Janine dragee 21 pcs ➤ instructions for use
The pills should be taken orally in the order indicated on the package, every day at approximately the same time, with a small amount of water. Janine® should be taken 1 tablet/day continuously for 21 days. Each subsequent package begins after a 7-day break, during which withdrawal bleeding (menstrual-like bleeding) is observed. It usually begins on the 2-3rd day after taking the last pill and may not end until you start taking a new package. Starting taking Zhanine If you have not taken any hormonal contraceptives in the previous month, taking Zhanine starts on the 1st day of the menstrual cycle (i.e. on the 1st day of menstrual bleeding). It is possible to start taking it on the 2-5th day of the menstrual cycle, but in this case it is recommended to use a barrier method of contraception during the first 7 days of taking the tablets from the first package. When switching from combined oral contraceptives, a vaginal ring, or a transdermal patch, taking Zhanine should begin the day after taking the last active pill from the previous package, but in no case later than the next day after the usual 7-day break in taking (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets per package). When switching from a vaginal ring or transdermal patch, it is preferable to start taking Janine on the day the ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied. When switching from contraceptives containing only gestagens (“mini-pills”, injectable forms, implant) or from a gestagen-releasing intrauterine contraceptive (Mirena), a woman can switch from taking the “mini-pill” to Zhanine® on any day (without a break), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from an injectable contraceptive - on the day when the next injection is due. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill. After an abortion in the first trimester of pregnancy, a woman can start taking the drug immediately. In this case, the woman does not need additional methods of contraception. After childbirth or abortion in the second trimester of pregnancy, it is recommended to start taking the drug on the 21-28th day after childbirth or abortion in the second trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pill. However, if a woman has already been sexually active, pregnancy should be excluded before taking Zhanine or she must wait until her first menstruation. Taking missed pills If the delay in taking the pill is less than 12 hours, contraceptive protection is not reduced. A woman should take the missed pill as soon as possible, and the next pill should be taken at the usual time. If the delay in taking the pill is more than 12 hours, contraceptive protection may be reduced. In this case, you can be guided by the following two basic rules: - taking the drug should never be interrupted for more than 7 days; — to achieve adequate suppression of the hypothalamic-pituitary-ovarian system, 7 days of continuous use of the pill are required. Accordingly, if the delay in taking active pills was more than 12 hours (the interval from the moment of taking the last active pill is more than 36 hours), the following can be recommended: The first week of taking the drug It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even , if this requires taking two pills at the same time). The next pill is taken at the usual time. Additionally, a barrier method of contraception (for example, a condom) should be used for the next 7 days. If sexual intercourse took place within a week before missing the pills, the possibility of pregnancy must be taken into account. The more tablets are missed, and the closer they are to a break in taking active substances, the greater the likelihood of pregnancy. Second week of taking the drug It is necessary to take the last missed tablet as soon as possible, as soon as the woman remembers it (even if this requires taking two tablets at the same time). The next pill is taken at the usual time. Provided that the woman took the pill correctly during the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as if you miss two or more pills, you must additionally use barrier methods of contraception (for example, a condom) for 7 days. Third week of taking the drug The risk of pregnancy increases due to the upcoming break in taking the pill. A woman must strictly adhere to one of the following two options. Moreover, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods. 1. It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this requires taking two pills at the same time). The next pill is taken at the usual time, until the pills from the current package run out. The next pack should be started immediately without interruption. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the pill. 2. A woman can also stop taking pills from the current package. She should then take a break for 7 days, including the day she missed the pills, and then start taking a new pack. If a woman misses taking a pill and then does not have withdrawal bleeding during a break in taking it, pregnancy must be ruled out. Recommendations in case of vomiting and diarrhea If a woman has vomiting or diarrhea within 4 hours of taking active tablets, absorption may not be complete and additional contraceptive measures should be taken. In these cases, you should follow the recommendations when skipping pills. Changing the day of the start of the menstrual cycle To delay the onset of menstruation, a woman should continue taking pills from the new package of Janine immediately after taking all the pills from the previous one, without interruption in taking. The pills from this new package can be taken for as long as the woman wishes (until the package runs out). While taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. You should resume taking Janine from a new package after the usual 7-day break. To move the start of menstruation to another day of the week, a woman should shorten the next break in taking the pills by as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding and will continue to have spotting and breakthrough bleeding while taking the second package (the same as in the case when she would like to delay the onset of menstruation). Additional information for special categories of patients For children and adolescents, Zhanine® is indicated only after menarche. After menopause, Zhanine® is not indicated. Zhanine® is contraindicated in women with severe liver disease until liver function tests have returned to normal. The drug Zhanin® has not been specifically studied in patients with impaired renal function. Available data do not suggest changes in treatment in these patients.
