Before the beginning of the course of taking the drug and, subsequently, every 6 months, a general medical and gynecological examination is recommended to exclude diseases that are contraindicated to the use of oral contraceptives, as well as pregnancy, including a cytological analysis of the vaginal smear, assessment of the condition of the mammary glands, determination of blood glucose , cholesterol, control of liver function indicators, blood pressure, urinalysis.
The use of any combination oral contraceptive increases the risk of venous thromboembolic disease. The risk of these diseases reaches a maximum in the first year of taking medications.
The appointment of Rigevidone® 21 + 7 to women with thromboembolic disease at a young age and increased blood coagulability in a family history is not recommended.
The use of oral contraception is allowed no earlier than 6 months after the transferred viral hepatitis in the normalization of liver function.
After long-term use hormonal contraceptives, in rare cases, benign, in very rare cases, a malignant liver tumor, which in some cases can lead to life-threatening bleeding in the abdominal cavity. When there are sharp pains in the upper abdominal areas, hepatomegaly and signs of intra-abdominal bleeding, there may be a suspicion of a liver tumor. If necessary, the drug should be discontinued.
If there is a violation of the liver, it is necessary to undergo medical supervision every 2-3 months.
If the liver function indicators worsen during the reception of Rigevidone® 21 +7 a consultation of the therapist is necessary.
When mild acyclic (intermenstrual) bleeding occurs, the drug should be taken, as in most cases these bleedings spontaneously cease.If acyclic (intermenstrual) bleeding does not disappear or recur, a medical examination should be performed to exclude the organic pathology of the reproductive system.
In the case of vomiting or diarrhea, taking the drug should be continued, additionally applying another, non-hormonal method of contraception.
Smokers who take hormonal contraceptives have an increased risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk increases with age and depending on the number of cigarettes smoked (especially in women older than 35 years).
A large number of epidemiological studies have investigated the incidence of ovarian, endometrial, cervical and breast cancer in women taking combined oral contraceptives. Studies have shown that these drugs protect women from ovarian and endometrial cancer.
Some studies have found an increase in the incidence of cervical cancer among women who have been taking combined oral contraceptives for a long time, but the results are mixed.In the formation of cervical cancer, there is sexual behavior, the presence of human papilloma virus and other factors, so the relationship between cervical cancer and the use of combined oral contraceptives is not proven.
The relative risk of developing breast cancer is slightly higher among women taking combined oral contraceptives. In the next 10 years after discontinuation of combined oral contraceptives, the risk level is gradually reduced. Since breast cancer is rare in women younger than 40, the increase in the number of diagnosed cases of breast cancer in women currently taking or taking previously combined oral contraceptives is low compared to the risk of breast cancer throughout life.
In the absence of bleeding cancellation, pregnancy should be excluded.
After discontinuation of the drug fertility is restored quickly enough, during 1-3 menstrual cycles.
The drug should be discontinued immediately in the following cases:
- when a migraine headache occurs for the first time or if it is worse (if it was not previously), or if there is an unusually severe headache;
- when there are early signs of phlebitis or phlebothrombosis (unusual pain or bloating of the veins on the legs);
- if there is jaundice or hepatitis without jaundice;
- with acute deterioration of visual acuity;
- with cerebrovascular disorders;
- with the appearance of stitching pains of unclear etiology during breathing or coughing, pain and tightness in the chest, with a sharp increase in blood pressure;
- at suspicion of a thrombosis or a heart attack;
- when generalized itching occurs;
- with increased epileptic seizures;
- for 3 months. before the planned pregnancy;
- before the planned operation (for 6 weeks before the operation);
- during prolonged immobilization (for example, after injuries);
- in the presence of pregnancy.