Label: information for the user
Gestinyl20/75 micrograms coated tablets
Ethinylestradiol/Gestodeno
Important things you should know about combined hormonal contraceptives (CHCs):
Read this label carefully before starting to take this medication, as it contains important information for you.
Before starting to take Gestinyl, 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 you can start taking Gestinyl, your doctor will ask you some questions about your personal medical history and that of your close relatives. The doctor will also take your blood pressure and, depending on your personal situation, may perform some other tests. In this prospectus, several situations are described in which you should stop taking this medication, or in which the effectiveness of this may be reduced. In such situations, you should not have sexual intercourse, or you should take another type of non-hormonal contraceptive, for example, a condom or another barrier method. Do not use the rhythm or temperature methods. These methods may not be reliable, as Gestinyl alters the monthly changes in body temperature and cervical mucus. Gestinyl, like other non-hormonal contraceptives, does not protect against HIV (AIDS) or any other sexually transmitted disease. |
Do not take
Do not use Gestinyl 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.
Warnings and Precautions
When to consult a doctor? Seek urgent medical attention
For a description of the symptoms of these serious side effects, see “How to recognize a blood clot”. Mental health disorders Some women who use hormonal contraceptives like Gestinyl have reported depression or a depressed mood. Depression can be severe and sometimes may induce suicidal thoughts. If you experience mood changes and depressive symptoms, contact your doctor for additional medical advice as soon as possible. If you experience symptoms of angioedema such as facial swelling, tongue, and/or throat swelling, and/or difficulty swallowing or urticaria with possible difficulty breathing, contact a doctor immediately. Products containing estrogens can cause or worsen symptoms of hereditary and acquired angioedema. |
Some of the conditions listed below may worsen when taking the pill. Or they may make it less suitable for you. You may be able to continue taking Gestinyl but you will need to be extra careful and have more frequent check-ups.
Inform your doctor if you have any of the following conditions
If the condition develops or worsens while using Gestinyl, you should also inform your doctor.
In some situations, you should be extra careful while using Gestinyl or any other combined hormonal contraceptive, and your doctor may need to perform regular check-ups. If any of the following conditions affect you, inform your doctor before starting to use Gestinyl:
Gestinyl and thrombosis
Blood clots
The use of a combined hormonal contraceptive like Gestinyl increases your risk of suffering a blood clot compared to not using it. In rare cases, a blood clot can block blood vessels and cause serious problems.
Blood clots can form:
The recovery of blood clots is not always complete. In rare cases, there may be long-lasting or even fatal effects.
It is essential to remember that the overall risk of a harmful blood clot due to Gestinyl is small.
How to recognize a blood clot
Seek urgent medical attentionif you notice any of the following signs or symptoms.
Do you experience any of these signs? | What may you be suffering from? |
| Deep vein thrombosis |
If you are unsure, consult your doctor, as some of these symptoms, such as coughing or shortness of breath, can be confused with a milder condition like a common respiratory infection (e.g., a “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 may be brief, with almost immediate and complete recovery, but you should still seek urgent medical attention as you may be at risk of another stroke. | Stroke |
| Blood clots that block other blood vessels. |
?Seek medical attention as soon as possible. Do not take more Gestinyl until your doctor tells you it is safe to do so. In the meantime, use another form of contraception, such as a condom.
Blood clots in a vein
What can happen if a blood clot forms in a vein?
When is the risk of a blood clot in a vein higher?
The risk of a blood clot in a vein is higher during the first year of taking a combined hormonal contraceptive for the first time. The risk may also be higher if you start taking a combined hormonal contraceptive again (the same medication or a different medication) after a break 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 Gestinyl, your risk of a blood clot returns to normal in a few weeks.
What is the risk of 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 a blood clot in the leg or lung (DVT or PE) with Gestinyl is small:
Risk of a blood clot in a year | |
Women whodo not usea combined hormonal contraceptive and are not pregnant | Approximately 2 of every 10,000 women |
Women who use a combined hormonal contraceptive containinglevonorgestrel, noretisterone, or norgestimato | Approximately 5-7 of every 10,000 women |
Women who use Gestinyl | Approximately 9-12 of every 10,000 women |
Factors that increase your risk of a blood clot in a vein
Your risk of a blood clot with Gestinyl is small, but some conditions increase the risk. Your risk is higher:
Your risk of a blood clot increases as you have more of these conditions.
