Lesinelle

Leaflet accompanying the packaging: information for the user

Lesinelle, 3 mg + 0.02 mg, film-coated tablets

Drospirenone + Ethinylestradiol

You should read the leaflet before taking the medicine, as it contains important information for the patient.

• You should keep this leaflet so that you can read it again if you need to.
• If you have any doubts, you should consult a doctor or pharmacist.
• This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If you experience any side effects, including those not listed in the leaflet, you should tell your doctor or pharmacist. See section 4.

Important information about combined hormonal contraceptives

• If used correctly, they are one of the most reliable, reversible methods of contraception
• They slightly increase the risk of blood clots in veins and arteries, especially in the first year of use or after resuming use after a break of 4 weeks or more
• You should be vigilant and consult a doctor if you suspect that you have symptoms of a blood clot (see section 2 "Blood clots")

Table of contents of the leaflet

• 1. What is Lesinelle and what is it used for
• 2. Important information before taking Lesinelle
• 3. How to take Lesinelle
• 4. Possible side effects
• 5. How to store Lesinelle
• 6. Contents of the pack and other information

1. What is Lesinelle and what is it used for

Lesinelle is a contraceptive pill and is used to prevent pregnancy.
Each film-coated tablet contains a small amount of two different female hormones, namely
drospirenone and ethinylestradiol.
Contraceptive pills containing two hormones are called "combined" pills.

2. Important information before taking Lesinelle

General notes

Before starting to take Lesinelle, you should read the information about
blood clots (thrombosis) in section 2. It is especially important to read about the symptoms
of blood clots (see section 2 "Blood clots").
Before you can start taking Lesinelle, your doctor will ask you a few questions about your health and
about the health of your close relatives. Your doctor will also measure your blood pressure and, in individual
cases, may also perform some other tests.
This leaflet describes several situations in which you should stop taking Lesinelle, or in which the effectiveness of Lesinelle may be reduced. In such situations, you should either not have sexual intercourse or use additional non-hormonal contraceptive methods,
such as condoms or other mechanical methods. You should not use the calendar method or the temperature measurement method. These methods may be unreliable, as Lesinelle modifies the monthly changes in body temperature and cervical mucus.

Lesinelle, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or other sexually transmitted diseases.

When not to take Lesinelle

You should not take Lesinelle if you have any of the following conditions. If you have any of the following conditions, you should inform your doctor. Your doctor will discuss with you which other contraceptive method will be more suitable for you.

• if you currently have (or have ever had) a blood clot in the veins of the legs (deep vein thrombosis), in the lungs (pulmonary embolism), or in other organs;
• if you know that you have blood coagulation disorders - such as protein C deficiency, protein S deficiency, antithrombin III deficiency, factor V Leiden, or antiphospholipid antibodies;
• if you need to have surgery or will be immobilized for a long time (see section "Blood clots").
• if you have had a heart attack or stroke;
• if you have had angina pectoris (a disease that causes severe chest pain and may be the first symptom of a heart attack) or a transient ischemic attack (temporary stroke symptoms);
• if you have any of the following diseases, which may increase the risk of a blood clot in an artery:
• severe diabetes with blood vessel damage
• very high blood pressure;
• very high levels of fats in the blood (cholesterol or triglycerides).
• hyperhomocysteinemia
• if you have had (or have ever had) a type of migraine called "migraine with aura";
• if you have (or have had) liver disease, and liver function is still abnormal;
• if you have hepatitis C and are taking medicines containing ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir (see also section "Lesinelle and other medicines");
• if you have kidney problems (kidney failure);
• if you have (or have had) liver cancer;
• if you have (or have had) or suspect you have breast cancer or cancer of the genital organs;
• if you have unexplained vaginal bleeding;
• if you are allergic to ethinylestradiol or drospirenone or any of the other ingredients of Lesinelle (listed in section 6). This allergy may cause itching, rash, or swelling.

Additional information for special populations
Children and adolescents
Lesinelle is not intended for use in girls who have not yet started their menstrual cycle.
Elderly women
Lesinelle is not intended for use after menopause.
Women with liver disease
You should not take Lesinelle if you have liver disease. See also sections "When not to take Lesinelle" and "Warnings and precautions".
Women with kidney disease
You should not take Lesinelle if you have kidney failure or acute kidney failure. See also sections "When not to take Lesinelle" and "Warnings and precautions".

