{"id":18850,"date":"2022-02-24T16:35:18","date_gmt":"2022-02-24T16:35:18","guid":{"rendered":"https:\/\/zeepedia.com\/?p=18850"},"modified":"2022-02-25T12:08:21","modified_gmt":"2022-02-25T12:08:21","slug":"neovletta-28","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/neovletta-28\/","title":{"rendered":"Neovletta 28 &#8211; Levonorgestrel \/ EthinylestradiolShow uses, dose and side effects"},"content":{"rendered":"\n<p>\\<\/p>\n\n\n\n<p>coated tablets.<br>Levonorgestrel \/ Ethinylestradiol<a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20040607011546#\" rel=\"noopener\">Show larger<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Neovletta 28 is and what it is used for<\/h2>\n\n\n\n<p>Neovletta 28 is used as a contraceptive.<br>Neovletta 28 is a combination pill that contains low amounts of two different female sex hormones.\u00a0Neovletta 28 consists of 21 tablets with active ingredients (\u00a0hormones\u00a0) and 7 hormone-free tablets (last row on the tablet map).\u00a0Each hormone tablet contains both Ethinyl estradiol (an\u00a0estrogen\u00a0) and levonorgestrel (a\u00a0progestogen\u00a0).\u00a0Due to the low hormone levels, Neovletta 28 is one of the low-dose birth control pills.\u00a0All hormone tablets in the pack contain the same\u00a0hormone\u00a0at a constant\u00a0dose, the contraceptive pill is therefore called monophasic.<\/p>\n\n\n\n<p>The preventive effect of combined\u00a0contraceptive pills\u00a0is based on the interplay between different factors.\u00a0The most important is considered to be that ovulation is inhibited and the changes in the uterine lining and by the\u00a0secretions\u00a0in the cervix.<\/p>\n\n\n\n<p>Menstruation is affected so that the bleeding becomes more regular, menstruation often becomes less painful and the amount decreases.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before you use Neovletta 28<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Generally<\/h2>\n\n\n\n<p>Before you start using Neovletta 28, read the information on blood clots in section 2. You must read the symptoms of blood clots (see section 2, \u201cBlood clots\u201d).<\/p>\n\n\n\n<p>This leaflet describes several situations in which you should stop taking Neovletta 28, or when the protective effect of the contraceptive pill may be reduced.\u00a0In these situations, you should not have intercourse, or you should take extra measures in the form of non-hormonal methods, e.g.\u00a0condom or any other\u00a0barrier method.\u00a0Do not use &#8220;safe periods&#8221; based on the menstrual cycle or temperature changes.\u00a0These methods can be unreliable as Neovletta 28 disrupts the normal changes in body temperature and cervical\u00a0mucosa\u00a0during the menstrual cycle.<\/p>\n\n\n\n<p>Like other\u00a0birth control pills, Neovletta 28 does not protect against\u00a0HIV\u00a0infection\u00a0(\u00a0AIDS\u00a0)\u00a0or other sexually transmitted diseases.<\/p>\n\n\n\n<p><strong>Do not use Neovletta 28:<\/strong><\/p>\n\n\n\n<p>Do not use Neovletta 28 if you have any of the conditions listed below.&nbsp;If you have any of these conditions, you need to tell your doctor.&nbsp;The doctor will discuss what other type of contraception may be more appropriate.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you have (or have had) a blood clot in a blood vessel in your legs (deep&nbsp;vein thrombosis&nbsp;, DVT), in your lungs (&nbsp;pulmonary embolism&nbsp;) or any other organ<\/li><li>if you know you have a disease that affects blood coagulation &#8211; e.g.&nbsp;protein&nbsp;C deficiency,&nbsp;protein&nbsp;S deficiency, antithrombin III deficiency, Factor V Leiden or antiphospholipid antibodies<\/li><li>if you need to have an operation or if you stay in bed for a longer period (see section &#8220;Blood clots&#8221;)<\/li><li>if you have (or have had) a heart attack or&nbsp;stroke&nbsp;(stroke)<\/li><li>if you have (or have had) angina (a condition that causes severe chest pain and may be a first sign of a heart attack) or&nbsp;transient&nbsp;ischemic attack (&nbsp;TIA&nbsp;&#8211; transient stroke symptoms)<\/li><li>if you have any of the following conditions that may increase the risk of a blood clot in your arteries:<ul><li>severe&nbsp;diabetes&nbsp;with damaged blood vessels<\/li><li>very high&nbsp;blood pressure<\/li><li>a very high level of fat in the blood (&nbsp;cholesterol&nbsp;or&nbsp;triglycerides&nbsp;)<\/li><li>a condition called hyperhomocysteinemia<\/li><\/ul><\/li><li>if you have (or have had) a type of&nbsp;migraine&nbsp;called &#8220;migraine with aura&#8221;<\/li><li>if you have jaundice or severe liver disease<\/li><li>whether you have or have hadcancer affected by sex hormones (eg breast cancer or genital cancer)<\/li><li>if you have or have had a benign or malignant liver tumor<\/li><li>if you have unexplained bleeding from the abdomen<\/li><li>if you are pregnant, or think you may be pregnant<\/li><li>if you are allergic to ethinyl estradiol or levonorgestrel, or any of the other ingredients of this medicine (listed in section 6).<\/li><\/ul>\n\n\n\n<p>Do not use Neovletta 28 if you have\u00a0hepatitis\u00a0C and are being treated with medicines containing ombitasvir\/paritaprevir \/ ritonavir, dasabuvir, glecaprevir \/ pibrentasvir, and sofosbuvir \/ velpatasvir \/ voxilaprevir (see also section \u201cOther medicines and Neovletta 28\u201d).<\/p>\n\n\n\n<p>If any of the above occur for the first time while you are\u00a0taking the pill, stop using the tablets immediately and consult a doctor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>When should you contact a doctor?