Lesiplus

Leaflet accompanying the packaging: information for the user

Warning! The leaflet should be kept. Information on the immediate packaging in a foreign language.

Lesiplus (Drospirenone/Ethinylestradiol 3/0.02 mg 24+4 Theramex)

3 mg + 0.02 mg, coated tablets

Drospirenonum + Ethinylestradiolum
Lesiplus and Drospirenone/Ethinylestradiol 3/0.02 mg 24+4 Theramex are different trade names
for the same medicine.

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.
• One should be vigilant and consult a doctor if the patient suspects that symptoms of blood clots have occurred (see section 2 "Blood clots (thrombosis)").

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

• You should keep this leaflet so that you can read it again if necessary.
• In case of any doubts, you should consult a doctor, pharmacist, or nurse.
• This medicine has been prescribed specifically for one person. It should not be given to others. The medicine may harm another person, even if the symptoms of their illness are the same.
• If the patient experiences any side effects, including any side effects not listed in the leaflet, they should tell their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet:

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

1. What is Lesiplus and what is it used for

• Lesiplus is a contraceptive and is used to prevent pregnancy.
• Each of the 24 pink tablets contains a small amount of two different female hormones, namely drospirenone and ethinylestradiol.
• The 4 white tablets that do not contain active substances are also called placebo tablets.
• Contraceptive tablets containing two hormones are called "combined" tablets.

2. Important information before using Lesiplus

General notes

Before starting to take Lesiplus, 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 (thrombosis)").
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Before you can start taking Lesiplus, 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, depending on
the individual case, may also perform some other tests.
In this leaflet, several situations are described in which you should stop taking Lesiplus, or in which the effectiveness of Lesiplus may be reduced. In such situations, you should either not have sexual intercourse or use additional non-hormonal contraceptives,
such as condoms or other mechanical methods. You should not use the calendar method or
the temperature measurement method. These methods can be unreliable because Lesiplus modifies
the monthly changes in body temperature and cervical mucus.

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

When not to use Lesiplus:

You should not use Lesiplus if you have any of the conditions listed below.
If you have any of the conditions listed below, you should inform your doctor. Your doctor will discuss with you which other contraceptive method will be more suitable.

• 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 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 (thrombosis)");
• if you have had a heart attack or stroke;
• if you have (or have had in the past) 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 that 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);
• a disease called hyperhomocysteinemia;
• if you have (or have had in the past) a type of migraine called "migraine with aura";
• if you have (or have had in the past) liver disease, and liver function is still impaired;
• if you have kidney function disorders (kidney failure);
• if you have (or have had in the past) liver cancer;
• if you have (or have had in the past) 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 Lesiplus (listed in section 6). This allergy may be the cause of itching, rash, or swelling;
• if you have hepatitis C and are taking medicines containing ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir (see also section "Lesiplus and other medicines").

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

Warnings and precautions

Before starting to take Lesiplus, 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 of the symptoms 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 section below "Blood clots (thrombosis)").

To find a description of the symptoms of these serious side effects, see "How to recognize a blood clot".
In certain situations, you should be particularly careful when taking Lesiplus or any other combined hormonal contraceptive and may need to be regularly examined by your doctor.

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

If these symptoms occur or worsen while taking Lesiplus, you should also tell your doctor.

• if someone in your immediate family has or 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 (chronic inflammatory bowel diseases);
• 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 of red blood cells);
• if you have been diagnosed with high levels of fats in the blood (hypertriglyceridemia) or have a positive family history for this disease. 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 (thrombosis)");

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• if you are immediately after childbirth, you are at increased risk of blood clots. You should consult your doctor for information on how soon you can start taking Lesiplus after childbirth;
• if you have superficial thrombophlebitis (blood clots in the veins under the skin);
• if you have varicose veins;
• if you have epilepsy (see "Lesiplus 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 (pregnancy pemphigoid), a nervous system disease characterized by involuntary movements of the body (Sydenham's chorea));
• if you have current or have had chloasma (a skin condition characterized by brown patches, so-called "pregnancy patches", mainly on the face). If so, you should avoid direct exposureto sunlight or ultraviolet radiation;
• if you have hereditary angioedema, estrogen-containing medications may cause or worsen its symptoms. You should contact your doctor immediatelyif you experience symptoms of angioedema, such as swelling of the face, tongue, and/or throat, and/or difficulty swallowing or hives with difficulty breathing.

