Combined Contraceptive Pill

Starting the first pack

Take the first pill on the first day of your period. This is day one of your cycle – the day when bleeding starts. If you start on day 2-5 of your period, you should use another method of contraception as well, such as the condom, for the first seven pill-taking days, but this is only for the first pack. You can take your pill at any time, but you should take it about the same time each day. You may find it easiest to take it either last thing at night or first thing in the morning. Take a pill every day in the order shown until you finish all 21 pills in the pack.

Once you have taken all 21 pills, stop for seven days. You will probably bleed during some of these seven days. You do not need to use any other form of contraception during the seven-day break provided you have taken the 21 pills properly and you start the next pack on time.

The next pack

After seven pill-free days, start your next pack. Do this whether or not you are still bleeding. You will always start a new pack on the same day of the week.

Changing to Millinette from another combined hormonal contraceptive

You should start with Millinette on the day after the tablet-free period of your previous pill finishes (or after the last inactive tablet of your previous pill).

Changing to Millinette from progestogen-only preparations (progestogen-only pills, injection, implant, intrauterine system) You may switch any day from the progestogen-only pill but you must use extra protective measures (for example, a condom) for the first 7 days of tablet-taking. If you have had an injection, an implant or an intrauterine system, you can start to take Millinette on the day that your next injection is due, or on the day that your implant or intrauterine system is removed, but in all of these cases you must use extra protective measures (for example, a condom) for the first 7 days of tablet-taking.

Starting after childbirth or miscarriage or abortion After a birth, abortion or miscarriage 

Your doctor should advise you about taking the pill. You can start using Millinette immediately after a miscarriage or abortion which occurs during the first three months of pregnancy. In this case it is not necessary to take further contraceptive measures. If you have had a delivery or abortion which occurs during the second three months of pregnancy, you can start taking Millinette 21-28 days after giving birth or having abortion. If you are breast-feeding, the combined pill is not recommended because it can reduce your flow of milk. Alternative contraception (such as the condom) must be used for the first 7 days of pill-taking. If you have had unprotected sex you should not start Millinette until your period starts or you are sure you are not pregnant. If you have any questions about starting Millinette after childbirth or abortion, ask your doctor or pharmacist.

▪ If you have (or have ever had) a blood clot in a blood vessel of your legs (deep vein thrombosis, DVT), your lungs (pulmonary embolus, PE) or other organs

▪ If you know you have a disorder affecting your blood clotting – for instance, protein C deficiency, protein S deficiency, antithrombin-III deficiency, Factor V Leiden or antiphospholipid antibodies

▪ If you need an operation or if you are off your feet for a long time  

▪ If you have ever had a heart attack or stroke

▪ If you have (or have ever had) angina pectoris (a condition that causes severe chest pain and may be a first sign of a heart attack) or transient ischaemic attack (TIA – temporary stroke symptoms)

▪ If you have any of the following diseases that may increase your risk of a clot in the arteries:

- severe diabetes with blood vessel damage 

- very high blood pressure

- a very high level of fat in the blood (cholesterol or triglycerides)

- a condition known as hyperhomocysteinaemia

▪ If you have (or have ever had) a type of migraine called ‘migraine with aura’

▪ If you have or have ever had breast cancer

▪ If you have ever had a severe liver disease, and you have been told by your doctor that your liver function test results are not yet back to normal

▪ If you have ever had liver tumours

▪ If you are allergic (hypersensitive) to any of the ingredients in Millinette

• If you have hepatitis C and are taking the medicinal products containing ombitasvir / paritaprevir / ritonavir, dasabuvir,glecaprevir / pibrentasvir or sofosbuvir / velpatasvir / voxilaprevir 

Very common side effects (may affect more than 1 in 10 people):

Headache, irregular bleeding and spotting between periods.

Common side effects (may affect up to 1 in 10 people):

Vaginitis, fungal infection of vagina, mood altered including depression, nervousness, dizziness, nausea, upper abdominal pain, acne, painful menstruation, changes in vaginal secretion, absence of menstruation, weight increase, breast tenderness, breast pain, breast swelling, breast discharge.

Uncommon side effects (may affect up to 1 in 100 people):

Migraine, fluid retention, changed appetite (increased or reduced), increase in blood pressure, vomiting, diarrhoea, rash, nettle-rash (urticaria), chloasma (yellowish-brown patches on the skin), excessive hair growth, hair loss, changes in serum lipid levels including hypertriglyceridemia, change in the interest in sex (reduced libido).

Rare side effects (may affect up to 1 in 1,000 people):

Anaphylactic reactions (reaction with very rare cases of hives, swelling of face, tongue, severe circulatory and respiratory disorders), glucose intolerance, jaundice, eye irritation when wearing contact lenses, general disease in ear and labyrinth, various skin diseases (such as erythema multiforme (characterized by rash with target-shaped reddening or sores), erythema nodosum (characterized by painful reddish skin nodules)), decrease in serum folate levels, other disease in the gastrointestinal tract, change in interest in sex (increased libido). Harmful blood clots in a vein or artery for example: ­ in a leg or foot (i.e. DVT), ­ in a lung (i.e. PE), ­ heart attack, ­ stroke, ­ mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic attack (TIA), ­ blood clots in the liver, stomach/intestine, kidneys or eye.

See other combined contraception pill products 

https://www.medicines.org.uk/emc/files/pil.14655.pdf

https://www.medicines.org.uk/emc/files/pil.14656.pdf