Package Leaflet: Information for the User
drospirenone/ethinylestradiol
Read this entire leaflet carefully before you start taking this medicine, because it contains important information for you.
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Important things to know about combined hormonal contraceptives (CHCs):
Contents of the Package Leaflet:
When not to use Liofora 2
Warnings and Precautions……………………………………………………………..….3
Blood Clots 5
Liofora and Cancer 9
Psychiatric Disorders…………………………………………………..…………………..9
Irregular Bleeding 9
What to do if you do not have your period during the week off 10
Other Medicines and Liofora 10
Taking Liofora with Food and Drink 11
Laboratory Tests 11
Pregnancy 11
Breastfeeding 11
Driving and Using Machines 11
Liofora contains Lactose 11
When can you start with the first pack? 12
If you take more Liofora than you should 13
If you forget to take Liofora 13
What to do in case of vomiting or severe diarrhea 15
Delayed Period: what you should know 15
Change of the first day of your period: what you should know 15
If you stop taking Liofora 16
General considerations
Before starting to use Liofora, you should read the information about blood clots in section 2. It is particularly important that you read the symptoms of a blood clot (see section 2 "Blood clots").
Before starting to take Liofora, your doctor will ask you some questions about your personal and family medical history. The doctor will also measure your blood pressure and, depending on your personal situation, may carry out some other tests.
In this prospectus, several situations are described in which you should interrupt the use of Liofora, or in which the effect of Liofora may decrease. In such situations, you should not have sexual intercourse or should take additional non-hormonal contraceptive precautions, for example, use of a condom or another barrier method. Do not use the rhythm or temperature method. These methods may not be reliable since Liofora alters the monthly changes in body temperature and cervical mucus.
Liofora, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease.
When not to use Liofora
Do not use Liofora if you have any of the conditions listed below. Inform your doctor if you have any of the conditions listed below. Your doctor will discuss with you what other form of contraception would be more suitable.
Do not use Liofora
Do not take Liofora if you have hepatitis C and are taking medications that contain ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir or sofosbuvir/velpatasvir/voxilaprevir (see also the section "Other medications and Liofora").
Additional information on special populations
Children and adolescents
Liofora is not indicated for use in women who have not yet had their first menstrual period.
Women of advanced age
Liofora is not indicated for use after menopause.
Women with liver insufficiency
Do not take Liofora if you suffer from liver disease. See sections "Do not use Liofora" and "Warnings and precautions".
Women with renal insufficiency
Do not take Liofora if you are suffering from kidney malfunction or acute renal insufficiency. See sections "Do not use Liofora" and "Warnings and precautions".
Warnings and precautions
Consult your doctor or pharmacist before starting to take Liofora.
When should you consult your doctor? Seek urgent medical attention
To obtain a description of the symptoms of these serious side effects, see "How to recognize a blood clot". |
Tell your doctor if you suffer from any of the following conditions.
In some situations, you will need to be particularly careful while using Liofora or any other combined contraceptive, and it may be necessary for your doctor to examine you periodically. If the condition develops or worsens while you are using Liofora, you should also inform your doctor.
BLOOD CLOTS
The use of a combined hormonal contraceptive like Liofora increases your risk of developing a blood clotcompared to not using it. In rare cases, a blood clot can block blood vessels and cause serious problems.
Blood clots can form:
Recovery from blood clots is not always complete. In rare cases, there can be serious long-term effects or, very rarely, they can be fatal.
It is essential to remember that the overall risk of a harmful blood clot due to Liofora is small.
HOW TO RECOGNIZE A BLOOD CLOT
Seek urgent medical attention if you notice any of the following signs or symptoms.