Blood clots (thrombosis)

Taking combined hormonal contraceptives, such as Lesiplus, is associated with an increased risk of blood clots, compared to not taking them.
In rare cases, a blood clot can block a blood vessel and cause serious complications.
Blood clots can occur

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

Not everyone who has a blood clot will recover completely. In rare cases, the effects of a blood clot can be long-lasting or, very rarely, fatal.

It is important to remember that the overall risk of having a harmful blood clot due to taking Lesiplus is small.

How to recognize a blood clot

You should contact your doctor immediately if you notice any of the following symptoms.
Are you experiencing any of these
symptoms?
Why is the patient likely to be suffering
from this?

• swelling of the leg or swelling along a vein in the leg or foot, especially if it is accompanied by:
• pain or tenderness in the leg, which may only be felt when standing or walking;
• increased temperature in the affected leg;
• change in the color of the leg skin, such as pallor, redness, or cyanosis.
• sudden unexplained shortness of breath or rapid breathing;

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Blood clots in a vein

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). Although these side effects are rare, they can occur, especially 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 Lesiplus, the risk of blood clots returns to normal within a few weeks.

What factors increase the risk of blood clots in a vein?

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 Lesiplus is small.

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

Factors that increase the risk of blood clots in veins

The risk of blood clots associated with taking Lesiplus 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/m²);

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• if someone in your immediate 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 genetic blood clotting disorder;
• if you need to have surgery or will be immobilized for a long time due to injury or illness or have a leg in a cast. It may be necessary to stop taking Lesiplus for a few weeks before surgery or immobilization. If you need to stop taking Lesiplus, you should ask your doctor when you can resume taking it;
• with age (especially over 35 years old);
• if you have given birth in the last few weeks.

The risk of blood clots increases with the number of risk factors present in the individual.
Air travel (>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 you from taking Lesiplus.
You should inform your doctor if any of the above conditions change while taking Lesiplus, e.g., if someone in your immediate family is diagnosed with a blood clot without a known cause or if you gain weight significantly.

Blood clots in an artery

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

Similar to blood clots in veins, blood clots in arteries can cause serious complications, 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 Lesiplus is very small, but it may increase:

• with age (over about 35 years old);
• if you smoke.While taking a hormonal contraceptive like Lesiplus, you are advised to stop smoking. If you are unable to stop 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 immediate 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 immediate 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);
• if you have diabetes.

If you have more than one of these 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 Lesiplus, e.g., if you start smoking, if someone in your immediate family is diagnosed with a blood clot without a known cause, or if you gain weight significantly.

Lesiplus and cancer

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Women taking combined oral contraceptives have a slightly higher risk of breast cancer, but it is not known if this is caused by the medicine. For example, it may be that more tumors are detected in women taking combined oral contraceptives because they are examined by doctors more frequently. The incidence 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 oral contraceptives have also 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 Lesiplus, you may experience unexpected bleeding (bleeding outside of the placebo period). If such bleeding occurs for 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 placebo period

If you have taken all the active tablets correctly, have not vomited, have not had severe diarrhea, and have not taken any other medicines, it is unlikely that you are pregnant.
If the expected bleeding does not occur twice in a row, it may mean that you are pregnant. You should contact your doctor immediately. Do not start the next pack until you are sure you are not pregnant.

Mental disorders

Some women taking hormonal contraceptives, including Lesiplus, 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.

