The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Olga asks:

Hello! I am taking Jess for the first time, can I start taking Jess from the 7th or 8th day of the menstrual cycle or wait for the next one. monthly?

Olga asks:

Thank you for the answer! Well, I started taking jess on the first day of July 18, my periods lasted 2 days, I didn’t feel sick. But on July 20, 3 hours (I take it at 15:00) before the appointment, I began to experience discomfort in my stomach and feel a little sick as I drink a pill everything passes. On July 21, I began to have spotting brown discharge. The question is: is it normal that menstruation lasted 2 days (and it went up to 5 days) and what I described, and when can I not use other contraceptives? and is it still possible drink ketorol for stomach pain? in advance Thank you very much!!!

The use of any painkillers in conjunction with Jess is undesirable, as they can reduce the contraceptive activity of the drug. There is nothing to worry about in shortening the duration of menstrual bleeding - this is the normal effect of a hormone-containing drug on the cycle. Full contraceptive activity when using Jess begins with the use of the seventh active tablet, before this period, additional contraceptives must be used.

Olga asks:

Thanks for the consultation!:)

We are always happy to help you.

Arina asks:

Hello, I'm 24, I've been taking Jess for 3 months, the intake is accompanied by nausea and migraines ... very frequent mood swings, feeling constantly PMS ... I haven't taken any pills before .... so I'm a little shocked by this effect ... but this not so important. for all the time I took the pills, I never had a period ... 2 days it will help and that's it ... I'm starting to get scared ...

IN this case it is recommended to consult with a gynecologist to decide whether to cancel the drug or replace it with another contraceptive drug. Read more about this drug in the article: "Jess"

Milan asks:

hello, I'm 15 years old, the gynecologist prescribed me Jess for acne. Hormone levels are good. Will it help me?

It is recommended to consult a dermatologist and take a scraping from the affected skin surface and exclude the presence of demodicosis. In the event that the level of hormones is within the normal range, there is no need to take hormonal drugs at puberty. Only after receiving the results of the examination, the dermatologist will make an accurate diagnosis and, if necessary, prescribe adequate treatment and decide on the need for application. hormonal drug. Read more about demodicosis by clicking on the link: Demodicosis.

Anna asks:

I drink jess regularly, as expected. Is there a risk of getting pregnant while taking inactive pills before menstruation begins? Or can you safely have unprotected intercourse?

In the event that you regularly took Jess during the entire menstrual cycle, did not take medications or substances that could reduce the activity of Jess (antibiotics, sorbents, alcohol), the contraceptive activity of Jess during the break will not decrease. The probability of pregnancy during the period of use of inactive tablets, subject to the above conditions, does not exceed that during the period of use of active Jess tablets. You can read more about Jess in our section of the same name: Jess.

Olga asks:

There are 4 empty tablets in the package of Jess, intended for the days of menstruation. If you need to drink the first pill on the first day of menstruation, then it will turn out that empty pills will be drunk on ordinary days. Should menstruation be rebuilt on these days? Is it worth taking protection on the days of taking empty pills? Thanks in advance for your reply!

Anna asks:

Good afternoon, I'm going to move from Yarina (tormented side effects) on Jess. Please explain how to do it right? There are 21 tablets in Yarina's package, after the last tablet I take I take a break for 7 days, then I start the next package. Jess has 28 tablets, when should I start drinking them, the day after the last Yarina (then there will be no menstruation this month), or after 7 days? And, yet, when I completely switch to Jess, do I need to drink them without interruption (I finished one package, started the next one the next day)? Thanks in advance for your reply.

In this situation, in order for the transition to occur more smoothly, you need to do the following. After applying the last (21st) tablet of Yarina, you should immediately (without a seven-day break) start using Jess. Jess will need to be taken completely (21 active tablets and 4 inactive tablets), after which the application of the next pack begins. In the event that you decide to take a break after using Yarina, you will need to start using Jess no later than the second day of menstrual bleeding, in addition, during the first ten days of using Jess, you will need to use additional contraception (condom). You can read more about the rules for using the contraceptive drug Jess in our thematic section of the same name: Jess.

Anna comments:

Good morning. Please specify, if I start drinking Jess immediately after the last pill of Yarina, will there be no menstruation this month? And, the second question, you write: "Jess will need to be taken completely (21 active tablets and 4 inactive tablets), after which the next pack begins" - and there are 28 tablets in a pack of Jess. Thanks in advance for your reply

On the first point: Yes, in this menstrual cycle, there will be no menstruation, it will have to begin with the use of inactive Jess tablets.
On the second point: This means the use of all Jess tablets (both active (there are 24 of them) and inactive (there are 4 of them)). When using Jess, you will need to carefully monitor the regularity of the drug and try to take the contraceptive at the same time. Even a few hours late can lead to breakthrough bleeding (withdrawal bleeding).

Sasha asks:

Hello!!! Tell me please, can I start taking Jess from the second day of menstruation ???

Katya asks:

Good afternoon!
Now, if my period only lasts 3-4 days, on the fourth day, is it possible to start drinking jess?

It is recommended to start taking Jess contraceptive pills from the first day of menstrual bleeding - in this case, additional barrier methods of contraception are not required. In the event that you start taking pills from the 2nd-5th day (this is also allowed by the instructions for use), you need to use additional barrier methods of contraception during the first 7 days of taking them to avoid unwanted pregnancy. You can get more information about the hormonal contraceptive Jess, indications and contraindications for its use, rules and features of admission in the thematic section of our website: Jess

Victoria asks:

Should I take "Jess" during my period?

Hormonal contraceptive Jess should be taken from the first day of menstruation and further according to the scheme, regardless of the time of onset and end of intermenstrual bleeding. Read more about the rules and features of taking this drug in the section of our website: Jess

Irina asks:

Hello! I bought Jess 28 tablets and found out that there are 21 tablets. What is the difference? Which ones should you buy? As I understand it, if I have a cycle of 21 days, do I need 21 tablets? Then what should I do if I have already started taking from the package where there are 28 tablets. Explain pliz ancient man)))

Jess pack contains 28 tablets, 24 of them are active and 4 tablets are inactive. Tablets should be taken strictly in order for 28 days, after which, without interruption, immediately start taking the tablets from the next package. Jess with the number of tablets 21 is not available, so follow the rules of administration described above. Jess tablets should be started on the first day of menstrual bleeding and then 1 per day at the same time until the end of the package. You can find out more detailed information on this issue in the relevant section of our website by clicking on the following link: Jess

Irina asks:

Hello! Started taking Jess after 3 patches. Menstruation was supposed to start last Thursday, and today is already Sat. They are not here. What to do?

In this case, it is necessary to exclude the possibility of pregnancy, so I recommend that you do a blood test for hCG. You can get more detailed information on the question you are interested in in the thematic section of our website by clicking on the following link: Analysis for hCG

Alesia asks:

Good afternoon. I started taking Jess from the 5th day of the menstrual cycle. In this case, is it also necessary to take all 28 before proceeding to the next package?

Regardless of when Jess was started, the pills should be taken strictly according to the scheme: active, then inactive, and after that, you should immediately start taking the pills from the next package. Read more on this issue in the thematic series of articles on our website by clicking on the link: Jess

Tatyana asks:

Good afternoon. Please tell me. In early December, I started taking Qlaira, my period started at 21 tablets and did not end until I started a new pack. Although my normal cycle: 4 days go. On the second pack, menstruation came for 17 tablets. ?Or should I switch to other pills? And how do I do that? Thanks in advance.

In the first months of taking hormonal contraceptives, this is possible, so do not worry, I recommend that you continue taking Klaira according to the scheme. You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Hormonal contraceptives

Olga asks:

Hello! I started taking Jess Plus tablets from the third day of my period. The instructions indicate: in this case, be protected by the barrier method during the first 7 days of taking the tablets. I took 7 pills at the same time. 2 hours after taking the seventh pill, there was unprotected intercourse. What is the chance of pregnancy?

In this situation, given the regular use of the hormonal contraceptive Jess according to the instructions, the risk of unwanted pregnancy is practically eliminated, so there is no cause for concern. You can get additional information on your question in the relevant section of our website by clicking on the following link: Hormonal contraceptives

Lara asks:

Hello, please tell me, I am now starting to drink the first pack of jess, today is Friday, so should I start with the first pill or the fifth? The instructions say take a pill that is marked with the corresponding day of the week, does this mean that I need to take the fifth in a row?

The first day of taking the hormonal contraceptive Jess is considered the first day of menstruation - this number, no matter what day of the week it falls on, will be considered the first day of admission for you. Then you take all the pills strictly according to the scheme - after finishing one package, immediately go to the next one and take all the pills in order, from the first, etc. You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Jess. You can also get additional information in the following section of our website: Hormonal contraceptives

Botagoz asks:

Hello! I am 22 years old! Tell me, please! then from June 15 to June 20, and I started taking a pill on July 1 every day at 9 pm, at the beginning there were headaches, weakness and mood swings and severe nausea, then my period started on July 14 and still does not end then I 3 ( July 10,11,12) I missed the pills because I had food poisoning, further as to be I correctly drink tablets? Why doesn't my period stop? Looking forward to your reply, thanks in advance!

In this situation, you need to continue taking the Jess pills according to the following scheme: if the gap is more than 2 days, then you should not take the pills for 4 days in total, and then start taking the pills regularly from the new package, regardless of the onset or end of menstrual bleeding . You can get more detailed information on the issue that interests you in the thematic section of our website by clicking on the following link: Jess. You can also get additional information in the following section of our website: Hormonal contraceptives

Sasha asks:

Good afternoon.
I am 22 years old. I'm finishing up taking 1 pack of Jess Plus. During the whole cycle spotting bleeding. The instructions say that this is normal during the adaptation period and I don’t particularly panic. But it still feels bad.
On the advice of a gynecologist, I still used barrier contraceptives for the first month. From the second pack of tablets I plan to stop using them. The question is: if the bleeding persists, can this somehow affect the effectiveness of the pills?