Compound
The active ingredients in Janine include 2 mg of dienogest and 30 mcg of ethinyl estradiol .
In addition to these substances, the tablets contain lactose in the form of monohydrate, potato starch, magnesium stearate, talc, and gelatin. The shell is made using sucrose, dextrose, macrogol 35000, calcium carbonate , polyvidone, titanium dioxide, carnauba wax.
Reviews about Janine
Reviews about Janine on the forums are quite varied. For the most part, they are positive, since the drug is well tolerated by women, is easy to use, and copes well with its main task.
In addition, patients and doctors in reviews of Janine note that the drug, in addition to contraception, has a number of other positive side effects: it helps with acne, normalizes the menstrual cycle, and reduces the intensity and pain of bleeding. In women who stop taking Zhanine tablets due to a desire to become pregnant, pregnancy after discontinuation of the drug often occurs within the first 2-3 cycles.
Due to the drug's ability to stabilize hormonal levels and suppress foci of pathological growth of the endometrium , it is often effective for fibroids and endometriosis (usually in situations where the disease is not too advanced).
However, there are also negative reviews about the drug, which are associated either with the lack of results in the treatment of endometriosis , or with side effects that significantly worsen the woman’s quality of life. Experts are inclined to believe that such phenomena can occur if the product was selected without taking into account contraindications for use, or is simply not suitable for a particular woman.
Analyzing doctors' reviews of Zhanine birth control pills, we can conclude that experts speak positively about this drug. Such a high rating is due to the fact that, being a low-dose drug, the latter has a pronounced contraceptive effect, helps restore hormonal imbalances and has a positive effect on the general condition of a woman.
Pharmacodynamics and pharmacokinetics
The action of the pill is aimed at inhibiting the secretion of gonadotropic pituitary hormones, inhibiting the maturation of follicles and suppressing ovulation . With the use of the drug, the viscosity of the mucus filling the cervical canal increases, which creates obstacles for the penetration of sperm into the uterine cavity.
Taking Janine pills is accompanied by normalization of the menstrual cycle , a decrease in the pain of menstruation and the intensity of discharge, thereby significantly reducing the risk of developing anemia .
Dienogest , the progestin component of the drug, is a derivative of nortestosterone . Clinical studies of the use of this substance in patients with acne have established its pronounced antiandrogenic activity. In addition, dienogest is characterized by the ability to increase the concentration of high-density drugs in the blood.
After p/os administration of 1 tablet, dienogest is quickly and completely absorbed from the gastrointestinal tract . Plasma concentration reaches a maximum after 2 hours 30 minutes. The absolute bioavailability indicator is at the level of 96% (and this value remains the same in combination with the estrogenic component of Janine tablets).
About 1/10 of the administered dose of dienogest remains in the plasma in free form, the remaining 90% is nonspecifically bound to albumin . The substance does not bind to specific transport proteins. And this is precisely the reason that it does not displace cortisol and testosterone from their connections with CSG and SHBG, respectively.
The effect of the first passage is negligible. The resulting metabolic products are inactive.