<br><strong>Seek medical attention immediately<\/strong>if you notice any possible signs of a blood clot that may indicate a blood clot in your leg (ie deep\u00a0vein thrombosis\u00a0), a blood clot in your lung (ie\u00a0pulmonary embolism\u00a0), a heart attack, or a\u00a0stroke\u00a0(see section \u201cBlood clots\u201d below). For a description of the symptoms of these serious\u00a0side effects, go to &#8220;How to recognize a blood clot&#8221;.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Tell your doctor if any of the following conditions apply to you.<\/strong><\/p>\n\n\n\n<p>If the condition occurs or worsens when you use Neovletta 28, you should also consult a doctor.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you smoke<\/li><li>if you have&nbsp;diabetes<\/li><li>if you are overweight<\/li><li>if you have high&nbsp;blood pressure<\/li><li>if you have heart valve disease or a heart rhythm disorder<\/li><li>if you have&nbsp;Crohn&#8217;s disease&nbsp;or&nbsp;ulcerative colitis&nbsp;(&nbsp;chronic&nbsp;inflammatory&nbsp;bowel disease)<\/li><li>if you have a systemic lupus erythematosus (&nbsp;SLE&nbsp;&#8211; a disease that affects your natural immune system)<\/li><li>if you have&nbsp;hemolytic uremic syndrome&nbsp;(HUS &#8211; a disorder of blood coagulation that leads to&nbsp;kidney failure&nbsp;)<\/li><li>if you have&nbsp;sickle cell anemia&nbsp;(a hereditary disease of the red&nbsp;blood cells&nbsp;)<\/li><li>if you have high blood fats (&nbsp;hypertriglyceridemia&nbsp;) or a hereditary condition.&nbsp;Hypertriglyceridemia&nbsp;has been associated with an increased risk of developing&nbsp;pancreatitis&nbsp;(inflammation of the pancreas)<\/li><li>if you need to have an operation or stay in bed for a longer period (see section 2 &#8220;Blood clots&#8221;)<\/li><li>if you have just given birth, you are at increased risk of getting blood clots.&nbsp;Ask your doctor how soon after giving birth you can start using Neovletta 28<\/li><li>if you have an&nbsp;inflammation&nbsp;of the veins under the skin (superficial&nbsp;thrombophlebitis&nbsp;)<\/li><li>if you have varicose veins<\/li><li>if a close relative has had a blood clot, heart attack or&nbsp;stroke<\/li><li>if you suffer from&nbsp;migraines<\/li><li>if a close relative has had breast cancer<\/li><li>if you have liver or biliary tract disease<\/li><li>if you have a condition that first appeared or worsened during pregnancy or previous use of sex hormones (eg hearing loss, a metabolic disease called&nbsp;porphyria&nbsp;, a skin disease called&nbsp;herpes&nbsp;gestationis, a neurological disease called Sydenham&#8217;s korea)<\/li><li>if you have or have had chloasma (yellow-brown pigment spots, especially on the face);&nbsp;if so, you should avoid&nbsp;exposing&nbsp;yourself to too much sunlight or ultraviolet radiation.<\/li><li>contact a doctor immediately if you experience symptoms of&nbsp;angioedema&nbsp;such as swelling of the face, tongue and \/ or throat and \/ or difficulty swallowing or&nbsp;hives&nbsp;, possibly with difficulty breathing.&nbsp;Products containing&nbsp;estrogen&nbsp;can cause or worsen the symptoms of hereditary or acquired&nbsp;angioedema&nbsp;.<\/li><\/ul>\n\n\n\n<p><strong>BLOOD CLOTS<\/strong><\/p>\n\n\n\n<p>If you use combined hormonal contraceptives such as Neovletta 28, the risk of blood clots increases compared to if you do not use these drugs.&nbsp;In rare cases, a blood clot can block the blood vessels and cause serious problems.<\/p>\n\n\n\n<p>Blood clots can form<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>in veins (called venous&nbsp;thrombosis&nbsp;, venous&nbsp;thromboembolism&nbsp;or VTE)<\/li><li>in the&nbsp;artery&nbsp;(called&nbsp;arterial&nbsp;thrombosis&nbsp;,&nbsp;arterial&nbsp;thromboembolism&nbsp;or ATE).<\/li><\/ul>\n\n\n\n<p>It is not always possible to fully recover from blood clots.&nbsp;In rare cases, they can have serious lasting effects and, in very rare cases, be fatal.<\/p>\n\n\n\n<p><strong>It is important to remember that the overall risk of a dangerous blood clot due to Neovletta 28 is small.<\/strong><\/p>\n\n\n\n<p><strong>HOW TO FEEL A BLOOD CLOTH AGAIN<\/strong><\/p>\n\n\n\n<p><strong>Seek medical attention immediately<\/strong>\u00a0if you notice any of the following signs or symptoms.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th scope=\"col\">Do you experience any of these signs?<\/th><th scope=\"col\">What can you possibly suffer from?<\/th><\/tr><\/thead><tbody><tr><td>swelling of a leg or along a vein in the leg or foot, especially if you also get: pain or tenderness in the leg that is only felt when you stand or walkincreased heat in the affected legdiscoloration of the skin on the leg, e.g.\u00a0pale, red or blue<\/td><td>Deep&nbsp;vein thrombosis<\/td><\/tr><tr><td>sudden unexplained shortness of breath or rapid breathing sudden cough for no apparent reason that could possibly cause you to cough up blood severe chest pain that may increase with deep breathing severe instability or dizziness fast or irregular heartbeat severe pain in the abdomen you are not sure, talk to a doctor because some of these symptoms, e.g.\u00a0cough and shortness of breath, can be mistakenly interpreted as a milder condition such as a respiratory infection (such as a common cold).