Taking the birth control pill generally results in lighter, less painful, and more regular menstrual bleeding.
This means that it is also sometimes prescribed for women who have trouble with particularly heavy, painful, or irregular periods.
This medicine is a contraceptive pill.
Mechanism of action
Marvelon tablets are a type of hormonal contraception commonly known as “the pill” or combined oral contraceptive pill. Marvelon tablets contain two active ingredients, ethinyl estradiol and desogestrel.
These are synthetic versions of the naturally occurring female sex hormones , estrogen and progesterone. Ethinylestradiol is a synthetic version of estrogen, and desogestrel is a ‘third generation’ synthetic form of progesterone.
Combined oral contraceptives like Marvelon work by bypassing the normal menstrual cycle. In a woman’s normal menstrual cycle, levels of sex hormones change throughout each month.
Hormones cause an egg to be released from the ovaries (ovulation) and prepare the lining of the uterus for possible pregnancy. At the end of each cycle, if the egg has not been fertilized, the levels of the hormones decrease, causing the lining of the uterus to shed as a monthly period.
The daily dose of hormones the pill takes works primarily by tricking your body into believing that ovulation has already happened. This prevents an egg from maturing and being released from the ovaries each month.
Hormones also thicken the natural mucus in the cervix, making it more difficult for sperm to cross from the vagina to the uterus and reach an egg.
They also change the quality of the lining of the uterus (endometrium), making it less likely that a fertilized egg can implant there.
The Marvelon is a monophasic pill. This means that each tablet has the same dose of hormones. One tablet is taken every day for 21 days and then has a seven-day break from taking pills.
During your seven-day break, the levels of hormones in your blood drop, resulting in a withdrawal bleed similar to your normal period. You start the next pack after the seven pill-free days are up, even if you are still bleeding.
The tablets come in a calendar pack marked with days of the week to help you remember to take a pill every day for three weeks, followed by a week off.
You will still be protected against pregnancy in your pill-free week, as long as you have taken all the pills correctly, start the next pack on time, and nothing has happened that could make the pill less effective (for example, illness, diarrhea, or take other pills).
You should try to take your pill at the same time every day; This will help you remember to take it. Each tablet must be swallowed with a drink. They can be taken with or without food.
When can you start taking it?
Ideally, you should start taking this pill on the first day of your menstrual cycle (the first day of your period). This will protect you from pregnancy immediately and you will not need to use any additional contraceptive methods.
If necessary, you can also start taking it up to day five of your cycle without the need for additional contraception when you start.
However, if you have a short menstrual cycle (with your period every 23 days or less), starting until the fifth day of your cycle may not give you immediate contraceptive protection.
You should talk to your doctor or nurse about this and whether you need to use an additional method of contraception for the first seven days.
You can also start taking this pill at any other time in your cycle if your doctor is reasonably certain that you are not pregnant.
However, if you start taking this pill at any other time in your cycle, you will not be protected against pregnancy right away and will need to use additional contraception, for example condoms (or not have sex) for the first seven days of the pill. .
If you have given birth and are not breastfeeding, you can take this pill on the 21st day after birth. You are protected against pregnancy immediately and do not need to use additional contraception.
If you start taking it more than 21 days after giving birth, you will need to use additional contraception for the first seven days.
If you are starting this pill immediately after a miscarriage or an abortion in less than 24 weeks, you will be protected against pregnancy immediately.
If you start taking it more than seven days after the abortion, you must use additional contraception for the first seven days of taking the pill.
What to do if you miss a pill?
If you forget to take your pill at the usual time, take it as soon as you remember. A missed pill is one that is 24 hours or more late. If you miss a pill, follow the instructions below.
A lost pill
If you forget to take a pill or start your new pack one day late, you should take the missed pill as soon as possible, even if this means taking two pills at the same time. Then continue taking the rest of the pack as usual.
You are still protected against pregnancy and do not need to use additional contraception.
Two or more lost pills
If you forget to take two or more pills, or start your new pack two or more days late, you will not be protected against pregnancy. You should take the last missed pill as soon as possible, even if this means taking two pills at the same time.
Leave out the other lost. Then continue taking your pills, one per day, as normal. You should not have sex, or use an additional barrier method of birth control, such as condoms, for the next seven days.
If there are fewer than seven pills left in your pack after your last missed pill, you should finish the pack and then start a new pack immediately without interruption. This means skipping your pill-free week.
If there are seven or more pills left in your pack after your last missed pill, you should finish the pack and have your seven day break as usual before starting the next pack.
