Diane 35 Bayer treat acne to severe to severe level (1 blister x 21 tablets)

Family history of the disease (for example, in a family with siblings or parents, each one, have artery or vein thrombosis at a young age). If it is known or suspected to have a congenital genetic factor, patients should consult the specialist's advice before deciding to use the hormone contraceptives.

The risk of arterial thrombosis or stroke increases with:

Plasma lipoprotein disorders.

Obesity (body mass index of over 30kg/m2).

Atrial fibrillation.

There is no consensus of the role of varicose veins and agricultural thrombosis for thrombosis in the vein.

Attention should be paid to increasing the risk of thrombosis during birth (information about pregnant women and breastfeeding to see the item "using drugs in pregnant and lactating women"). The group uses Diane - 35, which is likely to include patients who have increased cardiovascular risks as combined with polycystic ovarian syndrome.

Other pathological conditions can cause adverse events for the circulatory system including complicated diabetes, systemic erythema lupus, hemolytic urea syndrome, chronic bowel inflammation (Crohn's disease, colon ulcer) and sickle cell disease.

Need to stop using Diane - 35 even in the case of migraine appears more or more severe during the use of Diane - 35 (because this can be a sign of a foretail of cerebrovascular events).

Women use Diane - 35 should contact the doctor if the symptoms may be related to thrombosis. If doubtful or confirming thrombosis, Diane - 35 should be discontinued. It is advisable to apply appropriate contraception because the risk of teratogenicity when using anti -thrombotic therapy (Coumarin).

Factors may suggest genetic or infected factors for blood vessel thrombosis in the artery or venous, including anti -activation of protein C (APC, Homocystein reduction in blood, deficiency of anticoagulant factor III, protein deficiency, S deficiency, phospholipid antibodies (anti -phospholipid anti -anti -coagulants in lupus).

When considering the risk as well as the benefits of the drug, the doctor needs to consider the treatment conditions to reduce the risk of venous thrombosis and these risks are higher in pregnant women than women who use low -dose coc (

tumors

The most important risk factor for cervical cancer is prolonged HPV infection. A number of epidemiological studies have shown that the use of prolonged combined contraceptives can increase this risk, but there are still controversy over the participation of other factors such as the condition of the cervix and sexual behaviors including the use of other pregnancy prevention measures.

A gross analysis from 54 epidemiological studies shows that the risk of breast cancer in women is using coc slightly higher than women who do not use COC (RR = 1.24). The proportion of women diagnosed with this higher risk gradually lower after 10 years of stopping medication. Due to rare breast cancer in women under 40 years old, the number of women who have used or are using COC is diagnosed with breast cancer low in the total number of breast cancer causes.

These studies do not give the cause of those risks. The reason may be because these women go to the doctor more during the use of drugs, due to the biological effects of COC or due to the combination of both causes. Breast cancer in those who use drugs tends to be diagnosed earlier before there are clinical progressive symptoms compared to women who never use.

Rare cases of benign liver tumors and extremely rare cases of malignant Ugan tumor are reported when using COC. These tumors can cause internal bleeding. Notice immediately to your doctor if you appear intense pain in the lower abdomen, liver enlargement or show signs of internal bleeding during the use of COC.

Malignant tumors can endanger life or death.

Other conditions

Women, or in families with a history of increased trilycerides in the blood, are at higher risk of pancreatitis when using COC.

Although mild hypertension has been reported in women who are using COC, this condition is rarely clinically. However, if in the process of using coc patients constantly show clinical signs of hypertension, notify the doctor to stop using COC and treat hypertension. When the blood pressure parameters have returned to normal, the doctor may consider the reuse of COC.

The following conditions have also been reported in pregnant women as well as coc users, but there is no conclusion about the relationship of these conditions with the use of COC, including: jaundice with itchy or not related to bile stasis, gallstones, Porphyrin metabolism disorders, lupus erythematosus, high blood urea syndrome, fetal dance hearing.

In women with genetic angiema, external estrogen can appear or worse the symptoms of angioedema.

It is necessary to stop using COC immediately when signs of acute or chronic liver dysfunction until the liver function returns to normal. The reappearance of jaundice occurred in the first pregnancy or by the use of previous steroid hormones is also an essential sign to stop using COC.

Although COC may have an influence on peripheral insulin resistance and glucose tolerance, there is no evidence that it is necessary to change the treatment in diabetics with low doses of COC (containing

Crohn's disease and ulcerative colitis are also related to the use of COC.

Melasma can also appear, especially for women with a history of melasma during pregnancy. Women tend to have melasma should stay away from the sun or ultraviolet rays during the use of COC.

For women with symptoms with symptoms that appear and gradually increase, it is necessary to conduct a distinct diagnosis to clearly identify the cause of the disease (with tumor to increase androgen production, lack of adrenal enzymes).