Warnings and precautions

When to be particularly cautious when taking Lesinelle

Before starting to take Lesinelle, you should discuss it with your doctor or pharmacist.
When should you contact your doctor?
You should contact your doctor immediately

• if you notice any symptoms that may indicate the formation of a blood clot, which may indicate that you have a blood clot in your leg (deep vein thrombosis), a blood clot in your lungs (pulmonary embolism), a heart attack, or a stroke (see below "Blood clots (thrombosis)").

In order to describe the symptoms of these serious side effects, see "How to recognize the formation of blood clots".

You should tell your doctor if you have any of the following conditions.

Before starting to take Lesinelle, you should consult your doctor. In certain situations, you should be particularly cautious when taking Lesinelle or any other combined hormonal contraceptive, and you may also need to be regularly examined by your doctor. If these symptoms occur or worsen while taking Lesinelle, you should also tell your doctor:

• if someone in your close family has had breast cancer;
• if you have liver or gallbladder disease;
• if you have diabetes;
• if you have depression;
• if you have Crohn's disease or ulcerative colitis (a chronic inflammatory bowel disease);
• if you have systemic lupus erythematosus (a disease that affects the body's natural defense system);
• if you have hemolytic uremic syndrome (a blood clotting disorder that causes kidney failure);
• if you have sickle cell anemia (a genetic disorder that affects red blood cells);
• if you have been diagnosed with high levels of fats in the blood (hypertriglyceridemia) or a family history of this condition. Hypertriglyceridemia is associated with an increased risk of developing pancreatitis;
• if you need to have surgery or will be immobilized for a long time (see section 2 "Blood clots").
• if you have recently given birth, you are at increased risk of blood clots. You should consult your doctor to find out how soon you can start taking Lesinelle after giving birth.
• if you have superficial thrombophlebitis (blood clots in the veins under the skin);
• if you have varicose veins;
• if you have epilepsy (see section "Lesinelle and other medicines");
• if you have a disease that first appeared during pregnancy or while taking sex hormones (e.g., hearing loss, a blood disease called porphyria, a skin rash with blisters during pregnancy (pemphigoid gestationis), a nervous system disease characterized by involuntary movements of the body (Sydenham's chorea));
• if you have had chloasma (skin discoloration, especially on the face and neck, so-called pregnancy spots). If so, you should avoid direct exposure to sunlight or ultraviolet radiation;
• if you experience symptoms of angioedema, such as swelling of the face, tongue, and/or throat, and/or difficulty swallowing or hives that may cause difficulty breathing, you should contact your doctor immediately. Estrogen-containing medications may cause or worsen symptoms of both hereditary and acquired angioedema.

BLOOD CLOTS (THROMBOSIS)

Taking combined hormonal contraceptives, such as Lesinelle, is associated with an increased risk of blood clotscompared to not taking the therapy. In rare cases, a blood clot can block a blood vessel and cause serious complications.
Blood clots can form

• in veins (also called "venous thrombosis" or "venous thromboembolism")
• in arteries (also called "arterial thrombosis" or "arterial thromboembolism").

Not everyone recovers fully from a blood clot. In rare cases, the effects of a blood clot can be permanent or, very rarely, fatal.

Remember that the overall risk of having a harmful blood clot due to taking Lesinelle is small.

HOW TO RECOGNIZE THE FORMATION OF BLOOD CLOTS

You should contact your doctor immediately if you notice any of the following symptoms.
What disease is likely to occur in
the patient

• swelling of the leg or swelling along a vein in the leg or foot, especially if it is accompanied by: Is the patient experiencing any of these symptoms? Deep vein thrombosis
• pain or tenderness in the leg, which may only be felt when standing or walking,
• increased temperature in the affected leg
• change in skin color of the leg, such as pallor, redness, or cyanosis
• sudden onset of unexplained shortness of breath or rapid breathing;
• sudden onset of coughing without an obvious cause, which may be accompanied by coughing up blood;
• severe chest pain, which may worsen with deep breathing;
• severe dizziness or fainting;
• rapid or irregular heartbeat.
• severe abdominal pain;

