Composition, form of production and packaging
Tablets coated with 1 dragee
ethinylestradiol 30 Ојg
dienogest 2 mg
21 pcs. - blisters (1) - packs of cardboard.
21 pcs. - blisters (3) - packs of cardboard.
INSTRUCTION FOR THE SPECIALIST.
Description of the drug approved by the manufacturer for the printed edition of 2010.
PHARMACHOLOGIC EFFECT
The drug Genetten is a low-dose monophasic oral combined estrogen-progestational drug.
The contraceptive effect of the drug Zhenten is carried out by means of complementary mechanisms, the most important of which are suppression of ovulation and a change in the viscosity of cervical mucus, as a result of which it becomes impenetrable for spermatozoa.
When used correctly, the Perl index (an indicator that reflects the frequency of pregnancy in 100 women during the year of use of the contraceptive) is less than 1. When missing tablets or improperly used, the Pearl index may increase.
The gestagenic component of the drug Genetten - dienogest - has anti-androgenic activity, which is confirmed by the results of a number of clinical studies. In addition, dienogest improves the lipid profile of the blood (increases the number of high-density lipoproteins).
In women taking combined oral contraceptives (COCs), the soreness and intensity of menstrual bleeding decreases, which reduces the risk of iron deficiency anemia.In addition, there is evidence of a reduced risk of developing endometrial cancer and ovarian cancer.
PHARMACOKINETICS
Dienogest
Absorption. When administered orally, dienogest is quickly and completely absorbed, its C max of 51 ng / ml is reached after about 2.5 hours. Bioavailability is approximately 96%.
Distribution . Dienogest binds to blood serum albumin and does not bind to sex hormone binding globulin (SHBG) and corticoid-binding globulin (CSG). In a free form is about 10% of the total concentration in the blood serum; about 90% - are nonspecifically associated with serum albumin.
Induction with ethinylestradiol synthesis of SHBG does not affect the binding of dienogest to plasma proteins.
Metabolism. Dienogest is almost completely metabolized. The clearance from serum after taking a single dose is approximately 3.6 l / h.
Excretion. The half-life is about 8.5-10.8 hours. An insignificant quantity in unchanged form is excreted by the kidneys in the form of metabolites (the half-life is 14.4 hours), which are excreted by the kidneys and through the gastrointestinal tract in a ratio of approximately 3: 1.
Equilibrium concentration. The pharmacokinetics of dienogest are not affected by the content of SHBG in serum. As a result of the daily intake of the drug, the concentration of dienogest in the serum increases approximately 1.5-fold.
Ethinylestradiol
Absorption . After ingestion, ethinylestradiol is rapidly and completely absorbed. The maximum serum concentration in the blood serum is about 67 pg / ml, reached within 1.5-4 hours. During the absorption and first passage through the liver, ethinyl estradiol is metabolized, resulting in an average bioavailability of about 44%.
Distribution. Ethinyl estradiol is almost completely (approximately 98%), although non-specific, bound by albumin. Ethinyl estradiol induces synthesis of SHBG. The apparent volume of distribution of ethinyl estradiol is 2.8-8.6 l / kg.
Metabolism. Ethinyl estradiol undergoes presystemic conjugation, both in the mucosa of the small intestine and in the liver. The main pathway of metabolism is aromatic hydroxylation. The clearance rate from the blood plasma is 2.3-7 ml / min / kg.
Excretion. The decrease in the concentration of ethinyl estradiol in serum is biphasic; the first phase is characterized by a half-life period of about 1 h, the second - 10-20 h. Unchanged from the body is not excreted. Metabolites of ethinyl estradiol are excreted by the kidneys and through the gastrointestinal tract in a ratio of 4: 6 with T 1/2 for about 24 hours.
Equilibrium concentration. Equilibrium concentration is achieved during the second half of the course of the drug.
INDICATIONS
- contraception;
- treatment of mild to moderate acne and seborrhea in women who need contraception.
DOSING MODE
Tablets should be taken orally in the order given on the package, every day at about the same time, with a small amount of water. Take one tablet a day continuously for 21 days. Receiving tablets from the next package begins after a 7-day break in taking tablets, during which menstrual-like bleeding usually develops. Bleeding, as a rule, begins on day 2-3 after the last pill and may not end before taking pills from a new package.
