Logest - side effects. Logest contraceptive pills, use, side effects, contraindications Why does Logest have different instructions

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

This is a modern contraceptive drug, belonging to the third generation of combined oral contraceptives. Although Logest fully meets international standards and the requirements of the most ardent advocates of a healthy lifestyle, this drug has side effects. They do not always appear and not in all patients.

The use of the drug may cause disturbances in the functioning of the gastrointestinal tract. This may be yellowing of the mucous membranes and skin, the urge to vomit, pain in the epigastric area, adenoma in the liver area. There may also be disturbances in the functioning of some endocrine glands, which are expressed in weight gain, impaired sexual desire, painful phenomena in the mammary glands, and metrorrhagia. The use of Logest may also affect work nervous system. Perhaps the appearance of migraine-like pain and emotional instability.

Possible appearance side effects from the cardiovascular system: thromboembolism or thrombophlebitis. The organs of vision and hearing may also be affected. In some cases, the use of this drug causes allergic reactions, which may include urticaria, swelling and redness of the eyelids.

Some women complain of irritation of the mucous membrane caused by wearing contact lenses, which was not previously noticed. There may be itching in different parts of the body. With prolonged use of Logest, pigment spots may appear. The water-electrolyte balance may be disrupted, but only with long-term use.

Before use, you should consult a specialist.

Reviews

While taking Logest, I started having nosebleeds. And they were hard to stop. I went to the hospital. I stopped taking it and everything went away. You have to be very careful with COCs

A friend of mine died from long-term use of Logest in April. It provoked immunodeficiency, against the background of which central nervous system disorders began, disruption of the bacterial flora, which led to the development of inflammatory processes in organs and thromboembolism incompatible with life. COC is a gross interference in nature, sooner or later you can pay for it with your health and even life.

I’m 35. I’ve never taken OK. I prescribed Logest for myself. I drank for 8 days, my chest hurt, my mood disappeared. Apathy. I haven’t taken it for the second day and a blood stain has appeared... are these monsters or what, I don’t know (((

I was prescribed Logest, because I had a folecular cyst on the ovaries, and from the very first day there were side effects. It made me sleepy. Then I really wanted to eat, then I developed an aversion to food, and so the whole day I had mood changes, etc. The doctor advised me to switch from a morning appointment to an evening one. That’s all. what happened on the first day disappeared, but other side effects appeared: nausea, dizziness, constant headaches. Either I got a fake or I don’t know what it is. I used to take hormonal drugs and there were no side effects. I just lost 10-15 kg and that’s it, but It’s just some kind of nightmare here. I don’t know what to do. After all, you can’t quit drinking halfway, but being in this state is also not an option.

What kind of horror everyone writes here. I don’t know what kind of doctor prescribed Logest for you and whether it’s right for you, since everyone’s body reacts this way. I have been drinking for 2 years, except that my periods have become painless, no changes have occurred. No side effects

I took Logest for 6 months, I recovered instantly, and the worst thing is that I can’t lose extra pounds, I didn’t have such problems before. And I don’t want anything at all in my personal life (libido is completely absent).

Taking COCs always has a number of side effects that may occur, but when there is a need to normalize hormonal levels after an abortion, for example, there are no other options. You just need to monitor your health, it happens that this or that drug is not suitable, you need to change it.

Hello girls, I’ve been taking Logest for 7 years and I’m very happy with it, my nails and hair grew well and I kept my weight off, I didn’t gain weight, although they say that Logest makes you gain weight. Everything was wonderful, but 2.5 years ago I stopped drinking, gave birth to a baby, and now I have resumed taking Logest again and I feel somehow wrong, I think. Diarrhea, bled several times after PA. I probably changed after the third birth, or Logest became different.

In February I bought Logest because I was afraid of getting pregnant, then I went to another city for a couple of days and forgot to take them, after 2 days my period started, although I had been pregnant for a week
I stopped taking them, but recently I started taking them again.
Constant bloating, bile disorder, emotional stress, weight gain, the only plus is breast enlargement
I’ll drink for another 3 days and stop, because by then my period will start

They prescribed Logest after VB for a course of 3 months, but it didn’t start right away, I missed 2 cycles, despite the fact that my periods came normally without any pain and lasted 3 days, although before the operation I was bent for 5 days. So, on the 1st day of my period, I dared to take the OK dose, I drank the first one as expected and let’s go.... as a result, my period is already on the seventh day!!! and as I read in the reviews, it is absolutely forbidden to stop in the middle of the cycle. this shit won't end so easily. I'm shocked. I don’t know how to finish this pack and not any more of this crap!!!

I took Logest for 3 years from the age of 20, never observed any side effects, in the first year I lost 7 kilograms, which I was very happy about. Then I stopped drinking because there was no need. In 3 years I gained back my 7kg. 10 days ago I started taking Logest again, my breasts are swollen, it hurts, my weight is still stable, my appetite is normal, I want to eat. Over time, everything changes in the body, now I’m 27 and I don’t know how it will “behave.” I’ll take the course for 3 months, and then I’ll draw conclusions.

I've been taking Logest for two weeks. I'm thinking of quitting. Because I became terribly irritable, my appetite was like that of a bear, even during sexual intercourse today everything hurt and after it I began to bleed.

I have been taking Logest for the third day, as prescribed by the doctor (without any tests, they prescribed several drugs to choose from, I chose it because I had not taken it before and had nothing to compare it with). On the second day, swelling of the eyelids appeared, and on the third, redness appeared. Should I continue to take it or is this already a sign that it is not suitable for me? On the third day there was diarrhea.

I was prescribed to take Logest only for 3 months, preparing for pregnancy according to indications. Before that, I took Regulon, which caused bleeding. And with Logest everything is fine.

Was prescribed this year in 2001 due to the unrealistic NMC (in the regime of 45 days “go” - a break for a week - and another 27 days “go”))), they did not warn about the need for breaks in taking the OK. I took it for 10(!) years - yeah, I wouldn’t call myself smart either: (There weren’t any of the side effects: my weight was off, as always, my hair was growing, my skin was like skin, my nerves were like nerves, my appetite was in place.. I stopped taking it, when the body itself made it clear that it was too much: the gastrointestinal tract malfunctioned, problems with stool began (not diarrhea or constipation, problems in the direction of symptoms of hemorrhoids) - not a week on kefir, not oatmeal, sir - nothing shifted the problem except complete failure. from Logest there was no other method of birth control, but there was no pregnancy for a year - the 10th anniversary effect, apparently. And in May 2012 there was an unsuccessful pregnancy - anembryony, when the testicle is empty, without an embryo..
Think 300 times before drinking this -
the illusion of comfort provided by OK is not worth the weakly reversible consequences that you voluntarily instill in your body. Youth may not particularly want children - but life is longer than youth!

I’ve been taking Logest for 1 month (I drank 1 pack for 3 weeks). After the second week of taking it, my period started, and it’s already been going on for 1.5 weeks, very strongly. severe pain, I’m just dying, I’ve never had this before, I’ve gained weight. The doctor prescribed Logest to me to restore my cycle. I don’t know what to do next, take pills or not?

I took Logest for almost 2 years, it was prescribed because of some disease, and I liked it and didn’t stop drinking. At first, yes, the breasts increased, and the whole body weight, but over time this passed and after 2-3 months the previous figure returned. the chest and hips were gone to a lesser extent, but everything else seemed to have never happened. I don’t know about the other side effects, I want to get examined all the time, but there’s still no way. in two years there were many diseases, incl. problems with thyroid gland, but doctors say that logest has nothing to do with it. so I'm going to continue drinking it.

After the abortion, the doctor prescribed me to take Logest. I drank it for the first month, at first I didn’t notice anything, now I’m drinking it for the second month. A week after my period, heavy bleeding began, a pack of pads a day goes away. I have no appetite, my mood is always below average, I have become irritable, I can get angry out of nowhere, I take it out on my husband all the time. I lost almost ten kg - now my weight is 43 kg. I thought it was because of nerves, but there is no reason to be nervous. I stop drinking it. P.s. The doctor says that everything is fine. Yes, our doctor performed the abortion in such a way that a month later the miscarriage happened...