If the patient is unsure, they should contact their doctor, as some of these symptoms, such as coughing or shortness of breath, may be mistaken for milder conditions, such as a respiratory infection (e.g., a cold).
Pulmonary embolism
Symptoms usually occur in one eye:

• sudden loss of vision or
• painless vision disturbances, which may progress to loss of vision Retinal vein thrombosis (blood clot in the eye)
• chest pain, discomfort, feeling of pressure, heaviness
• feeling of squeezing or fullness in the chest, arm, or below the breastbone;
• feeling of fullness, indigestion, or choking;
• discomfort in the upper body that radiates to the back, jaw, throat, arm, and stomach;
• sweating, nausea, vomiting, or dizziness;
• extreme weakness, anxiety, or shortness of breath;
• rapid or irregular heartbeat. Heart attack
• sudden weakness or numbness of the face, arms, or legs, especially on one side of the body;
• sudden confusion, speech disturbances, or difficulty understanding;
• sudden vision disturbances in one or both eyes; Stroke

BLOOD CLOTS IN VEINS

What can happen if a blood clot forms in a vein?

• Taking combined hormonal contraceptives is associated with an increased risk of blood clots in the veins (venous thrombosis). However, these side effects are rare. They most often occur in the first year of taking combined hormonal contraceptives.
• If blood clots form in the veins in the leg or foot, it can lead to the development of deep vein thrombosis.
• If a blood clot moves from the leg and settles in the lungs, it can cause a pulmonary embolism.
• In very rare cases, a blood clot can form in another organ, such as the eye (retinal vein thrombosis).

When is the risk of blood clots in a vein highest?

The risk of forming a blood clot in a vein is highest during the first year of taking combined hormonal contraceptives for the first time. The risk may also be higher when resuming combined hormonal contraceptives (the same or a different medicine) after a break of 4 weeks or more.
After the first year, the risk decreases, but it is always higher compared to not taking combined hormonal contraceptives.
If you stop taking Lesinelle, the risk of blood clots returns to normal within a few weeks.

What factors increase the risk of blood clots in veins?

The risk depends on the natural risk of venous thromboembolism and the type of combined hormonal contraceptive used.
The overall risk of blood clots in the legs or lungs associated with taking Lesinelle is small.

• During a year, about 2 out of 10,000 women who do not take combined hormonal contraceptives and are not pregnant will develop blood clots.
• During a year, about 5-7 out of 10,000 women who take combined hormonal contraceptives containing levonorgestrel, norethisterone, or norgestimate will develop blood clots.
• During a year, about 9-12 out of 10,000 women who take combined hormonal contraceptives containing drospirenone, such as Lesinelle, will develop blood clots.
• The risk of blood clots depends on the individual medical history of the patient (see "Factors that increase the risk of blood clots", below).

Factors that increase the risk of blood clots in veins

The risk of blood clots associated with taking Lesinelle is small, but some factors can increase this risk. The risk is higher:

• if you are severely overweight (body mass index (BMI) over 30 kg/m);
• if someone in your close family has had blood clots in the legs, lungs, or other organs at a young age (e.g., under 50 years old). In this case, you may have a hereditary blood clotting disorder;
• if you need to have surgery or will be immobilized for a long time (see section 2 "Blood clots").
• with age (especially over 35 years old);
• if you have recently given birth;

The risk of blood clots increases with the number of risk factors present in the patient.
Long-haul flights (>4 hours) may temporarily increase the risk of blood clots, especially if you have another risk factor.
It is essential to tell your doctor if any of these risk factors apply to you, even if you are not sure. Your doctor may decide to stop taking Lesinelle.
You should inform your doctor if any of the above conditions change while taking Lesinelle, e.g., if someone in your close family is diagnosed with a blood clot without a known cause or if you gain weight significantly.

BLOOD CLOTS IN ARTERIES

What can happen if a blood clot forms in an artery?

Similarly to blood clots in veins, blood clots in arteries can cause serious consequences, such as a heart attack or stroke.