<\/td><td>Pulmonary embolism<\/td><\/tr><tr><td>Symptoms that usually occur in one eye:immediate loss of vision orblurred vision without pain that can lead to vision loss<\/td><td>Retinal&nbsp;venous thrombosis&nbsp;(blood clot in the eye)<\/td><\/tr><tr><td>chest pain, discomfort, pressure, heavinesspressure or feeling of fullness in the chest, arm or below the sternumfeeling full, indigestion or feeling of suffocationdiscomfort in the upper body that radiates to the back, jaw, neck, arm and abdomensweating, nausea, vomiting or dizzinessextreme weakness, anxiety or shortness of breathfast or irregular heartbeat<\/td><td>Myocardial infarction<\/td><\/tr><tr><td>sudden weakness or numbness in the face, arms or legs, especially on one side of the bodysudden confusion, difficulty speaking or understandingsudden vision problems in one or both eyes sudden difficulty walking, dizziness, loss of balance or coordination Sudden, severe or prolonged headache for no known reason consciousness or fainting with or without seizuresSometimes the symptoms of a\u00a0stroke\u00a0can be short-lived with almost immediate or complete recovery, but you should still seek medical attention immediately because you are at risk of having a new\u00a0stroke\u00a0.<\/td><td>Stroke<\/td><\/tr><tr><td>swelling and slight blue discoloration of an arm or leg severe pain in the abdomen (\u00a0acute\u00a0abdomen)<\/td><td>Blood clots that block other blood vessels<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>BLOOD CLOTS IN A FRIEND<\/strong><\/p>\n\n\n\n<p><strong>What can happen if a blood clot forms in a vein?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The use of combined hormonal contraceptives has been associated with an increased risk of blood clots in the vein (venous&nbsp;thrombosis&nbsp;).&nbsp;However, these&nbsp;side effects&nbsp;are rare.&nbsp;They usually occur during the first year of using a combined hormonal contraceptive.<\/li><li>If a blood clot forms in a vein in the leg or foot, it can lead to deep&nbsp;vein thrombosis&nbsp;(DVT).<\/li><li>If a blood clot moves from the bone and stays in the lung, it can lead to a&nbsp;pulmonary embolism&nbsp;.<\/li><li>In very rare cases, a blood clot can form in a vein in another organ such as the eye (&nbsp;retinal&nbsp;venous thrombosis&nbsp;).<\/li><\/ul>\n\n\n\n<p><strong>When is the risk of developing a blood clot in a vein greatest?<\/strong><\/p>\n\n\n\n<p>The risk of developing a blood clot in a vein is greatest during the first year that you use combined hormonal contraceptives for the first time.&nbsp;The risk can also be higher if you start again with a combined hormonal contraceptive (same product or another product) after a break of 4 weeks or longer.<\/p>\n\n\n\n<p>After the first year, the risk decreases, but it is always slightly higher than if you did not use a combined hormonal contraceptive.<\/p>\n\n\n\n<p>When you stop using Neovletta 28, the risk of a blood clot returns to normal within a few weeks.<\/p>\n\n\n\n<p><strong>How big is the risk of developing a blood clot?<\/strong><\/p>\n\n\n\n<p>The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking.<\/p>\n\n\n\n<p>The total risk of a blood clot in the leg or lungs with Neovletta 28 is small.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Of 10,000 women who use a combined hormonal contraceptive that contains levonorgestrel such as Neovletta 28, approximately 5\u20137 develop a blood clot in one year.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th scope=\"col\"><\/th><th scope=\"col\"><strong>Risk of developing a blood clot during a year<\/strong><\/th><\/tr><\/thead><tbody><tr><td>Women who&nbsp;<strong>do not use the<\/strong>&nbsp;combined&nbsp;contraceptive pill&nbsp;and who are not pregnant<\/td><td>About 2 out of 10,000 women<\/td><\/tr><tr><td>Women using a combined hormonal contraceptive containing&nbsp;<strong>levonorgestrel such as Neovletta 28<\/strong><\/td><td>About 5-7 out of 10,000 women<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Factors that may increase the risk of a blood clot in a vein<\/strong><\/p>\n\n\n\n<p>The risk of a blood clot with Neovletta 28 is small, but certain conditions increase the risk.&nbsp;The risk is higher:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are overweight (body mass index or&nbsp;BMI&nbsp;over 30 kg \/ m&nbsp;<sup>2<\/sup>&nbsp;)<\/li><li>if someone in your family has had a blood clot in their bones, lungs or other organ at a young age (eg for about 50 years).&nbsp;In this case, you may have a hereditary blood clotting disease<\/li><li>if you need to undergo surgery, or stay in bed for an extended period of time due to injury or illness, or if your leg is plastered.&nbsp;The use of Neovletta 28 may need to be stopped for several weeks before an operation or while you are less mobile.&nbsp;If you have to stop taking Neovletta 28, ask your doctor when you can start taking it again<\/li><li>with increasing age (especially if you are over about 35 years old)<\/li><li>if you gave birth a few weeks ago<\/li><\/ul>\n\n\n\n<p>The more conditions you have, the greater the risk of developing a blood clot.<\/p>\n\n\n\n<p>Air travel (over 4 hours) can temporarily increase the risk of a blood clot, especially if you have any of the other factors listed here.<\/p>\n\n\n\n<p>You must tell your doctor if any of these conditions apply to you, even if you are unsure.\u00a0Your doctor may decide that you must stop taking Neovletta 28.<\/p>\n\n\n\n<p>If any of the above conditions change when using Neovletta 28, e.g.&nbsp;a close relative suffers from a blood clot with an unknown cause, or you gain a lot of weight, talk to your doctor.