main purpose of these changes is to prepare for pregnancy and get pregnant.

Changes during a 28-day menstrual cycle (without fertilization)

Menstruation is a report from the body: “Mistress, the pregnancy did not work out. I’m resetting all preparation and starting a new cycle.” Each day of a normal menstrual cycle is slightly different from the previous one. That is why, when assessing an ultrasound picture or examining a woman, the gynecologist must compare the picture with the day of the patient’s menstrual cycle.

There is no “natural” cycle when taking COCs. The even, monotonous intake of pills prevents the follicles from actively growing, reaching ovulatory sizes and bursting, releasing an egg into the world. Accordingly, the uterus is in a calm state and does not prepare a “warm welcome” for the fertilized egg. All days of taking the pills correspond to the early follicular phase and are similar to one another.

Bloody discharge in the hormone-free interval while taking COCs is essentially withdrawal bleeding, however, in order not to scare people with the word “bleeding,” gynecologists use the term “menstrual-like reaction.” Since no cyclical changes occur, it is possible to maintain the body in a peacefully dormant state for much longer than 21 days. After all, the body is illiterate and cannot count. No pills for several days - menstrual-like reaction. The body will give it out both if you accidentally miss several tablets in the package, and with a planned hormone-free interval.

“21 + 7” is already history

The cyclic regimen of taking COCs (drink for 21 days + rest for 7 days) was proposed back in 1961 by the creators of the first contraceptive pill, Gregory Pincus and John Rock. Firstly, women really should have “rested” from the enormous hormonal load. Each tablet of the world's first COC contained an amount of estrogen equivalent to 103 mcg of ethnyl estradiol (5 modern tablets!). Secondly, John Rock was a Catholic and hoped that if the pills mimicked a woman's natural cycle, the method would be approved by the Catholic Church.

For almost 40 years, the classic regimen of using COCs “21 + 7” was the only possible one, however, researchers and practitioners have accumulated a number of claims. It turned out that in every fourth COC user, in a 7-day hormone-free interval, the hypothalamic-pituitary system can “wake up” and begin to command, triggering the growth of follicles and the maturation of eggs. Some women experience renewed symptoms of PMS, pelvic pain, or deterioration in health.

The second major problem was the late start of new packaging. Almost 40% of women admit that the 7-day interval sometimes turns into 8 days or even 10 days. Such “delays” are already fraught with ovulation and unwanted pregnancy.

This problem was solved by proposing a new reception mode “24 + 4”. A hormone-free interval shortened to 4 days does not allow the body to “wake up properly” and demonstrates better tolerability and contraceptive effectiveness. Jess/Jes Plus (Dimia, Vidora micro, Modell Trend) and Zoeli are accepted in this mode today.

In the USA, the drug Seasonale has been registered for many years, containing a combination of 30 mcg ethnylestradiol and 150 mcg levonorgestrel for use in the 84 + 7 mode. This allows a woman to have 4 menstruation per year - winter, spring, summer and autumn.

“120 + 4”: real life without menstruation

Researchers carefully studied the safety of long-term continuous use of COCs - the frequency and severity of side effects for the classic and prolonged regimens turned out to be the same, but contraceptive effectiveness turned out to be higher among fans of “life without menstruation” 2.

The maximum duration of continuous use of COCs is currently 120 days, after which it is worth stopping for 4 days and allowing the body to reject the functional layer of the endometrium.

The main problem for women taking long-term COCs is breakthrough bleeding. Most often they occur in women taking the drug for the first 3–4 months, then their likelihood decreases. Scanty spotting is not breakthrough bleeding and does not require any activity. Breakthrough bleeding is usually more profuse, but is not accompanied by painful sensations; upon examination and examination, the doctor cannot find any obvious causes.

Despite regularly taking the pills, pregnancy should be carefully excluded in such cases. If spotting appears while taking pills from the 25th to the 120th day, it means that the body is “telling” that it would be good to take a break right now. In this case, you should make a 4-day interval and continue taking the drug. It is this flexible prolonged dosing regimen that was officially registered in the Russian Federation in 2015.

Experts call the ability to postpone your menstruation the “second revolution” after the ability to plan the birth dates of your children. And parting words for gynecologists from specialists who have carefully studied the problem sound like this: “There is no medical or physiological reason to force COC-treated patients to have monthly withdrawal bleeding. Every woman who receives contraceptive pills should have the choice to reduce the number of periods or eliminate them completely. Don't assume she doesn't have menstrual problems just because she hasn't told you about them." 3

1.Management of the menstrual cycle: new opportunities. Innovations in contraception - flexible prolonged mode and digital dosing technologies: newsletter / M. B. Khamoshina, M. G. Lebedeva, N. L. Artikova, T. A. Dobretsova; edited by V. E. Radzinsky - M.: Editorial office of the magazine StatusPraesens, 2016. - 24 p.
2. Klipping C. et al. Contraceptive efficacy and tolerability of ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen: an open-label, multicentre, randomized, controlled study // J. Fam. Plann. Reprod. Health Care. 2012. Vol. 38. P. 73–83.
3. Yureneva S.V., Ilyina L.M. Flexible regimen: “second revolution” in the use of combined oral contraceptives // RMZh. 2016. No. 6. pp. 298–303.