The half-life of dienogest with a single dose is about 9 hours, with multiple doses - about 10. After oral administration, a little more than 85% of the dose is eliminated within 6 days (about half during the first day).
After p/os administration, ethinyl estradiol is quickly and completely absorbed from the digestive tract; the maximum plasma concentration is achieved in the next 1.5-4 hours after taking one tablet.
The substance is subject to the first passage effect, which accounts for its low bioavailability (this figure usually does not exceed 44%).
In free form, about 1.5% ethinyl estradiol , approximately 98.5% of the substance is bound to albumin . Ethinyl estradiol enhances the biosynthesis of CSG and SHBG without binding to these transport proteins .
After taking one tablet, the half-life of ethinyl estradiol is 10 hours. After three cycles of using the drug, it increases to 15 hours.
From 30 to 50% of metabolic products are excreted in the urine, about 30-40% are excreted in the intestinal contents.
Janina price, where to buy
The price of Janine birth control pills depends on which pharmacy sells them. How much a drug costs in pharmacies is influenced by the cost of transportation and the pricing features of a particular pharmacy chain. Considering that the pills are produced by only one pharmaceutical company, there is no difference between a more expensive and a cheaper drug.
The price of Zhanin in Ukrainian pharmacies is on average 215 UAH (for package No. 21).
The cost of a package containing 21 tablets in Russian pharmacies is approximately more than 870 rubles. You can buy a package of 63 dragees for approximately 2,200 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Janine dragee 21 pcs. Bayer Weimar GmbH and Co. KG
RUB 1,021 order - Janine dragee 63 pcs. Bayer Weimar/Bayer Pharma
RUB 2,547 order
Pharmacy Dialogue
- Janine (other No. 21x3) Bayer
RUR 2,478 order
- Janine (other No. 21) Bayer
RUB 1,038 order
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Pharmacy24
- Janine No. 21 tablets Bayer Weimar GmbH & Co.
KG, Nimechchyna 223 UAH. order
PaniPharmacy
- Janine tablets Janine etc. No. 21 Germany, Bayer Weimar
253 UAH order
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During pregnancy
In the course of epidemiological studies, it was found that Janine does not increase the risk of teratogenic effects in a child whose mother took birth control pills before pregnancy or, unknowingly, in the first weeks.
However, during pregnancy, taking the drug is contraindicated.
Since combined hormonal drugs are characterized by the ability to suppress lactation and affect the composition of breast milk, nursing women are advised to refrain from taking them.
If you are planning a child, you should stop using birth control pills. Doctors advise trying to get pregnant from the beginning of a new cycle. Pregnancy usually occurs fairly quickly after taking the pills.
Side effects of Janine
The most common side effects of taking estrogen-progestin oral contraceptives are:
- an increase in the size and tension of the mammary glands, their soreness, as well as the appearance of discharge from them;
- bloody discharge from the genital tract of varying intensity (can be spotting or have the character of breakthrough bleeding);
- headaches (migraine attacks are also possible);
- mood lability;
- change in libido ;
- deterioration of tolerance to contact lenses;
- visual impairment;
- abdominal pain;
- nausea;
- skin rashes;
- vomit;
- changes in the nature of vaginal discharge;
- nodular (nodous) or erythema multiforme ;
- cholestatic jaundice;
- generalized itching;
- weight fluctuations;
- fluid retention;
- allergic reactions.
Sometimes side effects of Zhanine are expressed in the form of increased plasma concentrations of triglycerides , diarrhea , increased fatigue, decreased tolerance to carbohydrates, chloasma (the risk of focal hyperpigmentation is especially high in women who chloasma during pregnancy).
Like other combined hormonal contraceptives for oral use, Janine can cause thrombosis or thromboembolism .
Analogs
Level 4 ATC code matches:
Ovidon
Rigevidon
Non-Ovlon
Mercilon
Yarina Plus
Yarina
Miniziston 20 fem
Novinet
Microgynon
Lindineth
Cyclo-Proginova
Regulon
Logest
Midiana
Belara
Femoden
Jess Plus
Jess
Zoely
Generics: Zhenetten , Diecyclen , Siluet , Bonade .