<\/p>\n\n\n\n<p><strong>BLOOD CLOTS IN AN&nbsp;ART<\/strong><\/p>\n\n\n\n<p><strong>What can happen if a blood clot forms in an\u00a0artery?<\/strong><\/p>\n\n\n\n<p>In the same way as a blood clot in a vein, a clot in an\u00a0artery\u00a0can lead to serious problems.\u00a0It can e.g.\u00a0cause a heart attack or\u00a0stroke.<\/p>\n\n\n\n<p><strong>Factors that may increase the risk of a blood clot in an&nbsp;artery<\/strong><\/p>\n\n\n\n<p>It is important to know that the risk of a heart attack or&nbsp;stroke&nbsp;due to the use of Neovletta 28 is very small but may increase:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>with increasing age (after about 35 years of age)<\/li><li><strong>if you smoke.&nbsp;<\/strong>When using combined hormonal contraceptives such as Neovletta 28, you should stop smoking.&nbsp;If you can not stop smoking and are over 35 years old, your doctor may advise you to use another type of contraceptive<\/li><li>if you are overweight<\/li><li>if you have high&nbsp;blood pressure&nbsp;that is not controlled with treatment<\/li><li>if a close relative has had a heart attack or&nbsp;stroke&nbsp;at a young age (younger than 50 years).&nbsp;In this case, you may also be at greater risk for a heart attack or&nbsp;stroke<\/li><li>if you or a close relative have high blood fats (&nbsp;cholesterol&nbsp;or&nbsp;triglycerides&nbsp;)<\/li><li>if you get&nbsp;migraines&nbsp;, especially&nbsp;migraines&nbsp;with an&nbsp;aura<\/li><li>if you have heart problems (valve disease, a heart rhythm disorder called&nbsp;atrial fibrillation&nbsp;)<\/li><li>if you have&nbsp;diabetes&nbsp;.<\/li><\/ul>\n\n\n\n<p>If you have more than one of these conditions or if any of them are particularly serious, the risk of developing a blood clot can be even greater.<\/p>\n\n\n\n<p>If any of the above conditions change when using Neovletta 28, e.g.\u00a0If you start smoking, a close relative suffers from thrombosis\u00a0of unknown cause, or if you gain a lot of weight, talk to your doctor.<\/p>\n\n\n\n<p><em>Birth control pills&nbsp;and cancer<\/em><\/p>\n\n\n\n<p>Breast cancer is diagnosed slightly more often in women who use\u00a0birth control pills\u00a0than in women of the same age who do not use\u00a0birth control pills.\u00a0The small increase in the number of breast cancer diagnoses gradually decreases during the first ten years after discontinuation of use.\u00a0It is not known whether this difference is due to the contraceptive pill.\u00a0It may be that women who use\u00a0birth control pills\u00a0are examined more often and thus any cancer is detected earlier.<\/p>\n\n\n\n<p>In rare cases, benign liver tumors and, even more uncommonly, malignant liver tumors have been reported in birth control pill users.&nbsp;These&nbsp;tumors&nbsp;can cause internal bleeding.&nbsp;Contact a doctor immediately if you have severe pain in the abdominal region.<\/p>\n\n\n\n<p>The most important risk factor for cervical cancer\u00a0is\u00a0human\u00a0papillomavirus\u00a0infection\u00a0(\u00a0condyloma\u00a0).\u00a0Some studies have shown that long-term use of\u00a0birth control pills\u00a0can contribute to an increased risk of\u00a0condyloma.\u00a0However, it is not clear to what extent this is due to other factors such as sexual habits (including reduced condom use) or increased detection as a result of more regular cervical smears in women using\u00a0birth control pills.<\/p>\n\n\n\n<p><em>Mental disorders<\/em><\/p>\n\n\n\n<p>Some women who use hormonal contraceptives, including Neovletta 28, have reported depression or depression.&nbsp;Depression can be severe and can sometimes lead to suicidal thoughts.&nbsp;If you experience mood swings and symptoms of depression, you should contact a doctor as soon as possible for advice.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Neovletta 28<\/h2>\n\n\n\n<p>Some medicines can affect the levels of&nbsp;birth control pills&nbsp;in the blood and thus prevent&nbsp;birth control pills&nbsp;from working properly.&nbsp;This applies, among other things, to medicines for the treatment of:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>epilepsy&nbsp;(eg primidone,&nbsp;phenytoin&nbsp;,&nbsp;barbiturate&nbsp;, carbamazepine, oxcarbazepine, <a href=\"https:\/\/zeepedia.com\/medical\/medicines\/topiramate-1a-pharma\/\">topiramate<\/a>, felbamate);<\/li><li>tuberculosis&nbsp;(eg rifampicin and rifabutin);<\/li><li>HIV&nbsp;and&nbsp;hepatitis&nbsp;C virus infections;<\/li><li>fungal infections (griseofulvin, azole antifungals such as itraconazole, voriconazole, fluconazole);<\/li><li>bacterial infections (macrolide antibiotics, eg clarithromycin, erythromycin);<\/li><li>certain heart diseases, high&nbsp;blood pressure&nbsp;(calcium channel blockers, eg verapamil,&nbsp;diltiazem&nbsp;);<\/li><li>osteoarthritis&nbsp;, rheumatism (etoricoxib);<\/li><li>herbal medicines containing St. John&#8217;s&nbsp;wort&nbsp;(used mainly to treat depression).<\/li><\/ul>\n\n\n\n<p>Birth control pills\u00a0can also affect the effectiveness of other medicines, for example:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>cyclosporine, a drug that inhibits the immune system;<\/li><li>omeprazole, a medicine for gastrointestinal ulcers and acid reflux;<\/li><li>lamotrigine, an antiepileptic drug;<\/li><li>melatonin&nbsp;, a sleeping pill;<\/li><li>midazolam, a hypnotic drug for use in anesthesia;<\/li><li>tizanidine, a muscle relaxant;<\/li><li>selegelin, a drug used to treat&nbsp;Parkinson&#8217;s disease<\/li><\/ul>\n\n\n\n<p>Do not use Neovletta 28 if you have\u00a0hepatitis\u00a0C and are taking medicines containing ombitasvir \/ paritaprevir \/ ritonavir, dasabuvir, glecaprevir \/ pibrentasvir and sofosbuvir \/ velpatasvir \/ voxilaprevir, as treatment with these products may lead to elevated liver levels (elevation of alanzaminase\u00a0ALAT\u00a0) ).