Are you experiencing any of these signs? | What might you be suffering from? |
| Deep vein thrombosis. |
If you are unsure, consult a doctor, as some of these symptoms, such as cough or shortness of breath, can be confused with a milder condition such as a respiratory infection (e.g., a "common cold"). | Pulmonary embolism. |
Symptoms that occur more frequently in one eye:
| Retinal vein thrombosis (blood clot in the eye). |
| Heart attack. |
Sometimes the symptoms of a stroke can be brief, with almost immediate and complete recovery, but you should still seek urgent medical attention as you may be at risk of having another stroke. | Stroke. |
| Blood clots that block other blood vessels. |
BLOOD CLOTS IN A VEIN
What can happen if a blood clot forms in a vein?
When is the risk of developing a blood clot in a vein higher?
The risk of developing a blood clot in a vein is higher during the first year in which you take a combined hormonal contraceptive for the first time. The risk may also be higher if you start taking a combined hormonal contraceptive (the same medication or a different one) after an interruption of 4 weeks or more.
After the first year, the risk decreases, but it is always slightly higher than if you were not taking a combined hormonal contraceptive.
When you stop taking Liofora, your risk of developing a blood clot returns to normal within a few weeks.
What is the risk of developing a blood clot?
The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking.
The overall risk of developing a blood clot in the leg or lung (DVT or PE) with Liofora is small.
Risk of developing a blood clot in a year | |
Women who do not usea combined hormonal contraceptive and are not pregnant | About 2 out of 10,000 women |
Women who use a combined hormonal contraceptive that contains levonorgestrel, norethisterone or norgestimate | About 5-7 out of 10,000 women |
Women who use Liofora | About 9-12 out of 10,000 women |
Factors that increase your risk of a blood clot in a vein
The risk of having a blood clot with Liofora is small, but some conditions increase the risk. Your risk is higher:
The risk of developing a blood clot increases with the number of conditions you have.
Long-haul flights (more than 4 hours) may temporarily increase the risk of a blood clot, especially if you have any of the other risk factors listed.
It is essential to inform your doctor if you suffer from any of the above conditions, even if you are not sure. Your doctor may decide that you should interrupt the use of Liofora.
If any of the above conditions change while you are using Liofora, for example, a close relative experiences a thrombosis without a known cause or you gain a lot of weight, inform your doctor.
BLOOD CLOTS IN AN ARTERY
What can happen if a blood clot forms in an artery?
Like a blood clot in a vein, a clot in an artery can cause serious problems. For example, it can cause a heart attack or a stroke.
Factors that increase your risk of a blood clot in an artery
It is essential to note that the risk of a heart attack or stroke due to Liofora is very small, but it can increase:
If you have more than one of these conditions or if any of them are particularly severe, the risk of developing a blood clot may be even higher.
If any of the above conditions change while you are using Liofora, for example, you start smoking, a close relative experiences a thrombosis without a known cause or you gain a lot of weight, inform your doctor.
Liofora and cancer
It has been observed that breast cancer occurs slightly more frequently in women who use combined contraceptives, but it is not known if this is due to the treatment. For example, it may be that more tumors are detected in women who take combined contraceptives because they are examined by a doctor more frequently. The incidence of breast tumors decreases gradually after stopping combined hormonal contraceptives. It is essential to undergo regular breast examinations, and you should see your doctor if you notice any lump.
In rare cases, benign liver tumors, and even more rarely, malignant liver tumors, have been reported in users of hormonal contraceptives. See your doctor if you have severe unusual abdominal pain.
Psychiatric disorders
Some women who use hormonal contraceptives like Liofora have reported depression or a depressive mood. Depression can be severe and sometimes can induce suicidal thoughts. If you experience mood changes
Liofora can be taken with or without food, and with some water if necessary.
Laboratory tests
If you need a blood test, tell your doctor or laboratory staff that you are taking a contraceptive, as hormonal contraceptives can influence the results of some tests.
Pregnancy, breastfeeding, and fertility
Pregnancy
If you are pregnant, you should not take Liofora. If you become pregnant during treatment with Liofora, you must stop treatment immediately and contact your doctor. If you want to become pregnant, you can stop taking Liofora at any time (see "If you interrupt treatment with Liofora", page 15).
Consult your doctor or pharmacist before using any medication.