The doctor prescribed Logest for me after surgery (apoplexy), I took the first pill at 21:30, half an hour later I went to bed, woke up in the middle of the night, dizzy, nauseous, cold sweat, losing consciousness - the state was like before the operation. I vomited, the pill came out, I think, with bile, and everything went away as if by hand, and I immediately began to feel great. Now I don’t know how to drink the second one, it’s really scary

Hi all! Advise what you would do in my place: Over the winter I gained 10 kg, there were no problems with excess weight, I always lost weight easily and by summer I was in shape. I took Logest for 1 month and quit. It's time to get your figure back to normal, but the weight won't budge! Previously, it was enough not to eat after 18.00, but now even exercising 3 times a week doesn’t help!!! I have been actively fighting for 3 months now and not a kilo has gone away! I would be glad, but now I need to lose weight! ((((I’m thinking maybe I should drink Logest for a month along with the diet???

SCHERING-PLOUGH Delpharm Lille S.A.S. Delpharm Lille S.a.S./Schering S.a.S. Schering S.A. (a subsidiary of Schering AG)

Country of origin

France

Product group

Hormonal drugs

Contraceptive (estrogen + progestogen)

Release forms

• 21 - blisters (1) - cardboard packs.

Description of the dosage form

• Dragee

pharmachologic effect

Logest is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug. The contraceptive effect of Logest is carried out through three complementary mechanisms: * suppression of ovulation at the level of hypothalamic-pituitary regulation; * changes in the properties of cervical secretion, as a result of which it becomes impermeable to sperm; * changes in the endometrium, which makes implantation of a fertilized egg impossible. In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstruation is less frequent, and the intensity of bleeding decreases, resulting in a reduced risk of iron deficiency anemia.

Pharmacokinetics

Gestodene Absorption. After oral administration, gestodene is rapidly and completely absorbed, its maximum serum concentration of 3.5 ng/ml is reached after approximately 1 hour. Bioavailability is approximately 99%. Distribution. Gestodene binds to serum albumin and does not bind to sex hormone binding globulin (SHBG). Only about 1.3% of the total concentration in the blood serum is found in free form; about 69% are specifically associated with SHBG. The induction of SHBG synthesis by ethinyl estradiol affects the binding of gestodene to serum protein. Metabolism. Gestodene is almost completely metabolized. Serum clearance is approximately 0.8 ml/min/kg. Excretion. The content of gestodene in the serum undergoes a two-phase decrease. The half-life in the terminal phase is about 12 hours. In unchanged form, gestodene is not excreted, but only in the form of metabolites (T1/2 - approximately 24 hours), which are excreted in urine and bile in a ratio of approximately 6:4. Equilibrium concentration. The pharmacokinetics of gestodene is influenced by the level of SHBG in the blood serum. As a result of daily dosing of the drug, serum levels of the substance increase approximately 4-fold during the second half of the treatment cycle. Ethinyl estradiol Absorption. After oral administration, ethinyl estradiol is rapidly and completely absorbed. The maximum serum concentration of approximately 65 pg/ml is achieved in 1.7 hours. During absorption and first passage through the liver, ethinyl estradiol is metabolized, resulting in its oral bioavailability averaging about 45%. Distribution. Ethinyl estradiol is almost completely (approximately 98%), although nonspecifically, bound by albumin. Ethinyl estradiol induces the 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 route of metabolism is aromatic hydroxylation. The clearance rate from blood plasma is 2.3 - 7 ml/min/kg. Excretion. The decrease in the concentration of ethinyl estradiol in the blood serum is biphasic; the first phase is characterized by a half-life of about 1 hour, the second - 10-20 hours. It is not excreted from the body unchanged. Metabolites of ethinyl estradiol are excreted in urine and bile in a ratio of 4: 6 with a half-life of about 24 hours. Equilibrium concentration. Steady-state concentration is achieved in approximately one week

Compound

• 0.02 mg ethinyl estradiol and 0.075 mg gestodene. excipients: lactose monohydrate, corn starch, talc, magnesium stearate, sucrose, polyvidone 25000, macrogol 6000, calcium carbonate, carnauba wax. ethinyl estradiol 20 mcg gestodene 75 mcg Excipients: lactose monohydrate, corn starch, polyvidone 25,000, magnesium stearate, sucrose, polyvidone 700,000, macrogol 6000, calcium carbonate, talc, montaglycol wax.

Logest indications for use

• Contraception.

Logest contraindications

• - presence of thrombosis (venous and arterial) currently or in history (for example, deep vein thrombosis lower limbs, thromboembolism of the branches of the pulmonary artery, myocardial infarction, cerebrovascular disorders); - the presence or history of conditions preceding thrombosis (for example, transient ischemic attacks, angina pectoris); - diabetes with vascular complications; - the presence of severe or multiple risk factors for venous or arterial thrombosis; - current or history of jaundice or severe forms of liver disease (until liver tests return to normal); - presence or history of liver tumors (benign or malignant); - migraine with focal neurological symptoms (including a history); - pancreatitis with severe hypertriglyceridemia (including a history); - identified hormone-dependent malignant diseases of the genital organs or mammary glands

Logest side effects

• From the outside digestive system: sometimes - nausea, vomiting. From the reproductive system: sometimes - intermenstrual bleeding (during the first few months of use), changes in vaginal secretion. From the endocrine system: sometimes - a feeling of tension and enlargement of the mammary glands, changes in body weight, changes in libido. From the side of the central nervous system: sometimes - decreased mood, headaches, migraines. Other: poor tolerance to contact lenses, fluid retention in the body, allergic reactions are possible.

Drug interactions

Sulfonamides and pyrazolone derivatives can enhance the metabolism of the steroid hormones included in the drug. Long-term treatment with drugs that induce liver enzymes, which increases the clearance of sex hormones, may lead to breakthrough bleeding and/or a decrease in the contraceptive effectiveness of Logest. Such drugs include: phenytoin, barbiturates, primidone, carbamazepine and rifampicin; There are also suggestions for oxcarbazepine, topiramate, felbamate, ritonavir and griseofulvin and products containing St. John's wort. Contraceptive protection is reduced when taking antibiotics (such as ampicillins and tetracyclines), since, according to some data, some antibiotics may reduce the intrahepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol.

Overdose

Symptoms that may occur in case of overdose: nausea, vomiting, spotting or metrorrhagia

Storage conditions

• keep away from children

Information provided by the State Register of Medicines.

Synonyms

• Lindinet 20, Lindinet 30, Logest, Milvane, Minulet, Mirelle

Content

Among the low-dose oral contraceptives, Logest can be distinguished, the instructions for use of which explain in detail the indications and dosage regimen. different cases. This German drug has several analogues, but many Russian women prefer the original. Positioned as a hormonal contraceptive with minimal side effects.

Manufacturer: Logest

This monophasic combined oral contraceptive was developed by Bayer Pharma. It is this German pharmaceutical giant that owns the registration number of the drug. Today, Logest tablets are produced in Germany and France. Accordingly, these are the companies Schering and Delpharm Lille. The composition of the drugs fully corresponds to that specified in the registration certificate. The price is also approximately the same. On Russian market You can purchase “Logest” of both French and German production. All information useful for the patient and doctor is contained in the instructions for use.

Composition "Logest"

The drug belongs to hormonal contraceptives that protect women from unplanned pregnancy. The photo “Logest” is presented at the beginning of the article. The manufacturer positions Logest as the safest in the group of monophasic COCs due to its ultra-low content of the hormonal component.

Composition of Logest hormones and additional components of the tablet:

• ethinyl estradiol;
• gestodene;
• polyvidone;
• corn starch;
• sucrose;
• talc, etc.

The first two components of the composition, which are indicated in the instructions for use, are the main active ingredients. These are synthetically created hormones, analogues of those produced by a woman’s endocrine glands. Their content in one tablet is 20 mcg and 75 mcg, respectively.

Important! It is due to the small dose of ethinyl estradiol that the tablets are considered safe and in some countries are sold without a doctor's prescription.

One package contains 21 tablets - this number of tablets is designed for 1 course of use, if you use the tablets as indicated in the instructions for use.

Indications for use

The main indication indicated in the instructions for use is oral contraception. It is this drug, as the safest, that is prescribed to patients who are protecting themselves from pregnancy for the first time using COCs. The mechanism of action of the tablets is similar to other standard drugs. Due to regular microdoses of hormones, the process of maturation and release of the egg into the uterine cavity is inhibited. Additionally, the abundant secretion of thick cervical fluid is stimulated, which is an additional barrier to sperm. According to the instructions, it blocks their penetration into the uterus.