\u00a0Your doctor will prescribe another contraceptive before starting treatment with these medicines.\u00a0Novelette 28 can be started again about 2 weeks after the end of treatment.\u00a0See section &#8220;Do not use Neovletta 28&#8221;.<\/p>\n\n\n\n<p>Tell your doctor\/midwife or pharmacist if you are taking, have recently taken, or might take any other medicines.\u00a0Also, tell other doctors or dentists who prescribe other medicines to you that you are using Neovletta 28. They may tell you if you need to use additional contraceptive methods and if so, for how long.\u00a0You can also get advice at the pharmacy.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Neovletta 28 with food and drink<\/h2>\n\n\n\n<p>You should not drink grapefruit juice while using Neovletta 28 as it could increase the risk of\u00a0side effects.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p><em>Pregnancy<\/em><br>Neovletta 28 should not be used by pregnant women or women who think they may be pregnant.\u00a0If you suspect that you are pregnant and you are already using Neovletta 28, you should contact your doctor\/midwife as soon as possible.<\/p>\n\n\n\n<p><em>Breast<\/em><br>-feeding Neovletta 28 is not recommended during breastfeeding.\u00a0If you want to use\u00a0birth control pills\u00a0while you are breastfeeding, you should consult your doctor\/midwife.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>Neovletta 28 has no or negligible effect on the ability to drive or use machines.<\/p>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Neovletta 28 contains lactose monohydrate and sucrose<\/h2>\n\n\n\n<p>If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to use Neovletta 28<\/h2>\n\n\n\n<p>Always use Neovletta 28 exactly as your doctor\/midwife has told you.\u00a0Always follow the doctor&#8217;s \/ midwife&#8217;s\u00a0prescription\u00a0and the instructions on the pharmacy label.\u00a0If you are not sure, talk to your doctor\/midwife or pharmacist.<\/p>\n\n\n\n<p><strong>When and how to take the tablets<\/strong><\/p>\n\n\n\n<p>The Neovletta 28 pack contains tablet charts with 28 tablets each.\u00a0The tablet should be taken at about the same time each day, along with some liquid.\u00a0Follow the direction of the arrows until all 28 tablets have been taken (a detailed description can be found in the section &#8220;How to prepare the tablet map for use&#8221;).\u00a0You usually get menstrual-like bleeding (loss of bleeding) two to three days after taking the last hormone tablet (ie during the time you are taking tablets from the last line of the tablet chart).\u00a0The day after you finish a tablet chart, you should start a new one even if you are still bleeding.\u00a0No tablet pause should be left between the tablet maps.\u00a0This means that you always start on a new tablet chart on the same day of the week and that you will have your dropout bleeding on approximately the same days each month.<\/p>\n\n\n\n<p><strong>How to start with your first tablet map Neovletta 28<\/strong><\/p>\n\n\n\n<p><em>When no hormonal contraceptive method has been used in the last month<\/em><br>Start taking Neovletta 28 on the first day of the menstrual cycle, ie the first day of bleeding.&nbsp;Then take the tablets in turn in the direction of the arrows.&nbsp;Neovletta 28 works from day one, so no additional method of contraception is necessary.<\/p>\n\n\n\n<p>You can also start taking Neovletta 28 on days two to five of the menstrual cycle, but then you must use an extra method of contraception (\u00a0barrier\u00a0method, such as a condom) as a supplement during the first seven days of tablet treatment in the first menstrual cycle.<\/p>\n\n\n\n<p><em>When changing from another combination contraceptive (\u00a0contraceptive pill<\/em>,\u00a0vaginal ring,\u00a0or\u00a0patch\u00a0)<br>You can start taking Neovletta 28 days after the last tablet of the previous pill (this means that there should be no tablet interruption).\u00a0If you already use a\u00a0contraceptive pill\u00a0where there are some hormone-free tablets per map (ie delivered with 28 tablets per map), you can start with Neovletta 28 after the last\u00a0hormone tablet\u00a0(if you are unsure which tablet it is, you can ask your doctor\/midwife, or ask at the pharmacy).\u00a0You can also start later, but never later than the day after the tablet-free interval (or the day after the last hormone-free tablet) for your previous birth control pills.\u00a0If you have used a\u00a0vaginal ring\u00a0or\u00a0patch, you should preferably start using Neovletta 28 on the same day as the ring or patch is removed and at the latest when treatment with the next ring or\u00a0patch\u00a0should have started.\u00a0If you follow these instructions, no additional method of contraception is needed.<\/p>\n\n\n\n<p><em>When changing from mini-pills\u00a0(\u00a0birth control pills\u00a0that only contain\u00a0progestin\u00a0)<\/em><br>You can stop taking the mini-pills any day and start with Neovletta 28 at the same time the next day.\u00a0Note that you should use an additional method of contraception (a\u00a0barrier method\u00a0) if you have intercourse during any of the first seven days of treatment.