Each pill contains 31 mg of lactose. Patients with rare genetic problems in galactose tolerance, lactase lactase deficiency or poor absorption of glucose - galactose are following lactose diet should consider the amount of use.

Medical examination

It is necessary to fully ask the patient's disease history and conduct medical examination before starting or when reusing Diane - 35, performing periodically the instructions in the contraindication and warning section, need to be reminded during the use of Diane - 35.

Periodic medical examination is very important because in the first time after using Diane - 35 may appear but the contraindication to use (such as a transient local cheek ...) or risk factors (such as family history of artery thrombosis or veins).

The frequency and properties of this examination need to be based on practical experiences and applies to each specific case, but it should include examination of blood pressure, breast, abdomen and cervical cytotics.

It should be noted that Diane - 35 has no effect on preventing HIV infection or any other genital infection.

Reduce the effectiveness of treatment

The contraceptive effect of Diane - 35 may be reduced in cases such as: forgetting to take the medicine (see the item "Handling when forgetting to take the medicine", the digestive disorder when taking the drug (the part of the digestive disorders ") or the accompanying drug (part" interact with other drugs and the forms of interaction ").

Reduce the effectiveness of menstrual cycle control

When treated with estrogen/progestogen preparations, there may be abnormal bleeding (menorrhagia or cycle bleeding), especially during the first time using birth control pills. Therefore, evaluating abnormal bleeding is only meaningful after 3 treatment cycles.

If abnormal bleeding or bleeding appears after a periodic menstrual cycle, it is advisable to consider the cause not due to the hormone and need to perform adequate diagnostic methods to determine whether there is a malignant or pregnant tumor. The cause may include abortion, in some women, the phenomenon of bleeding does not appear during the period of stopping medication.

If you continue to use birth control pills in accordance with the instructions in the "Dosage and usage)" section, this does not mean that the woman is pregnant. However, if you do not take the medication as directed when you lose your period at the first cycle or the second cycle, it is necessary to eliminate the possibility of pregnancy before continuing to use coc oral medication.

The ability to drive and operate machinery

No research has been conducted on the effect of the drug on the ability to drive and operate machinery, not record the effect on the ability to drive and operate machinery in Diane 35 users.

Pregnancy

diane - 35 is not indicated for pregnant women. If the patient is pregnant during treatment with Diane - 35, stop using Diane - 35 (see "Clinical safety data").

Breastfeeding period

diane - 35 also contraindicated for breastfeeding women. Cyproterone Acetate is excreted through breast milk. About 0.2% of the mother's Diane - 35 dose will be put into the baby's body through breast milk - this dose corresponds to about 1µg/kg. 0.02% daily dose of EthinyleLestradiol for mothers can be put into the baby's body through breastfeeding.

Drug interaction

The effect of other drugs on Diane - 35

Interactions can occur with liver enzyme induction drugs, thus increasing sex hormones and can lead to cycle bleeding and may lose the contraceptive effect of the drug. Patients who use any of the above drugs should temporarily use other contraception combined with Diane - 35 or choose other contraceptive methods. When using metabolic drugs in the liver, other contraception should be used during the time of taking the medicine and during 28 days after stopping taking the drug.

If the contraceptive drug is gone during the time you are using another contraceptive method, you should start the next birth control pills and do not have time to stop taking the usual medication.

Active ingredients increase Diane - 35 elimination (reducing the effect of Diane - 35 via liver touch), for example: Phenytoin, Barbiturates, Primidone, Carbamazepine, Rifampicin, maybe both Oxcarbazepine, Topiramate, Felbamate, Ritonavir, Griseofulvin and St. John).

Active ingredients with different effects on Diane's clearance ability - 35, for example:

When used in conjunction with Diane - 35, many HIV/HCV protease inhibitors and non -nucleoside inhibitors inhibit the reverse copy can increase or decrease the serum concentration of estrogen or progestin. These changes may be clinically related in some cases.

Effect of combining estrogen/progestogen on other drugs

Estrogen/Progestogen combined like Diane - 35 can affect the metabolism of other drugs so it can increase the concentration of drugs in plasma or in tissue (such as cyclosporin) or decrease (such as lamotrigine).

Other types of interactions

Interaction with laboratory tests:

Using preparations such as Diane - 35 can affect certain tests, including liver and thyroid biochemical parameters, biochemical parameters assess adrenal and kidney function, plasma proteins (transport proteins) such as: globulin with corticosteroids and lipid/lipoprotein, carbohydrate metabolism parameters, blood coagulation and cancellation parameters. In general, these changes are still within normal limits.

Note: The above information about the use of combined drugs can be referenced to identify drug interaction.