Initiation of treatment with the drug Genetten
In the absence of taking any hormonal contraceptives in the previous month.
Reception of the drug Genetten begins on the first day of the menstrual cycle (ie on the first day of menstrual bleeding). It is acceptable to start taking the menstrual cycle for 2-5 days, but in this case it is recommended to use the barrier method of contraception during the first 7 days of taking the tablets from the first package.
When switching from other combined hormonal contraceptives (COC, vaginal ring, transdermal patch).
It is preferable to start taking Zhenetten the day after receiving the last hormone-containing tablet from the previous package, but in no case later than the day after the usual 7-day break (for preparations containing 21 tablets) or after taking the last inactive tablet (for drugs, containing 28 tablets in a package). When moving from the vaginal ring, the transdermal patch, it is preferable to start taking Zhenetten's drug on the day of the ring or a new patch is applied.
When switching from contraceptives containing only gestagens ("mini-pili", injectable forms, implant) or with a gestagen releasing intrauterine contraceptive.
A woman can switch from a mini-drink to a Genetten drug on any day (without interruption), from an implant or intrauterine contraceptive with gestagen - on the day of removal, from the injection form - from the day that the next injection should be made. In all cases, it is necessary to additionally use the barrier method of contraception during the first 7 days of taking the tablets.
After abortion in the first trimester of pregnancy.
A woman can start taking the drug immediately. If this condition is met, the woman does not need additional contraceptive protection.
After childbirth or abortion in the second trimester of pregnancy.
It is recommended to start taking the drug on the 21-28th day after childbirth or abortion in the second trimester of pregnancy. If the reception is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the tablets. However, if a woman already had a sex life, pregnancy should be excluded before the start of the drug, or it is necessary to wait for the first menstruation.
Acceptance of missed tablets
If the delay in taking the drug is less than 12 hours, the contraceptive protection is not reduced. A woman should take the pill as soon as possible, the next one is taken at the usual time.
If the delay in taking the tablets is more than 12 hours, the contraceptive protection can be reduced. In this case, you can follow the following two basic rules:
- taking the drug should never be interrupted for more than 7 days;
- 7 days of continuous administration of tablets are required to achieve adequate suppression of the hypothalamic-pituitary-ovarian function.
Accordingly, the following tips can be given if the delay in taking the tablets was more than 12 hours (the interval from the moment of taking the last tablet is more than 36 hours):
The first week of taking the drug
A woman should take the last missed pill as soon as possible, as soon as she remembers (even if it means taking two tablets at the same time). The next tablet is taken at the usual time. In addition, a barrier method of contraception (for example, a condom) should be used for the next 7 days. If sexual intercourse took place within a week before skipping tablets, it is necessary to consider the likelihood of pregnancy. The more pills are missed, and the closer they are to the break in taking active substances, the greater the probability of pregnancy.
The second week of taking the drug
A woman should take the last missed pill as soon as possible, as soon as she remembers (even if you need to take two tablets at the same time). The next tablet is taken at the usual time.
Provided that the woman took the pill correctly for 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as when two or more tablets are missed, barrier methods of contraception (for example, a condom) should be used additionally within 7 days.
The third week of taking the drug
The risk of a decrease in reliability is inevitable due to the upcoming interruption in the intake of tablets. A woman should strictly adhere to one of the following two options. If, during the 7 days preceding the first missed tablet, all the pills were taken correctly, there is no need to use additional contraceptive methods.
1. A woman should take the last missed pill as soon as possible, as soon as she remembers (even if it means taking two tablets at the same time). The next tablet is taken at the usual time, until the tablets from the current package run out. The next package should be started immediately. Menstrualnopodobnoe bleeding is unlikely, until the second package is finished, but there may be spotting and breakthrough uterine bleeding during the taking of tablets.
2. A woman can also interrupt the taking of tablets from the current package. Then she should take a break for 7 days, including the day of the missing tablet and then start taking a new package.
If the woman missed taking the pill, and then during a break in taking the pills she does not have menstrual bleeding, it is necessary to exclude pregnancy.
Recommendations in case of vomiting and diarrhea
If a woman has vomiting or diarrhea within 4 hours after taking the pill, absorption may be incomplete, and additional contraceptive measures should be taken. In these cases, recommendations should be followed when skipping tablets (see "Taking Missed Tablets").