Oksana Bogdashevskaya

Photo thinkstockphotos.com

The most reliable form of contraception. When taken correctly it is 100% effective. Modern drugs contain 100 times smaller doses than the first ones, which appeared in the middle of the last century, and which our mothers remember. It is from them that the terrible myth “HORMONES!” has been going on since that time. Hormones are synonymous with the concept “very harmful, hormonal imbalance, inability to get pregnant, sick children, mustache, getting fat!” In fact, everything has not been like that for a long time, and in terms of reliability/safety ratio, COCs are superior to condoms. Modern drugs contain female sex hormones that are as close as possible in effects to natural ones, without additional androgenic effects, in very low doses. Avoiding possible side effects (increased blood clotting, varicose veins, vascular complications, liver pathology) allows a preliminary examination, which must be completed before choosing a drug: blood clotting tests, liver biochemistry, lipid spectrum, ultrasound and examination by a gynecologist. This examination will identify predisposition to conditions in which taking COCs is undesirable. Other people can take them under the control of the same tests for a long time. Contraception is absolutely reversible; the rate of cycle recovery depends on the initial hormonal levels and duration of use. There is no need to cancel COCs in advance; they are eliminated from the body within 36 hours, which is why missing a pill is dangerous. If you wanted to plan your pregnancy, you stopped taking COCs and started planning.

All modern COCs have an antiandrogenic effect, so they all have a beneficial effect on oily skin and excess hair. However, it is not advisable to take them only for cosmetic purposes - this is still their side effect, and not the main one, so it may not appear, but other side effects will appear. If a contraceptive effect is desirable, then COCs are a help to cosmetologists, but not a replacement for their arsenal. And in no case should you prescribe COCs yourself, especially for non-contraceptive purposes: skin, hair, breasts. Skin condition may depend not only on hormonal status; excess hair under the influence of COCs does not disappear anywhere, only the growth of new ones is slightly suspended; Not all medications cause breast enlargement - it all depends on individual sensitivity.

Weight does not increase due to hormones. Weight increases from eating. When you take hormones, your metabolism changes. COCs introduce the body into a state of pseudo-pregnancy. In this case, conception is impossible; there is no menstruation while hormones are taken. Perhaps (but not necessarily) some changes in mood, drowsiness, changes in libido, weight changes, fluid retention, nausea - pseudo-pregnancy. But the weight increases from the food that you continue to consume, focusing on your usual metabolism. But he changed and became focused on hoarding. Therefore, while taking COCs, you need to be stricter about your diet and don’t forget the gym - and you will see that hormones do not increase your weight.

And in general, in hormonal contraception everything is very individual, so it is absolutely impossible to choose a drug in absentia, focus on the effect it has on others, or guess in advance how it will affect you. After examination and examination, the doctor only suggests which drug may be more suitable for you, but the final decision and selection of the drug will be made through individual tests and assessment of the condition by the doctor.

There is no ideal, best drug. Newer doesn't mean better, it's just newer. Lower dosage does not mean better; low dosage has its own disadvantages. There is no better drug, otherwise the rest would disappear from the shelves. There is one more suitable for you. The state of pseudopregnancy that develops against the background of COCs has a positive effect on health: monthly hormonal changes in ovulation/menstruation disappear. After all, the human body is not biologically adapted to long-term menstruation. A woman must give birth and breastfeed - 2-3 years of absence of menstruation, then 2-3 cycles and a new pregnancy. The body is adapted to this. And constant fluctuations in hormonal levels have an adverse effect not only on mood, it is one of the provoking factors in the development of genital cancer. And long-term use of hormonal contraceptives, which creates a constant low level of hormones, protects against endometrial and ovarian cancer, osteoporosis, cardiovascular diseases, Alzheimer's disease (senile insanity) and other consequences of a lack of female sex hormones.

