Lisvy 60 µg/24 óra és 13 µg/24 óra Dosage

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Dosage of Lisvy 60 µg/24 óra és 13 µg/24 óra in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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How to Take Lisvy 60 µg/24 óra és 13 µg/24 óra: Tablets 1-21 contain active ingredients (active tablets). Tablets must be taken in the order directed on the package every day at about the same time. One tablet is to be taken daily for 21 consecutive days, followed by a 7-day tablet free interval. Each subsequent pack is started on the day after the tablet-free interval. A withdrawal bleed usually starts on days 2-3 after the last active tablet and may not have finished before the next pack is started.

How to Start Lisvy 60 µg/24 óra és 13 µg/24 óra: No Hormonal Contraceptive Use (within the Preceeding Month): The patient should begin taking Lisvy 60 µg/24 óra és 13 µg/24 óra on Day 1 of her natural menstrual cycle (i.e., the first day of menstrual bleeding).

Beginning Lisvy 60 µg/24 óra és 13 µg/24 óra use on days 2-7 of the menstrual cycle (e.g., Sunday start) is allowed; however, a nonhormonal back-up method of birth control (e.g., condoms, spermicide) is recommended during the first 7 days of Lisvy 60 µg/24 óra és 13 µg/24 óra use.

Switching from Another COC: The woman should start Lisvy 60 µg/24 óra és 13 µg/24 óra preferably on the day after the last active tablet of her previous COC, but no later than the day following the usual tablet-free or inactive tablet interval of her previous COC.

Switching from a Progestin Only Method of Birth Control [Pill, Implant, Intrauterine Device (IUD) Injection]: The woman may discontinue use of progestin-only pill on any day and should begin Lisvy 60 µg/24 óra és 13 µg/24 óra the next day. Start Lisvy 60 µg/24 óra és 13 µg/24 óra on the same day that a progestin-only implant or a progestin-only IUD is removed; or on the day that the next progestin-only injection is scheduled. In each of these situations, the woman should be advised to use a nonhormonal back-up method of birth control during the first 7 days of Lisvy 60 µg/24 óra és 13 µg/24 óra use.

Following First-Trimester Abortion: The woman may start Lisvy 60 µg/24 óra és 13 µg/24 óra immediately. Additional contraceptive measures are not needed.

Postpartum: Because the immediate postpartum period is associated with an increased risk of thromboembolism, Lisvy 60 µg/24 óra és 13 µg/24 óra use should be started no sooner than 28th postpartum day following either delivery in a nonlactating mother or second-trimester abortion. The woman should be advised to use a nonhormonal back-up method of birth control for the first 7 days of Lisvy 60 µg/24 óra és 13 µg/24 óra use. However, if intercourse has already occurred, pregnancy should be ruled out before Lisvy 60 µg/24 óra és 13 µg/24 óra use has begun; otherwise the woman has to wait for her 1st menstrual period before beginning Lisvy 60 µg/24 óra és 13 µg/24 óra use.

How to Delay a Period: To delay a menstrual period, the woman should skip the tablet-free interval and immediately begin a new pack of Lisvy 60 µg/24 óra és 13 µg/24 óra. The delay may be continued for as long as desired up until all the tablets in the new pack are taken. During the delay, the woman may experience breakthrough-bleeding or spotting. Regular intake of Lisvy 60 µg/24 óra és 13 µg/24 óra is then resumed after the usual 7 day tablet-free interval.

Management of Missed Tablets: Contraceptive protection may be reduced if active tablets are missed and particularly if the missed tablets extend the tablet-free interval.

If one active tablet is missed, but is remembered within 12 hours of the usual dose, it should be taken as soon as it is remembered. Subsequent tablets should be taken at the usual time.

If one active tablet is missed and is more than 12 hours after the usual dose or if 2 or more active tablets are missed, contraceptive protection may be reduced. The last missed tablet should be taken as soon as it is remembered, even if this means taking 2 tablets on the same day. Subsequent tablets should be taken at the usual time. A nonhormonal back-up method of birth control should be used for the next 7 days.

If the user takes the last active tablet before the 7-day interval during which use of a nonhormonal back-up method of birth control is required has ended, the next pack must be started as soon as the current pack is finished; there should be no tablet-free interval between packs. This prevents an extended break in tablet-taking interval thereby reducing the risk of escape ovulation. The user is unlikely to have a withdrawal bleed until all the tablets in the new pack are taken, although she may experience spotting or breakthrough bleeding on tablet-taking days. If the user does not have a withdrawal bleed after all tablets in the new pack are taken, the possibility of pregnancy must be ruled out before resuming tablet-taking.