In addition to contraception, Logest is prescribed according to the instructions for:

• irregular periods;
• endometriosis;
• heavy bleeding during menstruation;
• pronounced PMS with deterioration in general well-being.

The drug can be prescribed to women who have a systematic sex life. To prevent cancer during menopause, Logest is prescribed after 50 years. These are the recommendations that are mentioned in the instructions for use.

"Logest" for endometriosis

The drug is indeed prescribed for the growth of the inner layer of the uterus in women, although the instructions for use do not indicate information about the treatment of the problem. Everything has to do with a good balance of hormones in the composition. Doctors have information that endometriosis is a hormone-dependent condition, which often provokes an imbalance of a woman’s own sex hormones.

To normalize hormonal status and reduce the risk of developing a tumor in the uterus, the drug Logest is prescribed.

Important! According to the instructions, fibroids, which often grow with endometriosis, are not a contraindication for its use.

You need to take tablets to treat the disease according to the usual regimen, which is explained in detail in the instructions for use.

Contraindications

Any hormonal drug, even the safest one from a medical point of view, has a lot of contraindications. Especially if its use is intended for long time. Instructions for use indicate the following contraindications for Logest:

• varicose veins, thrombosis, thromboembolism, any suspicion of these diseases;
• history or existing cardiovascular disease ( ischemic disease heart disease, angina pectoris, etc.);
• migraine, frequent intense headaches;
• diabetes;
• liver diseases, benign or malignant tumors of the organ;
• diseases of the pancreas, including pancreatitis;
• malignant tumors of internal organs;
• pregnancy and lactation;
• individual intolerance to the components of the composition.

Contraceptive pills "Logest" should not be taken in case of unexplained bleeding from the genital organs, as well as in case of kidney disease. The instructions for use recommend that before starting to take COCs, you should be examined by a gynecologist, endocrinologist and therapist, and take the necessary tests to minimize the risk of side effects.

How to take Logest

Typically, gynecologists prescribe a regimen of taking 1 tablet per day for 21 days. Next, a break is taken for exactly 1 week, during which menstrual-like bleeding is observed. The next pack should be started immediately after the end of the 7-day break, regardless of whether there is bleeding or not. The instructions for use contain such clear information.

How to take Logest for the first time

In order for the effect of using the pills to be maximum, complications to be minimal and the use of other contraceptives to be inappropriate, the first pill is drunk on the first day of the cycle - that is, on the first day of menstruation. Next, the remaining 20 tablets are taken once a day at the same time. This recommendation in the instructions for use is mandatory. If after consuming the pills there is discomfort in the stomach or attacks of nausea, taking the pills is postponed until the evening, closer to bedtime.

The complete instructions for use of Logest indicate the following features of administration in different situations.

1. If you need to switch from one COC to Logest, the first pill of the drug is drunk the next day after taking the tablet of the previous COC. That is, there should be no break. So, according to the instructions, the maximum protective effect is achieved.
2. When switching from mini-pills, implants or injectable contraceptives containing only gestagen, Logest is taken on the day when their effect ends. That is, after the mini-pill - the next day, after the injections - on the day when the next injection was supposed to be given.
3. In case of an interrupted pregnancy in the first trimester, the pills are taken immediately. If the pregnancy is terminated in the second trimester, the pills are taken after 21 or 28 days. In these cases, the first 7 days of admission require additional contraception using barrier agents.

In all cases, Logest is taken according to the same scheme: 21 days - 1 tablet, the next 7 days - a break. This is the main recommendation from the instructions for use.

When you can not use protection with Logest

If the first pill from the package is drunk on the first day of the menstrual cycle, as indicated in the instructions for use, then there is no need for additional contraceptive measures. By the end of her period, a woman will be protected from unwanted pregnancy. If the pill is taken between days 2 and 5 of the cycle, you will have to take additional protection for the next 7 days.

What to do if you missed 1 tablet of Logest

If the patient has missed 1 tablet of Logest, the contraceptive effect of the previous pill lasts 12 hours. If the interval without a pill is less than 12 hours, take the pills as soon as possible. If the interval is more than 12 hours, take the pill at the usual time, but in the next 7 days use an additional means of contraception. Next, the pills are taken according to the schedule, and the next package is started not after 7 days, but after 6. This is what the instructions for use of the medicine recommend.

What are the dangers of long-term use of Logest?

Combined oral contraceptives today are a fairly safe means of protection against pregnancy and more. Many studies have been conducted to study their effects on the woman’s body. No serious evidence of their negative effects has been published, although an increased risk of developing ovarian and breast cancer is present.

Contraceptives "Logest" and its analogues do not significantly harm health when used for a long time if they were prescribed by a doctor after a thorough examination. If the patient is healthy and in reproductive age, all ovarian functions are restored by the next cycle and there are no problems with conception.

Cancellation of "Logest"

The female body adapts to COCs for about 3 months. Adaptation occurs similarly after the end of use. The endocrine glands will have to work more intensively to regulate the balance of hormones. As a rule, after the withdrawal of Logest, the body’s reaction is hardly noticeable. A one-time disruption of the menstrual cycle, increased bleeding, and severe PMS are possible.

Important! If the doctor prescribed COCs for the purpose of treating diseases, for example, fibroids or endometriosis, then the situation may worsen.

If a woman stops taking pills in order to become pregnant, doctors recommend giving the body 1-2 months to fully recover. This information is also contained in the instructions for use.

Side effects of Logest

Not all women take hormonal medications painlessly. Here is the list side effects"Logesta", which are indicated in the instructions for use:

• headache;
• nausea, epigastric pain;
• tension in the mammary glands;
• swelling;
• decreased libido;
• allergy;
• mood swings;
• weight gain;
• bleeding in the middle of the cycle.

A woman may also notice more intense vaginal discharge in the first months of using the pill.

Consequences of refusing Logest for long-term use

Doctors say that long-term use of COCs does not have a negative impact on women's health. On the contrary, if a woman starts taking COCs after 40, she additionally protects herself from the likelihood of developing malignant tumors of the pelvic organs.

If a young girl has been taking COCs for a long time, the consequences of such use can be expressed in an unstable menstrual cycle in the first 2-3 months after discontinuation. This is due to the fact that the ovaries “forgot” how to work in full force, and increase the rate of production of sex hormones. If a woman has gynecological diseases, ultrasound monitoring should be done every 3-6 months.

Drug interactions

The following drugs affect the effectiveness of COCs:

• "Ampicillin";
• "Tetracycline";
• "Phenobarbital";
• "Rifampicin";
• NSAIDs.

Logest does not affect the absorption and effectiveness of drugs. This is indicated in the instructions for use.

Logest and alcohol

The instructions for using the pills do not indicate the connection between alcohol intake and COCs. However, in medical practice there is an opinion that any medications should not be taken 3 hours before or 3 hours after drinking alcoholic beverages.

Terms and conditions of storage

Like most medicines, Logest is stored at room conditions. Shelf life: 4 years. The instructions for use warn of the consequences of spoilage of the medicine if the conditions and storage period are not observed.

Price "Logest" in pharmacies

One package of the drug consists of a blister with 21 tablets and instructions for use, costs about 900 rubles. The cost of “Logest” in a package designed for 3 months is a little more than 2000 rubles.

Analogues of "Logest" in composition

Below is a list of direct analogues of Logest based on its constituent components:

• "Milvane";
• "Ginelea";
• "Femoden";
• "Lindynet."

“Logest” or “Jess”: which is better

These drugs differ in one component. In Logest it is gestodene, and in Jess it is drospirenone. In each individual case, only the doctor decides which drug is best for the patient. Self-prescription of COCs is fraught with consequences. Before use, be sure to read the instructions for use.

“Janine” or “Logest”: which is better

These drugs also differ in their constituent components. Therefore, there is no point in talking about the priority of one over the other. Only a thorough examination of the hormonal status and condition of the genital organs can answer the question of which COC is better. If a doctor gives a woman a choice between these two drugs, she can give preference to Logest as the most microdosed one. In any case, it is important to study the instructions for use with an emphasis on special instructions.

Conclusion

The drug "Logest", the instructions for use of which provide detailed information on all issues of interest to the patient, is known as one of the safest COCs. It is recommended for both young nulliparous women and those who are already approaching menopause. With proper selection, the drug can be taken for a long time.