If you had unprotected sex in the seven days before the date you missed the pills, you may need emergency contraception (the morning-after pill). Ask for medical advice.
If you are confused about any of this, you can get individual advice for your circumstances from your doctor, pharmacist, or local family planning clinic.
What if you have vomiting or diarrhea?
If you vomit within two hours of taking a pill, it may not have been fully absorbed into your bloodstream. You should take another pill as soon as you feel well enough and take your next pill at the usual time.
You still need to be protected from pregnancy. However, if vomiting continues for more than 24 hours, this can make your pill less effective.
You should continue to take your pill at the usual time, but treat each vomiting day as if you forgot to take a pill and follow the instructions in “What should I do if I miss a pill” above?
If you have very bad diarrhea for more than 24 hours, this can make your pill less effective. You should continue to take your pill at the usual time, but treat each day that you have severe diarrhea as if you forgot to take a pill and follow the instructions in ‘What to do if you miss a pill’.
This birth control pill will not protect you against sexually transmitted infections, so you may also need to use condoms.
Women using this contraceptive for the first time may experience menstrual irregularities such as spotting, breakthrough bleeding, or missed periods. Consult your doctor if breakthrough bleeding persists.
If you do not have a withdrawal bleed for two consecutive months, you should take a pregnancy test before starting the next month’s contraceptive cycle.
It is important to note that compared to women not using these contraceptives, women taking the combined pill appear to have a small increased risk of developing a blood clot in a vein.
For example, they may develop blood clots in the leg (deep vein thrombosis) or in the lungs (pulmonary mbolia) or a blood clot in an artery, for example, causing a stroke or heart attack.
This risk is higher in certain groups of women, especially smokers and women who are obese; see precautions and do not use below).
The risk of blood clots in the veins is slightly higher with ‘third-generation’ pills like this one, which contain desogestrel or gestiondene, than with other pills.
However, pregnancy carries a much higher risk of blood clots than any pill, so the potential risk must be weighed against the benefits of the contraceptive. You should discuss this with your doctor.
The risk of blood clots forming in your veins (venous thromboembolism) while taking the pill may temporarily increase if you are immobile for long periods of time, for example if you have a serious accident or major surgery.
For this reason, your doctor will generally recommend that you stop taking this pill for a period of time (usually four to six weeks) before any planned surgery, particularly abdominal surgery or orthopedic surgery on the lower limbs (but not before surgery. smaller as teeth).
You will also need to stop taking this pill if you are going to be immobile for long periods of time, for example because you are confined to bed or have a leg in a cast. You should not start taking the pill again until at least two weeks after you are fully mobile.
There may also be an increased risk of blood clots in the veins if you travel for long periods of time where you will be sitting (more than three hours).
The risk of blood clots during long trips can be reduced by appropriate exercise during the trip and possibly by wearing elastic stockings. You should check with your doctor or pharmacist for more information.
It is important to note that women who use hormonal contraceptives appear to have a small increased risk of being diagnosed with breast cancer, compared to women who do not use these contraceptives.
Women who use oral contraceptives for more than five years may also have a small increased risk of being diagnosed with cervical cancer.
However, these risks must be weighed against the benefits of contraceptive use, which include a decreased risk of cancers of the ovaries and endometrium (uterus). You should discuss the risks and benefits of the pill with your doctor before you start taking it.
Stop taking this medicine and tell your doctor immediately if you experience any of the following symptoms :
- Shooting pains and / or unusual swelling in one leg.
- Painful breathing or coughing.
- Coughing up blood
- Sudden shortness of breath
- Sudden and severe chest pain.
- Migraine pain or severe headaches.
- Sudden alteration of vision, hearing or speech.
- Sudden weakness or numbness on one side of the body.
- Epileptic attack.
- Significant increase in blood pressure.
- Itching of the whole body.
- Yellowing of the skin or whites of the eyes (jaundice).
- Severe stomach pain
- Severe depression
- Or if you think you might be pregnant.
The Marvelon should not be worn by
- Women who are breastfeeding (the combined pill should not be taken until weaning or for six months after birth).
- Women who have ever had a blood clot in a vein (venous thromboembolism), for example in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
- Women with a father, brother or sister who has had a blood clot in a vein (venous thromboembolism), for example in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism) before the age of 45.
- Women with blood disorders that increase the risk of blood clots in the veins, for example antiphospholipid syndrome or factor V Leiden.
- Women who have sclerosing treatment for varicose veins.
- Women with two or more additional risk factors for getting a blood clot in a vein, for example obesity, smoking, and long-term immobility.