<\/p>\n\n\n\n<p><em>When changing from the contraceptive methods contraceptive\u00a0syringe<\/em>, contraceptive rod,<em> or<\/em><br>hormonal IUD Start taking Neovletta 28 on the day you should have received a new\u00a0syringe\u00a0or the day the IUD or IUD is removed.\u00a0Note that you should use another method of contraception (a barrier method; eg condoms or\u00a0diapers\u00a0) if you have intercourse during any of the first seven days of treatment.<\/p>\n\n\n\n<p><em>After delivery<\/em><br>If you have just given birth, a doctor\/midwife may ask you to wait with Neovletta 28 until you have had your first normal menstrual period.\u00a0Sometimes you can start earlier, ask your doctor\/midwife for advice.\u00a0If you are breastfeeding and want to use Neovletta 28, you should discuss this with your doctor\/midwife before you start.<\/p>\n\n\n\n<p><em>After an abortion or miscarriage<\/em><br>Ask your doctor for advice.<\/p>\n\n\n\n<p><strong>How to prepare the tablet map for use<\/strong><\/p>\n\n\n\n<p>The packs of Neovletta 28 contain both tablet charts (with 21 active hormone tablets and 7 inactive hormone-free tablets (in the last row)) and self-adhesive labels to put on the tablet charts.\u00a0Each set of self-adhesive labels contains seven strips with the days of the week.\u00a0Select the strip that starts with the day you plan to start taking tablets.\u00a0If you e.g.\u00a0start on the tablet map on a Wednesday, select the strip that begins with &#8220;Wed&#8221;.<\/p>\n\n\n\n<p>Attach the weekday strip at the top of the tablet map to the side that is transparent, the side where the tablets are visible, so that the first day is above the tablet at the arrow that marks &#8220;start&#8221;.<\/p>\n\n\n\n<p>You can now see which day of the week you should take each tablet.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you take more Neovletta 28 than you should<\/h2>\n\n\n\n<p>If you have ingested too much medicine or if a child has accidentally ingested the medicine: contact a doctor or hospital for risk assessment and advice.\u00a0No serious adverse effects have been reported after taking too many hormone tablets (lines 1-3 on the tablet map) at the same time.\u00a0If you have taken several tablets at the same time, you may experience nausea, vomiting, or bleeding from the vagina.\u00a0Even girls who have not had their first period but have accidentally used this medicine may experience this type of bleeding.\u00a0Taking tablets from row four on the tablet map is harmless as they do not contain the active substance.<\/p>\n\n\n\n<p><strong>If you want to quit Neovletta 28<\/strong><\/p>\n\n\n\n<p>You can stop taking Neovletta 28 at any time.\u00a0If you stop because you want to get pregnant, it is recommended that you wait until you have had your first natural menstrual bleeding before trying to get pregnant.\u00a0This facilitates the calculation of when the birth is to take place.\u00a0Ask your doctor\/midwife about other methods of contraception if you do not want to get pregnant.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to take Neovletta 28<\/h2>\n\n\n\n<p>If you forgot to take tablets\u00a0<strong>from the fourth row on the tablet map<\/strong>, it does not matter.\u00a0You are still protected against pregnancy because they do not contain any active ingredients.\u00a0To maintain reliable protection against pregnancy, you mustn&#8217;t change the dosing schedule.\u00a0To avoid confusion, discard the forgotten tablets and take the next tablet as usual.\u00a0If you have forgotten a tablet in row 4 on your current tablet map, you must take the first tablet from the next map at the right time.<\/p>\n\n\n\n<p>The following advice applies if you forgot to take hormone tablets (lines 1-3 on the tablet map):<\/p>\n\n\n\n<p>If&nbsp;<strong>less than 12 hours<\/strong>&nbsp;have passed since you took your hormone tablet, you are still protected against pregnancy.&nbsp;Take the tablet as soon as you remember and take the next tablet at the usual time.<\/p>\n\n\n\n<p>If\u00a0<strong>more than 12 hours<\/strong>\u00a0have elapsed, the effect of the contraceptive pill may be reduced.\u00a0The more hormone tablets in a row that you have missed, the higher the risk that the preventive effect has decreased.\u00a0The risk of getting pregnant is especially high if you forget tablets at the beginning of the tablet chart or the end of week 3 (third row on the tablet chart).\u00a0Therefore, always follow the instructions given below (see also the diagram):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>More than 1 tablet in the tablet map has been forgotten: Contact your doctor \/ midwife for advice.<\/li><li>1 tablet forgotten during week 1:<br>Take the skipped tablet as soon as you remember, even if it means taking two tablets at the same time.&nbsp;Take the following tablets at the usual time, but do not forget to use extra contraceptive protection (&nbsp;barrier method&nbsp;, eg condom) for the next seven days.&nbsp;If you have had intercourse during the week before the forgotten tablet, there is a risk that you will become pregnant.&nbsp;Inform your doctor \/ midwife immediately.<\/li><li>1 tablet forgotten during week 2:<br>Take the skipped tablet as soon as you remember, even if it means taking two tablets at the same time.&nbsp;Take the following tablets at the usual time.&nbsp;The contraceptive pill still has the desired effect and you do not need to use extra preventive protection.&nbsp;If more than 1 tablet is forgotten, supplementary contraceptive protection should be used for 7 days.