Lesiplus and other medicines

Always tell your doctor or pharmacist about all medicines or herbal products 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 Lesiplus. They may tell you if you need to use additional contraceptives (e.g., condoms) and for how long or if you need to modify the use of other medicines.
Do not give Lesiplus to patients with hepatitis C who are taking medicines containing ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir, as this may cause increased liver enzyme levels in the blood (increased ALT activity).
Your doctor will prescribe a different type of contraception before starting treatment with these medicines.
Lesiplus can be taken again about 2 weeks after finishing this treatment.
See section "When not to use Lesiplus".
Some medicines may affect the levels of Lesiplus in your blood and may make Lesiplus less effective in preventing pregnancyor may cause unexpected bleeding.
This applies to medicines used to treat:

• epilepsy (e.g., primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine)
• tuberculosis (e.g., rifampicin)
• HIV and hepatitis C infections (so-called protease inhibitors and non-nucleoside reverse transcriptase inhibitors, such as ritonavir, nevirapine, efavirenz)

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• fungal infections (griseofulvin, ketoconazole)
• arthritis, degenerative joint disease (etoricoxib)
• high blood pressure in the blood vessels of the lungs (bosentan)
• and herbal products containing St. John's Wort ( Hypericum perforatum). Lesiplus may affect the action of other medicines, such as:
• medicines containing cyclosporin
• antiepileptic drugs
• theophylline (used for breathing problems)
• tizanidine (used to treat muscle pain and/or muscle spasms)
• medicines containing lamotrigine (may lead to an increased frequency of epileptic seizures).

You should consult your doctor or pharmacist before taking any medicine.

Lesiplus with food and drinks

Lesiplus can be taken with or without food, and if necessary, washed down with a small amount of water.

Lab tests

If you need to have a blood test, you should tell your doctor or laboratory staff that you are taking contraceptives, as the hormones in contraceptives may affect the results of some tests.

Pregnancy and breastfeeding

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

Driving and using machines

There is no information suggesting that taking Lesiplus affects the ability to drive or operate machines.

Lesiplus contains lactose

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

Lesiplus contains sodium

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

3. How to use Lesiplus

This medicine should always be taken as directed by your doctor or pharmacist. If you are unsure, you should consult your doctor or pharmacist.
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Each pack contains 24 pink tablets and 4 white tablets (placebo).
The Lesiplus tablets in two different colors are arranged in the pack in a specific order.
One pack contains 28 tablets.
You should take one Lesiplus 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.
Do not confuse the tablets:the pink tablets are taken for the first 24 days, followed by the white tablets for the last 4 days. A new pack should be started immediately (24 pink, followed by 4 white tablets). There is no break between the two packs.
Due to the differences in tablet composition, it is essential to start taking the tablets from the first tablet in the top left corner of the pack and continue taking them every day. To maintain the correct order, you should move in the direction of the arrows on the pack.

Preparing the pack

To help you remember to take your contraceptive, each Lesiplus pack comes with 7 self-adhesive strips with the days of the week printed on them. According to the day of the week you start taking the tablets, you should choose the appropriate self-adhesive strip. For example, if the first day of taking the tablets was Wednesday, you should choose the strip with "Wed" as the first day of the week.
You should stick the strip along the top of the pack, where it says "start Plaats het etiket hier".
This way, each tablet has the corresponding day of the week, and you can check if you have taken a tablet. The arrows show the order in which to take the tablets.
During the 4 days when the white placebo tablets are taken (placebo days), you should experience bleeding (so-called "withdrawal bleeding"). This bleeding usually starts 2 or 3 days after taking the last pink active tablet. After taking the last white tablet, you should start a new pack, regardless of whether the bleeding has stopped. This means that each new pack will be started on the same day of the week, and the bleeding should occur at about the same time every month.
If you take Lesiplus in this way, you are also protected against pregnancy during the 4 days when you take the placebo tablets.

When can you start the first pack?

• If you have not used a hormonal contraceptive in the previous monthYou should start taking Lesiplus on the first day of your cycle (i.e., the first day of your period). If you start taking Lesiplus on the first day of your period, you are immediately protected against pregnancy. You can also start taking Lesiplus on days 2-5 of your cycle, but you will need to use additional contraceptive methods (e.g., condoms) for the first 7 days.
• Switching from a combined hormonal contraceptive or a combined hormonal contraceptive vaginal ring or patchYou can start taking Lesiplus the next day after taking the last active tablet (the last tablet containing active substances) from the previous pack, but no later than the day after the end of the previous contraceptive's tablet-free period (or the last inactive tablet of the previous contraceptive). When switching from a combined hormonal contraceptive vaginal ring or patch, you should follow your doctor's advice.