- Women who have ever had a heart attack, stroke, or mini-stroke caused by a blood clot in an artery.
- Women with angina, heart valve disease, or an irregular heartbeat called atrial fibrillation.
- Women with moderate to severe high blood pressure ( hypertension ).
- Women who smoke more than 40 cigarettes per day.
- Women over 50 years old.
- Women over 35 who smoke more than 15 cigarettes per day.
- Women with severe diabetes, for example, with complications that affect the eyes, kidneys, or nerves.
- Women with two or more risk factors for developing a blood clot in an artery.
- Women who suffer from migraines with aura, severe migraines that regularly last more than 72 hours despite treatment, or migraines that are treated with ergot derivatives.
- Women with breast cancer or a history of breast cancer (although the pill can be used if you have been cancer-free for five years and do not want to use non-hormonal contraception).
- Women with abnormal vaginal bleeding where the cause is unknown.
- Women with a long-term condition called systemic lupus erythematosus (SLE).
- Women with a history of excess urea in the blood, causing damaged red blood cells (hemolytic uremic syndrome).
- Women with active liver disease, eg liver cancer, hepatitis.
- Women with a history of liver disease when liver function has not returned to normal.
- Women with disorders of biliary excretion causing jaundice (eg, Dubin-Johnson or Rotor syndrome).
- Women with gallstones.
- Women with a history of jaundice, severe itching, a hearing disorder called otosclerosis, or a skin rash called gestational pemphigoid during a previous pregnancy or previous use of sex hormones.
- Hereditary blood disorders known as porphyrias.
This medicine should not be used if you are allergic to one or any of its ingredients. Tell your doctor or pharmacist if you have already experienced such an allergy.
If you feel that you have experienced an allergic reaction, stop using this medicine and tell your doctor or pharmacist immediately.
Marvelon should be used with caution in:
- Women over 35 years of age.
- Women whose parents, brothers or sisters had a heart attack or stroke caused by a blood clot before age 45.
- Women who are obese.
- Women with diabetes mellitus.
- Women with high blood pressure (hypertension).
- Women with heart failure.
- Women who use a wheelchair.
- Women with a history of inflammation of a vein caused by a superficial blood clot (thrombophlebitis).
- Women with anemia caused by an inherited blood disorder in which abnormal hemoglobin is produced (sickle cell anemia).
- Women with a history of severe depression, especially if this was caused by taking the pill in the past.
- Women with a history of migraines.
- Women with inflammatory bowel disease, for example Crohn’s disease or ulcerative colitis.
- Women with a personal or family history of high levels of fats called triglycerides in the blood (hypertriglyceridaemia).
- Women with elevated levels of the hormone prolactin in the blood (hyperprolactinaemia).
- Women with undiagnosed breast lumps or genetic mutations associated with breast cancer, eg. Eg, BRCA1.
- Women with a history of irregular brown spots that appear on the skin, usually on the face, during pregnancy or previous use of a contraceptive pill (chloasma).
Pregnancy and breastfeeding
Certain medications should not be used during pregnancy or breastfeeding. However, other medications can be used safely during pregnancy or breastfeeding, as long as the benefits to the mother outweigh the risks to the fetus.
Always inform your doctor if you are pregnant or planning a pregnancy, before using any medication.
This medicine is used to prevent pregnancy and should not be taken during pregnancy. However, if the pill fails or you miss the pills and you become pregnant while taking it, there is no evidence to suggest that the pills you have already taken will harm the baby.
If you think you might be pregnant while taking this pill, you should stop taking it and consult your doctor immediately.
The hormones in this pill can reduce breast milk production. For this reason, it is not recommended for women who are breastfeeding. It should not be used until weaning, or at least six months after birth.
Other methods of contraception are more suitable for women who are breastfeeding. Ask your doctor for advice.
Possible side effects of Marvelon
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this drug.
Just because a side effect is listed here does not mean that everyone using this drug will experience that or any side effect.
- Nausea and vomiting
- Abdominal pain.
- Headache / migraine.
- Tenderness and enlargement of the breasts.
- Weight changes
- Retention of water in the tissues of the body (fluid retention).
- Zorzal vaginal (candidiasis).
- Change in menstrual bleeding, usually lighter periods or sometimes stopping periods.
- Menstrual spotting or breakthrough bleeding.
- Decreased sexual desire
- Increase in blood pressure.
- Skin reactions
- Irregular brown spots on the skin, usually on the face (chloasma).
- Inclination of the corneal curvature, which can make contact lenses uncomfortable.