Advise in Case of Vomiting and/or Diarrhea: If vomiting or diarrhea occurs within 4 hours after tablet-taking, absorption may not be complete. In such an event, the advice concerning Management of Missed Tablet is applicable. The woman must take the extra active tablet(s) needed from a back-up pack.

Lisvy 60 µg/24 óra és 13 µg/24 óra interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Lisvy 60 µg/24 óra és 13 µg/24 óra, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Interactions between ethinyl estradiol (EE) and other substances may lead to decreased or increased serum EE concentrations, respectively.

Decreased EE serum concentrations may cause an increased incidence of breakthrough bleeding and menstrual irregularities and may possibly reduce efficacy of the COC.

During concomitant use of EE-containing products and substances that may lead to decreased EE serum concentrations, it is recommended that a nonhormonal back-up method of birth control (eg, condoms and spermicide) be used in addition to the regular intake of Lisvy 60 µg/24 óra és 13 µg/24 óra. In the case of prolonged use of such substances COCs should not be considered the primary contraceptive.

After discontinuation of substances that may lead to deceased EE serum concentrations, use of a nonhormonal back-up method is recommended for at least 7 days. Longer use of a back-up method is advisable after discontinuation of substances that have lead to induction of hepatic microsomal enzymes, resulting in decreased EE serum concentrations. It may sometimes take several weeks until enzyme induction has completely subsided, depending on dosage, duration of use and rate of elimination of the inducing substance.

Examples of substances that may decrease serum EE concentrations: Any substance that reduces gastrointestinal transit time and, therefore, EE absorption. Substances that induce hepatic microsomal enzymes eg, rifampicin, rifabutin, barbiturates, primidone, phenylbutazone, phenytoin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil. Hypericum perforatum, also known as St. John's wort, and ritonavir* (possibly by induction of hepatic microsomal enzymes. Certain antibiotics (eg, ampicillin and other penicillins, tetracyclines), by a decrease of enterohepatic circulation of estrogens.

Examples of substances that may increase serum EE concentrations: Atorvastatin. Competitive inhibitors for sulfation in the gastrointestinal wall eg, ascorbic acid (vitamin C) and paracetamol (acetaminophen). Substances that inhibit cytochrome P-450 3A4 isoenzymes eg, indinavir, fluconazole, and troleandomycin*. Troleandomycin may increase the risk of intrahepatic cholestasis during co-administration with COCs.

EE may interfere with the metabolism of other drugs by inhibiting hepatic microsomal enzymes, or by inducing hepatic drug conjugation, particularly glucuronidation. Accordingly, plasma and tissue concentrations may either be increased (eg, cyclosporine, theophylline, corticosteroids) or decreased (eg, lamotrigine).

In patients treated with flunarizine, use of oral contraceptives has been reported to increase the risk of galactorrhea.

The prescribing information of concomitant medications should be consulted to identify potential interactions.

*Although ritonavir is an inhibitor of cytochrome P-450 3A4, treatment with ritonavir has been shown to decrease EE serum concentrations.

Laboratory Test Information: Estrogen-containing preparations can affect many laboratory tests. Some examples are: Increased prothrombin and Factors VII, VIII, IX, and X; decreased antithrombin 3; increased norepinephrine-induced platelet aggregability.

Increased thyroid-binding globulin (TBG) leading to increased circulating total-thyroid hormone, as measured by protein-bound iodine (PBI). T4 by radioimmunoassay. Free T3 resin uptake is decreased, reflecting the elevated TBG; free T4 concentration is unaltered.

Reduced response to metyrapone test.

The results of these tests should not be regarded as reliable until oral contraceptive use has been discontinued for 1-2 months. Abnormal tests should then be repeated.

Oral contraceptives may produce false positive results when neutrophil alkaline phosphatase activity is evaluated for the early diagnosis of pregnancy.


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References

  1. FDA/SPL Indexing Data. "1664P6E6MI: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
  2. MeSH. "Contraceptives, Oral, Synthetic". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. European Chemicals Agency - ECHA. "Gestodene: The information provided here is aggregated from the "Notified classification and labelling" from ECHA's C&L Inventory. ". https://echa.europa.eu/information-o... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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