Analogues of Zhanin by mechanism of action: Belara , Yarina , Dailla , Midiana , Jess , Logest , Evra , Lindinet 30 , Mercilon , Marvelon , Egestrenol , Femoden , Oralcon , Dimia .
Janine or Silhouette - which is better?
The drugs Zhanine and Silhouette are structural analogues, that is, they contain identical substances in the same dosage as active components, they have the same mechanism of action, indications and contraindications.
The products are produced by different companies and have a significant difference in price; Silhouette is about half the price of its counterpart.
Which is better: Claira or Janine?
The basis of the drug Qlaira is dienogest and estradiol valerate of 17β-estradiol produced by the human body ). Each package contains 5 types of tablets, which differ in the composition of the active ingredients and their concentration.
The ethinyl estradiol contained in the Janine dragee exhibits greater metabolic stability in contrast to the estrogenic component of Qlaira , however, it also has a more pronounced effect on the liver .
The mechanism of action of Qlaira is due to the ability of its active components to suppress ovulation and change the properties of cervical mucus. In addition, the drug reduces pain and intensity of bleeding during menstruation , prevents the development of iron deficiency anemia , and reduces the risk of developing ovarian and endometrial cancer .
Which is better: Janine or Diana 35?
Diane-35 is a combination of cyproterone (2 mg) and ethinyl estradiol (35 mcg). If Zhanine is prescribed primarily to prevent pregnancy in women with endometriosis , then the use of Diane-35 is advisable for contraception in women with pronounced signs of androgenization .
Janine or Visanne - which is better?
The drug Visanne of micronized dienogest as an active component . The drug is intended for the treatment of endometriosis. To achieve a therapeutic effect, the tablets are taken for six months.
The main indication for use of the drug Zhanine is contraception (in particular contraception in women with endometriosis ).
According to doctors and patients who were treated with both drugs, treatment of endometriosis with Janine is not always as effective as treatment with Visanne. In addition, the latter is often better tolerated and causes fewer side effects.
When wondering which drug to choose, you should remember that each woman’s body is individual, in addition, in each specific case, the indications for use may differ. In this regard, a specialist must prescribe this or that remedy.
special instructions
The use of the drug Zhanine is contraindicated before the onset of menarche and after the onset of menopause .
In some cases, the use of sex hormones can cause the development of tumors in the liver . liver size , severe abdominal pain, as well as signs of intraperitoneal bleeding must be taken into account when making a differential diagnosis.
Taking the drug Janine may be accompanied by irregular bleeding (both in the form of spotting and breakthrough bleeding), especially in the first months of therapy. In this regard, assessment of irregular bleeding should be carried out only after an adaptation period of approximately 3 cycles.
If such bleeding recurs or occurs after previous regular cycles, a non-hormonal cause should be sought. Diagnosis is carried out to exclude the presence of a malignant neoplasm or pregnancy . In some cases, diagnostic curettage may be required.
Janine does not protect against STDs and HIV infection.
Contraindications
Contraindications to the use of birth control pills are:
- thrombosis of veins and arteries (including a history; including PE, DVT, myocardial infarction , cerebrovascular disorders );
- conditions preceding thrombosis (including a history; for example, angina pectoris attacks of focal or cerebral disorders associated with cerebral circulation
- diabetes mellitus occurring with vascular complications ;
- severe and/or multiple factors that increase the risk of thrombosis of veins or arteries ;
- severe forms of liver disease (including a history; taking the drug is allowed only if the liver test results are normal);
- liver tumors;
- malignant diseases of the mammary glands or reproductive organs (as well as suspicion of them) caused by an imbalance of hormones
- vaginal bleeding of unspecified etiology;
- established or suspected pregnancy ;
- hypersensitivity to substances contained in the tablets.