Logest (gestodene + ethinyl estradiol) - monophasic tablet contraceptive. The mechanism of action of the drug is associated with the suppression of ovulation and a change in the rheological properties of mucus produced in the cervix. Medical abortion is a serious intervention, often leading to hormonal imbalance in a woman’s body, which, in turn, is fraught with metabolic and menstrual disorders. In this regard, tablet contraception acts as a real lifesaver, being a reliable and at the same time safe way to avoid unwanted pregnancy. Today, about 150 million women around the world resort to this option to prevent pregnancy, and in highly developed countries - more than 35% of women. The first tablet contraceptives came into use in the 60s of the last century. They included hormones in high doses, so they exhibited a wide range of side effects. Pharmacologists continue to create new contraceptives with a more favorable safety profile, working in two directions: reducing hormone levels and creating highly selective progestins. Reducing the hormonal load allows you to minimize the risk of developing such undesirable reactions as dyspepsia, breast engorgement, weight gain, migraine pain, etc. Requirements for newly synthesized progestins: high activity (i.e., reliability of the contraceptive effect against the background of low doses of progestin), high selectivity of action with target receptors, high bioavailability, allowing accurate predictions of the content of active components in the patient’s blood.

The most active progestin, which is also highly selective and has almost one hundred percent bioavailability, is gestodene. In terms of activity, it surpasses all known progestins. For example: other progestins (desogestrel and norgestimate) have less bioavailability and require additional metabolic transformations in the liver to convert to their active form. Logest from the German pharmaceutical company Schering is one of the lowest-dose contraceptives, which sets it apart from other drugs in this group. When using Logest during one cycle, the patient receives a total of no more than 2 mg of estrogen. This is one of the first drugs in Russia with such a low (20 mcg) concentration of female sex hormones. Logest shown everything healthy women who want to avoid unplanned pregnancy. It is the first choice drug for those women who are not yet familiar with tablet contraceptives. You should start taking the drug on the first day of the menstrual cycle. The frequency of administration is 1 time per day for three weeks. Pharmacotherapy is then suspended for one week. The result of the intake is the restoration of a 28-day cycle (three weeks of taking Logest - one week break).

Pharmacology

Logest ® is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

The contraceptive effect of Logest is carried out through complementary mechanisms, the most important of which include suppression of ovulation and changes in the state of cervical mucus.

In women taking combined oral contraceptives, the cycle becomes more regular, the pain and intensity of menstrual bleeding decreases, resulting in a reduced risk of iron deficiency anemia. In addition, there is evidence that the risk of developing endometrial and ovarian cancer is reduced.

At correct use the Pearl index (an indicator reflecting the frequency of pregnancy in 100 women during a year of using a contraceptive) is less than 1. If the pills are used incorrectly, including when pills are missed, the Pearl index may increase.

Pharmacokinetics

Gestoden

Absorption. After oral administration, gestodene is quickly and completely absorbed, its maximum serum concentration of 3.5 ng/ml is reached after about 1 hour. Bioavailability is approximately 99%. Distribution. Gestodene binds to serum albumin and sex hormone binding globulin (SHBG). Only about 1.3% of the total concentration in the blood serum is found in free form; about 69% are specifically associated with SHBG. The induction of SHBG synthesis by ethinyl estradiol affects the binding of gestodene to plasma proteins.

Metabolism. Gestodene is almost completely metabolized. Serum clearance is approximately 0.8 ml/min/kg.

Excretion. The content of gestodene in the serum undergoes a two-phase decrease. The half-life in the terminal phase is about 12 hours. Gestodene is not excreted unchanged, but only in the form of metabolites, which are excreted by the kidneys and through the intestines in a ratio of approximately 6:4 with a half-life of about 24 hours.

Equilibrium concentration. The pharmacokinetics of gestodene is affected by the concentration of SHBG in the blood serum. As a result of daily administration of the drug, the concentration of the substance in the serum increases approximately 4 times during the second half of the contraceptive cycle.

Ethinyl estradiol

Absorption. After oral administration, ethinyl estradiol is rapidly and completely absorbed. The maximum concentration in the blood serum, equal to approximately 65 pg/ml, is achieved in 1-2 hours. During absorption and “first passage” through the liver, ethinyl estradiol is metabolized, as a result of which its bioavailability when taken orally averages about 45%.

Distribution. Ethinyl estradiol is almost completely (approximately 98%), although nonspecifically, bound by albumin. Ethinyl estradiol induces the synthesis of SHBG. The apparent volume of distribution of ethinyl estradiol is 2.8-8.6 l/kg. Metabolism. Ethinyl estradiol undergoes presystemic conjugation, as in the thin mucosa. intestines and in the liver. The main route of metabolism is aromatic hydroxylation. The clearance rate from blood plasma is 2.3 -7 ml/min/kg.

Excretion. The decrease in the concentration of ethinyl estradiol in the blood serum is biphasic; the first phase is characterized by a half-life of about 1 hour, the second - 10-20 hours. It is not excreted from the body unchanged. Ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6 with a half-life of about 24 hours.

Equilibrium concentration. Equilibrium concentration is reached after approximately one week.

Release form

Film-coated tablets white, round shape.

Excipients: lactose monohydrate - 37.155 mg, corn starch - 15.5 mg, polyvidone 25,000 - 1.7 mg, magnesium stearate - 550 mcg, sucrose - 19.66 mg, polyvidone 700,000 - 171 mcg, macrogol 6000 - 2.18 mg, calcium carbonate - 8.697 mg, talc - 4.242 mg, mountain glycolic wax - 50 mcg.

21 pcs. - blisters (1) - cardboard packs.
21 pcs. - blisters (3) - cardboard packs.

Dosage

The tablets should be taken orally in the order indicated on the package, every day at approximately the same time, with a small amount of water. Take one tablet per day continuously for 21 days. The next package begins after a 7-day break from taking pills, during which withdrawal bleeding usually develops. Bleeding usually begins 2-3 days after taking the last tablet and may not stop until you start taking a new pack.

How to start taking Logest

If you have not taken any hormonal contraceptives in the previous month.

Taking Logest begins on the first day of the menstrual cycle (i.e., on the first day of menstrual bleeding). It is allowed to start taking it at 2-5 menstrual cycles, but in this case it is recommended to additionally use a barrier method of contraception during the first 7 days of taking tablets from the first package .

When switching from other combined oral contraceptives, vaginal ring or contraceptive patch.

It is preferable to start taking Logest the day after taking the last hormone-containing tablet from the previous package, but in no case later than the next day after the usual 7-day break (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets per package). Taking Logest should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

When switching from contraceptives containing only gestagens (mini-pills, injection forms, implant), or from a gestagen-releasing intrauterine contraceptive (Mirena ®).

A woman can switch from a mini-pill to Logest on any day (without a break), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from an injection form - from the day when the next injection is due. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.

After an 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 21-28 days after birth, if the woman is not breastfeeding, or after an abortion in the second trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman has already been sexually active, before starting to take Logest, pregnancy should be excluded or she must wait until her first menstruation.

Taking missed pills

If the delay in taking the drug is less than 12 hours, contraceptive protection is not reduced. The woman should take the pill as soon as possible, and the next one should be taken at the usual time.

If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. The more pills are missed, and the closer the missed pill is to the 7-day break in taking pills, the greater the likelihood of pregnancy. In this case, you can be guided by the following two basic rules:

The drug should never be interrupted for more than 7 days.

7 days of continuous tablet use are required to achieve adequate suppression of hypotapamic-pituitary-ovarian regulation.

Accordingly, the following recommendations can be given if the delay in taking the pills is more than 12 hours (the interval since the last pill was taken is more than 36 hours).

First week of taking the drug

A woman should take the last missed pill as soon as she remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time. Additionally, 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 missing a pill, the possibility of pregnancy must be taken into account.

Second week of taking the drug

A woman should take the last missed pill as soon as she remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time.

Provided that the woman has taken the pills correctly for the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as if you miss two or more tablets, you must additionally use barrier methods of contraception (for example, a condom) for 7 days.

Third week of taking the drug

The risk of decreased reliability is inevitable due to the upcoming break in taking the pills. A woman must strictly adhere to one of the following two options. Moreover, if in the 7 days preceding the first missed pill, all 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 she remembers (even if this means taking two pills at the same time). The next tablets are taken at the usual time until the tablets in the current pack are gone. The next pack should be started immediately. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the tablets.