Indeed, in the first months of taking hormonal contraceptives, including Jess, spotting is possible, but after the first seven days of taking they do not affect the contraceptive effect, that is, additional barrier methods of contraception are required only during the first 7 days of taking in the first month.

You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Jess - a completely new contraceptive regimen and in a series of articles: Contraception and contraceptives. You can also get additional information in the following section of our website: Hormonal contraceptives

Composition

Each pink film-coated tablet contains:

Tablet core:

Active substances:

Ethinylestradiol (as betadex clathrate) 0.020 mg

Drospirenone 3,000 mg

Excipients:

Tablet shell:

Hypromellose, macrogol 6000, talc, titanium dioxide (E 171), iron oxide red (E 172).

Each light orange film-coated tablet contains:

Tablet core:

Active substances:

Calcium levomefolate [Metafolin®] 0.451 mg

Excipients:

Lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl cellulose, magnesium stearate.

Tablet shell:

Hypromellose, macrogol 6000, talc, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172).

Description

Pink film-coated tablets: round biconvex film-coated tablets, Pink colour. On one side of the tablet, "Z+" is engraved in a regular hexagon.

Light orange film-coated tablets: round biconvex tablets, film-coated light orange. On one side of the tablet in the correct hexagon is engraved "M +".

Pharmacotherapeutic group

Combined contraceptive (estrogen + progestogen + calcium lovomefolate). The codeATX G03AA12.

Pharmacological properties

Pharmacodynamics

Drospirenone is an analogue of spironolactone with antimineralocorticoid and antiandrogenic effects. The estrogen in Jess® Plus is ethinyl estradiol.

Contraception

No specific pharmacodynamic studies have been conducted with Jess® Plus. Two studies evaluated the effect of 3 mg drospirenone/0.02 mg ethinyl estradiol combinations on ovarian suppression as assessed by measurement of follicle size via transvaginal ultrasound and serum hormone (progesterone and estradiol) analysis over two cycles of therapy (a 21-day hormonal dosing period). containing tablets plus a 7-day tablet-free period). More than 90% of the subjects in these studies demonstrated suppression of ovulation.

One study compared 3mg drospirenone/0.02mg ethinylestradiol combinations with two different regimens (24-day hormonal pill plus 4-day pill-free versus 21-day hormonal pill plus 7-day pill-free period) to suppress ovarian activity during two cycles of therapy. There were no subjects (0/49.0%) using the 24-day regimen who ovulated during the first cycle of therapy compared to 1 subject (1/50.2%) using the 21-day regimen. After intentionally introduced medication errors (3 missed hormone-containing tablets on days 1-3) on the second cycle of therapy, 1 subject (1/49.2%) ovulated on the 24-day regimen compared to 4 subjects (4 /50.8%) on a 21-day scheme.

Acne

Moderate acne is a skin condition of multifactorial etiology, including androgen stimulation of sebum production. While the combination of ethinyl estradiol and drospirenone increases sex hormone-binding globulin (SHBG) and decreases free testosterone levels, a relationship between these changes and a reduction in the severity of facial acne in otherwise healthy women with this skin condition has not been established. The effect of the antiandrogenic activity of drospirenone on acne is unknown.

folate supplement

Two studies evaluated the effect of Jess® Plus on plasma folate and erythrocyte folate levels. A randomized, double-blind, actively controlled, parallel-group study compared plasma and erythrocyte folate levels during 24 weeks of therapy with Jess + 0.451 mg calcium levomefolate compared with Jess alone in a US population. The pharmacodynamic effect on plasma folate, erythrocyte folate and on the profile of circulating folate metabolites was evaluated during 24 weeks of therapy with 0.451 mg calcium levomefolate or 0.4 mg folic acid(dose equimolar to 0.451 mg calcium levomefolate), in combination with 3 mg drospirenone/0.03 mg ethinyl estradiol (Yarina), followed by 20 weeks of open-label treatment with Yarina alone (elimination phase).

Pharmacokinetics

Drospirenone

Absorption

When taken orally, drospirenone is rapidly and almost completely absorbed. After a single oral dose, the maximum serum concentration of drospirenone, equal to about 35 ng / ml, is reached after about 1-2 hours. Bioavailability ranges from 76 to 85%. Compared with taking the substance on an empty stomach, food intake does not affect the bioavailability of drospirenone.

Distribution

After oral administration, a biphasic decrease in serum levels of the drug is observed, with elimination half-lives of 1.6 ± 0.7 hours and 27.0 ± 7.5 hours, respectively. Drospirenone binds to serum albumin and does not bind to sex steroid-binding globulin (SHBG) or corticosteroid-binding globulin (CBG). Only 3-5% of the total serum concentration of the substance is present as a free steroid. The increase in SHBG induced by ethinylestradiol does not affect the binding of drospirenone to serum proteins. The average apparent volume of distribution is 3.7±1.2 l/kg.

Metabolism

Following oral administration, drospirenone is extensively metabolized. Most of the plasma metabolites are represented by the acidic forms of drospirenone, formed due to the opening of the lactone ring, and 4,5-dihydro-drospirenone-3-sulfate, each of which is formed without the participation of the P450 system. Drospirenone is metabolized to a small extent by cytochrome P450 ZA4 and is able to inhibit this enzyme and cytochrome P450 1A1, cytochrome P450 2C9 and cytochrome P450 2C19 in vitro.

Excretion from the body

The rate of metabolic clearance of drospirenone in serum is 1.5±0.2 ml/min/kg. Unchanged drospirenone is excreted only in trace amounts. Drospirenone metabolites are excreted in faeces and urine in a ratio of approximately 1.2:1.4. The elimination half-life for excretion of metabolites in urine and faeces is approximately 40 hours.

Equilibrium concentration

During cyclic treatment, the maximum steady-state serum concentration of drospirenone is reached between days 7 and 14 of treatment and is approximately 60 ng/ml. There was an increase in the concentration of drospirenone in serum by about 2-3 times (due to cumulation), which was determined by the ratio of the half-life in the terminal phase and the dosing interval. A further increase in the serum concentration of drospirenone is noted between 1 and 6 cycles of administration, after which no increase in concentration is observed.

Special populations of patients

Impact of kidney failure

Steady-state serum concentrations of drospirenone in women with mild renal insufficiency (creatinine clearance = 50–80 ml/min) were comparable to those in women with normal renal function (Cl.cr. > 80 ml/min). In women with moderate renal insufficiency (Cl. cr. = 30-50 ml / min), the serum level of drospirenone was on average 37% higher than in women with normal renal function. Treatment with drospirenone was well tolerated in all groups. Drospirenone did not have a clinically significant effect on serum potassium concentration.

Impact of liver failure

Drospirenone is well tolerated by patients with mild or moderate hepatic impairment (Child-Pugh class B). The mean half-life of drospirenone observed in volunteers with moderate hepatic impairment is 1.8 times longer than in volunteers with normal liver function.

Approximately 50% reduction in apparent total clearance (Cl/f) was observed in volunteers with moderate hepatic impairment compared to volunteers with normal hepatic function. The observed decrease in drospirenone clearance in volunteers with moderate hepatic impairment compared with volunteers with normal liver function did not have any apparent difference in serum potassium concentrations between the two groups of volunteers. Even with concomitant treatment of diabetes with spironolactone (two factors that may predispose the patient to hyperkalemia), no increase in serum potassium above the upper limit of the normal range was observed. It can be concluded that drospirenone is well tolerated in patients with mild to moderate hepatic impairment (Child-Pugh class B).

ethnic groups

The influence of ethnic factors on the pharmacokinetics of drospirenone and ethinylestradiol was studied after single and multiple daily oral administration in young healthy Caucasian and Japanese women. The results showed that ethnic differences between them did not have a clinically significant effect on the pharmacokinetics of drospirenone and ethinyl estradiol.

Ethinylestradiol

Absorption

After oral administration, ethinylestradiol is rapidly and completely absorbed. The peak serum concentration after a single oral dose is reached after 1-2 hours and is about 88-100 pg / ml. Absolute bioavailability as a result of presystemic conjugation and first passage metabolism is approximately 60%. Concomitant food intake reduces the bioavailability of ethinylestradiol in about 25% of the examined, while in other subjects such changes were not observed.

Distribution

The serum concentration of ethinylestradiol decreases biphasically, the terminal phase is characterized by an elimination half-life of approximately 24 hours. Ethinylestradiol is highly, but not specifically, bound to serum albumin (about 98.5%) and causes an increase in serum SHBG concentrations. The apparent volume of distribution is about 5 l/kg.

Metabolism

Ethinylestradiol undergoes presystemic conjugation in the mucosa of the small intestine and in the liver. Ethinylestradiol is primarily metabolized by aromatic hydroxylation, producing a variety of hydroxylated and methylated metabolites, both as free metabolites and as conjugates with glucuronic and sulfuric acids. Ethinylestradiol is completely metabolized. The rate of metabolic clearance of ethinyl estradiol is about 5 ml / min / kg.

Excretion from the body

Ethinylestradiol is practically not excreted unchanged. Metabolites of ethinylestradiol are excreted in the urine and bile in a ratio of 4:6. The half-life for excretion of metabolites is approximately 1 day.

Equilibrium concentration

The state of equilibrium concentration is reached during the second half of the treatment cycle, and the serum level of ethinylestradiol increases by about 1.4-2.1 times.

Levomefolate calcium

Absorption

The acid form of calcium levomefolate is structurally identical to natural L-5-methyltetrahydrofolate (L-5-methyl-THF), the predominant form of folic acid in food. The average basal concentration of about 15 nmol/l is achieved in populations under normal nutritional conditions (without intentional fortification of food with folic acid). After oral administration, levomefolate calcium is rapidly absorbed. Peak plasma concentration of about 50 nmol / l, which exceeds the baseline, is achieved within 0.5 - 1.5 hours after a single oral intake of 0.451 mg of calcium levomefolate.

