Slinda® (Progestin-only Birth Control Pill/Mini-pill)

What is Slinda® used for?

Also known as a POP (progestin-only pill) or the mini pill, Slinda® is the newest birth control pill to be approved by HSA for contraception in women to prevent pregnancy and promote regular menstrual bleeding.

Slinda® contains the active ingredient Drospirenone (which is a new-generation progesterone), and it does not contain any oestrogen. As Slinda® does not contain oestrogen, it can be used with more reliability in women who cannot tolerate oestrogen, or for whom oestrogen is considered too risky such as:

• Lactating/ breastfeeding moms
• Women with a history of heart issues or blood clots
• Women with a history of hypertension
• Women with a history of migraine with aura
• Smokers
• Overweight (BMI ≥ 30 kg/m2) patients

It works by preventing ovulation, increasing the viscosity of the cervical mucus, and thinning the endometrium lining.

Slinda® works similarly to the combined oral contraceptive pill by suppressing ovulation, thickening the cervical mucous and thinning the uterus lining. It has a contraceptive efficacy of 99% (with perfect pill use), 91% with typical pill use and there is a larger window of opportunity to remember a missed pill compared to older POPs (24 hours instead of 3 hours).

Slinda® vs Combination Birth Control Pills/Patch

Slinda® works similarly to combined oral contraception pills/patches by suppressing ovulation, thickening the cervical mucous and thinning the uterus lining. It has a contraceptive efficacy of 99% (with perfect pill use), 91% with typical pill use. As Slinda® does not contain oestrogen, it can be used with more reliability in women who cannot tolerate oestrogen, or for whom oestrogen is considered too risky.

Slinda® vs Older Progestin-Only Pill (POP)

For Slinda®, a dose is considered 'missed' when more than 24 hours have passed since the regular dosing time. For older POP, a dose is considered 'missed' when more than 3 hours have passed since the regular dosing time.

As such, there is a larger window of opportunity to remember a missed pill compared to older POPs (24 hours instead of 3 hours).

Dosage and how to use

• Do not stop taking your medication without checking with your healthcare professional.
• If you are switching from other forms of contraception, please seek advice from your healthcare professional. 
• You should take this medication after food.

If this is your first time taking hormonal contraceptives or you have not used hormonal contraception in the past month

• You may start taking this medication on the first day of your menses. No additional contraceptive methods are required.
• Alternatively, you may start taking this medication on the second to fifth day of your menses, however, a barrier method of contraception (e.g. condoms), is recommended for the first 7 days of taking this medication.
• Each pack contains 24 white (active) tablets and 4 green (inactive) tablets = 28 tablets.
• You should take one tablet daily for 28 days in a row, preferably at the same time every day. You must take the tablets in the correct sequence i.e. start each pack with the white (active) tablets, followed by the green (inactive) tablets. 
• The next pack is started after the last tablet of the previous pack. Withdrawal bleeding (menses) usually starts on day 2 – 3 after the last green (inactive) tablet is taken and may not have finished before the next pack is started.

If you vomit or suffer from diarrhea within 3 to 4 hours of taking this medication, the tablet may not be absorbed. A new (replacement) tablet should be taken as soon as possible within 12 hours. If more than 12 hours have passed, it is considered a missed dose. You should then follow the instructions above. 

What are the possible side effects of Slinda®?​

• 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 Paracetamol to manage headaches.
• Weight changes, mood swings. Take the medication at the same time every day to avoid huge changes in the hormone levels in your body. 
• Acne

Check with your doctor about any symptoms that become bothersome.

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 or planning to become pregnant.
• 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, kidney problems, heart diseases, epilepsy (seizure), high blood pressure, diabetes or cancer.

If you are seeing other healthcare professionals for any other medical conditions, inform them that you are taking this medication.

What other medications and foods should I avoid when taking Slinda®?

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

Handling and storage

• Store in a cool, dry place away from moisture, heat and 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

Centers for Disease Control and Prevention. (2014, April). Appendix D: Contraceptive Effectiveness.

Slinda Patient Information Leaflet.