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• Switching from a progestogen-only method (mini-pill, injection, implant, or intrauterine system releasing progestogen)You can switch at any time from a progestogen-only mini-pill (from an implant or intrauterine system on the day it is removed, 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 Lesiplus.
• After a miscarriageFollow your doctor's advice.
• After childbirthAfter childbirth, you can start taking Lesiplus from 21 to 28 days after delivery. If you start taking Lesiplus later than 28 days, you should use a mechanical method (e.g., condoms) for the first 7 days of taking Lesiplus. If you have had sexual intercourse after childbirth before (re)starting Lesiplus, you should first ensure that you are not pregnant or wait for your next period.
• If you are breastfeeding and want to (re)start taking Lesiplus after childbirth.You should read the section "Breastfeeding".

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

What to do if you take more Lesiplus than you should

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

What to do if you forget to take Lesiplus

The last four tablets in the fourthrow of the pack are placebo tablets. If you forget to take one of them, the contraceptive effectiveness of Lesiplus is maintained. You should discard the missed placebo tablet.
If you miss a pink active tablet (tablets 1-24 of the pack), you should follow these instructions:

• If less than 24 hourshave passed since missing the tablet, contraceptive protection is not reduced. You should take the tablet as soon as possible, and then take the next tablets at the usual time.
• If more than 24 hourshave passed since missing the tablet, contraceptive protection may be reduced. The more tablets you miss, the higher the risk of becoming pregnant.

The risk of reduced contraceptive protection is highest if you miss a pink active tablet at the beginning or end of the pack. Therefore, you should follow these rules (see also the diagram below):

Missing more than one tablet in a pack

You should contact your doctor.

Missing one tablet between days 1-7 (first row)

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You should take the missed 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 protectionfor the next 7 days, such as condoms. If you had sexual intercourse in the week before missing the tablet, there is a risk of pregnancy. In this case, you should contact your doctor.

Missing one tablet between days 8-14 (second row)

You should take the missed 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. Contraceptive protection is not reduced, and you do not need to use additional protection.

Missing one tablet between days 15-24 (third and fourth rows)

There are two options to choose from:

• 1. Take the missed tablet as soon as possible, even if it means taking two tablets at the same time. Then take the next tablets at the usual time. Instead of taking the white placebo tablets from this pack, you should discard them and start taking the tablets from the next pack (the starting day will be different).

Bleeding will most likely occur at the end of the second pack, during the placebo period, but it may also occur as spotting or irregular bleeding during the second pack.

• 2. You can also stop taking the pink active tablets and go directly to the 4 white placebo tablets ( before starting the placebo tablets, you should note the day you missed the tablet). If you want to start the next pack on your usual start day, take the placebo tablets for less than 4 days.

If you follow one of these two instructions, contraceptive protection will be maintained.

• If you miss any tablet from the pack and do not experience bleeding during the placebo period, it may mean that you are pregnant. In this case, you should contact your doctor before starting the next pack.

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4. Possible side effects

Like all medicines, this medicine 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 Lesiplus, you should consult a doctor.
In all women taking 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 different risk factors associated with the use of combined hormonal contraceptives, you should refer to section 2 "Important information before taking Lesiplus".
The following side effects have been associated with the use of Lesiplus.

• Common side effects (may occur in up to 1 in 10 people):
• mood swings;
• headaches;
• nausea;
• breast pain, menstrual disorders, such as irregular periods, absence of periods.
• Uncommon side effects (may occur in up to 1 in 100 people):
• depression, nervousness, drowsiness;
• dizziness, "tingling and numbness";