Breastfeeding
In general, it is not recommended to take Liofora during the breastfeeding period. If you want to take the contraceptive while breastfeeding, you should consult your doctor.
Consult your doctor or pharmacist before using any medication.
Driving and using machines
There is no information to suggest that the use of Liofora has any effect on the ability to drive or use machinery.
Liofora contains lactose
If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.
Follow exactly the administration instructions of this medication indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.
Take one Liofora tablet every day, with some water if necessary. You can take the tablets with or without food, but always at approximately the same time every day.
The package (blister) contains 21 film-coated tablets. Next to each tablet is printed the day of the week on which it should be taken. If, for example, you start on a Wednesday, take a tablet with "WED" next to it. Follow the direction of the arrow on the package until you have taken all 21 tablets.
After that, you should not take any tablets for 7 days. During these 7 days in which you do not take tablets (called the rest week), you should have your period. The period, which can also be called withdrawal bleeding, usually starts on the 2nd or 3rd day of the rest week.
On the 8th day after taking the last Liofora tablet (i.e., after the 7-day rest period), you should start with the next package, even if you have not yet finished your period. This means that you should start each package on the same day of the week, and your period should take place during the same days every month.
If you use Liofora in this way, you are also protected against pregnancy during the 7 days in which you do not take any tablets.
When can you start with the first package?
Start taking Liofora on the first day of your cycle (i.e., the first day of your period). If you start Liofora on the first day of your period, you are immediately protected against pregnancy. You can also start on days 2-5 of your cycle, but you must use additional contraceptive methods (e.g., a condom) during the first 7 days.
You can start taking Liofora preferably the day after taking the last active tablet (the last tablet that contains active ingredients) of your previous contraceptive, but no later than the day after the rest week of your previous contraceptive (or after taking the last inactive tablet of your previous contraceptive). When switching from a combined vaginal ring or patch, follow your doctor's recommendations.
You can switch from the progestin-only pill at any time (if it's an implant or IUS, on the day of its removal; if it's an injection, when the next injection is due), but in all cases, use additional contraceptive measures (e.g., a condom) during the first 7 days of tablet-taking.
Follow your doctor's recommendations.
You can start taking Liofora between 21 and 28 days after having a child. If you start later than day 28, use a barrier method (e.g., a condom) during the first 7 days of Liofora use.
If, after having a child, you have already had sexual intercourse before starting to take Liofora again, you must be sure you are not pregnant or wait for your next menstrual period.
Read the section "Breastfeeding", page 11.
Ask your doctor if you are not sure when to start.
If you take more Liofora than you should
No cases have been reported in which an overdose of Liofora has caused serious harm.
The symptoms that may appear if you take many tablets at once may include feeling unwell or vomiting or vaginal bleeding. This bleeding can occur even in girls who have not yet had their first period, if they accidentally take this medication.
If you have taken too many Liofora tablets, or discover that a child has taken them, consult your doctor or pharmacist.
In case of overdose or accidental ingestion, consult your doctor or pharmacist or call the Toxicology Information Service, phone 915 620 420, indicating the medication and the amount taken.
If you forget to take Liofora
The risk of incomplete protection against pregnancy is highest if you forget to take a tablet at the beginning or end of the package. Therefore, you should follow the following recommendations (see the diagram on page 14):
Consult your doctor.
Take the forgotten tablet as soon as you remember, even if it means taking two tablets at once. Continue taking the tablets at the usual time and use additional precautions, such as condoms, for the next 7 days. If you have had sexual intercourse in the week before forgetting the tablet, you may be pregnant. In that case, consult your doctor.
Take the forgotten tablet as soon as you remember, even if it means taking two tablets at once. Continue taking the tablets at the usual time. The protection against pregnancy does not decrease, and you do not need to take additional precautions.
You can choose between two options:
You will likely have your period at the end of the second package, although you may experience light bleeding or spotting during the second package.
If you follow one of these two recommendations, you will remain protected against pregnancy.