Factors that increase the risk of blood clots in arteries

It is essential to note that the risk of a heart attack or stroke associated with taking Lesinelle is very small, but it may increase:

• with age (over about 35 years old);
• if you smoke.While taking a hormonal contraceptive like Lesinelle, it is recommended to quit smoking. If you are unable to quit smoking and are over 35 years old, your doctor may recommend a different type of contraception;
• if you are overweight;
• if you have high blood pressure;
• if someone in your close family has had a heart attack or stroke at a young age (under 50 years old). In this case, you may also be at increased risk of having a heart attack or stroke;
• if you or someone in your close family has high levels of fats in the blood (cholesterol or triglycerides);
• if you have migraines, especially migraines with aura;
• if you have heart disease (valve damage, irregular heartbeat called atrial fibrillation)
• if you have diabetes.

If you have more than one of the above conditions or if any of them are severe, the risk of blood clots may be even higher.
You should inform your doctor if any of the above conditions change while taking Lesinelle, e.g., if you start smoking, someone in your close family is diagnosed with a blood clot without a known cause, or if you gain weight significantly.

Lesinelle and cancer

Women taking combined contraceptives, including Lesinelle, have a slightly higher risk of breast cancer, but it is not known if this is caused by the medication. For example, it may be that more tumors are detected in women taking combined contraceptives because they are more frequently examined by doctors. The frequency of breast tumors decreases gradually after stopping combined hormonal contraceptives.
It is essential to examine your breasts regularly and contact your doctor if you feel any lump.
Women taking combined contraceptives have been reported to have, in rare cases, benign liver tumors, and in even rarer cases, malignant liver tumors. If you experience severe abdominal pain, you should contact your doctor.

Irregular bleeding

During the first few months of taking Lesinelle, you may experience unexpected bleeding (bleeding outside of the weekly break). If such bleeding lasts longer than a few months or starts after a few months, your doctor should investigate the cause.

What to do if bleeding does not occur during the weekly break

If you have taken all the tablets according to the schedule, have not vomited or had severe diarrhea, and have not taken any other medications, it is very unlikely that you are pregnant.
If the expected bleeding does not occur for two consecutive weeks, it may mean that you are pregnant. You should contact your doctor immediately. Do not start the next blister pack until you are sure you are not pregnant.

Psychological disorders

Some women taking hormonal contraceptives, including Lesinelle, have reported depression or low mood. Depression can be severe and sometimes lead to suicidal thoughts. If you experience mood changes and symptoms of depression, you should contact your doctor as soon as possible for further medical advice.

Lesinelle and other medicines

You should tell your doctor or pharmacist about all the medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
You should also tell any other doctor or dentist prescribing another medicine (or pharmacist) that you are taking Lesinelle. They may tell you if you need to use additional contraceptive methods (e.g., condoms) and for how long or if you need to modify the use of other medicines.
Some medicines may affect the levels of Lesinelle in your blood and may make it less effective in preventing pregnancy or may cause unexpected bleeding. These include:

• medicines used to treat: epilepsy (e.g., primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine), tuberculosis (e.g., rifampicin), HIV and hepatitis C virus infections (protease inhibitors and non-nucleoside reverse transcriptase inhibitors such as ritonavir, nevirapine, efavirenz), fungal infections (griseofulvin, ketoconazole), arthritis, degenerative joint disease (etoricoxib), high blood pressure in the blood vessels of the lungs (bosentan)
• herbal medicines containing St. John's Wort (Hypericum perforatum).

Lesinelle may affect the action of other medicines, such as:
medicines containing cyclosporin
antiepileptic medicines containing lamotrigine (may increase the frequency of seizures)
theophylline (used for breathing problems),
tizanidine (used to treat muscle pain and/or muscle spasms).
Before taking any medicine, consult your doctor or pharmacist.
You should not take Lesinelle if you have hepatitis C and are taking medicines containing ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir, as this may cause increased liver function test results in the blood (increased liver enzyme activity).
Your doctor will prescribe a different type of contraception before starting treatment with these medicines.
Lesinelle can be taken again about 2 weeks after finishing this treatment.
See section "When not to take Lesinelle".

Lesinelle with food and drink

Lesinelle can be taken with or without food, if necessary with a small amount of water.

Lab tests

If a blood test is necessary, you should tell your doctor or laboratory staff that you are taking a contraceptive, as oral contraceptives may affect the results of some tests.