Three-phase drugs (triquilar, triziston, trimersi) were originally invented to reduce the total dose in the package - on some days of the cycle the dose of the hormone in the tablet can be reduced, the entire cycle cannot be kept at such a low dose, but several tablets in a pack are possible - the total dose is packaging is reduced. Modern monophasic drugs are low enough in dosage to avoid the use of triphasic drugs. They actually somewhat imitate the real cycle, and therefore are less effective, because the point of hormonal contraception is to block the natural cycle, block ovulation, and not to imitate these processes. Therefore, three-phase drugs are more indicated for therapeutic purposes - for the treatment of initial ovarian dysfunction, for establishing a cycle, the development of secondary sexual characteristics with reduced ovarian function. For contraception, monophasic drugs are preferred in most cases. The lower the dose of ethinyl estradiol in them, the more low-dose they are and the fewer side effects they have on coagulation, blood vessels, and weight. But the less they are able to retain the endometrium. Low-dose drugs have their own side effect - intermenstrual bleeding. The dose of the drug that is most suitable for you depends not on your desire to “fewer hormones”, but on your initial hormonal status. If your initial level of female hormones is high, a low-dose drug may not be suitable for you, and a high-dose drug does not mean “many hormones,” but means “normal hormones.”

Of the modern COCs, the highest dose is Diane-35 (35 mcg ethinyl estradiol). Rigevidon and Silest contain the same amount. The next group (30 mcg) is Marvelon (Regulon), Femoden, Miniziston, Belara, Zhanine; the lowest dosage (20 mcg) are Mercilon (Novinet) and Logest. The tablets should be taken every day at the same time, preferably at night (possible side effects such as nausea do not appear). The maximum interval between tablets is 36 hours; if not much time has passed since taking the last tablet, you simply drink it and drink the next ones again at a 24-hour interval. If more than 36 hours have passed, then the contraceptive effect in this pack is impaired and before starting a new pack you need to additionally protect yourself with a condom.

COCs are started on day 1 of the cycle (day 1 of menstruation). At the same time, the length of the cycle changes because its cycle no longer exists. There is a time for taking pills and a break between packs, during which menstruation occurs and we make sure that there is no pregnancy. The usual rhythm is 21 days on, 7 days off. It is not necessary to take the pills exactly 21 days; you can take less or more - for example, to shift your menstruation to a convenient point in time. If bleeding does not occur during the 7-day break between packs, the next pack cannot be started; you need to go to the doctor and find out the reason for the delay - pregnancy or excessive suppression of your own hormonal system.

At the beginning of treatment, the body adapts to the new state. Therefore, the side effects that occur usually disappear after 2-3 months of use. If they don’t go away or you are completely unsatisfied, the doctor must decide which drug you should switch to. Switching from one monophasic drug to another is very simple - instead of a tablet of the first, you drink a tablet of the second with the same number. It is better, of course, to switch to a new drug after finishing the pack of the old one and taking a 7-day break.

Abnormal bowel movements, vomiting and certain medications (for example, antibiotics) interfere with the absorption of hormones. In this case, additional contraception with a condom is required for the entire cycle. In a cycle of taking antibiotics, this is necessary both to avoid re-infection during treatment and to prevent pregnancy during antibiotics. It is not advisable to stop taking COCs for this time, as well as for the period of forced abstinence (departure of a partner, etc.) You force the body to first get used to stopping the drug, and then to starting it again - you will get a new portion of side effects.

If for some reason you decide to stop taking the drug, remember that bleeding occurs immediately upon withdrawal. Some side effects (for example, bleeding) do not disappear by discontinuation, but rather by increasing the dose of the hormone.

In any case, hormonal contraception is selected and monitored by the attending physician, focusing on your feelings.

Today, there are two main types of birth control pills:

Combined oral contraceptives (COCs)
These drugs contain 2 synthetic analogues of female hormones: estrogen (ethinyl estradiol) and progesterone. Combined oral contraceptives are either monophasic (the level of hormonal substances in the tablets remains unchanged throughout the entire administration) or triphasic (the tablets contain three combinations of hormones that change during the menstrual cycle).
Progestin-based birth control pills (“mini-pills”)
These drugs contain only synthetic progestogen and are intended specifically for nursing mothers, or in case of contraindications to the use of combined oral contraceptives (estrogens).

1. Combined contraceptive pills (COCs)

Combined contraceptive pills can be divided into several groups, each of which is suitable for a specific category of women. This takes into account age, whether the woman has given birth or not, and whether she suffers from any hormonal or other disorders of the body.

ATTENTION!!!
All groups of COCs equally reliably block ovulation, which means they equally protect against pregnancy. Ovulation is blocked by progestogen, and its dose is the same in all combination drugs. The difference between microdosed and low-dose is only in the content of the estrogen dose. Estrogens are added not to protect against unwanted pregnancy, but to control the menstrual cycle.

1.1. Microdosed birth control pills

Contraception for young, nulliparous women who have regular sex life. Drugs in this group are easily tolerated and have minimal side effects. Great for those who have never used hormonal contraceptives. As well as contraception for mature women over 35 years of age (up to the onset of menopause).