2. A woman can also stop taking pills from the current package. She should then take a break for 7 days, including the day she missed the pills, and then start taking a new pack.

If a woman misses taking pills and then does not have withdrawal bleeding during the break, pregnancy must be ruled out.

If a woman has vomiting or diarrhea within 4 hours of taking the tablets, absorption may be incomplete and additional contraceptive measures should be taken. In these cases, you should follow the recommendations when skipping pills.

Changing the days of the onset of menstrual-like bleeding

In order to delay the onset of menstrual-like bleeding, a woman should continue taking tablets from a new Logest package immediately after taking all the tablets from the previous one, without interruption. The tablets from this new pack can be taken for as long as the woman wishes (until the pack runs out). While taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. You should resume taking Logest from a new pack after the usual 7-day break.

In order to move the day of the onset of menstrual bleeding to another day of the week, a woman should shorten the next break in taking pills by as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding, and will continue to have spotting and breakthrough bleeding while taking the second package (just as in the case when she would like to delay the onset of menstrual-like bleeding).

Additional information for specific patient groups

Elderly patients

Not applicable. The drug Logest is not indicated after menopause.

Patients with liver disorders

Logest is contraindicated in women with severe liver disease until liver function tests return to normal. See also the section “Contraindications”.

Patients with kidney disorders

Overdose

No serious adverse events have been reported following overdose. Symptoms that may occur in case of overdose: nausea, vomiting, spotting or metrorrhagia.

There is no specific antidote; symptomatic treatment should be carried out.

Interaction

Interaction of oral contraceptives with other drugs may lead to breakthrough bleeding and/or decreased contraceptive effectiveness. Women taking these drugs should temporarily use barrier methods of contraception in addition to Logest, or choose another method of contraception. The following types of interactions have been reported in the literature.

Effect on hepatic metabolism: the use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones. Such drugs include: phenytoin, barbiturates, primidone, carbamazepine, rifampicin; There are also suggestions regarding oxcarbazepine, topiramate, felbamate, griseofulvin and drugs containing St. John's wort.

HIV proteases (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and combinations thereof also have the potential to affect hepatic metabolism.

Effect on enterohepatic recirculation: According to individual studies, some antibiotics (for example, penicillins and tetracyclines) may reduce the enterohepatic recirculation of estrogens, thereby reducing the concentration of ethinyl estradiol.

While taking medications that affect liver microsomal enzymes, and for 28 days after their discontinuation, you should additionally use a barrier method of contraception.

While taking antibiotics (such as penicillins and tetracyclines) and for 7 days after their discontinuation, you should additionally use a barrier method of contraception. If the period of using a barrier method of contraception ends later than the tablets in the package, you need to move on to the next package of Logest without the usual break in taking the tablets.

Oral combination contraceptives may affect the metabolism of other drugs, resulting in an increase (eg, cyclosporine) or decrease (eg, lamotrigine) in plasma and tissue concentrations.

Side effects

When taking Logest, like other combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. While taking combined oral contraceptives, women experienced other undesirable effects, the connection of which with taking the drugs has not been confirmed, but has not been refuted.

Organ system	Often (>1/100)	Uncommon (>1/1000 and<1/100)	Rarely (<1/1000)
Organ of vision			intolerance to contact lenses (unpleasant sensations when wearing them)
Gastrointestinal tract	nausea, abdominal pain	vomiting, diarrhea
The immune system			hypersensitivity
General symptoms	weight gain		weight loss
Metabolism		fluid retention
Nervous system	headache	migraine
Mental disorders	decreased mood, mood swings	decreased libido	increased libido
Reproductive system and mammary glands	breast tenderness, breast engorgement	mammary hypertrophy	vaginal discharge, breast discharge
Skin and subcutaneous tissues		rash, hives	Erythema nodosum, erythema multiforme

The following serious adverse events have been reported in women using combined oral contraceptives. Additional information about possible side effects of oral combined contraceptives, including Logest, is presented in the “Special Instructions” section:

Venous thromboembolic disorders

Arterial thromboembolic disorders

Cerebrovascular disorders

Increased blood pressure

Hypertriglyceridemia

Changes in glucose tolerance or effects on peripheral insulin resistance

Liver tumors (benign and malignant)

Impaired liver function parameters

Chloasma

The onset or worsening of conditions for which an association with the use of combined oral contraceptives has not been proven: jaundice and/or itching associated with cholestasis; formation of gallstones; porphyrin disease; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis; Crohn's disease; ulcerative colitis; cervical cancer.

The incidence of breast cancer diagnosis in women using oral contraceptives is increased only slightly. Breast cancer is rarely observed in women under 40 years of age, the excess incidence is insignificant in relation to the overall risk of breast cancer. The cause-and-effect relationship between the occurrence of breast cancer and the use of combined oral contraceptives has not been established. For more information, see the “Contraindications” and “Special Instructions” sections.

Indications

• oral contraception.

Contraindications

Logest should not be used if you have any of the conditions/diseases listed below. If any of these conditions/diseases develop for the first time while taking the drug, the drug should be discontinued immediately;

• thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular disorders;
• conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history;
• the presence of pronounced or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see section “Special instructions”);
• migraine with focal neurological symptoms currently or in history;
• diabetes mellitus with vascular complications;
• pancreatitis with severe hypertriglyceridemia currently or in history;
• liver failure and severe liver disease (until liver tests return to normal);
• liver tumors (benign or malignant) currently or in history;
• identified or suspected hormone-dependent malignant neoplasms (including genital organs or mammary glands);
• bleeding from the vagina of unknown origin;
• pregnancy or suspicion of it;
• breast-feeding;
• hypersensitivity to any of the components of the drug Logest.

Carefully:

If any of the conditions/diseases/risk factors listed below currently exist, the potential risks and expected benefits of combined oral contraceptives should be carefully weighed in each individual case:

• risk factors for the development of thrombosis and thromboembolism: smoking; thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate family; obesity; dyslipoproteinemia, arterial hypertension; migraine without focal neurological symptoms; heart valve diseases; heart rhythm disturbances, prolonged immobilization, serious surgical interventions, extensive trauma;
• other diseases in which peripheral circulatory disorders may occur: diabetes mellitus without vascular complications; systemic lupus erythematosus; gsmolytic-uremic syndrome; Crohn's disease and non-specific ulcerative colitis; sickle cell anemia; as well as phlebitis of the superficial veins;
• hypertriglyceridemia;
• liver diseases;
• diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (for example, jaundice, cholestasis, gallbladder disease, otosclerosis with hearing impairment, porphyria, pregnancy herpes, Sydenham's chorea);
• In women with hereditary angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.

Features of application

Use during pregnancy and breastfeeding

Logest ® is contraindicated during pregnancy and breastfeeding. If pregnancy is detected while taking Logest ®, the drug should be discontinued immediately. However, numerous epidemiological studies have found no increased risk of developmental defects in children born to women who received sex hormones before pregnancy or teratogenic effects when sex hormones were taken inadvertently in early pregnancy.

Taking Logest, like other combined oral contraceptives, can reduce the amount of breast milk and change its composition, therefore, their use is not recommended during lactation. Small amounts of sex hormones and/or their metabolites may be excreted in breast milk.

Use for liver dysfunction

Logest is contraindicated in women with severe liver disease until liver function tests return to normal. See also section Contraindications.

Use for renal impairment

Logest has not been specifically studied in patients with renal impairment. Available data do not suggest adjustment of the dosage regimen in such patients.

Use in children

The drug Logest ® is indicated only after the onset of menarche.

special instructions

If any of the conditions/diseases/risk factors listed below currently exist, the potential risks and expected benefits of using combined oral contraceptives, including Logest, should be carefully weighed in each individual case and discussed with the woman before how she decides to start taking the drug/ If any of these conditions or risk factors worsen, intensify, or appear for the first time, the woman should consult with an obstetrician-gynecologist, who may decide whether to discontinue the drug.

Diseases of the cardiovascular system

The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of combined oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients suggest that this increased risk is predominantly present during the first 3 months. The overall risk of VTE in patients taking low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола) в два-три раза выше, чем у небеременньгх пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах.

VTE can be fatal (in 1-2% of cases).