Distribution

For folates, biphasic kinetics have been reported with fast and slow cycle pools. The fast cycle pool, probably reflecting freshly ingested folates, corresponds to a terminal half-life of approximately 4–5 hours after a single oral dose of levomefolate calcium 0.451 mg.

The slow cycle pool, reflecting the folate polyglutamate cycle, has an average residence time of at least 100 days. Exogenous folates and the enterohepatic folate cycle maintain a constant supply of L-5-methyl-THF.

L-5-methyl-THF is the predominant circulating folate and thus the form of folate normally transported to peripheral tissues for use in cellular folate metabolism. There are three physiological mechanisms for transport and uptake of L-5-methyl-THF by different cell types: two carrier-mediated active transport mechanisms (reduced folate transporter and folate receptor) and passive diffusion.

Metabolism

L-5-methyl-THF is the main transport form of folate in plasma. When comparing 0.451 mg calcium levomefolate with 0.4 mg folic acid, similar patterns of other important circulating folates were found. The uptake of L-5-methyl-THF into cellular folate metabolism is preceded by conversion to L-tetrahydrofolate via reaction with methionine synthase before effective polyglutamylation and tissue retention is achieved. Folate coenzymes are involved in three main interrelated metabolic cycles in the cytosol of cells. These cycles are required for the synthesis of thymidylate and purines, precursors for DNA and RNA synthesis, and for the synthesis of methionine from homocysteine, as well as for the interconversion of serine and glycine.

Excretion from the body

L-5-methyl-THF is excreted in the urine as unchanged folate and catabolic products, and is also excreted in the feces through a biphasic kinetic process. A rapid decrease in the concentration of folates and their catabolites in urine and feces, with a half-life of several hours, is followed by a long-term decrease, with a half-life of approximately 100-360 days.

Equilibrium concentration

Steady-state concentrations for L-5-methyl-THF in plasma after oral administration of 0.451 mg calcium levomefolate are reached in approximately 8-16 weeks, depending on baseline concentrations. In erythrocytes, the achievement of equilibrium concentration is delayed due to the long life span of erythrocytes, which is about 120 days.

Preclinical safety data

Preclinical data obtained in the course of standard studies on toxicity with repeated doses of drosperinone and ethinyl estradiol, as well as genotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate a particular risk to humans. However, it should be remembered that sex steroids may promote the growth of certain hormone-dependent tissues and tumors.

Preclinical data obtained in the course of standard studies on the detection of toxicity with repeated doses of calcium levomefolate, as well as genotoxicity and toxicity to the reproductive system, do not indicate a particular risk to humans.

Indications for use

Contraception. Contraception and increasing folate levels. Contraception and treatment of moderate acne in women 14 years of age or older (see Precautions section). Contraception and management of symptoms of premenstrual dysphoric disorder (PMDD) (see Precautions section).

Dosage and administration

How and when to take the pills

Tablets should be taken orally in the order indicated on the package, every day at the same time, without chewing, with a small amount of water. Take 1 tablet per day continuously for 28 days. Taking pills from the next pack begins immediately after taking the pills from the previous pack.

"Withdrawal" bleeding usually begins 2-3 days after the start of hormone-free pills and may not end before the next pack of pills is started.

Taking pills from the first pack of Jess ® Plus

In the absence of taking any hormonal contraceptives in the previous month.

Taking the drug Jess® Plus should be started on the first day of the menstrual cycle, that is, on the first day of menstrual bleeding. On this day, you need to take one pink (hormone-containing) pill, which is marked with the corresponding day of the week. Then you should take the pills in order. The drug Jess® Plus begins to act immediately, so there is no need to use additional barrier methods of contraception.

It is allowed to start taking the drug on the 2nd-5th day of the menstrual cycle, but in this case, during the first 7 days of taking pink (hormone-containing) pills, an additional barrier method of contraception (for example, a condom) must be used.

When switching from other combined contraceptive drugs (COC, vaginal ring or contraceptive patch)

It is preferable to start taking Jess® Plus the next 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 hormone-containing tablet. non-containing tablet (for preparations containing 28 tablets per pack). Jess® Plus should be started on the day the vaginal ring or patch is removed, but no later than the day a new ring is to be inserted or a new patch is pasted.

When switching from contraceptives containing only gestagens ("mini-pills", injectable forms, implant) or from an intrauterine therapeutic system with the release of a progestogen

You can switch from mini-pill to Jess® Plus any day (without a break), from an implant or IUD with a progestogen - on the day of their removal, from an injectable contraceptive - on the day when the next injection should be made. In all cases, during the first 7 days of taking Jess® Plus, you must additionally use a barrier method of contraception (for example, a condom).

After an abortion (including spontaneous) in the first trimester of pregnancy

You can start taking the drug immediately. If this condition is met, additional contraceptive measures are not required.

After childbirth (in the absence of breastfeeding) or abortion (including spontaneous) in the second trimester of pregnancy

It is recommended to start taking the drug on the 21st - 28th day after childbirth or abortion (including spontaneous) in the second trimester of pregnancy. If the drug is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the tablets. However, if sexual intercourse has taken place, pregnancy should be excluded before starting Jess® Plus.

How to handle the packaging of the drug Jess ® Plus

A blister containing 24 hormone-containing (pink) tablets and 4 auxiliary (light orange) tablets (bottom row) is glued into the Jess® Plus folding package. The package also contains a block of stickers, consisting of 7 self-adhesive strips with the names of the days of the week marked on them, which is necessary for designing the appointment calendar. It is necessary to select the strip where the first day of the week is indicated on which the pills start to be taken. For example, if you start taking your pills on Wednesday, you should use a strip that starts with "Wed." (see fig. 1).

The strip is glued along the top of the package so that the designation of the first day is above the tablet to which the arrow with the inscription "Start" is directed (Fig. 2).

Now you can see on which day of the week you should take each pill (Fig. 3).

Taking missed pills

The omission of auxiliary light orange tablets can be ignored. However, missed pills should be discarded so as not to inadvertently prolong the period of supplementary pills. The following recommendations apply only to the pass hormone-containing pink tablets (tablets 1-24 per package):

less than 24 hours, contraceptive protection is not reduced. The woman should take the missed pill as soon as possible and take the next one at the usual time.

If the delay in taking any pink (hormone-containing) pill was more than 24 hours, contraceptive protection may be reduced. The more pills missed, and the closer the missed pills to the light orange (auxiliary) pill phase, the higher the chance of pregnancy.

In doing so, you must remember:

The drug should never be interrupted for more than 7 days (please note that the recommended interval for taking the light orange (auxiliary) tablets is 4 days). 7 days of continuous administration of hormone-containing (pink) tablets is required to achieve adequate suppression of the hypothalamic-pituitary-ovarian system.

Accordingly, if the delay in taking hormone-containing (pink) tablets was more than 24 hours, the following can be recommended:

From 1st to 7th day:

The woman should take the last missed tablet as soon as she remembers, even if it means taking two tablets at the same time. The following tablets must be taken at the usual time. In addition, over the next 7 days, you must additionally use a barrier method of contraception (for example, a condom). If sexual intercourse took place within 7 days before skipping the pill, the possibility of pregnancy should be considered.

8th to 14th day

The woman should take the last missed tablet as soon as she remembers, even if it means taking two tablets at the same time. The following tablets must be taken at the usual time.

Provided that the tablet-taking regimen is observed within 7 days preceding the first missed tablet, there is no need to use additional contraceptive measures. Otherwise, and also if you miss two or more pills, you must additionally use barrier methods of contraception (for example, a condom) for the next 7 days.

From the 15th to the 24th day

The risk of reduced contraceptive reliability is inevitable due to the approaching phase of taking light orange (auxiliary) pills. In this case, you must adhere to the following algorithms:

If during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods. When taking the missed pills, follow steps 1 or 2. If during the 7 days preceding the first missed tablet, the pills were taken incorrectly, then during the next 7 days it is necessary to additionally use a barrier method of contraception (for example, a condom) and in this case point 1 should be followed to take missed pills. Take the missed pill as soon as possible, as soon as the woman remembers (even if it means taking two pills at the same time). The next pills are taken at the usual time until the pink (hormone-containing) pills in the package run out. The four light orange (relief) pills should be discarded and the pink (hormone-containing) pills from the new pack should be started immediately. Until the pink (hormone-containing) pills from the second pack run out, "withdrawal" bleeding is unlikely, but "spotting" discharge and / or "breakthrough" bleeding may occur. Stop taking pink (hormone-containing) tablets from the current package, then take a break of 4 days or less (including missed pill days) then start taking the drug from a new package.

If a woman missed the pink (hormone-containing) pills and did not bleed while taking the light orange (auxiliary) pills, it is necessary to make sure that she is not pregnant.

For convenience, this information is presented on the packaging in the form of the following diagram:

Taking missed pills

It is allowed to take no more than two tablets in one day.

In severe gastrointestinal disorders, the absorption of the drug may be incomplete, so additional contraceptive measures should be taken.

If vomiting or diarrhea occurs within 3-4 hours after taking a pink (hormone-containing) pill, you should be guided by the recommendations for skipping pills. If a woman does not want to change her usual dosing schedule and move her period to another day of the week, an additional pink (hormone-containing) tablet should be taken from another pack.

Stopping Jess ® Plus

You can stop taking Jess® Plus at any time. If a woman is not planning a pregnancy, other methods of contraception should be considered. If pregnancy is planned, you should simply stop taking Jess® Plus, wait for natural menstrual bleeding, and only then try to get pregnant. This will help to more accurately calculate the gestational age and time of birth.