Pregnancy and breastfeeding

Pregnancy
Lesinelle should not be taken during pregnancy. If you become pregnant while taking Lesinelle, you should stop taking it immediately and contact your doctor.
If you want to become pregnant, you can stop taking Lesinelle at any time (see also "Stopping Lesinelle").
Before taking any medicine, consult your doctor or pharmacist.
Breastfeeding
Lesinelle is not usually recommended if you are breastfeeding. If you want to use a contraceptive while breastfeeding, you should contact your doctor.
Before taking any medicine, consult your doctor or pharmacist.

Driving and using machines

There is no information to suggest that taking Lesinelle affects the ability to drive or operate machines.

Lesinelle contains lactose.

If you have been diagnosed with an intolerance to some sugars, you should contact your doctor before taking this medicine.

Lesinelle contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per dose, which means it is essentially "sodium-free".

3. How to take Lesinelle

This medicine should always be taken as directed by your doctor or pharmacist. If you are unsure, you should consult your doctor or pharmacist.
You should take one Lesinelle tablet every day, if necessary with a small amount of water.
You can take the tablets with or without food, but you should take them every day at about the same time.
The blister pack contains 21 film-coated tablets. The day of the week is printed next to each tablet. If, for example, you start taking the tablets on a Wednesday, you should take the tablet with "Wed" printed next to it. You should move in the direction of the arrow on the blister pack until all 21 tablets have been taken.
Then, you should not take any tablets for 7 days. During these 7 days (also called the "tablet-free week"), you should experience bleeding. This is called "withdrawal bleeding", which usually starts on the 2nd or 3rd day of the tablet-free week.
On the 8th day after taking the last Lesinelle tablet (i.e., after the 7-day break), you should start a new blister pack, regardless of whether the bleeding has stopped or not. This means you should start each new blister pack on the same day of the week, and the withdrawal bleeding should occur on the same days every month.
If you take Lesinelle in this way, you are also protected against pregnancy during the 7 days when you are not taking tablets.

When can you start the first blister pack?

• If you have not taken a hormonal contraceptive in the previous month.You should start taking Lesinelle on the first day of your cycle (i.e., the first day of your period). If you start taking Lesinelle on the first day of your period, you are immediately protected against pregnancy. You can also start taking the medicine on days 2-5 of your cycle, but in that case, you should use additional contraceptive methods (e.g., condoms) for the first 7 days.
• Switching from a combined hormonal contraceptive or a combined hormonal contraceptive vaginal system or transdermal system.You can start taking Lesinelle the next day after taking the last active tablet (the last tablet containing active ingredients) from the previous pack, but no later than the day after the end of the tablet-free period of the previous contraceptive. In the case of switching from a combined hormonal contraceptive vaginal system or transdermal system, you should follow your doctor's advice.
• Switching from a progestogen-only method (mini-pill, injection, implant, or intrauterine system releasing progestogen).You can switch at any time from a mini-pill (from an implant or intrauterine system on the day of its removal, or from injections when the next injection is due) but in all these cases, you should use additional contraceptive methods (e.g., condoms) for the first 7 days of taking Lesinelle.
• After a miscarriage.Follow your doctor's advice.
• After childbirth.You can start taking Lesinelle from 21 to 28 days after giving birth. If you start taking the medicine later than 28 days after giving birth, you should use additional contraceptive methods (e.g., condoms) for the first 7 days of taking Lesinelle. If you have had sexual intercourse after giving birth, before (re)starting Lesinelle, you should first ensure that you are not pregnant or wait for your first menstrual period.
• If you are breastfeeding and want to (re)start taking Lesinelle after childbirth.You should read the section "Breastfeeding".

If you are unsure when to start taking Lesinelle, you should consult your doctor.

What to do if you take more Lesinelle than you should

There are no reports of serious, harmful effects from taking too many Lesinelle tablets at once.
If you take several tablets at the same time, you may experience nausea and vomiting or bleeding from the vagina. This type of bleeding may occur even in girls who have not yet started their menstrual cycle, but have taken the medicine by mistake.
If you take too many Lesinelle tablets or if a child has taken them, you should consult your doctor or pharmacist.

What to do if you forget to take Lesinelle

• If it has been less than 12 hourssince you forgot to take a tablet, your protection against pregnancy is not reduced. You should take the tablet as soon as possible and then take the next tablets at the usual time.
• If it has been more than 12 hourssince you forgot to take a tablet, your protection against pregnancy may be reduced. The more tablets you have forgotten, the higher the risk of becoming pregnant.