- Disturbance in liver function.
- Blood clots in blood vessels (eg, DVT, pulmonary embolism, heart attack, stroke, see warnings above).
Talk to your doctor, nurse, or pharmacist if you want more information about the possible side effects of this medicine.
How can Marvelon affect other medicines?
It is important that you tell your doctor or pharmacist what medicines you are taking, including those bought without a prescription and herbal medicines, before you start taking this contraceptive.
Similarly, check with your doctor or pharmacist before taking any new medications while using this one, to make sure the combination is safe.
The following medications accelerate the breakdown of hormones in this contraceptive by the liver, making it less effective in preventing pregnancy:
- Perampanel(12 mg).
- The herbal remedy St John’s wort (Hypericum perforatum).
If you regularly take any of these medications, these contraceptives are likely to be ineffective in preventing pregnancy.
It is important to talk to your doctor about this. Your doctor will usually recommend that you use a different form of contraception.
However, if you want to use the pill (and you are not taking rifampin or rifabutin, see below), your doctor may prescribe an additional pill in combination with this one, which would give you a higher dose of hormones.
If you do this, your doctor will also ask you to take three packs in a row without interruption, just take a four-day pill-free break, and then go back to taking three packs. Repeat this while you are taking the other medicine and for another four weeks after stopping it.
If you are prescribed a short course (up to two months) of any of the above medications, they will also make this contraceptive less effective. Your doctor may recommend that you temporarily use a different form of contraception to prevent pregnancy.
However, if you want to keep taking this pill, your doctor will probably advise you to take three packs in a row without interruption, then you will only have a four-day pill-free break.
You will also need to use an additional method of birth control (such as condoms) while you are doing this, for as long as you are taking the liver-affecting medicine, and for at least four weeks after you stop.
Alternatively, your doctor could prescribe an additional pill in combination with this one, as indicated above. Discuss your options with your doctor.
If you are prescribed rifampin or rifabutin , an alternative contraceptive method will always be recommended, as these two antibiotics make the pill so ineffective.
In the past, if you were prescribed an antibiotic other than rifampicin or rifabutin (eg, Amoxicillin, erythromycin, doxycycline) while taking the pill, it used to be recommended to use an additional method of contraception while taking the antibiotic medicine and for seven days after finishing the course.
However, this advice has now changed. It is no longer necessary to use an additional contraceptive method with the pill while taking a course of antibiotics.
This change in advice is because to date there is no evidence to show that antibiotics (other than rifampin or rifabutin) affect the pill.
However, if you experience vomiting or diarrhea as a result of taking an antibiotic, you should follow the instructions for vomiting and diarrhea outlined in the warning section above.
The emergency contraceptive ulipristal (Ellaone) has the potential to make the pill less effective. If you take Ellaone for emergency contraception while taking Marvelon, you must use an additional method of contraception, such as condoms, for 14 days after taking it.
The antifungal drug griseofulvin can make the pill less effective. You must use an additional method of contraception both during treatment with griseofulvin and for one month after stopping treatment.
The weight loss drug orlistat (purchased over the counter as Alli and prescribed as Xenical) can cause severe diarrhea. If you take any of these medications while taking Marvelon and have diarrhea that lasts more than 24 hours, you should follow the directions for missed pills described above.
If you are taking the cholesterol-lowering drug Colesevelam in combination with the pill, it should be taken at least four hours after taking your pill, as otherwise it may reduce the absorption of the pill from the gut and make it less effective.
The pill may oppose the hypoglycemic effect of diabetes medications. If you have diabetes, you should monitor your blood sugar level and consult your doctor or pharmacist if your blood sugar control seems to be altered after you start using this contraceptive.
The pill can oppose the effect of drugs used to lower high blood pressure. Usually your blood pressure will be checked periodically while taking the pill, but this is particularly important if you are also taking medication for high blood pressure.
The pill can also oppose the fluid-wasting effect of diuretic drugs.
If you have an underactive thyroid gland (hypothyroidism), you may need a higher dose of your thyroid hormones while taking the pill. Your thyroid hormone levels need to be checked regularly.
The pill can lower the amount of the antiepileptic medicine lamotrigine in your blood. As this could increase the risk that seizures will come back or get worse, the pill may not be recommended for women taking lamotrigine by themselves to treat epilepsy.
The pill can increase the blood levels of the following medicines and this could possibly increase the risk of their side effects:
- Selegiline (to be avoided in combination with the pill).
- Theophylline (a reduced dose of theophylline may be necessary).
Other contraceptives that contain the same active ingredients: