নরেস্ট ২৮

Combination of hormonal contraceptives (Norgestrel, Ethinylestradiol & Ferrous Fumarate) inhibits ovulation by modulating pituitary secretion of gonadotrophins, luteinising hormone and follicle stimulating hormone through a negative feedback system. They reduce sperm penetration if ovulation does occur by altering the cervical mucus; cause changes in the endometrium which reduce the risk of nidation and may change the tubal transport of the ova through the fallopian tubes.

Ferrous fumarate is an iron preparation that is used in the prevention and treatment of iron deficiency.

ব্যবহার

Ethinylestradiol, Norgestrel & Ferrous Fumarate is indicatd for prevention of pregnancy.

নরেস্ট ২৮ এর দাম কত? নরেস্ট ২৮ এর দাম

সুচিপত্র

• কাজ
• খাওয়ার নিয়ম
• পার্শ্বপ্রতিক্রিয়া
• সতর্কতা
• মিথস্ক্রিয়া
• গর্ভাবস্থাকালীন ব্যবহার
• তীব্র ওভারডোজ
• অন্যান্য ওষুধের সাথে প্রতিক্রিয়া
• বৈপরীত্য
• সংরক্ষণ

খাওয়ার নিয়ম / ব্যবহারের নিয়ম

নরেস্ট ২৮ খাওয়ার নিয়ম / ব্যবহারের নিয়ম

How to take Levonorgestrel, Ethinylestradiol & Ferrous Fumarate:

To achieve maximum contraceptive effectiveness, Levonorgestrel, Ethinylestradiol & Ferrous Fumarate must be taken in the order directed on the package and at intervals not exceeding 24 hours. Women should be instructed to take the pills at about the same time every day, preferably after the evening meal or at bedtime. One pill is to be taken daily for 28 consecutive days. Each subsequent pack is started on the day after the current pack is completed.

• If you have decided to take Levonorgestrel, Ethinylestradiol & Ferrous Fumarate for contraception, wait for your next menstruation begins.
• From the first day of your menstruation, start taking the first white pill from the left corner of the top row(with arrow mark) of your Levonorgestrel, Ethinylestradiol & Ferrous Fumarate pill pack.
• Continue taking one white pill each day along the arrow mark.
• After taking 21 white pills for 21 days, continue taking one brown iron pill every day from the last row in the foil for next 7 days.

It is most likely that your menstruation will start while taking the brown pills. Do not discontinue taking the brown pills. In addition to giving you iron supplementation regular taking of the brown tablets for 7 days will help you keep your pill taking routine. If your menstruation does not start during this time, check with your doctor to make sure you are not pregnant.After completing the seven iron pills, start taking white pills from another Levonorgestrel, Ethinylestradiol & Ferrous Fumarate pack and continue taking the pill as long as you don't want to be pregnant.

What to do after missing the pill?

How to delay a period: To delay a period you should continue with another new pack of Levonorgestrel, Ethinylestradiol & Ferrous Fumarate just after finishing the white active pill of the present pack(that is no need to take brownish inert tablet of present pack). The extension can be carried on for as long as wished until the end of the second pack. When you wish your period to begin, just stop tablet taking. While using the second pack woman may have some breakthrough bleeding or spotting. Start with your next pack after the usual 7 day red inactive pill interval.

Advice in case of Vomiting: If vomiting occurs within 4 hours after white active pill taking, absorption may not be complete. In such an event, the advice concerning Management of Missed Pills is applicable. The woman must take the extra active pill(s) needed from a back up pack after vomiting.

পার্শ্বপ্রতিক্রিয়া

At the initial stage some women may experience side-effects like dizziness, headache, nausea, diarrhea, abdominal pain, weight gain, fluid retension, depression, mood changes, breast pain, breast tenderness, rash, vaginal discharge, erythema etc. If taken regularly, such types of side-effects normally lessen with time. If she continues to have the side effects beyond 2-3 months, she could consult with a doctor.

সতর্কতা

Some medications may interfere with the efficacy of the tablet. Contact your doctor if you are taking any drugs, such as antibiotics, rifampicin or medicines for seizures. You may have to use another method of contraception during this time.

মিথস্ক্রিয়া

Interactions between ethinylestradiol and other drugs may lead to decreased or increased ethinylestradiol concentrations, respectively.Decreased ethinylestradiol serum concentrations may cause an increased incidence of breakthrough bleeding and menstrual irregularities and may possibly reduce efficacy of the oral contraceptive. Example of substances that may decrease serum ethinylestradiol concentrations include rifampicin, phenytoin, primidone, rifabutin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil, ritonavir and barbiturates. Certain antibiotics including ampicillin, other penicillins and tetracyclines may reduce the efficacy of oral contraceptives. During concomitant use of Ethinylestradiol, Norgestrel & Ferrous Fumarate & other drugs that may lead to decreased ethinylestradiol serum concentrations, it is recommended that a non-hormonal back-up method of contraception to be used in addition to the regular intake of Ethinylestradiol, Norgestrel & Ferrous Fumarate.

গর্ভাবস্থাকালীন ব্যবহার

During Pregnancy: Pregnancy must be excluded before starting Norgestrel, Ethinylestradiol & Ferrous Fumarate. If pregnancy occurs during use of Norgestrel, Ethinylestradiol & Ferrous Fumarate, the preparation must be withdrawn immediately. Oral contraceptives have not been shown to have any deleterious effects on the foetus or to increase the incidence of miscarriage in women who discontinue their use prior to conception. However, in women who discontinue oral contraceptives with the intent of becoming pregnant, a non-hormonal method of contraception is recommended for three months before attempting to conceive.

During Lactation: Estrogen-containing oral contraceptives given in the postpartum period may interfere with lactation. There may be a decrease in the quantity and a change in the composition of the breast milk. Furthermore, small amounts of contraceptive steroids and/or metabolites have been identified in the milk of mothers receiving them. A few adverse effects have been reported, including jaundice and breast enlargement. The use of oestrogen-containing oral contraceptives should be deferred until the infant has been completely weaned.

বৈপরীত্য

Ethinylestradiol, Norgestrel & Ferrous Fumarate should not be used:

• If you are pregnant or think to become pregnant
• If you had stroke or thrombosis in blood vessels of heart, legs, lungs or other parts of body
• If you are a heavy smoker
• If you suffer from liver disease or jaundice
• If you are suffer from high blood pressure, migraine, feel something hard in your breast, diabetes with vascular involvement, experience excessive bleeding for which no reason has yet been ascertained
• If you have or had a benign or malignant liver tumor
• Hypersensitivity to any of the components of Ethinylestradiol, Norgestrel & Ferrous Fumarate.

অতিরিক্ত সতর্কতা

তীব্র ওভারডোজ

Symptoms of oral contraceptive overdosage in adults and children may include nausea, vomiting, breast tenderness, dizziness, abdominal pain, drowsiness, fatigue; withdrawal bleeding may occur in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.

অন্যান্য ওষুধের সাথে প্রতিক্রিয়া

সংরক্ষণ

Store in a cool, dry place. Keep away from light & out of reach of children.