<\/li><li>1 tablet forgotten during week 3:<br>You can choose between one of the following two options and you do not need to use extra contraceptive protection:<ol><li>Take the skipped tablet as soon as you remember, even if it means taking two tablets at the same time.&nbsp;Take the following tablets at the usual time.&nbsp;When the hormone tablets on the tablet chart are finished (after row 3), start on the next tablet chart immediately, without stopping the tablet.&nbsp;(The seven hormone-free tablets should not be used.) You will probably not have a proper bleeding until you reach the end of row 3 on the second tablet map.&nbsp;However, you may experience spotting and breakthrough bleeding during the days you take tablets.<br><br>or:<\/li><li>You can stop taking hormone tablets and switch to hormone-free tablets.&nbsp;It is important that the number of hormone-free days never exceeds a total of 7 days.&nbsp;Then start on a new tablet map as usual.<\/li><\/ol><\/li><li>If you have forgotten to take tablets in a tablet chart and you do not get your expected period while taking tablets from line 4, you may be pregnant.&nbsp;Consult your doctor \/ midwife before starting the next tablet chart.<\/li><\/ul>\n\n\n\n<p><strong>Overview of the procedure in case of missed tablet<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20040607011546#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/res\/RootMedia\/Bayer\/Media\/Neovletta2028\/Neovletta202820PL20bild.jpg\" alt=\"Schedule\" title=\"Schedule\"\/><\/a><\/figure>\n\n\n\n<p><strong>If you suffer from gastrointestinal problems (eg vomiting or severe diarrhea)<\/strong><\/p>\n\n\n\n<p>If you vomit or have severe diarrhea after taking tablets from lines 1-3 on the tablet map, the active ingredients in Neovletta 28 may not be fully absorbed.&nbsp;If you vomit within 3-4 hours after taking the tablet, it gives the same situation as if you have not taken the tablet.&nbsp;Therefore, follow the instructions for the forgotten tablet above.&nbsp;Contact a doctor if you have severe diarrhea.&nbsp;Vomiting or diarrhea while taking tablets from row 4 on the tablet map does not affect the protection against pregnancy.<\/p>\n\n\n\n<p><strong>If you want to postpone a period<\/strong><\/p>\n\n\n\n<p>You can postpone your period if you continue to take the hormone tablets from a new tablet map Neovletta 28 immediately after line 3 on the previous map is used up (do not take the tablets from line 4).\u00a0You can continue to take tablets from the new map for as long as you wish until all the hormone tablets (they end in line 3) on the new map are used up.\u00a0If you want your period to start earlier than that, just stop taking the tablets from the other map.\u00a0Take a tablet break for a maximum of seven days (during which you get your period) and then start a new pack.\u00a0Under the second tablet map, you may experience breakthrough bleeding or spotting even on days when you take tablets.<\/p>\n\n\n\n<p><strong>If you want to change the start date for your period<\/strong><\/p>\n\n\n\n<p>If you take your tablets according to the instructions, you will experience a loss of bleeding about the same day of the week every four weeks.\u00a0If you want to change this to another day, you can refrain from taking all the tablets in row 4 before starting on the next tablet chart.\u00a0For example.\u00a0If you usually start bleeding on a Friday and in the future want the bleeding to start on a Tuesday (three days earlier), you can start on the next tablet chart three days earlier than usual.\u00a0Discard the three remaining hormone-free tablets on the current tablet map and start on a new tablet map without pausing between maps.\u00a0If you take very few tablets from line 4 (eg three or less), there may be no bleeding.\u00a0You may instead experience breakthrough bleeding or spotting while using the next tablet chart.<\/p>\n\n\n\n<p><strong>If you experience unexpected bleeding<\/strong><\/p>\n\n\n\n<p>When using all\u00a0birth control pills, during the first months there may be irregular bleeding (breakthrough bleeding and splashing bleeding) between your regular dropout bleeding.\u00a0You may need to use menstrual pads, but continue to take the tablets as usual.\u00a0The irregular bleeding usually stops as soon as the body has adapted to the contraceptive pill (normally after about three rounds of treatment).\u00a0If they persist after this, become stronger or return, you should inform the doctor\/midwife.<\/p>\n\n\n\n<p><strong>If menstruation is absent<\/strong><\/p>\n\n\n\n<p>If you have taken all the tablets at the right time, have not vomited, or had severe diarrhea while taking tablets from lines 1-3 or used other medicines, it is very unlikely that you would be pregnant.\u00a0Continue taking Neovletta 28 as usual.<\/p>\n\n\n\n<p>If there is no bleeding twice in a row, you may be pregnant.\u00a0Inform doctor\/midwife immediately.\u00a0Do not start on the next tablet card until your doctor\/midwife has verified that you are not pregnant.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, Neovletta 28 can cause\u00a0side effects, although not everybody gets them.\u00a0If you get any\u00a0side effects, especially if they are serious or persistent, or if your health changes and you think it may be due to Neovletta 28, talk to your doctor.<\/p>\n\n\n\n<p>An increased risk of blood clots in the veins (venous\u00a0thromboembolism, VTE) or blood clots in the\u00a0arteries\u00a0(\u00a0arterial\u00a0thrombosis, ATE) is present for all women taking hormonal combined contraceptives.