Long flights (over 4 hours) may temporarily increase your 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 have any of the conditions listed above, even if you are unsure. Your doctor may decide to stop your treatment with Gestinyl.
Inform your doctor if any of the conditions listed above change while you are using Gestinyl, for example, if a close relative experiences a blood clot without a known cause or if you gain a lot of weight.
Blood clots in an artery
What can happen if a blood clot forms in an artery?
Like a blood clot in a vein, a blood 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 Gestinyl is very small, but it may increase:
If you have one or more of these conditions or if any of them are particularly severe, your risk of a blood clot may be even higher.
If any of the conditions listed above change while you are using Gestinyl, for example, if you start smoking, a close relative experiences a blood clot without a known cause, or you gain a lot of weight, inform your doctor.
Gestinyl and cancer
It appears that taking the pill increases the risk ofuterine cervical cancer, although this may be due to having unprotected sex and not the pill itself. All women should undergo periodicsmears.
If you havebreast canceror have had it in the past, do not take the pill.
The pill increases the risk of breast cancer. This risk increases the longer you take the pill, but returns to normal after 10 years of stopping it. Since breast cancer is rare in women under 40, the additional cases of breast cancer in current and recent users of the pill are small. For example:
Your risk of developing breast cancer is higher
?Seek medical attention as soon as possible if you notice any changes in your breasts, such as dimpling of the skin, changes in the nipple, or any lump that you can see or feel.
The pill has also been associated with liver diseases, such as jaundice and non-cancerous liver tumors, but this is rare. In very rare cases, the pill has also been associated with some forms of liver cancer in women who have taken it for a long time.
?Seek medical attention as soon as possible if you have severe stomach pain or yellow skin or eyes (jaundice). You may need to stop taking Gestinyl.
Menstrual bleeding
Some women experience a small amount of bleeding or spotting while taking Gestinyl, especially during the first few months. Normally, this bleeding is not a cause for concern and will stop within one or two days. Continue taking Gestinyl as usual. The problem should resolve after the first few packs.
You may also experience unexpected bleeding if you do not take the pills regularly, so try to take the pills at the same time every day. Additionally, unexpected bleeding can sometimes be caused by other medications.
?Make an appointment with your doctorif you have intermenstrual bleeding or spotting that:
- continues even after you stop taking Gestinyl.
What to do if no bleeding occurs during the pill-free period
If you have taken all the pills correctly, have not vomited, and have not had severe diarrhea, and have not taken other medications, it is very unlikely that you are pregnant.
If bleeding does not occur during two consecutive cycles, you may be pregnant. Contact your doctor immediately. Do not start taking the next pack until you are sure you are not pregnant.
Other medications and Gestinyl
Always inform your doctor who prescribes Gestinyl about any medications or herbal preparations you are taking. Also, inform any other doctor or dentist who prescribes another medication (or pharmacist who dispenses it) that you are taking Gestinyl. They may advise you to take additional contraceptive precautions (e.g., condoms) and, if so, for how long. |
This includes medications used to treat epilepsy (e.g., phenytoin, topiramate, felbamate, lamotrigine, primidone, barbiturates, carbamazepine, oxcarbazepine) and tuberculosis (e.g., rifampicin), immunomodulators (ciclosporin), HIV (ritonavir) or other infectious diseases (griseofulvin); and the herbal preparation St. John's Wort.
Your doctor will prescribe another type of contraceptive before starting treatment with these medications.
Gestinyl can be restarted approximately 2 weeks after the end of this treatment. See the section “Do not take Gestinyl”.
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.
Laboratory tests
If you need to have a blood test, inform your doctor or the person performing the test that you are taking the pill, as hormonal contraceptives can affect the results of some blood tests.
Pregnancy and breastfeeding
Do not take Gestinyl if you are pregnant. If you become pregnant while taking Gestinyl, stop taking it immediately and consult your doctor.
Generally, it is not recommended to use Gestinyl during breastfeeding. If you are breastfeeding and want to start taking Gestinyl, consult your doctor.
Consult your doctor or pharmacist before starting any medication.
Driving and operating machinery
No information is available to suggest that Gestinyl affects driving or operating machinery.