VTE, manifested as deep vein thrombosis or pulmonary embolism, can occur with the use of any combined oral contraceptives. It is extremely rare that when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives.

Symptoms of deep vein thrombosis (DVT) include the following: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing up or when walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg. Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, including with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; sense of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may be misinterpreted as signs of other more or less severe complications (eg, respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. Symptoms of a stroke include: sudden weakness or loss of feeling in the face, arm or leg, especially on one side of the body, sudden confusion, problems with speech and comprehension; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the limbs, “acute” abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be fatal.

The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases:

With age;

For smokers (the risk increases with increasing number of cigarettes or increasing age, especially in women over 35 years of age);

in the presence of:

Family history (for example, venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;

Obesity (body mass index more than 30 kg/m2);

Dyslipoproteinemia;

Arterial hypertension;

Migraine;

Heart valve diseases;

Atrial fibrillation;

Prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of planned surgery, at least four weeks before it) and not to resume use for two weeks after the end of immobilization.

The possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial. The increased risk of thromboembolism in the postpartum period should be taken into account.

Peripheral circulatory disorders may also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis), and sickle cell anemia.

An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include the following: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant). When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (< 0,05 мг этинилэстрадиола).

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. The connection with the use of combined oral contraceptives has not been proven. Controversy remains regarding the extent to which these findings are related to screening for cervical pathology or to sexual behavior (lower use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies found that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking combined oral contraceptives (relative risk 1.24). The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. Its connection with the use of combined oral contraceptives has not been proven. The observed increased risk may also be a consequence of earlier diagnosis of breast cancer in women using combined oral contraceptives. Women who have ever used combined oral contraceptives are diagnosed with earlier stages of breast cancer than women who have never used them.

In rare cases, during the use of combined oral contraceptives, the development of benign, and in extremely rare cases, malignant liver tumors, which in some cases led to life-threatening intra-abdominal bleeding, was observed. If severe abdominal pain, liver enlargement, or signs of intra-abdominal bleeding occur, this should be taken into account when making a differential diagnosis.

Other states

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.

Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant increases have rarely been reported. However, if a persistent, clinically significant increase in blood pressure develops while taking combined oral contraceptives, this drug should be discontinued and treatment of arterial hypertension should be initiated. Taking combined oral contraceptives can be continued if normal blood pressure values ​​are achieved with antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their relationship with taking combined oral contraceptives has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described during the use of combined oral costraceptives.

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema. Acute or chronic liver dysfunction may require discontinuation of combined oral contraceptives until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives.

Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (<0,05 мг этинилэстрадиола). Тем не менее, женщины с сахарным диабетом должны тщательно наблюдаться во время приема комбинированных пероральных контрацептивов. Иногда может развиваться хлоазма, особенно у женщин с наличием в анамнезе хлоазмы беременных. Женщины со склонностью к хлоазме во время приема комбинированных пероральных контрацептивов должны избегать длительного пребывания на солнце и воздействия ультрафиолетового излучения. Каждая таблетка препарата Логест содержит 35 мг лактозы. Пациенты с редкими наследственными заболеваниями - непереносимостью галактозы, дефицитом лактазы, глюкозо-галактозной мальабсорбцией, находящиеся на диете с исключением лактозы, должны принимать во внимание информацию о содержании лактозы в препарате.

Laboratory tests

Taking combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma transport protein levels, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond normal values.

Reduced efficiency

The effectiveness of combined oral contraceptives may be reduced in the following cases: missed pills, vomiting and diarrhea, or as a result of drug interactions.

Effect on bleeding pattern

While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular bleeding should be assessed only after an adaptation period of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, careful evaluation should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding while off the pill. If combined oral contraceptives are taken as directed, the woman is unlikely to be pregnant. However, if combined oral contraceptives have not been taken regularly before or if there are no two withdrawal bleedings in a row, pregnancy should be ruled out before continuing to take the drug.

Medical examinations

Before starting or resuming the use of the drug Logest, it is necessary to familiarize yourself with the woman’s life history and family history, conduct a thorough general medical examination (including measuring blood pressure, determining body mass index) and gynecological examination (including examination of the mammary glands and cytological examination of the cervical epithelium), and exclude pregnancy. The scope of additional studies and the frequency of follow-up examinations are determined individually. Typically, follow-up examinations should be carried out at least once every 6 months.

A woman should be warned that drugs like Logest do not protect against HIV infection (AIDS) and other sexually transmitted diseases!

Impact on the ability to drive vehicles and operate machinery

The contraceptive effect of combined oral contraceptives (COCs) is based on the interaction of various factors, the most important of which are suppression of ovulation and changes in cervical secretion. In addition to preventing pregnancy, PDAs have a number of other positive properties that can be used when choosing a method of contraception. The menstrual cycle becomes more regular, menstruation becomes less painful, and blood loss decreases. The latter helps reduce the incidence of iron deficiency anemia. There is evidence of a reduced risk of endometrial and ovarian cancer. In addition, it has been proven that when using COCs in high doses (50 mcg ethinylestradiol), the risk of ovarian cysts, pelvic inflammatory diseases, benign breast diseases and ectopic pregnancy is reduced. It is necessary to find out whether this applies to low-dose COCs.
Gestoden
After oral administration, gestodene is quickly and completely absorbed. The maximum serum concentration of 4 ng/ml is achieved 1 hour after a single dose. Bioavailability is about 99%.
Gestodene binds to serum albumin and sex hormone binding globulin (SHBG). Only 1-2% of the total concentration of the substance in the blood serum is in the form of a free steroid, and 50-70% is specifically associated with SHBG. The increase in SHBG levels induced by ethinyl estadiol determines an increase in the gestodene fraction associated with SHBG and a decrease in the fraction associated with albumin.
The metabolism of gestodene occurs entirely through the known pathways of steroid metabolism. Serum clearance is 0.8 ml/min/kg body weight.
The level of gestodene in the blood serum decreases in two phases. Distribution in the final phase is characterized by a half-life of 12-15 hours. Gestodene is not excreted unchanged. Its metabolites are excreted from the body in urine and bile in a ratio of approximately 6:4. The half-life of metabolites is 1 day.
The pharmacokinetics of gestodene is affected by the level of SHBG, which increases 3 times while taking ethinyl estradiol. After daily administration, the level of gestodene in the blood serum increases approximately 4 times, reaching a state of equilibrium in the second half of the course of taking the pill.
Ethinyl estradiol
When taken orally, ethinyl estradiol is rapidly and completely absorbed. Peak serum concentrations of approximately 80 pg/ml are achieved within 1-2 hours.
Ethinyl estradiol binds tightly but not specifically to serum albumin (approximately 98%) and increases serum SHBG concentrations.
Ethinyl estradiol is metabolized mainly by aromatic hydroxylation, however, a large number of hydroxylated and methylated metabolites are additionally formed, including both free metabolites and conjugates with glucuronides and sulfates. Clearance is 2.3-7 ml/min/kg body weight.
The level of ethinyl estradiol in the blood serum decreases in 2 phases with half-lives of about 1 and 10-20 hours, respectively. The substance is not excreted from the body unchanged; ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6. The half-life of metabolites is approximately 1 day.
Based on variable serum half-life and daily dosing, steady-state serum concentrations of ethinyl estradiol are achieved in approximately 1 week.

Indications for use of the drug Logest

Contraception.