\u00a0For more information on the different risks of using combined hormonal contraceptives, see section 2 &#8220;What you need to know before using Neovletta 28&#8221;.<\/p>\n\n\n\n<p>Contact a doctor immediately if you experience any of the following symptoms of angioedema: swelling of the face, tongue, and\/or throat and\/or difficulty swallowing,\u00a0hives, possibly with difficulty breathing.\u00a0See also section &#8220;Warnings and precautions&#8221;.<\/p>\n\n\n\n<p>During the first rounds of treatment, you can be expected to get some side effects, e.g.\u00a0chest tightness, nausea, and spotting.\u00a0These initial\u00a0side effects\u00a0usually disappear within 2 to 4 months of treatment.<\/p>\n\n\n\n<p>Other&nbsp;side effects&nbsp;that have been reported in birth control pill users are:<\/p>\n\n\n\n<p><em>Common (affects more than 1 in 100 people):<\/em>\u00a0Weight gain, headache, depression, mood swings, nausea, abdominal pain, breast tenderness, chest pain, chest tightness, and bleeding.<\/p>\n\n\n\n<p><em>Uncommon (affects less than 1 in 100 people):\u00a0<\/em>Fluid retention\u00a0(accumulation of fluid in the body),\u00a0migraine, decreased sexual desire, a moderate increase in blood pressure, vomiting, diarrhea, skin rash,\u00a0hives, missed menstrual bleeding, and breast enlargement.<\/p>\n\n\n\n<p><em>Rare (affects less than 1 user in 1,000):\u00a0<\/em>Hypersensitivity reaction, decreased glucose tolerance, increased blood sugar, increased insulin requirements, weight loss, increased sexual desire, decreased tear flow, difficulty wearing contact lenses, hepatic impairment,\u00a0pruritus, jaundice,\u00a0gallstones, cholestasis face), skin reactions, fluid secretion from the breasts and altered vaginal discharge, dangerous blood clots in a vein or\u00a0artery\u00a0which includes heart attack,\u00a0stroke, blood clot in a leg, foot or lung.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to store Neovletta 28<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<br>No special storage instructions.<br>Do not use this medicine after the expiry date which is stated on the carton.\u00a0The expiration date is the last day of the specified month.<br>The medicine should not be disposed of via wastewater or household waste.\u00a0Ask your pharmacist how to dispose of medicines no longer required.\u00a0These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the package and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<p><em><strong>Hormone tablet<\/strong><\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substances are ethinyl estradiol 0.03 mg and 0.15 mg levonorgestrel.<\/li><li>The other ingredients are&nbsp;lactose monohydrate&nbsp;, maize starch, povidone 25,000, talc, magnesium stearate, sucrose, povidone 700,000, macrogol 6000,&nbsp;calcium carbonate&nbsp;, montan glycol wax,&nbsp;glycerol&nbsp;85%, titanium dioxide (E 171) and iron oxide pigment yellow (E 172).<\/li><\/ul>\n\n\n\n<p><strong>Hormone-free tablet<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Contains:&nbsp;lactose monohydrate&nbsp;, corn starch, povidone, talc, magnesium stearate, sucrose, macrogol,&nbsp;calcium carbonate&nbsp;, wax.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and contents of the pack<\/h2>\n\n\n\n<p>Neovletta 28 is delivered in&nbsp;calendar&nbsp;packs of 3&#215;28 tablets or 13&#215;28 tablets.&nbsp;The tablets are biconvex and round.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Bayer AB<br>Box 606<br>SE-169 26 Solna<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Bayer AG<\/p>\n\n\n\n<p>13353 Berlin<\/p>\n\n\n\n<p>Germany<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Neovletta 28 is a combination pill that contains low amounts of two different female sex hormones. Neovletta 28 consists of 21 tablets with active ingredients ( hormones ) and 7 hormone-free tablets (last row on the tablet map). Each hormone tablet contains both ethinyl estradiol (an estrogen ) and levonorgestrel (a progestogen ). Due to the low hormone levels, Neovletta 28 is one of the low-dose birth control pills. All hormone tablets in the pack contain the same hormone at a constant dose , the contraceptive pill is therefore called monophasic.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,15581],"tags":[18737,18742,18733,18736,18738,18741,18734,18739,18735,18740],"class_list":["post-18850","post","type-post","status-publish","format-standard","hentry","category-medicines","category-n","tag-benefits-of-levonorgestrel-ethinylestradiolshow","tag-benefits-of-neovletta-28","tag-levonorgestrel-ethinylestradiolshow","tag-levonorgestrel-ethinylestradiolshow-side-effects","tag-neovletta-28","tag-neovletta-28-side-effects","tag-what-is-levonorgestrel-ethinylestradiolshow","tag-what-is-neovletta-28","tag-what-levonorgestrel-ethinylestradiolshow-is-used-for","tag-what-neovletta-28-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18850","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=18850"}],"version-history":[{"count":3,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18850\/revisions"}],"predecessor-version":[{"id":18905,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18850\/revisions\/18905"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=18850"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=18850"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=18850"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}