Delaying the onset of menstrual bleeding

To delay the onset of "withdrawal" bleeding, you should skip taking 4 light orange (auxiliary) tablets from the current package and start taking pink (hormone-containing) tablets from the next package of Jess® Plus. If you have taken all 24 pink tablets from the second package, then you should also take 4 light orange tablets. Only after that you can start taking the pills from the new package. Thus, the cycle can be extended, if desired, for any period, up to 3 weeks, including until all the pink tablets from the second package are taken. If you want menstrual bleeding to start sooner, you should stop taking the pink pills from the second pack, throw it away and stop taking all the pills for no more than 4 days, and then start taking the pills from the new pack. In this case, menstrual bleeding will begin approximately 2-3 days after taking the last pink pill from the second package. While taking the drug Jess® Plus from the second package, there may be "spotting" discharge and / or "breakthrough" bleeding on the days of taking the tablets.

Changing the day of onset of menstrual bleeding

If the tablets are taken as directed, menstrual bleeding will occur on or about the same day every 4 weeks. If you want to change the day your period starts, stop taking the light orange tablets for as many days as you want to change the start of your period. For example, if your cycle usually starts on Friday, and in the future you want it to start on Tuesday (3 days earlier), the pills from the next pack should be started 3 days earlier than usual, that is, do not use the last 3 light days. orange pills from the current pack and start taking the pills from the next pack. The fewer light orange pills you take, the more likely it is that menstrual bleeding will not occur. While taking the drug Jess® Plus from the following package, "spotting" discharge and / or "breakthrough" bleeding may occur.

Application in certain groups of patients

In children

The effectiveness and safety of Jess® Plus as a contraceptive have been studied in women of reproductive age. The use of the drug is contraindicated until the establishment of regular menstrual cycles.

In the elderly

The drug Jess® Plus is not used after menopause.

For impaired liver function

The drug is contraindicated for use in women with severe liver dysfunction.

For impaired renal function

The drug is contraindicated for use in women with severe renal impairment and in acute renal failure.

Contraindications

The drug Jess® Plus is contraindicated in the presence of 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 immediately discontinued.

Thrombosis (venous and arterial) and thromboembolism (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders - currently or in history. Conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at present or in history. Identified acquired or hereditary predisposition to venous or arterial thrombosis, including resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia, antibodies to phospholipids (anti-cardiolipin antibodies, lupus anticoagulant). The presence of a high risk of venous or arterial thrombosis (see section "Precautions"). Migraine with focal neurological symptoms at present or in history. Pancreatitis with severe hypertriglyceridemia at present or in history. Diabetes mellitus with vascular complications. Liver failure and severe liver disease (before normalization of liver tests). Severe and / or acute renal failure. Reception antiviral drugs direct-acting, containing ombitasvir, paritaprevir or dasabuvir and their combinations (see section "Interaction with other drugs") Liver tumors (benign or malignant) at present or in history. Identified hormone-dependent malignant neoplasms (including the genital organs or mammary glands) or suspicion of them. Bleeding from the vagina of unknown origin. Pregnancy or suspicion of it. breastfeeding period. Hypersensitivity or intolerance to any of the components of Jess® Plus. The drug Jess® Plus contains lactose, therefore it is contraindicated in patients with rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

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Side effect

The most common adverse reactions reported in connection with the use of the drug Jess® are as follows: nausea, pain in the mammary glands, irregular uterine bleeding, bleeding from the genital tract of an unspecified origin (more than 3% of women using the drug according to indications "Contraception" and “Contraception and treatment of moderate acne (acne vulgaris)”); nausea, pain in the mammary glands, irregular uterine bleeding (more than 10% of women using the drug for the indication "Contraception and treatment of severe premenstrual syndrome (PMS)").

Serious adverse reactions are arterial and venous thromboembolism.

The table below shows the frequency of adverse reactions reported during clinical trials of Jess® and Jess® Plus preparations for the indication “Contraception”, as well as for the indications “Contraception and treatment of moderate acne (acne vulgaris)” (N = 3565) and “Contraception and treatment of severe premenstrual syndrome (PMS)” (N=289) for Jess®. Within each group, allocated depending on the frequency of occurrence, adverse reactions are presented in order of decreasing severity. By frequency, they are divided into frequent (≥1/100 and<1/10), нечастые (≥1/1000 и <1/100) и редкие (≥1/10000 и <1/1000). Для дополнительных побочных реакций, выявленных только в процессе постмаркетинговых наблюдений, и для которых оценку частоты возникновения провести не представлялось возможным, указано «частота неизвестна».

Adverse events were classified using the MedDRA (Regulatory Medical Dictionary). Various MedDRA terms representing the same symptom have been grouped together and presented as a single adverse reaction to avoid diluting or blurring the true effect.

* - Approximate frequency based on the results of epidemiological studies covering the COC group. The frequency bordered on very rare.

- “Venous or arterial thromboembolism” includes the following nosological units: peripheral deep vein occlusion, thrombosis and embolism / occlusion of pulmonary vessels, thrombosis, embolism and infarction / myocardial infarction / cerebral infarction and hemorrhagic stroke.

Incidence in studies evaluating PMS was very common >10/100 Incidence in studies evaluating PMS was common ≥1/100

For venous and arterial thromboembolism and migraine, see also "Contraindications" and "Precautions".

Additional Information

Listed below are adverse reactions with a very rare frequency of occurrence or with delayed symptoms that are believed to be associated with the use of drugs from the COC group (see also "Contraindications" and "Precautions").

Tumors

In women using COCs, the incidence of breast cancer is very slightly increased. Since breast cancer is rare in women younger than 40 years of age, the increased incidence of cancer in women using COCs is insignificant in relation to the overall risk of breast cancer. A causal relationship with the use of COCs is unknown. Tumors of the liver (benign and malignant).

Other states

Erythema nodosum Hypertriglyceridemia (increased risk of pancreatitis while taking COCs) Increased blood pressure (BP) Conditions that develop or worsen while taking COCs, but their relationship has not been proven: jaundice and / or itching associated with cholestasis; the formation of stones in the gallbladder; epilepsy; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis In women with hereditary angioedema, estrogens may cause or exacerbate symptoms of angioedema Liver dysfunction Crohn's disease, ulcerative colitis Chloasma Hypersensitivity (including symptoms such as rash, urticaria)

Interaction

Interactions of oral contraceptives with other medicinal products (enzyme inducers) may lead to breakthrough bleeding and/or reduced contraceptive efficacy (see "Interaction with other medicinal products").

Overdose

Clinical cases of overdose hormone-containing Jess® Plus tablets are not available. Based on the overall experience with combined oral contraceptives, symptoms that may occur with an overdose of hormone-containing tablets are as follows: nausea, vomiting, breakthrough bleeding. Breakthrough bleeding can occur even in young girls before menarche if the drug is accidentally taken. There is no specific antidote, symptomatic treatment should be carried out.

Calcium levomefolate and its metabolites are identical to the natural forms of folate found in foods that are consumed daily without apparent harm. Calcium levomefolate at doses of 17 mg / day (37 times the dose of calcium levomefolate contained in Jess® Plus) was well tolerated after long-term use up to 12 weeks.

Interaction with other drugs

Note: The instructions for use of the concomitant medicinal product should be taken into account to determine potential interactions.

The influence of other drugs on the drug Jess ® Plus

Interaction with drugs that induce microsomal liver enzymes is possible, as a result of which the clearance of sex hormones may increase, which, in turn, may lead to "breakthrough" uterine bleeding and / or a decrease in the contraceptive effect.

Enzyme induction can be observed after a few days of treatment. The maximum induction of enzymes is usually observed within a few weeks. After discontinuation of drug therapy, enzyme induction can be maintained for about 4 weeks.

Women who receive treatment with such drugs in addition to Jess® Plus are recommended to use a barrier method of contraception or choose another non-hormonal method of contraception. The barrier method of contraception should be used during the entire period of taking concomitant drugs, as well as within 28 days after their withdrawal. If the period of using a barrier method of contraception ends later than the pink (hormone-containing) pills in the Jess Plus package, you should skip taking the light orange (auxiliary) pills and start taking the pills from the new Jess Plus package.

Substances that increase the clearance of Jess® Plus (weakening efficiency by enzyme induction):

phenytoin, barbiturates, primidone, carbamazepine, rifampicin and possibly also oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John's wort.

Substances with different effects on the clearance of Jess® Plus

When used together with Jess® Plus, many HIV or hepatitis C protease inhibitors and non-nucleoside reverse transcriptase inhibitors can either increase or decrease the concentration of estrogens or progestins in the blood plasma. In some cases, such influence can be clinically expressed.

Substances that reduce the effectiveness of calcium levomefolate

Effect on folate metabolism: Some drugs reduce plasma folate concentration and reduce folate efficacy by inhibiting the enzyme dihydrofolate reductase (eg, methotrexate, trimethoprim, sulfasalazine, and triamterene) or by decreasing folate absorption (eg, cholestyramine) or by unknown mechanisms (eg, antiepileptic drugs: carbamazepine, phenytoin, phenobarbital, primidone and valproic acid).

Substances that reduce the clearance of COCs (enzyme inhibitors)

Strong and moderate CYP3A4 inhibitors such as azole antimycotics (eg, itraconazole, voriconazole, fluconazole), verapamil, macrolides (eg, clarithromycin, erythromycin), diltiazem, and grapefruit juice may increase plasma concentrations of estrogen or progestin, or both.

It was shown that etoricoxib at doses of 60 and 120 mg / day, when taken together with COCs containing 0.035 mg of ethinylestradiol, increases the concentration of ethinylestradiol in blood plasma by 1.4 and 1.6 times, respectively.

The effect of COCs or calcium levomefolate on other drugs

COCs can interfere with the metabolism of other drugs, resulting in either an increase (eg, cyclosporine) or a decrease (eg, lamotrigine) in plasma and tissue concentrations.

In vitro, drospirenone is able to weakly or moderately inhibit the cytochrome P450 enzymes CYP1A1, CYP2C9, CYP2C19 and CYP3A4.