Use of the drug Logest

The pills should be taken daily according to the order indicated on the blister, at approximately the same time, with a small amount of liquid. The drug is taken 1 tablet per day for 21 days. Taking pills from each subsequent package must be started after the end of a 7-day break in taking the drug, during which, as a rule, menstrual-like bleeding occurs, which usually begins on the 2-3rd day after taking the last pill and may not end by the time you start taking it dragee from the next package.
If hormonal contraceptives were not used in the previous period (last month)
Taking pills should start on the 1st day of the menstrual cycle. You can start taking it from the 2-5th day, but in this case, during the first cycle, it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the drug.
Switching from another combined oral contraceptive (COC)
It is advisable to start taking Logest the day after taking the last active tablet of the previous COC, at least no later than the next day after a break in taking pills or after taking placebo tablets of the previous COC.
Switching from a progestogen-only method (mini-pills, injections, implants) or a progestogen-containing intrauterine system
You can start taking Logest any day after you stop taking the mini-pill (in the case of implants or intrauterine system - on the day of their removal; in the case of injection - instead of the next injection). However, in all cases it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the pill.
After an abortion in the first trimester of pregnancy
You can start using Logest immediately. In this case, there is no need to use additional contraception.
After childbirth or abortion in the second trimester of pregnancy
If breastfeeding, see subsection "Pregnancy and breastfeeding"
It is recommended to start taking Logest from the 21st to 28th day after childbirth or abortion in the second trimester of pregnancy. If you start taking the pill later, you should additionally use a barrier method of contraception during the first 7 days of taking the drug. However, if sexual intercourse has already taken place, then before starting to use the PDA it is necessary to exclude possible pregnancy or wait until menstruation.
What to do if you miss a pill dose
If the delay in taking the pill does not exceed 12 hours, the contraceptive effect of the drug is not reduced. The missed pill should be taken as soon as possible. The next pill from this package is taken at the usual time.
If the delay in taking the missed pill exceeds 12 hours, contraceptive protection may decrease. In this case, you can follow two basic rules:

• the break in taking the pill should never exceed 7 days;
• Adequate suppression of the hypothalamic-pituitary-ovarian system is achieved by continuous intake of the pill for 7 days.

Accordingly, the following recommendations should be followed in daily life:
1st week
You should take the last missed pill as soon as possible, even if you have to take 2 pills at the same time. After this, continue to take the pills at the usual time. In addition, over the next 7 days you must use a barrier method of contraception, such as a condom. If sexual intercourse took place in the previous 7 days, the likelihood of pregnancy should be taken into account. The more pills you miss and the closer the break in taking the drug, the higher the likelihood of pregnancy.
2nd week
It is necessary to take the last missed tablet as soon as possible, even if you have to take 2 tablets at the same time. After this, continue to take the pills at the usual time. If you take the tablets correctly for 7 days before the first missed period, there is no need to use additional contraceptives. In another case or if more than 1 tablet is missed, it is recommended to additionally use a barrier method of contraception for 7 days.
3rd week
The risk of decreased reliability increases as the break in taking the pill approaches. However, if you follow the regimen for taking pills, you can avoid a decrease in contraceptive protection. If you adhere to one of the following options, then there will be no need to use additional contraceptives, provided you take the tablets correctly for 7 days before the missed period. If this is not the case, you should stick to the first option below and use additional methods of contraception for the next 7 days.
It is necessary to take the last missed pill as soon as possible, even if you have to take 2 pills at the same time. After this, continue to take the pills at the usual time. The pills from the next package must be taken immediately after the end of the previous one, that is, there should be no breaks. It is unlikely that the patient will experience menstrual-like bleeding by the end of the second pack, although spotting or breakthrough bleeding may occur while taking the tablets.
You may also be advised to stop taking the tablets from the current package. In this case, the break in taking the drug should be up to 7 days, including days of missing pills; You should start taking the pills from the next package.
If you miss taking a pill and there is no menstrual-like bleeding during the first regular break in taking the pill, you need to exclude the possibility of pregnancy.
Recommendations in case of gastrointestinal disorders
In case of severe gastrointestinal disorders, incomplete absorption of the drug is possible; in this case, additional contraception should be used.
If vomiting occurs within 3-4 hours after taking the pills, it is advisable to use the recommendations regarding skipping pills. If the patient does not want to change her usual regimen of taking the drug, she needs to take additional pill(s) from a different package.
How to change the timing of your period or how to delay your period
To delay the appearance of menstruation, you should continue to take Logest tablets from a new package and not take a break from taking the drug. If desired, the period of administration can be continued until the end of the second package. In this case, the possibility of breakthrough bleeding or spotting cannot be excluded. The usual use of the drug Logest is restored after a 7-day break from taking the pill.
To shift the onset of menstruation to another day of the week, it is recommended to shorten the break in taking pills by the desired number of days. It should be noted that the shorter the break, the more often the absence of menstrual-like bleeding and breakthrough bleeding or spotting is noted while taking the pills from the second package (as in the case of a delay in the onset of menstruation).

Contraindications to the use of the drug Logest

PDAs should not be used if you have at least one of the following conditions or diseases. If any of these conditions or diseases occurs for the first time during the period of use of the COC, the drug should be stopped immediately.
Venous or arterial thrombotic/thromboembolic events (eg deep vein thrombosis, pulmonary embolism, myocardial infarction) or cerebrovascular disorders, current or in history.
The presence or history of prodromal symptoms of thrombosis (for example, transient cerebrovascular accident, angina pectoris).
History of migraine with focal neurological symptoms.
Diabetes mellitus with vascular damage.
The presence of severe or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see).
Current or history of pancreatitis if associated with severe hypertriglyceridemia.
Current or history of severe liver disease until liver function tests return to normal.
Diagnosed or history of liver tumors (benign or malignant).
Diagnosed or suspected malignant tumors (for example, genitals or mammary glands) that are dependent on sex hormones.
Vaginal bleeding of unknown etiology.
Diagnosed or suspected pregnancy.
Hypersensitivity to the active substances or to any of the components of the drug.

Side effects of the drug Logest

The most serious side effects associated with the use of COCs are described in the section.
Other undesirable effects have been reported with the use of COCs, but their connection with the use of COCs has been neither confirmed nor refuted:

Organs and systems	Frequent (≥1/100)	Uncommon (≥1/1000 and ≤/100)	Single (≤1/1000)
			Contact lens intolerance
	Nausea, abdominal pain	Vomiting, diarrhea
The immune system			Hypersensitivity
Study	Weight gain		Reducing body weight
Metabolism and nutritional disorders		Fluid retention
Mental disorders	Depressed state, mood disturbance	Decreased libido	Increase libido
Reproductive system and mammary glands			Changes in vaginal secretion, the appearance of secretion from the mammary glands
Skin and subcutaneous tissues		Skin rashes, urticaria	Erythema nodosum, exudative erythema multiforme

Special instructions for the use of the drug Logest

If any of the following conditions/risk factors are present, the benefits of using COCs should be assessed against the possible risks, taking into account the individual characteristics of each patient and discussed with her before she decides to take COCs. If any of the following conditions or risk factors become worse, worse, or occur for the first time, it is recommended that you consult your doctor. The doctor must decide whether to stop using the COC.
Circulatory disorders
Based on the results of epidemiological studies, there is an association between the use of COCs and an increased risk of venous and arterial thrombotic and thromboembolic diseases, such as myocardial infarction, stroke, deep vein thrombosis and pulmonary embolism. These conditions occur rarely.
Venous thromboembolism (VTE), manifested as venous thrombosis and/or pulmonary embolism, can occur with the use of any COC. The risk of venous thromboembolism is highest during the 1st year of COC use. The incidence of VTE in women taking oral contraceptives with low doses of estrogens (≤0.05 mg ethinyl estradiol) is up to 4 cases per 10,000 women/year compared with 0.5-3 cases per 10,000 women/year in women not using oral contraceptives. The incidence of VTE associated with pregnancy is 6 cases per 10,000 women/year.
Thrombosis of other blood vessels, such as arteries and veins of the liver, kidneys, mesenteric vessels, cerebral or retinal vessels, has been extremely rarely reported in women using COCs. There is no consensus regarding the connection between these complications and the use of COCs.
Symptoms of venous or arterial thrombotic/thromboembolic events or stroke may include: unilateral lower extremity pain or swelling; sudden severe chest pain radiating to the left arm; sudden shortness of breath; sudden onset of cough; any unusual, severe, prolonged headache; sudden decrease or complete loss of vision; diplopia; speech impairment or aphasia; vertigo; collapse with or without partial epileptic seizure; weakness or very severe sudden numbness of one side or one part of the body; motor impairment; acute abdomen syndrome.
Factors that increase the risk of venous or arterial thrombotic/thromboembolic events or stroke:

• age;
• tobacco smoking (in combination with heavy smoking and with age, the risk increases, especially in women over 35 years of age);
• family history (for example, cases of venous or arterial thromboembolism in siblings or parents at a relatively early age).

If a hereditary tendency is suspected, before making a decision on the use of any PDA, the woman should be referred for consultation to an appropriate specialist:

• obesity (body mass index more than 30 kg/m2);
• dyslipoproteinemia;
• hypertension;
• heart valve pathology;
• atrial fibrillation;
• prolonged immobilization, radical surgical interventions, any surgical operations on the lower extremities, significant injuries.