Change in the day of menstrual bleeding
In order to delay the onset of menstrual bleeding, a woman should continue taking the pills from a new package of the drug Genetten immediately after taking all the pills from the previous one, without interruption in admission. Tablets from this new package can be taken for as long as the woman wishes (until the package is finished). Against the background of taking the drug from the second package, a woman may have spotting or breakthrough uterine bleeding. Renewal of the drug Genetten from the new pack follows after an ordinary 7-day break.
In order to transfer the day of the onset of menstrual bleeding to the next day of the week, the woman should shorten the nearest break in taking the pills for as many days as she wants. The shorter the interval, the higher the risk that it will not have menstrual bleeding, and thereafter, there will be spotting and breakthrough uterine bleeding during the second package (as well as in the case when it would like to delay the onset of menstrual bleeding).
Information for individual patient groups
Children and teens
The drug Zhenten is shown only after the onset of menarche.
Elderly patients
Not applicable. The drug Genetten is not indicated after the onset of menopause.
Patients with hepatic impairment
The drug Zhenten is contraindicated in women with severe liver disease until the liver function test results are normal. See also the section "Contraindications".
Patients with impaired renal function
The drug Genetten has not been specifically studied in patients with impaired renal function. The available data do not imply a change in treatment in such patients.
SIDE EFFECT
When taking Zhenetten, irregular bleeding can occur (spotting spotting or breakthrough uterine bleeding), especially during the first months of use.
Against the background of taking Zhenetten in women, there were also other undesirable effects, indicated in the table below. Within each group, isolated depending on the frequency of the undesirable effect, the undesirable effects are presented in order of decreasing severity.
In frequency, unwanted effects are divided into frequent (> 1/100 and <1/10), infrequent (> 1/1000 and <1/100) and rare (> 1/10000 and <1/1000). For additional undesirable effects, revealed only during post-marketing observations and for which it is not possible to estimate the frequency, "frequency is unknown" is indicated.
Body system Frequently (> 1/100 and <1/10) infrequently (> 1/1000 and <1/100) Rarely (> 1/10000 and <1/1000) Frequency not known
Infections and infected Vaginitis / vulvovaginitis Vaginal candidiasis or other fungal vulvovaginal infections Salpingo-oophoritis (undesitis) Urinary tract infections Cystitis Mastitis Cervicit Fungal infections Candidiasis Herpetic oral lesions Influenza Bronchitis Sinusitis Upper respiratory tract infections Viral infection
Benign, malignant and unspecified tumors (including cysts and polyps) Myoma of the uterus Lipoma of the breast
Blood and lymphatic system Anemia
Immune system Allergic reactions
Endocrine system Virulism
Metabolism Increased appetite Anorexia
Mental Disorders Decreased Mood Depression Mental Disorders Insomnia Sleep Disorders Aggression Mood Changes Decreased libido Increased libido
Nervous system Headache Vertigo Migraine Ischemic stroke Cerebrovascular disorders Dystonia
Body of sight Dry eye mucosa Irritation of the eye mucosa Oscilloscopy Visual impairments Intolerance to contact lenses (unpleasant sensations when wearing them)
Hearing organs Sudden hearing loss Tinnitus Dizziness Hearing impairment
Heart Cardiovascular disorders Tachycardia, including increased heart rate
Vessels Hypertension Hypotension Thrombosis / TELATromboflebit Diastolic hypertension Orthostatic circulatory dystonia Tides Varicose veins Vein diseases Pain along the veins
Pathology of the respiratory tract, chest and mediastinum Bronchial asthma Hyperventilation
Gastrointestinal pain Abdominal pain, including pain in the upper and lower abdomen, discomfort / bloating Nausea Vomiting Diarrhea Gastritis Enteritis Dyspepsia
Skin, subcutaneous tissue Acne Aherapy Rash including macular rash Itching, including generalized itching Allergic dermatitis Atopic dermatitis / neurodermatitis Eczema Psoriasis Hyperhidrosis Chloasma Disorders of pigmentation / hyperpigmentation Seborrhea Dandruff Hirsutism Skin diseases Skin reactions Orange peel Vascular asterisks Urticaria Nodal erythema multiforme Erythema multiforme
Musculoskeletal and connective tissue Back pain Discomfort in the muscles and skeleton Myalgia Pain in the extremities