Based on in vivo interaction studies in female volunteers treated with omeprazole, simvastatin, or midazolam as marker substrates, it can be concluded that a clinically significant effect of 3 mg drospirenone on drug metabolism mediated by cytochrome P450 enzymes is unlikely.

In vitro, ethinylestradiol is a reversible inhibitor of CYP2C19, CYP1A1, and CYP1A2, and an irreversible inhibitor of CYP3A4/5, CYP2C8, and CYP2J2. In clinical studies, the administration of a hormonal contraceptive containing ethinyl estradiol did not lead to any increase or only a slight increase in plasma concentrations of CYP3A4 substrates (eg, midazolam), while plasma concentrations of CYP1A2 substrates may increase slightly (eg, theophylline ) or moderately (eg, melatonin and tizanidine).

Folates can alter the pharmacokinetics or pharmacodynamics of some drugs that affect folate metabolism, such as antiepileptic drugs (phenytoin), methotrexate or pyrimethamine, which may be accompanied by a decrease (generally reversible, subject to an increase in the dose of the drug affecting folate metabolism) of their therapeutic effect. The use of folate during treatment with such drugs is recommended mainly to reduce the toxicity of the latter.

Pharmacodynamic Interactions

Co-administration of ethinylestradiol-containing drugs with direct-acting antivirals containing ombitasvir, paritaprevir or dasabuvir, as well as their combination, is associated with a more than 20-fold increase in ALT levels compared with the upper limit of normal in healthy women and in women infected with hepatitis C (see section "Contraindications").

Other forms of interaction

In patients with intact renal function, the combined use of drospirenone and angiotensin-converting enzyme inhibitors or non-steroidal anti-inflammatory drugs does not have a significant effect on the concentration of potassium in the blood plasma. However, the combined use of Jess® Plus with aldosterone antagonists or potassium-sparing diuretics has not been studied. In such cases, the concentration of potassium in the blood plasma must be monitored during the first cycle of administration.

Precautionary measures

Premenstrual dysphoric disorder (PMDD)

Jess® Plus is also indicated for the treatment of symptoms of premenstrual dysphoric disorder (PMDD) in women when using an oral contraceptive. The effectiveness of Jess® Plus, used to treat PMDD for more than three menstrual cycles, has not been studied.

The main manifestations of PMDD, according to the 4th edition of the Diagnostic and Statistical Manual (DSM-IV), are as follows: severe depression, anxiety or tension, affective lability, constant anger or irritability. Other manifestations include decreased interest in daily activities, difficulty concentrating, loss of energy, changes in appetite or sleep, and feeling out of control. Physical symptoms of PMDD include breast tenderness, headache, joint and muscle pain, flatulence, and weight gain. The listed symptoms regularly appear in the indicated order throughout the luteal cycle and disappear a few days after the onset of menstruation; this disorder significantly affects educational or production activities, makes it difficult for ordinary social activities and relationships with other people. Diagnosis is by the treating physician based on DSM-IV criteria, and symptomatology is assessed prospectively over at least two menstrual cycles. When making a diagnosis, it is critical to rule out other cyclical mood disorders.

The effectiveness of Jess® Plus in the treatment of premenstrual syndrome (PMS) has not been studied.

acne

Jess® Plus is indicated for the treatment of moderate acne vulgaris (acne vulgaris) in women aged at least 14 years who have no contraindications to oral contraceptive therapy and who have had their first menstruation. Jess® Plus should be used to treat acne only if the patient wishes to use an oral contraceptive to prevent pregnancy.

Folate supplement

Jess® Plus is prescribed to women who choose oral contraception as a method of contraception to increase folate levels in order to reduce the risk of a neural tube defect in the fetus if pregnancy occurs while taking the drug or immediately after its withdrawal.

For disorders of the cardiovascular system

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

The risk of developing VTE is highest in the first year of taking COCs. An increased risk is present after the initial use of COCs or the resumption of the use of the same or another COC (after a break between doses of 4 weeks or more). Data from a large prospective study in 3 groups of patients show that this increased risk is predominantly present during the first 3 months.

The overall risk of VTE in women taking low-dose COCs (< 0,05 мг этинилэстрадиола) в два-три раза выше, чем у небеременных пациенток, которые не принимают КОК, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ во время беременности и родов.

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

VTE manifesting as deep vein thrombosis or pulmonary embolism can occur with any COC.

Very rarely, when using COCs, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or vessels of the retina.

Symptoms of deep vein thrombosis: unilateral swelling of the lower limb or along a vein in the lower limb, pain or discomfort in the lower limb only in an upright position or when walking, local temperature increase in the affected lower limb, redness or discoloration of the skin on the lower limb.

Symptoms of pulmonary embolism: difficulty or rapid breathing; sudden cough, including hemoptysis; sharp pain in the chest, which may worsen with a deep breath; 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 conditions/diseases (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 sensation in the face, limbs, especially on one side of the body, sudden confusion, problems with speech and understanding; sudden unilateral or bilateral loss of vision; sudden disturbance of gait, dizziness, loss of balance or coordination of movements; sudden, severe or prolonged headache with no apparent cause; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight bluing of the extremities, "acute" abdomen.

Symptoms of myocardial infarction: pain, discomfort, pressure, heaviness, a feeling of compression or fullness in the chest or behind the sternum, radiating to the back, jaw, left upper limb, epigastric region; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety, or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be life-threatening or fatal.

In women with a combination of several risk factors or a high severity of one of them (for example, complicated diseases of the valvular apparatus of the heart, uncontrolled arterial hypertension, extensive surgical interventions with prolonged immobilization, etc.), the possibility of their mutual reinforcement should be considered. In such cases, the total value of the existing risk factors increases. In this case, taking the drug Jess® Plus is contraindicated (see section "Contraindications").

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

With age; in smokers (with an increase in the number of cigarettes or an increase in age, the risk increases, especially in women over 35 years old);

in the presence of:

Obesity (body mass index over 30 kg/m2); 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, a woman should be examined by an appropriate specialist to decide whether it is possible to take Jess® Plus; prolonged immobilization, major surgery, any lower limb surgery or major trauma. In these situations, it is necessary to stop taking Jess® Plus (in the case of a planned operation, at least four weeks before it) and not resume taking it within two weeks after the end of immobilization. Temporary immobilization (eg, air travel longer than 4 hours) may also be a risk factor for venous thromboembolism, especially if other risk factors are present; dyslipoproteinemia; arterial hypertension; migraine; heart valve disease; atrial fibrillation.

The question of the possible role of varicose veins and superficial thrombophlebitis in the development of VTE remains controversial.

An increased risk of thromboembolism in the postpartum period should be taken into account.

Peripheral circulatory disorders can 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 the use of the drug Jess® Plus (which may precede cerebrovascular disorders) is the basis for immediate discontinuation of the drug.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (antibodies to cardiolipin, lupus anticoagulant).

When evaluating the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition can reduce the risk of thrombosis associated with it. It should also be borne in mind that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (< 0,05 мг этинилэстрадиола).

Tumors

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 COCs. However, the connection with the use of COCs has not been proven. The possibility of the relationship of these data with the screening of diseases of the cervix and with the peculiarities of sexual behavior (more rare use of barrier methods of contraception) is discussed.

A meta-analysis of 54 epidemiological studies showed that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking COCs (relative risk 1.24). The increased risk gradually disappears within 10 years after stopping these drugs. Due to the fact that breast cancer is rare in women under 40 years of age, the increase in the number of breast cancer diagnoses in women who are currently taking COCs or have recently taken them is insignificant in relation to the overall risk of this disease. Its association with COC use has not been proven. The observed increase in risk may be due to careful monitoring and earlier diagnosis of breast cancer in women using COCs. In women who have ever used COCs, earlier stages of breast cancer are detected than in women who have never used them.

In rare cases, against the background of the use of COCs, the development of benign, and in extremely rare cases, malignant liver tumors was observed, which in some patients led to life-threatening intra-abdominal bleeding. If there is severe pain in the abdomen, an enlarged liver, or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis.

Other states

Clinical studies have shown no effect of drospirenone on the concentration of potassium in the blood plasma of patients with mild to moderate renal insufficiency. However, in patients with impaired renal function and an initial concentration of potassium at the upper limit of normal, the risk of developing hyperkalemia while taking drugs that lead to potassium retention in the body cannot be ruled out.

In women with hypertriglyceridemia (or a family history of this condition), there may be an increased risk of developing pancreatitis while taking COCs.

Although a slight increase in blood pressure (BP) has been described in many women taking COCs, clinically significant increases have been rare. However, if a persistent clinically significant increase in blood pressure develops while taking Jess® Plus, this drug should be discontinued and treatment of arterial hypertension should be started. The drug can be continued if normal blood pressure values ​​are achieved with the help of antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and when taking COCs, but their relationship with taking COCs has not been proven: jaundice and / or itching associated with cholestasis; the formation of stones in the gallbladder; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis. There are also described cases of worsening of the course of endogenous depression, epilepsy, Crohn's disease and ulcerative colitis against the background of the use of COCs.

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen the symptoms of angioedema.

Acute or chronic liver dysfunction may require discontinuation of Jess® Plus until the liver function returns to normal. Recurrence of cholestatic jaundice, which developed for the first time during a previous pregnancy or previous use of sex hormones, requires discontinuation of Jess® Plus.

Although COCs may have an effect on insulin resistance and glucose tolerance, the need for dose adjustment of hypoglycemic drugs in diabetic patients using low-dose oral contraceptives (< 0,05 мг этинилэстрадиола), как правило, не возникает. Тем не менее, женщины с сахарным диабетом должны тщательно наблюдаться во время приема КОК.

Occasionally, chloasma may develop, especially in women with a history of chloasma of pregnancy. Women with a tendency to chloasma while taking Jess® Plus should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

Folate can mask a vitamin B12 deficiency.

Preclinical safety data

Preclinical data obtained in the course of standard studies for the detection of toxicity with repeated doses of the drug, as well as genotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate a particular risk to humans. However, it should be remembered that sex hormones can promote the growth of certain hormone-dependent tissues and tumors.