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• migraine, varicose veins, high blood pressure;
• abdominal pain, vomiting, indigestion, intestinal gas, gastritis, diarrhea;
• acne, itching, rash;
• pain, such as back pain, limb pain, painful muscle spasms;
• vaginal thrush, pelvic pain, breast enlargement, benign breast tumors, uterine and/or vaginal bleeding (which usually subsides during treatment), vaginal discharge, hot flashes, vaginal inflammation (vaginitis), menstrual disorders, painful menstruation, scanty menstruation, very heavy menstruation, vaginal dryness, abnormal Pap smear, decreased libido;
• lack of energy, increased sweating, fluid retention;
• weight gain.
• Rare side effects (may occur in up to 1 in 1000 people):
• candidiasis (fungal infection);
• anemia, increased platelet count in the blood;
• allergic reactions;
• hormonal disorders (endocrine);
• increased appetite, loss of appetite, abnormally high potassium levels in the blood, abnormally low sodium levels in the blood;
• inability to achieve orgasm, insomnia;
• dizziness, tremors;
• eye disorders, such as conjunctivitis, dry eye syndrome;
• abnormally fast heart rate;
• phlebitis, nosebleeds, fainting;
• abdominal enlargement, intestinal disease, feeling of fullness, abdominal hernia, oral thrush, constipation, dry mouth;
• biliary colic or cholecystitis;
• chloasma, eczema, abnormal hair growth (hirsutism), acne-like skin inflammation, dry skin, nodular skin inflammation, excessive hair loss (alopecia), skin disorders, skin stretch marks, skin inflammation, photosensitive skin inflammation, skin tumors;
• difficult and painful intercourse, vaginal inflammation (vulvovaginitis), intermenstrual bleeding, withdrawal bleeding, breast cyst, breast hyperplasia, malignant breast tumors, abnormal growth of the cervical mucosa, contraction or thinning of the endometrium, ovarian cysts, uterine enlargement;
• general malaise;
• weight loss;
• harmful blood clots in a vein or artery, such as:
• in the leg or foot (e.g., deep vein thrombosis);
• in the lungs (e.g., pulmonary embolism);
• heart attack;
• stroke;
• mini-stroke or transient stroke symptoms, known as a transient ischemic attack; ischemic;
• blood clots in the liver, stomach, and intestine, kidneys, or eye.

The likelihood of blood clots may be higher if the patient has any other risk factors (see section 2 for more information on risk factors for blood clots and symptoms of blood clots).
The following side effects have been reported, but their frequency cannot be determined from the available data: hypersensitivity, erythema multiforme (rash with red, painful borders).
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Reporting side effects

If any side effects occur, including any side effects not listed in the leaflet, you should tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C, 02-222 Warsaw
Phone: +48 22 49 21 301
Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
By reporting side effects, you can help provide more information on the safety of the medicine.

5. How to store Lesiplus

The medicine should be stored out of sight and reach of children.
Do not use Lesiplus after the expiry date stated on the packaging. The expiry date refers to the last day of the specified month.
There are no special precautions for storage.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Package contents and other information

What Lesiplus contains

• The active substances of Lesiplus are ethinylestradiol and drospirenone.
• Each pink film-coated tablet contains the active substances: 0.02 milligrams of ethinylestradiol and 3 milligrams of drospirenone.
• The white film-coated tablets do not contain active substances.
• Other ingredients are:
• Pink film-coated tablets containing active substances:
• Tablet core: lactose monohydrate, maize starch, povidone K 30, croscarmellose sodium, polysorbate 80, magnesium stearate.
• Tablet coating: polyvinyl alcohol, titanium dioxide (E 171), macrogol 3350, talc, yellow iron oxide (E 172), red iron oxide (E 172), black iron oxide (E 172).
• White film-coated placebo tablets:
• Tablet core: lactose, povidone K 30, magnesium stearate.
• Tablet coating: polyvinyl alcohol, titanium dioxide (E 171), macrogol 3350, talc.

What Lesiplus looks like and what the pack contains

• Each Lesiplus blister pack contains 24 pink film-coated tablets containing active substances in rows 1, 2, 3, and 4 of the blister pack and 4 white film-coated placebo tablets in row 4 of the blister pack.
• Lesiplus tablets, both pink and white, are film-coated; the tablet core is coated.
• Lesiplus is available in boxes with one blister pack, each containing 28 tablets (24 + 4).

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To obtain more detailed information, you should contact the marketing authorization holder or the parallel importer.

Marketing authorization holder in the Netherlands, the country of export:

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 24008-León
Spain

Parallel importer:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź

Repackaged by:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź
Netherlands, country of export, authorization number: RVG 109940

Parallel import authorization number: 37/21

Leaflet approval date: 19.06.2023

[Information about the trademark]
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