What to do in case of vomiting or severe diarrhea
If you vomit within 3-4 hours after taking a tablet or have severe diarrhea, there is a risk that the active ingredients of the contraceptive will not be fully absorbed by the body. The situation is almost equivalent to forgetting a tablet. After vomiting or diarrhea, take a tablet from a reserve package as soon as possible. If possible, take it within 12 hoursafter the usual time you take your contraceptive. If this is not possible or more than 12 hours have passed, follow the advice in the section "If you forget to take Liofora", page 13.
Delayed menstrual period: what you should know
Although it is not recommended, you can delay your menstrual period if you start taking a new package of Liofora instead of continuing with the rest week and finish it. You may experience light bleeding or spotting during the use of the second package. After the usual rest week, startthe next package.
You should ask your doctor for advice before deciding to delay your menstrual period.
Changing the first day of your menstrual period: what you should know
If you take the tablets according to the instructions, your menstrual period will start during the week corresponding to the rest week. If you need to change the day, reduce the number of rest days (but never increase them - 7 at most!). For example, if your rest days usually start on Fridays and you want to change to Tuesdays (3 days earlier), start a new package 3 days earlier than usual. If you make the rest week very short (e.g., 3 days or less), you may not have bleeding during these days. Then you may experience light bleeding or spotting.
If you are not sure how to proceed, consult your doctor.
If you interrupt treatment with Liofora
You can stop taking Liofora whenever you want. If you do not want to become pregnant, consult your doctor about other effective birth control methods.
If you want to become pregnant, stop taking Liofora and wait until your menstrual period before trying to become pregnant. This way, you can more easily calculate the estimated due date.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.
If you experience any adverse effect, especially if it is severe and persistent, or if you have any change in health that you think may be due to Liofora, consult your doctor.
All women who take combined hormonal contraceptives are at a higher risk of developing blood clots in the veins (venous thromboembolism (VTE)) or blood clots in the arteries (arterial thromboembolism (ATE)). For more detailed information on the different risks of taking combined hormonal contraceptives, see section 2 "What you need to know before taking Liofora".
Severe Adverse Effects
Contact a doctor immediately if you experience any of the following symptoms of angioedema: swelling of the face, tongue, and/or throat, and/or difficulty swallowing or urticaria with possible difficulty breathing (see also the "Warnings and Precautions" section).
The following list of adverse effects has been associated with the use of Liofora.
Frequent Adverse Effects(may affect up to 1 in 10 patients):
Uncommon Adverse Effects(may affect up to 1 in 100 patients):
Rare Adverse Effects(may affect up to 1 in 1000 patients):
The likelihood of having a blood clot may be higher if you have any other condition that increases this risk (see section 2 for more information on conditions that increase the risk of blood clots and symptoms of a blood clot).
Reporting Adverse Effects:
If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.
Keep this medicine out of sight and reach of children.
This medicine does not require any special storage conditions.
Do not use this medicine after the expiration date stated on the packaging after "CAD:". The expiration date is the last day of the month indicated.
Medicines should not be disposed of through wastewater or household waste. Deposit the packaging and any unused medicines at the SIGRE collection point in your pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medicines. This will help protect the environment.
Composition of Liofora
Each coated tablet contains 3 milligrams of drospirenone and 0.020 milligrams of ethinylestradiol (as betadex clathrate).
Appearance of the Product and Package Contents
The film-coated tablets are pale pink, round, with convex surfaces, and one side has the letters "DS" marked in a regular hexagon.
Only some package sizes may be marketed.
Marketing Authorization Holder and Manufacturer
Marketing Authorization Holder
Bayer Hispania, S.L.
Av. Baix Llobregat, 3 - 5
08970 Sant Joan Despí - Barcelona
Spain
Manufacturer
Bayer AG, 13342 Berlin, Germany
or
Bayer Weimar GmbH und Co. KG, Döbereinerstr. 20 99427 Weimar, Germany
This medicine is authorized in the Member States of the European Economic Area under the following names:
Date of the Last Revision of this Prospectus:May 2023
Detailed information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es)