Name	Compound	Notes
	Nomegestrol acetate 2.50 mg; Estradiol hemihydrate 1.55 mg.	A new monophasic drug containing hormones similar to natural ones.
	Estradiol valerate 2 mg; Dienogest 3 mg.	New three-phase drug. Best suits the natural hormonal background of a woman.
Jess	Ethinyl estradiol 20 mcg; drospirenone 3 mg.
Jess Plus	Ethinyl estradiol 20 mcg; drospirenone 3 mg; calcium levomefolate 451 mcg.	New monophasic drug + vitamins (folates). Has an anti-androgenic (cosmetic) effect.
Dimia	Ethinyl estradiol 20 mcg; drospirenone 3 mg.	Monophasic drug. Similar to Jess.
Miniziston 20 fem	Ethinyl estradiol 20 mcg; levonorgestrel 100 mcg.	New monophasic drug.
Lindinet-20	Ethinyl estradiol 20 mcg; gestodene 75 mcg.	Monophasic drug.
Logest	Ethinyl estradiol 20 mcg; gestodene 75 mcg.	Monophasic drug.
Novinet	Ethinyl estradiol 20 mcg; desogestrel 150 mg.	Monophasic drug.
Mercilon	Ethinyl estradiol 20 mcg; desogestrel 150 mcg.	Monophasic drug.

1.2. Low-dose birth control pills

Contraception for young, nulliparous women who have regular sex life (in the event that microdosed drugs are not suitable - the presence of spotting on the days of taking active pills after the end of the period of adaptation to the drug). As well as contraception for women who have given birth, or women of late reproductive age.

Name	Compound	Notes
Yarina	Ethinyl estradiol 30 mcg; drospirenone 3 mg.	Monophasic drug of the latest generation. Has an anti-androgenic (cosmetic) effect.
Yarina Plus	Ethinyl estradiol 30 mcg; drospirenone 3 mg; calcium levomefolate - 451 mcg.	A monophasic drug of the latest generation containing vitamins (folates). Has an anti-androgenic (cosmetic) effect.
Midiana	Ethinyl estradiol 30 mcg; drospirenone 3 mg.	Yarina.
Tri-Mercy	Ethinyl estradiol 30 mcg; desogestrel 125 mcg.	Three-phase drug of the latest generation.
Lindinet-30	Ethinyl estradiol 30 mcg; gestodene 75 mcg.	Monophasic drug.
Femoden	Ethinyl estradiol 30 mcg; gestodene 75 mcg.	Monophasic drug.
Silest	Ethinyl estradiol 30 mcg; norgestimate 250 mcg.	Monophasic drug.
Janine	Ethinyl estradiol 30 mcg; dienogest 2 mg.	Monophasic drug. Has an anti-androgenic (cosmetic) effect.
Silhouette	Ethinyl estradiol 30 mcg; dienogest 2 mg.	New monophasic drug. Analogue of Janine.
Janetten	Ethinyl estradiol 30 mcg; dienogest 2 mg.	New monophasic drug. Analogue of Janine.
Miniziston	Ethinyl estradiol 30 mcg; levonorgestrel 125 mcg.	Monophasic drug.
Regulon	Ethinyl estradiol 30 mcg; desogestrel 150 mcg.	Monophasic drug.
Marvelon	Ethinyl estradiol 30 mcg; desogestrel 150 mcg.	Monophasic drug.
Microgynon	Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg.	Monophasic drug.
Rigevidon	Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg.	Monophasic drug.
Belara	Ethinyl estradiol 30 mcg; chlormadinone acetate 2 mg.	New monophasic drug. Has an anti-androgenic (cosmetic) effect.

Diana-35	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	Monophasic drug with anti-androgenic (cosmetic) effect.
Chloe	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	Monophasic drug. Analogous to Diana-35.
Bellune-35	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	New monophasic drug. Analogous to Diana-35.
Desmoulins	Ethinyl estradiol 35 mcg; ethynodiol diacetate 1 mg.	Monophasic drug.

1.3. High dose tablets

They are used to treat various hormonal diseases, as well as for contraception during the treatment of hormonal disorders. Ovidon

Ethinyl estradiol 50 mcg;
levonorgestrel 250 mcg. Non-Ovlon Estradiol 50 mcg;
norethisterone acetate 1 mg. Therapeutic monophasic drug.

2. Progestin-based birth control pills (“mini-pills”)

Contraception for women during lactation (breastfeeding). Contraception for women who have given birth or women of late reproductive age who have regular sex life, in case of contraindications to the use of estrogens. Contraception for smoking women over 35 years of age.

Name	Compound	Notes
Lactinet	Desogestrel 75 mcg.	Monophasic drug of the latest generation. Especially for nursing mothers.
Charosetta	Desogestrel 75 mcg.	New monophasic drug.
Exluton	Linestrenol 500 mcg.	Monophasic drug of the latest generation.
Microlute	Levonorgestrel 30 mcg.	Monophasic drug.