Gestinyl contains lactose and saccharose
If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.
Take one Gestinyl tablet every day, with a small amount of water if necessary. You can take the tablets with or without food, but you must take them approximately at the same time every day.
Each blister pack contains 21 tablets. Next to each tablet is printed the day of the week. If, for example, you start on a Wednesday, take a tablet with "MI" next to it. Follow the direction of the arrow on the blister pack until you have taken all the tablets.
Do not take any tablets for 7 days after that. During those 7 days without tablets (also called "rest week" or "week without tablets"), a bleeding should occur. This bleeding, known as "withdrawal bleeding," usually starts on the second or third day of the rest week.
On the eighth day after the last Gestinyl tablet (i.e., after the rest week), start the next blister pack, even if the bleeding has not stopped. This means that you must start the next blister pack on the same day of the week and that the withdrawal bleeding should occur during this time.
If you use Gestinyl in this way, you will also be protected against pregnancy during the 7 days when you do not take the tablets.
When can you start with the first blister pack
Start taking Gestinyl on the first day of your cycle (i.e., the first day of your menstruation). If you start taking Gestinyl on the first day of your menstruation, you will be immediately protected against pregnancy. You can also start taking Gestinyl between days 2-5 of your cycle, but in this case, you must take additional contraceptive measures (e.g., a condom) during the first 7 days.
You can start taking Gestinyl the day after the break of your previous oral contraceptive (or after the last placebo tablet). When switching from a vaginal ring or patch, follow your doctor's advice.
You can switch at any time from the pill, from an injectable when it's due for the next injection. In the case of an implant or IUD, on the same day of its removal. In all cases, you must take additional contraceptive measures (e.g., a condom) during the first 7 days of taking the tablets.
Follow your doctor's instructions.
You can start taking Gestinyl between 21 and 28 days after childbirth. If you start after day 28, you must use a barrier method (e.g., a condom) during the first 7 days of using Gestinyl.
If, after giving birth, you have had sex before starting to take Gestinyl, (again), first make sure you are not pregnant, or wait until your next menstruation.
Let your doctor advise you if you are unsure when to start.
Gestinyl should not be used during breastfeeding. Read the section "Pregnancy and breastfeeding."
If you take more Gestinyl than you should
No serious adverse effects have been reported for taking too many Gestinyl tablets.
If you take several tablets at once, you may experience nausea or vomiting symptoms. Young girls may experience vaginal bleeding.
If you have taken more Gestinyl tablets than you should, or if you discover that your child has taken them, consult your doctor or pharmacist immediately, or call the Toxicology Information Service, phone 91 562 04 20, indicating the medication and the amount ingested.
If you forget to takeGestinyl
The risk of incomplete protection against pregnancy is greater if you forget a tablet at the beginning or end of the blister pack. Therefore, you must follow the following rules (see also the diagram below):
Consult your doctor.
Take the forgotten tablet as soon as you remember, even if this means taking two tablets at once. Continue taking the tablets at the usual time and takeadditional precautionsfor the next 7 days, for example, a condom. If you have had sex in the week before forgetting the tablet or have forgotten to start a new pack after the rest period, you must consider the risk of pregnancy. In that case, consult your doctor
Take the forgotten tablet as soon as you remember, even if this means taking two tablets at once. Continue taking the tablets at the usual time. The protection against pregnancy is not reduced, and you do not need to take additional precautions.
You can choose between two options:
1.Take the forgotten tablet as soon as you remember, even if you have to take two tablets at once. Continue taking the tablets at the usual time. Instead of the rest period, go directly to the next pack.
You are likely to experience bleeding (withdrawal bleeding) at the end of the second pack, but you may also experience spotting or intermenstrual bleeding during the use of the second pack.
2.You can also interrupt taking the tablets and go directly to the rest period of 7 days (marking the day you forgot the tablet). If you want to start a new pack on the established start day, make the rest period shorter than 7 days.
If you follow either of these two recommendations, you will still be protected against pregnancy.
What to do in case of vomiting or intense diarrhea
If you vomit within 3-4 hours after taking the tablet or have intense diarrhea, there is a risk that your body will not fully absorb the active ingredients of the tablet. The situation is similar to forgetting to take a tablet. After vomiting or diarrhea, you must take another tablet from a reserve strip as soon as possible. If possible, take itwithin 12 hoursafter the usual time. If this is not possible or more than 12 hours have passed, you must follow the instructions in the section "If you forgot to take Gestinyl."