Preclinical data obtained in the course of standard studies of calcium levomefolate to detect toxicity with repeated doses of the drug, as well as genotoxicity and toxicity to the reproductive system, do not indicate a particular risk to humans.

Laboratory tests

Taking Jess® Plus may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma concentration of transport proteins, carbohydrate metabolism, blood coagulation and fibrinolysis parameters. Changes usually do not go beyond the boundaries of normal values. Drospirenone increases plasma renin activity and aldosterone concentration, which is associated with its antimineralocorticoid effect.

Reduced efficiency

The effectiveness of Jess® Plus may be reduced in the following cases: when pink (hormone-containing) tablets are missed, gastrointestinal disorders while taking pink (hormone-containing) tablets, or as a result of drug interactions.

Frequency and severity of menstrual bleeding

While taking Jess® Plus, irregular (acyclic) bleeding from the vagina (“spotting” spotting and / or “breakthrough” uterine bleeding) may occur during the first few months. You should apply hygiene products and continue taking the tablets as usual. Any irregular bleeding should be assessed after an adaptation period of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, a thorough examination should be carried out to exclude malignant neoplasms or pregnancy.

Absence of regular menstrual bleeding

Some women may not experience "withdrawal" bleeding while taking the light orange relief pills. If the drug Jess® Plus was taken according to the recommendations, it is unlikely that the woman is pregnant. However, with irregular use of Jess® Plus and the absence of two consecutive "withdrawal" bleedings, the drug cannot be continued until pregnancy is excluded.

Medical examinations

Before starting or resuming the use of the drug, it is necessary to familiarize yourself with the history of life, the woman's family history, conduct a thorough physical examination (including measurement of blood pressure, heart rate, determination of body mass index, examination of the mammary glands), gynecological examination, cytological examination of the cervix (Papanicolaou test ), rule out pregnancy. When you resume taking the drug Jess® Plus, the volume of additional studies and the frequency of follow-up examinations are determined individually, but at least 1 time in 6 months.

It must be borne in mind that the drug Jess ® Plus does not protect against HIV infection and other sexually transmitted diseases!

Conditions requiring medical advice

Any changes in health, especially the occurrence of conditions listed in the sections "Contraindications" and "Use with caution"; Local compaction in the mammary gland; Simultaneous use of other drugs (see also "Interaction with other drugs"); If prolonged immobility is expected (for example, a cast is applied to the lower limb), hospitalization or surgery is planned (at least 4 weeks before the proposed operation); unusually heavy bleeding from the vagina; Missed a pill in the first week of taking the pack and had sexual intercourse seven days or less before; Absence of another menstrual-like bleeding twice in a row or suspicion of pregnancy (do not start taking pills from the next package before consulting a doctor).

You should stop taking the tablets and consult your doctor immediately if there are possible signs of thrombosis, myocardial infarction or stroke: unusual cough; unusually severe pain behind the sternum, radiating to the left arm; sudden onset of shortness of breath, unusual, severe and prolonged headache or migraine attack; partial or complete loss of vision or double vision; inarticulate speech; sudden changes in hearing, smell, or taste; dizziness or fainting; weakness or loss of sensation in any part of the body; severe pain in the abdomen; severe pain in the lower limb or sudden swelling of any of the lower limbs.

Pregnancy and lactation

Jess® Plus is contraindicated during pregnancy. If pregnancy is detected while taking Jess® Plus, the drug should be discontinued immediately. Women after discontinuation of the drug Jess® Plus should be recommended additional intake of folates.

However, extensive epidemiological studies have not identified any increased risk of malformations in children born to women who received combined oral contraceptives before pregnancy, or teratogenic effects when combined oral contraceptives were taken by negligence in early pregnancy.

Existing data on the results of taking Jess® Plus during pregnancy are limited, which does not allow drawing any conclusions about the effect of the drug on the course of pregnancy, the health of the newborn and fetus. There are currently no significant epidemiological data on Jess® Plus.

Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is not recommended until breastfeeding is stopped. Small amounts of sex steroids and/or their metabolites may be excreted in milk.

Influence on the ability to drive a car and machinery

There were no cases of adverse effects of Jess® Plus on the speed of psychomotor reactions; studies to study the effect of the drug on the speed of psychomotor reactions have not been conducted.

Content

Every woman should take care of contraceptive measures herself. Jess Plus tablets deserve special attention, the action of which is reliable, and side effects are extremely rare. Before buying, you need to consult with a local gynecologist. Contraceptive pills Jess Plus are intended for oral administration, suppress the process of ovulation, and prevent an extremely unwanted pregnancy. It is important to know what kind of medication it is, how it affects the female body.

What is Jess Plus

According to pharmacological properties, it is a monophasic contraceptive with antiandrogenic action for oral administration. The use of active tablets helps a woman protect herself from unwanted pregnancy, normalize the menstrual cycle, and solve a number of problems in a feminine way. This is one of the reliable barrier methods of contraception, which, with a minimal hormonal component, successfully suppresses ovulation and prevents conception. Detailed instructions for Jess Plus should not become a guide to use, it is important to discuss oral contraceptives with your doctor.

Advantages and disadvantages

This medication has a direct effect on the hormonal background, guarantees additional contraception, normalizes the abundance of menstrual bleeding, gently and purposefully acts on the reproductive system of the fairer sex. When choosing this kind of oral contraception, it is important to be aware of all its advantages and disadvantages. Here are the positive aspects of such a pharmacological appointment:

• stable contraceptive effect;
• ensuring regular menstrual cycles;
• enrichment of the female body with valuable vitamins;
• reduction of discomfort during the next menstruation;
• prevention of sickle cell anemia;
• reduced risk of developing ovarian and endometrial cancer;
• no harm to intrauterine development during unexpected pregnancy.

The composition of the drug

The effect of the drug on the woman's body determines the dosage and chemical composition of the oral contraceptive. Active ingredients of synthetic origin - drospirenone, ethinyl estradiol and calcium levomefolate, which enhance the therapeutic effect of each other. The chemical composition of these hormonal tablets contains auxiliary components, among which it is important to place special emphasis on the presence of sodium and magnesium.

Active ingredients of the active tablet

In 1 blister there are 24 main tablets of a round shape and pink color with an engraving in the center "Z +". Each active component of these oral tablets reduces the likelihood of pregnancy, directly affects the reproductive system and the menstrual cycle, and demonstrates a therapeutic and preventive effect in the body of women of reproductive age:

1. Drospirenone has a depressing effect on the natural process of ovulation. The active ingredient has an antimineralocorticoid effect, removes fluid from the body, and has antiandrogenic properties.
2. Ethinyl estradiol reduces the pain of menstrual flow, is the prevention of oncology, inhibits the activity of sex hormones, does not cause an addictive effect after cessation of use.
3. Calcium levomefolate is actively absorbed in the female body (even better than folic acid), while it satisfies the daily need of the female body for folate, prevents intrauterine pathologies during progressive pregnancy.

The composition of the auxiliary tablet

Each pack contains 4 round, pale pink inactive pills that act as vitamins. The tablets are convex, have a risk in the center and the letter “M +” pushed aside on the surface. The active ingredient is calcium levomefolate, which is necessary to reduce the risk of the spread of iron deficiency anemia and strengthen weakened immunity.

Release form

The release of drugs for oral contraception in most cases is represented by tablets for oral administration. Pack of 28 Jess Plus tablets. 1 blister contains 24 rich pink tablets, plus 4 auxiliary pills of a pale shade, as a useful vitamin complex. For a woman's health is simply irreplaceable. Jack Plus low-dose, instructions for use are attached.

How do contraceptives Jess Plus work?

You can protect yourself with a monophasic oral contraceptive, which acts locally in the female body. With prolonged use of contraceptives, reproductive functions are inhibited, but the risk of side effects in the form of obesity and increased body hair is minimal. With irregular use, the effect of contraceptives is unreliable, since the concentration of hormones in the blood is insufficient to suppress ovulation.

The principle of action of Jess Plus is as follows: after oral administration of the required dose, the ability of ethinylestradiol to suppress the natural processes of ovulation and slightly change the physical characteristics and composition of cervical mucus progresses. With irregular bleeding, drospirenone normalizes the menstrual cycle, removes fluid from the body and reduces swelling, removes signs of acne, controls the patient's weight, restores placebo, and provides a visible weight loss effect.

Indications for use

This low-dose monophasic contraceptive is recommended as protection against highly unwanted pregnancies. In addition, oral tablets not only protect, but also successfully treat, and are prescribed in the following clinical pictures:

• premenstrual syndrome;
• menopause, menopause;
• acne, acne;
• folate deficiency;
• hormone-dependent fluid retention in the body.

Jess plus - instructions for use

If pregnancy is not in the plans of a woman, oral administration of COC should not be delayed. It is necessary to use Jess Plus strictly according to the instructions, while not missing a single session. Women who use a contraceptive do not expect obesity or a sharp deterioration in general well-being, however, an overdose of the drug, in any case, must be avoided in every possible way. So, throughout the entire period it is shown to take 1 tablet per day at the same time, with water. Starting a new pack of Jess Plus is required after the previous intake of the contraceptive.

How to take Jess for the first time

The medication can only be taken on the advice of a doctor. It is required to start from the 1st day of the menstrual cycle, but no later than 2-5 days. Each package contains 7 self-adhesive strips that correspond to the days of the week. It is necessary to find out on what day intensive therapy began and “sign” the pill. This is necessary for clarity, so as not to stray from the set course. The contraceptive acts almost immediately, therefore, in additional protection with caps, condoms, etc. the need does not arise.

When at the beginning of the hormonal course there is a risk of bleeding, the drug should be discontinued. The effect of adverse reactions on the female body is temporary, but it can worsen the general well-being of the fairer sex. In such a clinical picture, it is shown to urgently stop taking it, contact a gynecologist and, together with a specialist, search for a more effective medication for the implementation of hormonal contraception.