Reproductive system and mammary glands Pain in the mammary glands, discomfort, breast engorgement Change in the duration and volume of menstrual bleeding, including menorrhagia, hypomenorrhea, oligomenorrhoea and amenorrhea Acyclic bleeding, incl. bleeding from the vagina and metrorrhagia Increasing the size of the mammary glands, swelling and bursting of the mammary glands Mammary edema Dysmenorrhea Discharge from the genital tract / discharge from the vagina Ovarian cysts Pelvic pain Dysplasia of the cervical epithelium Cysts of the uterine appendages Pain in the appendages of the uterus Cysts of the breast Fibrozno Cystic mastopathy Dyspareunia Galactorrhea Discharge from the mammary glands
General symptoms Fatigue, asthenia, poor health Chest pain Peripheral swelling Flu-like effects Inflammation Elevated temperature Irritability Liquid retention
Results of examinations Changes in body weight (increase, decrease and body weight fluctuations) Increase in triglycerides in blood Hypercholesterolemia
Congenital, family and genetic disorders Detection of additional mammary gland / polymastia
CONTRAINDICATIONS
The drug Genetten should not be used in the presence of any of the conditions / diseases listed below. If any of these conditions develop for the first time against the background of its administration, the drug should be immediately withdrawn.
- Thrombosis (venous and arterial) and thromboembolism now or in history (including deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI), stroke;
- conditions preceding thrombosis (including, transient ischemic attacks, angina pectoris) at present or in the anamnesis;
- Migraine with focal neurological symptoms in the present or in history;
- diabetes mellitus with vascular complications;
- multiple or severe venous or arterial thrombosis risk factors, including complicated lesions valvular atrial fibrillation, cerebrovascular disease, or coronary artery; uncontrolled hypertension, major surgery with prolonged immobilization, smoking at the age of 35 years;
- hepatic failure, and severe liver disease (before normalization of liver function);
- liver tumors (benign or malignant) now or in the anamnesis;
- pancreatitis with severe hypertriglyceridemia at present or in history;
- hormone-dependent malignancies identified (including the genitalia or mammary glands) or suspicion on them;
bleeding from the vagina of unknown origin;
- pregnancy or suspected it;
- the period of breastfeeding;
- hypersensitivity to any component of the drug Genette;
- Genette drug contains lactose, therefore patients with rare hereditary lactose intolerance, lactase deficiency or malabsorption of glucose-galactose should not take it.
Be wary: should carefully weigh the potential risks and expected benefits of the drug application Genette in each individual case in the presence of the following diseases / conditions and risk factors:
- risk factors for thrombosis and thromboembolism: smoking (under the age of 35 years); obesity; dislipoproteinemia controlled hypertension; migraine without focal neurological symptoms; uncomplicated valvular disease; genetic predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age, someone from the next of kin);
- other diseases in which the may occur peripheral circulation disorders: diabetes; systemic lupus erythematosus; hemolytic-uremic syndrome; Crohn's disease and ulcerative colitis; sickle cell anemia; phlebitis of superficial veins;
- hereditary angioedema;
- hypertriglyceridemia;
- diseases caused or aggravated by the first time during pregnancy, or on the background of the previous use of sex hormones (eg, jaundice, cholestasis, gallbladder disease, otosclerosis with hearing impairment, porphyria, herpes gestationis, Sydenham's chorea);
- postpartum period.
PREGNANCY AND LACTATION
Genette drug is not appointed during pregnancy and lactation.
If pregnancy is detected during the reception of Genette drug, it should be immediately abolished. However, extensive epidemiological studies have revealed no increased risk of defects in children born to women treated with hormones before pregnancy, or teratogenic effects when sex hormones were taken inadvertently in early pregnancy. COCs can reduce the amount of breast milk and change its composition, so their use is contraindicated in lactation. A small amount of hormones and / or their metabolites may be derived from milk, but there is no confirmation of their negative impact on infant health.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated:
- hepatic failure, and severe liver disease (before normalization of liver function);
- liver tumors (benign or malignant) currently or history.
In rare cases on the background of COCs observed development of liver tumors, which in some cases lead to life-threatening internal bleeding intraperitoneal. In case of severe pain in the abdomen, liver enlargement or signs of intra-abdominal bleeding it should be considered in the differential diagnosis.
APPLICATION FOR CHILDREN
Preparation Genette В® shown only after menarche.
SPECIAL INSTRUCTIONS
If any of the conditions, diseases, and the risk factors listed below are currently available, you should carefully weigh the potential risks and expected benefits of the use of Genette drug in each individual case and discuss it with the woman before she decides to start taking the drug . In the event of aggravation, the gain or the first manifestation of any of these conditions, diseases or risk factors, the woman should consult with your doctor, who can decide whether to cancel the drug.
Diseases of the cardiovascular system
Epidemiological studies indicate a relationship between the use of COCs and increased incidence of venous and arterial thrombosis and thromboembolism (such as deep venous thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders). These diseases are rare.
The risk of venous thromboembolism (VTE) is maximal for the first year of exposure of such preparations, preferably within the first 3 months. The increased risk is observed after the initial use of COCs or resumption of use of the same or a different COC (after an interval between doses of the drug in 4 weeks or more).
The overall risk of venous thromboembolism (VTE) in patients receiving low-dose COC (<50 micrograms ethinyl estradiol) are two to three times higher than in non-pregnant patients who are not taking COCs, nevertheless, this risk is lower than the risk of VTE during pregnancy and childbirth.
VTE may be fatal (in 1-2% of cases).
Venous thromboembolism (VTE), manifesting as deep venous thrombosis or pulmonary embolism may occur when using any COCs.
It rarely occurs when using COCs thrombosis other blood vessels, for example, hepatic, mesenteric, renal, and cerebral arteries veins or the retinal vessels. Consensus about the connection between the occurrence of these events and the use of COCs is absent.
Arterial thrombosis may clinically manifest stroke, vascular occlusion or myocardial infarction.
Arterial thromboembolism can be fatal.
The risk of thrombosis (venous and / or arterial) and thromboembolism is increased:
- age;
- smokers (with an increase in the number of cigarettes and increasing age the risk increases, especially in women over 35 years old);
in the presence of:
- obesity (BMI over 30 kg / m2);
- family history (eg venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of hereditary or acquired predisposition, the woman should be assessed by appropriate specialist to address the issue of the possibility of receiving the drug Genette;
- prolonged immobilization, major surgery, any surgery to the legs, or major trauma. In these situations, it is desirable to terminate the application Genette drug (in the case of planned operation, at least 4 weeks prior to it) and not to resume its reception within 2 weeks after immobilization;
- dislipoproteinemia;
- hypertension;
- migraine;
- diseases of the heart valves;
- atrial fibrillation.
The possible role of varicose veins and superficial thrombophlebitis in the development of VTE remains controversial.
It should take into account the increased risk of thromboembolism during the postpartum period.
Peripheral circulatory disorders as may occur in diabetes mellitus, systemic lupus erythematosus, hemolytic-uremic syndrome, chronic inflammatory bowel diseases (Crohn's disease or ulcerative colitis) and sickle cell anemia.
The increase in frequency and severity of migraine during use Genette drug (which may be preceded by cerebrovascular disorders) can be grounds for immediate discontinuation of the drug.
By biochemical parameters indicating the inherited or acquired predisposition to venous or arterial thrombosis include: rezitentnost to activated protein C, hyperhomocysteinemia, lack of antithrombin-III, lack protein C deficiency S, antiphospholipid antibody protein (antibodies to cardiolipin, lupus anticoagulant).
In assessing the risk-benefit ratio, it should be noted that the treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be borne in mind that the risk of thrombosis and thromboembolism in pregnancy is higher than when taking low-dose oral contraceptives (<0.05 mg ethinylestradiol).
Tumors
The most significant risk factor for cervical cancer is persistent papilloma virus infection. There are reports of some increase in the risk of cervical cancer in long-term use of COCs. However, the relationship with the COC has not been proved. The possibility of the relationship of these data with the screening of cervical disease and with features of sexual behavior (less frequent use of barrier methods of contraception).
A meta-analysis of 54 epidemiological studies showed that there is a slightly increased relative risk of breast cancer diagnosed in women who used COCs (relative risk 1.24). The increased risk disappears gradually within 10 years after discontinuation of these drugs. Due to the fact that breast cancer is rare in women under 40 years, an increase in the number of diagnosed breast cancer in women taking COCs are currently taking or have recently, it is insignificant in relation to the total risk of the disease. His connection with the COC has not been proved. The observed increase in risk may be due to an earlier diagnosis of breast cancer in women using COCs cancer. Women who had ever used COCs identified earlier stages of breast cancer than women,never let them apply.
In rare cases on the background of COCs observed development of liver tumors, which in some cases lead to life-threatening internal bleeding intraperitoneal. In case of severe pain in the abdomen, liver enlargement or signs of intra-abdominal bleeding it should be considered in the differential diagnosis.
other conditions
Women with hypertriglyceridemia (or the presence of this condition have a family history) may increase the risk of developing pancreatitis while taking COCs. Although a slight increase in blood pressure (BP) have been reported in many women taking COCs, clinically relevant increases were rare. However, if during the reception Genette drug develops persistent, clinically significant increase in blood pressure, should be discontinued the drug and begin the treatment of hypertension. The drug can be extended when using antihypertensive therapy achieved normal values ​​AD
The following states have been reported to develop or worsen both during pregnancy and while taking COCs, but their association with COC use is not proven: jaundice and / or pruritus related to cholestasis; the formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes gestationis; hearing loss associated with otosclerosis. cases of Crohn's disease and ulcerative colitis against application COCs also described.
In women with hereditary forms of angioedema exogenous estrogens may induce or worsen symptoms of angioedema. Acute or chronic disturbances of liver function may require discontinuation Genette as long as liver function tests have not returned to normal. Recurrent cholestatic jaundice which occurred first during pregnancy or previous use of sex hormones, requires discontinuation of the drug Genette.
Although COCs may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetics who use drug Genette. However, women with diabetes should be carefully monitored while taking this drug. Sometimes it can develop chloasma, especially in women with a history of chloasma during pregnancy. Women with a tendency to chloasma during treatment ZhenettenВ® should avoid prolonged exposure to sunlight and ultraviolet radiation.
Preclinical safety data
Preclinical data obtained in the course of toxicity studies with repeated doses of the drug taking, as well as genotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate a particular risk to humans. Nevertheless, we should remember that sex hormones may promote the growth of certain hormone-dependent tissues and tumors.
Laboratory tests
Admission Genette can influence the results of certain lab tests, including liver function tests, kidney, thyroid, adrenal glands, the contents of transport proteins in the plasma, carbohydrate metabolism parameters of blood coagulation and fibrinolysis. Changes do not usually go beyond the normal range.
decline in efficiency
Efficacy Genette drug may be reduced in the following cases: when skipping tablets, vomiting and diarrhea, or resulting from drug interactions. The frequency and severity of bleeding menstrualnopodobnoe Genette While taking the drug can be marked irregular bleeding (spotting or breakthrough uterine bleeding), especially during the first few months of use. Therefore, evaluation of any irregular bleeding should be performed only after a period of adaptation of approximately 3 cycles.
If irregular bleeding recur or develop after previous regular cycles, you should conduct a thorough examination to exclude malignancy or pregnancy.
Some women during the tablet-free interval may not develop menstrualnopodobnoe bleeding. If the drug Genette taken according to the directions, it is unlikely that the woman is pregnant. However, if before the drug was taken Genette irregular or if no two consecutive withdrawal bleeding to continue taking the drug should be excluded pregnancy.
medical examinations
Before the start of the drug Genette should be familiar with the history of life, a family history of a woman, a thorough general medical (including blood pressure measurement, heart rate, body mass index) and gynecological examination, including the study of mammary glands and cytological examination of scrapings from the cervix (the test for Papanicolaou) to exclude pregnancy. When resuming the drug Genette amount of additional research and frequency of inspection tests determined individually. Typically, control examinations should be carried out at least 1 time in 6 months.
It should warn the woman that Genette drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases through!
Impact on the ability to drive vehicles and manage mechanisms
Not found.
OVERDOSE
Serious violations of overdose have been reported. Symptoms that can be marked with an overdose: nausea, vomiting, spotting or metrorrhagia.
No specific antidote, symptomatic treatment should be conducted.
DRUG INTERACTION
Genette drug interaction with other drugs
