Estelle 35

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What is this medication used for​​​?

Estelle™-35 contains two types of sex hormones, a progestogen called Cyproterone acetate and an estrogen called Ethinylestradiol. It is used in women of reproductive age who suffer from conditions due to an increased sensitivity to androgens in the body. Androgens are hormones in the body that make one display more male characteristics. Women who are more sensitive to androgen may have conditions such as acne, very oily skin or excessive hair growth in certain areas of the face or body. The medication also provides effective oral contraception in women being treated for the above conditions. 

If you are taking Estelle™-35 for any of the conditions above, you must not take any other hormonal contraceptive at the same time.  

Dosage and How to Use​

Estelle™-35 is a 21-day pack.

  • Do not stop taking your medication without checking with your healthcare professional.
  • You should take this medication after food.
  • You may start taking this medication on the first or second day of your menses (if this is your first time taking hormonal contraceptives).
  • If you are also using it for contraceptive purposes, a barrier method of contraception e.g. condoms, is recommended for the first 7 days of taking Estelle™-35 for the first time.
  • You should take one yellow (active) tablet daily for 21 consecutive days, preferably at the same time every day.
  • After completion of the pack, there will be 7 days where you do not need to take any tablets (7-day tablet-free interval), during which you will experience withdrawal bleeding (menses) within two to three days after the last tablet. 
  • Start taking your next pack of medication after the 7-day tablet-free days, even if you are still having menstrual bleeding. 

What to do if I missed a tablet?

If you miss any of your 21 yellow (active) tablets, you must follow the steps below to ensure that the contraceptive effect is not reduced.

​​If you missed a tablet for less than 12 hours from your usual time​

  • Take the missed tablet as soon as you remember.
  • Take the next tablet at your usual time. 

If you missed a tablet for more than 12 hours from your usual time​

If the missed tablet is within week 1 of the pack: 

  • Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. 
  • Continue to take your tablets at your usual time on the next day. 
  • Use a barrier method such as a condom for the next 7 days.

If the missed tablet is within week 2 of the pack: 

  • Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. 
  • Continue to take your tablets at your usual time. 
  • If you have taken your tablets correctly in the 7 days before the first missed tablet, there is no need to use extra contraceptive precautions. However if this is not the case, or you have missed more than 1 tablet, use a barrier method such as a condom for the next 7 days.

If the missed tablet is within week 3 of the pack:  

If you took your tablets correctly in the previous 7 days, follow any of the following 2 methods. You do not need extra contraception. If this was not the case, follow the first method and you would need additional contraception, such as condoms, for the next 7 days.

  • First method: Take the last missed tablet as soon as you remember, even if it means taking 2 tablets at the same time. Continue to take your tablets at your usual time and start the next pack right away without the 7-day tablet free period i.e. no gap should be left between packs. Your menses may not come until the next pack is finished, but there is no need to worry. However, if your menses does not occur after the next pack is finished, you should take a pregnancy test to rule out pregnancy. 
  • Second method: Stop the current pack and have a tablet-free period of up to 7 days – during which time a withdrawal bleed (menses) usually occurs and then continue with the next pack. 
What to do if you missed a tablet?

If you vomit or suffer from diarrhea within 3 to 4 hours of taking this medication, the tablet may not be absorbed. This is considered a missed dose. You should then follow the instructions above. 

What are the possible side effects of the medicines?​

  • Spotting or bleeding may occur between your periods during the first 1-2 months of taking oral contraceptives. However, if this continues after the second month, check with your doctor.
  • Nausea, vomiting, bloating and stomach cramps - Take the medication after food to reduce these side effects 
  • Breast tenderness
  • Headache or migraine - You may take painkillers such as Paracetamol to manage headaches 
  • Unable to tolerate contact lenses
  • Weight changes, mood swings - Take medication at the same time every day to avoid huge changes in the hormone levels in your body
  • Pigmentation of the skin - Apply sunblock when you are outdoors and avoid long hours of sun exposure

Inform your doctor if the side effects above become severe and bother you.

What are some rare but serious side-effects that I need to seek medical advice immediately?

Using a combined hormonal medication increases a woman’s risk of developing blood clots compared with a woman not taking any combined hormonal medication. The risk of developing blood clots in a vein is highest during the first year a woman uses the medication. Other risk factors of developing blood clots include smoking and obesity. However, blood clot formation is rare and the doctor would have evaluated and weighed its benefits over risks before making the recommendation. 

  • The symptoms of blood clot include one or more of the following: 
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Other rare but serious side effects that you may or may not experience.

  • Unusual, severe or long lasting headache or worsening of migraine
  • Dizziness or fainting
  • Severe pain in your abdomen
  • Dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin

The symptoms of a drug allergy include one or more of the following: 

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

If you experience any of these side effects/ symptoms, you should stop your medication and see your healthcare professional immediately.

What precautions should I take?

Inform your healthcare professional if: 

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding 
  • You are taking any other medications, including supplements, traditional medications and herbal remedies
  • You have a history of or current medical conditions such as liver problems, stroke, heart disease, migraine headaches, epilepsy (fits), diabetes or cancer

What other medications and foods should I avoid when taking Estelle™-35?

Some medications including antibiotics and antifungals may affect how the medication works or be affected by the medication.  Please inform your other healthcare professionals about this medication that you are taking if you are seeing them for other medical conditions.

Handling and storage

  • ​Keep your medicines in the original container or packaging, tightly closed or sealed in a cool and dry place, away from direct sunlight.
  • Keep the medicine out of reach of children.
  • Throw away all expired medicines.

The above information answers some common questions about this medicine. It does not contain all the available information. It also does not take the place of talking to your doctor or pharmacist.

References

https://www.healthhub.sg/a-z/medications/310/Cyproterone-acetate-Ethinylestradiol


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