Dosage regimen when switching from other oral contraceptives

With the manifestation of spotting, it is better to immediately change the oral contraceptive. The patient should take a break between taking one and another medication for no more than 7 days, and it is necessary to start a hormonal course only according to the annotation. You can enter the shift the next day after the previous tablet. An unscheduled visit to a specialist is indicated to eliminate the risk of developing drug interactions.

Taking Jess Plus after gestagens

The level of bioavailability of the progestogen is high, so this indicator is important to regularly monitor during hormone therapy. If a woman decides to take such oral contraceptives for protection, it is necessary to first consult with a local gynecologist, especially for patients with diabetes, hormone-dependent patients. There is no need to take a break after taking gestagenic agents, use Jess Plus the very next day. However, during the week it is desirable to use other, additional methods of contraception.

Features of use after childbirth

The risk of a decrease in estrogen in the blood after taking a characteristic medication is minimal, but there are some peculiarities of oral administration. For example, after childbirth, it is allowed to continue taking pills for 21-28 days, while using additional methods of protection during the next week. Tablets contain hormones, so it is contraindicated to disturb the concentration of their entry into the blood.

Taking missed pills Jess

Missing active tablets may be preceded by a woman's inattention or increased employment. However, for the female body, this is not an excuse, therefore, if possible, it is required to take the missed dose. Time and day of the week do not matter, even if you have to drink two active pills at the same time. This is important so as not to deviate from the set course and not reduce the contraceptive effect of Jess Plus.

Missing inactive pills is not a problem, and the patient can simply throw away the unused medication, do not drink it late, do not violate the prescribed regimen. In this case, the planned effectiveness of calcium is somewhat reduced, but does not cause colossal harm to health. So, due to inattention and forgetfulness, such a single dose can be disposed of.

Side effects of Jess Plus

Before ordering from a photo and buying this medical product at an online pharmacy, it is important to read the instructions and carefully study potential anomalies. For example, at the very beginning of the hormonal course, bleeding may develop, which requires the urgent cancellation of the contraceptive, the introduction of a replacement. Other side effects are detailed below:

• breast pain;
• nausea, an attack of vomiting;
• uterine bleeding;
• hormonal imbalance;
• thromboembolism;
• depression of psychomotor functions;
• bouts of high blood pressure;
• chloasma may develop;
• allergic reactions;
• dysfunction of the liver.

Contraindications

The drug is contraindicated in patients with liver and kidney failure, with progressive thromboembolism, increased sensitivity of the female body to active substances of synthetic origin. Jess Plus is not prescribed for angioedema, and other medical contraindications are detailed below:

• malignant tumors;
• migraine attacks;
• diabetes;
• lactose intolerance;
• tendency to uterine bleeding;
• periods of pregnancy, lactation;
• in chronic liver diseases.

During pregnancy and breastfeeding

If an adult woman takes a contraceptive in an "interesting position", bleeding may suddenly develop, the appearance of chloasma in pregnant women is not excluded. Therefore, in order to reduce the risk of complications, oral pills must be urgently stopped. The risk of intrauterine pathologies is minimal, therefore, if desired, a progressive pregnancy is allowed to be saved.

When breastfeeding, it is advisable for a young mother to temporarily refuse such an appointment, since the synthetic components of Jess Plus in high concentrations are excreted in breast milk, which can damage the health of the baby. However, it is important to understand that there must be reliable protection, since during lactation the risk of re-pregnancy is possible.

With renal and hepatic insufficiency

Since the drug helps to remove fluid from the female body, it is not recommended to take it with serious violations of the kidneys. This is an absolute contraindication, non-observance of which can provoke a painful attack of the underlying ailment. You should not trust your own health to a medicine for chronic liver diseases.

Interaction with other drugs

Before you start taking synthetic hormones, you need to study drug interactions. For example, the simultaneous use of several contraceptives at once causes the risk of uterine bleeding, as with menstruation. In addition, in combination with medications that induce microsomal liver enzymes, doctors do not exclude an increase in the clearance of sex hormones. There is also a deviation of the therapeutic effect of fourth-generation antibiotics from the planned norm.

Jess plus and alcohol

To eliminate the symptoms of intoxication of the body, it is not recommended to combine oral contraceptives with alcoholic beverages. The presence of ethanol in the blood plasma leads to severe poisoning, and the patient complains of nausea, dizziness, prolonged vomiting, acute allergic reactions, and changes in the chemical composition of urine.

Jess plus price

The official cost of the drug in city pharmacies is much more expensive than on the Internet. In the second case, it is much more profitable to make a purchase in an online store, while there is no doubt about the high quality of the specified pharmacological products. Delivery of a characteristic medication is not difficult, but many patients go to the official pharmacies of the city. Moscow rates are as follows:

Name of pharmacy in the capital	Price Jess Plus (Bayer), rubles
ElixirPharm
EuroPharm
ZdravZone
Apteka ru

In addition, the composition of the tablets includes additional ingredients: corn starch, lactose monohydrate, magnesium stearate.

The composition of the tablet shell includes hypromellose, titanium dioxide, talc, dye.

Release form

Jess hormonal tablets are covered with a film shell.

Active tablets are round, biconvex, have a light pink color. On the one hand, there is an engraving “DS” in a hexagon, on the break of the tablet there is a white core.

Placebo tablets are round, biconvex, covered with a white film shell. On one side of the tablet is engraved "DP" in a hexagon. At the break - a white core.

pharmachologic effect

The summary indicates that Jess is a monophasic oral contraceptive, which also has an antiandrogenic and antimineralocorticoid effect on the body.

The contraceptive suppresses the process ovulation , and also has an effect on the cervical secret, as a result of which spermatozoa cannot penetrate freely through it.

Those women who take this medicine note that their monthly cycle is more regular, menstruation becomes less painful, and bleeding is not so profuse. As a result, the risk is reduced anemia . When using combined oral contraceptives, the likelihood of ovarian cancer And endometrium .

The active substance drospirenone has an antimineralocorticoid effect on the body. Under its influence, the accumulation of extra pounds in the body is prevented, as well as the appearance of edema. It has a positive effect on the condition of a woman during PMS, reducing the intensity of psycho-emotional disorders, chest pain in the joints, and other unpleasant symptoms.

Antiandrogenic activity of this component is noted, which determines a positive effect on the skin condition. As a result, the amount of acne decreases, the level of oily skin and hair decreases. The effect of drospirenone is similar to the effect of natural in the body.

Drospirenone has no estrogenic, androgenic, glucocorticoid and antiglucocorticoid activity. Combined with ethinyl estradiol, drospirenone has a beneficial effect on the lipid profile.

Pharmacokinetics and pharmacodynamics

Drospirenone after oral administration, it is absorbed quickly and almost completely. The maximum concentration is noted 1-2 hours after ingestion. The level of its bioavailability is 76-85%. Bioavailability does not depend on the connection between food intake and the drug. When taken in cycles, the maximum serum level of drospirenone is observed between days 7 and 14 of treatment.

Following oral administration, drospirenone is extensively metabolized. Only a small part of the substance is excreted unchanged. Metabolites are excreted through the kidneys and intestines. The substance is well tolerated by patients with mild to moderate hepatic insufficiency.

Ethinylestradiol after oral administration, it is absorbed completely and quickly. After a single dose, the maximum concentration is observed after 1-2 hours. The bioavailability of the component is about 60%. It is metabolized completely through aromatic hydroxylation. Metabolites are excreted from the body with bile and urine.

Indications for use

Side effects

The most common side effects of Jess are noted:

• nausea;
• irregular periods;
• bleeding from the genitals of unknown origin;
• pain in the mammary glands.

Serious side effects of the drug, which manifests itself in rare cases - thromboembolism (venous, arterial).

The following side effects have also occasionally been noted:

• migraine ;
• depressed mood, mood swings, decreased sex drive;
• erythema multiforme .

There are a number of side effects that occur very rarely, but they may be associated with the use of Jess:

• tumors;
• hypertension ;
• exacerbation of symptoms of angioedema;
• liver dysfunction ;
• influence on insulin resistance, changes in glucose tolerance;
• Crohn's disease ;
• chloasma ;
• nonspecific ulcerative ;
• hypersensitivity symptoms.

Instructions for use Jess (Method and dosage)

If a woman chooses Jess contraceptive pills, the instructions for use must be strictly observed by her. It is envisaged that the tablets must be taken strictly in the order indicated on their packaging. Every day, the drug should be taken at approximately the same time, washed down with a small amount of liquid. Instructions for the use of Jess provides for taking one tablet per day for 28 days. A new pack should start the day after the woman has taken the last pill from the previous pack. As a rule, bleeding can begin 2-3 days after withdrawal has occurred.

If a woman did not take any hormonal contraceptives in the previous month, Jess begins on the first day of the monthly cycle. It is possible to start taking it on the 2nd-5th day of the cycle, but it is advisable to use additional barrier contraception during the first seven days of taking Jess tablets.

How to take tablets when switching to them after other methods of protection, you should ask the gynecologist who recommended this drug.

After an early abortion, you can start taking Jess immediately, with no need for additional contraceptive measures.

If childbirth or abortion occurred in the second trimester, then it is advisable to start taking Jess OK on the 21-28th day after that.

In the event that a woman has missed a pill that is inactive, this can be ignored. But still, you should not take the missed inactive pills, for which they are thrown away.

If there is a missed tablet that is active, and the delay does not exceed 12 hours, in this case, protection is not reduced. You need to take the drug as soon as possible. If the delay exceeded 12 hours, the woman missed 2 tablets, or the break was even longer, in which case the level of protection is reduced. Accordingly, the longer the break was, the greater the probability of fertilization.

Thus, the consequences of stopping taking Jess are as follows: if it is 4 days or more, the likelihood of pregnancy increases significantly. In order for adequate suppression of the hypothalamic-pituitary-ovarian system to occur, it is necessary to take the tablets continuously for seven days.