In these cases, it is recommended to stop using the PDA (for planned operations at least 4 weeks before they are performed) and not restore it earlier than 2 weeks after complete remobilization.
There is no consensus regarding the possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism.
It is necessary to take into account the increased risk of thromboembolism in the postpartum period.
Other diseases that may be associated with serious circulatory disorders include diabetes mellitus; systemic lupus erythematosus; hemolytic uremic syndrome; chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis) and sickle cell anemia.
An increased incidence of migraine or its exacerbation during the period of use of COCs (which may be a harbinger of cerebrovascular accident) may require urgent cessation of COC use.
Biochemical indicators characteristic of a hereditary or acquired tendency to venous or arterial thrombosis include: resistance to CRP, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies).
When analyzing the risk/benefit ratio, the physician should take into account that adequate treatment for the conditions mentioned above can reduce the associated risk of thrombosis, and also that the risk of thrombosis associated with pregnancy is higher than with the use of COCs in low doses (≤0.05 mg ethinyl estradiol).
Tumors
The most important risk factor for the development of cervical cancer is the persistence of papillomavirus. Some epidemiological studies indicate an additional increase in this risk with long-term use of COCs, however, this statement is controversial because the extent to which the study results account for concomitant risk factors, such as cervical smears and sexual behavior, including the use of barrier methods of contraception, is not clear. .
The results of a meta-analysis based on data from 54 epidemiological studies indicate a slight increase in the relative risk (RR = 1.24) of developing breast cancer in women using COCs. This increased risk gradually disappears within 10 years of stopping taking COCs. Because breast cancer is rarely diagnosed in women under 40 years of age, the increase in breast cancer diagnosis among current or recent COC users is small relative to the overall risk of breast cancer. The results of these studies do not provide evidence of a causal relationship. The increased risk may be due to both earlier diagnosis of breast cancer in women using COCs, the biological effects of COCs, or a combination of both factors. There has been a tendency that breast cancer detected in women who have ever taken COCs is clinically less severe than in those who have never taken COCs.
In isolated cases, benign, and even less often, malignant liver tumors were noted in women using COCs, which sometimes led to the development of life-threatening intra-abdominal bleeding. If there are complaints of severe pain in the epigastric region, liver enlargement, or signs of intra-abdominal bleeding, the differential diagnosis should take into account the possibility of a liver tumor in women taking COCs.
Other conditions
Women with hypertriglyceridemia or a family history of this disorder are at risk of developing pancreatitis when using COCs.
Although slight increases in blood pressure have been reported in many women taking COCs, clinically significant increases in blood pressure are rare. However, if prolonged clinically significant hypertension (arterial hypertension) occurs during the period of taking COCs, then sometimes it is more appropriate to discontinue the COC and direct treatment to hypertension (arterial hypertension).
The occurrence or exacerbation of the following diseases has been reported during pregnancy and with the use of COCs, but their relationship with the use of COCs has not been conclusively established: jaundice and/or itching associated with cholestasis, gallstone formation, porphyria, systemic lupus erythematosus, hemolytic-uremic syndrome, Sydenham's chorea, herpes of pregnancy, hearing loss associated with otosclerosis.
In acute or chronic liver dysfunction, it may be necessary to stop taking COCs until liver function tests return to normal. If cholestatic jaundice relapses, which first occurred during pregnancy or previous use of sex hormones, taking COCs should be discontinued.
Although COCs may affect peripheral insulin resistance and glucose tolerance, there are no data regarding the need to change the therapeutic regimen in women with diabetes mellitus taking low-dose COCs (containing ≤0.05 mg ethinyl estradiol). However, women with diabetes should be closely monitored while taking COCs.
Crohn's disease and ulcerative colitis may be associated with COC use.
Chloasma can sometimes occur, especially in women with a history of chloasma during pregnancy. Women prone to chloasma should avoid exposure to direct sunlight or ultraviolet radiation while taking COCs.
Medical examination
Before starting or resuming taking the drug Logest, you should conduct a full medical examination and study the patient’s medical history in detail, taking into account contraindications (see) and warnings (see). When using COCs, it is recommended to conduct periodic examinations, which is very important, since contraindications (transient circulatory disorders, etc.) or risk factors (for example, a family history of venous or arterial thrombosis) may first appear during the period of taking COCs. The frequency and nature of these examinations should be based on the standards of medical practice, taking into account the individual characteristics of each woman, however, special attention is paid to examination of the pelvic organs, including a standard analysis of cytology of the cervix, abdominal organs, mammary glands, determination of blood pressure.
The patient must be warned that oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Reduced efficiency
The effectiveness of combined oral contraceptives may be reduced if you miss a pill, have gastrointestinal problems, or use other medications.
Cycle control
When taking oral contraceptives, intermenstrual bleeding (spotting or breakthrough bleeding) may occur, especially during the first few months of treatment. Taking this into account, examination in the event of any intermenstrual bleeding should be carried out only after a period of adaptation of the body to the drug, which is approximately 3 cycles.
If menstrual irregularities continue or recur after several normal cycles, non-hormonal causes of bleeding should be considered and appropriate investigations should be carried out to exclude the presence of tumors and pregnancy. Diagnostic measures can include curettage.
Some women may not experience menstrual bleeding during a break from taking the drug. There is a low chance of pregnancy when you take COCs as directed. However, if the contraceptive was taken irregularly or if menstrual-like bleeding is absent for 2 cycles, pregnancy must be excluded before continuing to take the COC.
During pregnancy and breastfeeding
The drug is contraindicated for use during pregnancy. If pregnancy occurs during the use of the drug Logest, it is necessary to stop taking it. However, research results do not indicate an increased risk of congenital pathologies in children born to mothers who took COCs during pregnancy, nor do they indicate the existence of a teratogenic effect when unintentionally taking COCs in early pregnancy.
PDAs can affect lactation, since under their influence the amount of breast milk can decrease and also change its composition. With this in mind, COCs are not recommended for use while breastfeeding.
The active substances that make up the drug and/or their metabolites are excreted in small quantities in breast milk, but there is no data on their negative effect on the health of the infant.
Impact on the ability to drive vehicles and operate machinery
No effect noted.

Interactions of the drug Logest

Interactions between oral contraceptives and other drugs may result in breakthrough bleeding and/or decreased contraceptive effectiveness. The following interactions have been reported in the literature.
Hepatic metabolism: possible interaction with drugs that induce microsomal enzymes, which can cause an increase in the clearance of sex hormones (for example, phenytoin, barbiturates, primidone, carbamazepine, rifampicin and possibly also oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin and drugs containing St. John's wort).
Interaction with the enterohepatic circulation: The results of some clinical studies suggest that the enterohepatic circulation of estrogens may be reduced when taking certain antibiotics that reduce ethinyl estradiol concentrations (for example, penicillin and tetracycline antibiotics).
When treating any of the above drugs, a woman should temporarily use a barrier method in addition to taking COCs or choose another method of contraception. When treating with drugs that induce microsomal enzymes, the barrier method must be used throughout the entire period of treatment with the corresponding drug and for another 28 days after stopping its use. When treating with an antibiotic (with the exception of rifampicin and griseofulvin), the barrier method should be used for another 7 days after discontinuation of the antibiotic. If the barrier method is still being used, and the tablets in the PDA package have already run out, taking the tablets from the next package should be started without the usual break.
Oral contraceptives may affect the metabolism of other drugs. Taking this into account, the concentrations of active substances in blood plasma and tissues (for example, cyclosporine) may change.
Note. To determine the potential for interaction with drugs that are prescribed concomitantly with COCs, it is recommended that you read the instructions for medical use of these drugs.
Impact on laboratory results
Taking contraceptives may affect the results of certain laboratory tests, including biochemical parameters of liver, thyroid, adrenal and kidney function, plasma levels of proteins (carriers), such as sex hormone binding globulin and lipid/lipoprotein fractions, parameters carbohydrate metabolism, as well as parameters of coagulation and fibrinolysis.

Logest overdose, symptoms and treatment

No serious adverse effects due to overdose have been reported. The following symptoms of overdose are possible: nausea, vomiting, and in young patients - slight bleeding from the vagina. There are no specific antidotes; treatment should be symptomatic.

Storage conditions for the drug Logest

At room temperature not higher than 30 °C.

List of pharmacies where you can buy Logest:

• Saint Petersburg