The risk of reduced protection against pregnancy is highest if you forget tablets at the beginning or end of the blister pack. Therefore, you should follow the rules below (see also the diagram below):

• Forgetting to take more than one tablet in this blister packYou should contact your doctor.
• Forgetting to take one tablet in week 1.You should take the forgotten tablet as soon as possible, even if it means taking two tablets at the same time. You should then take the next tablets at the usual time and use additional protection, such as condoms, for the next 7 days. If you have had sexual intercourse in the week before forgetting the tablet, there is a risk of pregnancy. In this case, you should contact your doctor.
• Forgetting to take one tablet in week 2.You should take the forgotten tablet as soon as possible, even if it means taking two tablets at the same time. You should then take the next tablets at the usual time. Your protection against pregnancy is not reduced, and you do not need to use additional protection.
• Forgetting to take one tablet in week 3.There are two options to choose from:
• 1. Take the forgotten tablet as soon as possible, even if it means taking two tablets at the same time. You should then take the next tablets at the usual time. Instead of the tablet-free week, you should start taking tablets from the next blister pack immediately.

Most likely, your period will occur at the end of the second blister pack, but you may experience bleeding or spotting during the second blister pack.

• 2. You can also stop taking tablets from the blister pack and go directly to the 7-day tablet-free period ( make a note of the day you forgot to take the tablet). If you want to start the next blister pack on your usual start day, you can shorten the tablet-free period to less than 7 days.

If you follow one of these two instructions, your protection against pregnancy will be maintained.

• If you have forgotten to take any of the tablets in the blister pack and do not experience bleeding during the first tablet-free period, you may be pregnant. In this case, you should contact your doctor before starting the next blister pack.

Forgot to take more
than 1 tablet from the
blister pack
Should consult a doctor
yes
in week 1.
Was there sexual intercourse
in the week before forgetting
the tablet?
no

• Take the forgotten tablet
• Use a mechanical method (condoms) for the next 7 days and
• Finish taking the tablets from the blister pack

Only 1 tablet forgotten
(taken more than 12 hours
late)

• Take the forgotten tablet
• Finish taking the tablets from the blister pack
• Take the forgotten tablet and
• Finish taking the tablets from the blister pack
• Instead of the tablet-free week, start taking tablets from the next blister pack

or
in week 3.

• Immediately stop taking tablets from the blister pack
• Start the tablet-free week (not longer than 7 days, including the forgotten tablet)
• Start taking tablets from the next blister pack in the next week.

What to do if you vomit or have severe diarrhea

If you vomit within 3-4 hours of taking a tablet or experience severe diarrhea, there is a risk that the active ingredients of the tablet may not have been fully absorbed into your body.
The situation is similar to forgetting a tablet. After vomiting or diarrhea, you should take another tablet from the spare blister pack as soon as possible. If possible, you should take it within 12 hoursof the normal time of taking the tablet. If this is not possible or more than 12 hours have passed, you should follow the instructions in the section "Forgetting to take Lesinelle".

Delaying the start of bleeding: what you need to know

Although it is not recommended, it is possible to delay the start of bleeding by going directly to a new Lesinelle blister pack, skipping the tablet-free week, until the end of the pack. You may experience spotting or bleeding during the second pack.
After the usual 7-day tablet-free period, you should starttaking tablets from the next blister pack.
You can ask your doctor for advice before deciding to delay the start of bleeding.
Bleeding.

Changing the first day of bleeding: what you need to know

If you take the tablets according to the instructions, bleeding should start during the tablet-free week. If you want to change this day, you do so by shortening (but never lengthening - maximum 7 days!) the tablet-free period. For example, if your tablet-free period starts on a Friday and you want to change the day to Tuesday (3 days earlier), you should start the new blister pack 3 days earlier than usual. If the break in taking the medicine is very short (e.g., to 3 days or less), you may experience bleeding during those days. As a result, you may experience spotting or irregular bleeding.
If you are unsure what to do, you should contact your doctor.