Therefore, when skipping, a woman needs to take the next pill as soon as possible, taking two pills at once is allowed. Then continue taking active tablets at the usual time. Inactive ones should be discarded and a new pack should be started. In this case, bleeding upon ingestion is unlikely, however, small discharges may occur during ingestion.

If during the period of taking there was a break in the use of active pills, and no bleeding was noted on the days of taking inactive pills, pregnancy should be excluded.

In the case of the development of serious disorders of the gastrointestinal tract, incomplete absorption of the active substances is possible. On such days, the use of additional contraception is necessary. If a woman vomits within 4 hours after taking the pill, proceed as if she missed the pill.

How to stop taking pills and at the same time switch to other methods of contraception, it is advisable to ask a specialist gynecologist in detail.

Overdose

There is no information on serious cases of drug overdose. As a result of an overdose, a woman may experience vomiting, nausea, the appearance of spotting discharge, as well as metrorrhagia. Symptomatic therapy is carried out.

Interaction

With the simultaneous use of Jess and other drugs (a number of antibiotics, enzyme inducers) can provoke the manifestation of breakthrough bleeding, as well as a decrease in the level of reliability.

With simultaneous use with Jess of drugs that induce microsomal liver enzymes (this barbiturates , primidone , carbamazepine , phenytoin , rifampicin etc.), increases the clearance of sex hormones.

Under the influence of some, it is possible to reduce the enterohepatic circulation of estrogens and, accordingly, a decrease in the concentration of ethinylestradiol.

During the period of simultaneous administration of drugs that affect microsomal enzymes, as well as for 28 days after the withdrawal of such drugs, additional contraceptives are needed. Additional contraception is needed within 7 days after taking ampicillins and tetracyclines.

Jess may affect the metabolism of other medicines.

To determine the likelihood of interaction with Jess other drugs, you must carefully read the instructions for them.

Terms of sale

It is sold in pharmacies by prescription.

Storage conditions

Jess should be stored at temperatures up to 30 ° C, protected from moisture and children's access.

Best before date

Can be stored for 5 years.

special instructions

If there are certain risk factors, before taking Jess, you need to weigh the advisability of using this particular contraceptive.

It should be noted that in the process of research, a connection was found between protection with oral contraceptives and an increase in the incidence of thromboembolism, venous and arterial thrombosis. However, these diseases are very rare. A higher risk of thrombosis is observed in smokers, at an older age, with obesity, migraine, heart valve disease, dyslipoproteinemia, atrial fibrillation.

With an increase in the intensity and frequency of migraine, you need to stop taking Jess.

There is also a risk of cervical cancer in women with persistent human papillomavirus infection .

Rarely, in women who took oral contraceptives, the development of benign liver tumors was noted. In very rare cases, malignant tumors of the liver have been reported.

Women who are at high risk of developing hyperkalemia , should determine the level of potassium in the blood during the first cycle of using Jess.

Women with hypertriglyceridemia I must take into account that when taking Jess, they have an increased risk of developing pancreatitis.

If during the period of taking the drug a woman has a pronounced increase in pressure, the contraceptive should be stopped. If, through antihypertensive treatment, blood pressure indicators can be normalized, then taking the tablets can be continued further.

In acute or chronic liver disorders, it is necessary to cancel the remedy until the condition returns to normal.

In the process of taking combined oral agents, some laboratory parameters may change, but they do not go beyond the boundaries of normal values.

Jess, like other combined oral contraceptives, cannot protect against sexually transmitted diseases, as well as from HIV infection.

Using Jess pills for protection, a woman notes that there are no periods when she takes it. Sometimes, more often in the first months, a woman notes that the menstrual cycle becomes irregular. As a rule, the adaptation period lasts for three cycles.

Reception of means does not influence ability to concentration of attention.

Jes's analogs

Coincidence in the ATX code of the 4th level:

Analogues of the drug Jess are contraceptives, Yarina . There are also other analogues from different manufacturers that are oral contraceptives. How to take similar drugs, and which one to prefer, you should ask your gynecologist.

The difference between Jess and Jess plus is that Jess Plus contains calcium levomefolate or folate . Folate belongs to the B vitamins. They are not synthesized in the body, so sometimes when choosing - Jess or Jess plus - a woman prefers the latter. What else is the difference between Jess plus and Jess, and which of the tablets to prefer, you should ask your gynecologist.

Dimia or Jess - which is better?

Dimia is an oral contraceptive that contains similar components. He is a cheaper analogue of Jess. But the final decision on the choice of drug should be made by the doctor.

Which is better: Clayra or Jess?

is a low-dose oral contraceptive that contains the active substance estradiol valerate . This drug is indicated for use by women who have a high level of estrogen in the body. As a rule, Qlaira is recommended for older women.

Which is better: Yarina or Jess?

is a low-dose monophasic contraceptive that has anti-ISS and anti-androgenic effects. Yarina has a positive effect on the condition of the skin, hair, does not cause weight gain. The components in both drugs are the same, only the dose of ethinylestradiol differs.

Which is better: Jess or Jeannine?

Jeannine is a combined estrogen-progestin contraceptive, which contains ethinyl estradiol and. When taking Jeannine, women are more likely to report some side effects, although the drug is just as reliable as a contraceptive.

Logest or Jess - which is better?

The contraceptive contains ethinyl estradiol and. Side effects and effects on the body are similar to the action of Jess. However, only a doctor can choose the optimal oral contraceptive.

Jess or Diana 35 - which is better?

The drug Diane 35 has gestagenic properties, it contains ethinyl estradiol and the antiandrogen cyproterone acetate. When taking Diana 35, women are more likely to notice slight weight gain and some other side effects.

children

Teenage girls can use Jess after their first period.

Sometimes teenagers this drug is prescribed for acne. Reviews of Jess from acne testify to the effectiveness of this drug.

With alcohol

Jess and alcohol can be combined if a woman consumes alcohol in small quantities and infrequently. Alcohol does not reduce the effectiveness of oral contraceptives.

During pregnancy and lactation

Pregnancy and breastfeeding are contraindications for taking Jess. In the event that pregnancy is determined while taking the pills, you should immediately stop taking the contraceptive. Established studies show that if pregnancy occurs after taking Jess, there are no negative consequences for the child.

Since oral contraceptives can negatively affect the composition and amount of breast milk, they are not recommended for women until they stop breastfeeding.

Stands in front of a modern woman. Many of the fair sex choose hormonal drugs that have many benefits. Among other oral contraceptives, Jess is also popular. Gynecologists recommend it to their patients.

Features and benefits of birth control pills Jess

Jess is a combined hormonal contraceptive. Due to the fact that the composition includes drospirenone, it has antiandrogenic and antimineralcorticoid effects.

In women who take Jess contraceptive pills, the menstrual cycle becomes regular, the pain during menstruation disappears or becomes less pronounced, and there is a decrease in the abundance of blood discharge.

Thanks to drospirenone, when taking the drug, body weight does not increase, and edema does not occur. In addition, the substance has a positive effect on the premenstrual cycle. Pain, irritability and other signs of PMS go away. Drospirenone also has an antiandrogenic effect, and therefore, when taking the drug, acne and pimples on the face and body disappear.

The main purpose of Jess is contraception. But it is also prescribed in the treatment of acne or severe PMS. It is not surprising that the majority of reviews of Jess contraceptive pills are positive. Taking the drug allows you to perfectly protect yourself from, maintain a slim figure and improve skin condition.

Contraceptive pills Jess: contraindications

Despite the fact that Jess plus contraceptive pills have a positive effect on the body, they also have contraindications for taking. You should not take the drug if you:

• thrombosis of any kind;
• diabetes mellitus with vascular complications;
• kidney failure;
• liver failure or liver tumor;
• pancreatitis;
• adrenal insufficiency.

You should also refuse to take the drug if you:

• pregnant;
• breastfeed your baby;
• have hypersensitivity to one of the components of the drug.

How to take birth control pills Jess: instructions for use

Jess contraceptive pills are available in blister packs of 28 pieces. The package contains 24 active tablets and 4 inactive. For the convenience of women, there is a self-adhesive calendar in the package, in which you can mark when the pill is drunk. According to the instructions for Jess' birth control pills, you need to drink them regularly, without taking a break between packs. It is advisable to take the tablets every day at the same time.

How to take a contraceptive Jess for the first time?

If you have not previously taken any hormonal contraceptives, then the first Jess tablet should be drunk on the first day of menstruation. You can also start taking it on another day of menstruation, in which case the first 7 days must be additionally protected by barrier contraceptives,.

How to switch from hormonal contraceptives to Jess contraceptive pills?

If you have previously taken other combinations, then you can start drinking Jess the next day. It is important not to take breaks between drugs. Additional contraception in this case is not required. But if you took mini-pills, then the first 7 days after switching to Jess, additionally protect yourself with condoms.

What to do if Jess contraceptive pills are missed?

If for some reason you missed taking the drug, then immediately drink it as soon as you remember. If you follow the instructions for taking Jess contraceptive pills, then the contraceptive must be taken regardless of the time of taking the next pill. Maybe even two at once, if it's time.

If you missed a pill, you should know what to do:

1. If 36 hours have not passed since the last dose, then it is enough to immediately drink a pill, and then take the drug at the set time.
2. If more than 36 hours have passed, then you need not only to drink the missed pill, but also for 7 days after that, additionally protect yourself with barrier methods.

Keep in mind that the risk of getting pregnant in the case of a missed pill increases regardless of whether there was sexual intercourse before or after.

Contraceptive pills Jess: reviews of doctors and patients

On many sites on the Internet, you can easily find reviews of Jess contraceptives. Most women respond positively to the drug. While taking Jess contraceptive pills, disruptions in the menstrual cycle disappear, the skin becomes clearer. But most importantly, women note that the drug is highly effective and does not contribute to weight gain, like some hormonal contraceptives.

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