Delayed menstrual period: what you should know
Although not recommended, it is possible to delay the menstrual period (withdrawal bleeding). This can be done by going directly to a new Gestinyl pack instead of the rest period after the first pack. You may experience spotting (drops or spots of blood) or intermenstrual bleeding during the use of the second pack. After the usual rest period of 7 days, continue with the next pack.
You can consult your doctor before deciding to delay your menstrual period.
Change in the first day of your menstrual period: what you should know
If you take the tablets following the instructions, your menstrual period/withdrawal bleeding will start during the rest period. If you need to change that day, do it by shortening the rest period (but never lengthening it!). For example, if your rest period starts on a Friday, and you want to change the day to Tuesday (3 days earlier), you must start a new pack 3 days earlier than usual. If you make the rest period very short (e.g., 3 days or less), you may not experience withdrawal bleeding during that rest period. In that case, you may experience spotting (drops or spots of blood) or intermenstrual bleeding.
If you are unsure how to proceed, consult your doctor.
If you interrupt treatment withGestinyl
You can stop taking Gestinyl whenever you want. If you do not want to become pregnant, consult your doctor about other reliable contraceptive methods.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like other medicines, this medicine may cause side effects, although not everyone will experience them. If you experience any side effect, especially if it is severe and persistent, or if you notice any change in your health that you think may be related to Gestinyl, consult your doctor.
All women taking 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 starting to take Gestinyl.
Seek medical attention 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 section “Warnings and precautions”).
Severe side effects – seek medical attention immediately
Frequent side effects(may affect more than 1 in 10 people)
Common side effects(may affect up to 1 in 10 people)
Rare side effects(may affect up to 1 in 100 people)
Very rare side effects(may affect up to 1 in 1,000 people)
Very rare side effects(may affect up to 1 in 10,000 people)
Other reported side effects
Frequent side effects(may affect more than 1 in 10 people)
Rare side effects(may affect up to 1 in 1,000 people)
Very rare side effects(may affect up to 1 in 10,000 people)
?Inform your doctor, pharmacist or family planning specialist if you are concerned about any side effect that you think may be related to Gestinyl. Also tell them if any existing disease worsens while you are taking Gestinyl.
Reporting side effects
If you experience any type of side effect, consult your doctor, pharmacist or nurse, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Vigilance of Medicines for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Do not store above 86°F (30°C).
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the blister pack and on the case after “CAD”. The expiration date is the last day of the month indicated.
Medications should not be disposed of through drains or in the trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at your pharmacy. If in doubt, ask your pharmacist how to dispose of unused packaging and medications. By doing so, you will help protect the environment.
Composition ofGestinyl
Core of the tablet: magnesium stearate, povidone K‑25, cornstarch, lactose monohydrate.
Coating of the tablet: povidone K‑90, macrogol 6000, talc, calcium carbonate, saccharose, glycolated montan wax.
Appearance of the product and contents of the package
Gestinyl are white, round, biconvex, and unprinted coated tablets.
The tablets are supplied in blisters, each blister contains 21 tablets. The blisters are supplied in carton boxes. Each box contains 1, 3 or 6 blisters.
Only some package sizes may be marketed.
Holder of the marketing authorization and responsible manufacturer
Holder of the marketing authorization
Effik Laboratories, S.A.
C/ San Rafael, 3
28108 Alcobendas, Madrid
Spain
Responsible manufacturer
Haupt Pharma Münster GmbH
Scheebrüggenkamp 15
48159 Münster
Germany
This medicine is authorized by the member states of the European Economic Area with the following names
Denmark | Gestinyl, overtrukne tabletter |
Spain | Gestinyl 20/75 microgramos coated tablets |
Finland | Gestinyl 20 mikrog/75 mikrog tabletti, päällystett |
Hungary | Gestomix 20 mikrogramm / 75 mikrogramm bevont tabletta |
Italy | GESTODIOL 20 microgrammi / 75 microgrammi compresse rivestite |
Poland | Kontracept |
United Kingdom | Sunya 20/75 coated tablets |
Last review date of this leaflet:June 2023
Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS) (http://www.aemps.gob.es/).
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