4. Possible side effects

Like all medicines, Lesinelle can cause side effects, although not everybody gets them. If side effects occur, especially severe and persistent ones, or changes in health that the patient considers related to the use of Lesinelle, the patient should consult a doctor.
In all women using combined hormonal contraceptives, there is an increased risk of blood clots in the veins (venous thromboembolism) or blood clots in the arteries (arterial thromboembolism). For detailed information on the various risk factors associated with the use of combined hormonal contraceptives, the patient should refer to section 2 "Important information before taking Lesinelle".
Severe side effects
The patient should immediately contact a doctor if any of the following symptoms of angioedema occur: swelling of the face, tongue, and/or throat, and/or difficulty swallowing or urticaria, which may cause difficulty breathing (see also the section "Warnings and precautions").
The following side effects have been associated with the use of Lesinelle:
Common side effects (may occur in up to 1 in 10 people)

• mood swings,
• headache,
• abdominal pain (stomach),
• acne,
• breast pain, breast enlargement, breast tenderness, painful or irregular menstrual periods,
• weight gain

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

• candidiasis (fungal infection)
• herpes simplex (cold sore),
• allergic reactions
• increased appetite
• depression, nervousness, sleep disorders,
• feeling of tingling and numbness, vertigo (dizziness),
• vision problems
• heart rhythm disorders or extremely rapid heart rate
• blood clots (thrombosis) in the lung (pulmonary embolism)
• high blood pressure, low blood pressure, migraine, varicose veins,
• sore throat
• nausea, vomiting, gastritis and/or enteritis, diarrhea, constipation
• hair loss (alopecia), eczema, itching, rashes, dry skin, seborrheic dermatitis (seborrhea)
• neck pain, limb pain, muscle cramps
• urinary tract infection
• breast lump (benign and malignant), milk secretion in non-pregnant women (galactorrhea), ovarian cysts, sudden reddening of the face, absence of menstruation, very heavy menstruation, white discharge, vaginal dryness, pain in the lower abdomen (pelvis), abnormal Pap smear, decreased libido
• fluid retention, lack of energy, strong desire, increased sweating
• weight loss.

Rare side effects (may occur in up to 1 in 1000 people)

• asthma
• hearing problems
• erythema nodosum (characterized by painful, red nodules on the skin)
• erythema multiforme (characterized by a rash with red, painful borders)
• harmful blood clots in a vein or artery, for example: o in the leg or foot (e.g., deep vein thrombosis) o in the lungs (e.g., pulmonary embolism) o heart attack o stroke o mini-stroke or transient stroke-like symptoms, known as transient ischemic attack o blood clots in the liver, stomach/intestine, kidney, or eye

The likelihood of blood clots may be higher if the patient has any other risk factors (see section 2 for further information on risk factors for blood clots and symptoms of blood clots).

Reporting side effects

If any side effects occur, including any side effects not listed in the leaflet, the patient should tell their doctor or pharmacist. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices, and Biocidal Products, Urząd Rejestracji Produktów Leczniczych, ul. Jerozolimskie 181C, 02-222 Warsaw, Tel.: +48 22 49 21 301, Fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, more information can be gathered on the safety of the medicinal product.

5. How to store Lesinelle

The medicinal product should be stored out of sight and reach of children.
This medicinal product does not require any special storage precautions.
The medicinal product should not be used after the expiry date stated on the packaging after the words "Expiry date" or "EXP:". The expiry date refers to the last day of the given month.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

What Lesinelle contains

The active substances of Lesinelle are ethinylestradiol and drospirenone.
Each tablet contains 0.02 mg of ethinylestradiol and 3 mg of drospirenone.
The other ingredients of Lesinelle are:
Core: lactose monohydrate, maize starch, povidone K30, sodium croscarmellose, polysorbate 80, magnesium stearate.
Coating: partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), macrogol 3350, talc, yellow iron oxide (E172), red iron oxide (E172), black iron oxide (E172).

What Lesinelle looks like and contents of the pack

Pink, round, film-coated tablets.

• Lesinelle is available in packs of 1 or 3 blisters, each containing 21 tablets.

Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder

Theramex Ireland Limited
3rd Floor, Kilmore House,
Park Lane, Spencer Dock,
Dublin 1
D01 YE64
Ireland

Manufacturer

Laboratorios León Farma S.A.
C/ La Vallina s/n, Pol. Ind. Navatejera
24193 Villaquilambre – Leon
Spain
Merckle GmbH
Ludwig-Merckle-Straße 3
89143 Blaubeuren
Germany

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Country Name:

Date of revision of the leaflet:May 2025