Progestogens "mini-pill"

Question 1

Norethisterone.

Answer 1

Class: progestogen

Indications:

• contraception (progestogen-only or as a component of COCs)
• menstrual disorders eg heavy menstrual bleeding (HMB)
• endometriosis
• HRT (as adjunct to oestrogen)

AEs: 
Common
- menstrual irregularity > prolonged bleeding, spotting, amenorrhoea
- breast tenderness
- depression
- acne

Rare
cholestatic jaundice

Dose:
Contraception - 350mcg d

Counselling:
Contraception
- take it at the same time every day (not more than 3 hours late)
- taken continuously; there are no inactive (sugar) pills or 7-day break as with the combined pill
- changes in bleeding pattern can include spotting, irregular or prolonged bleeding or periods stopping.
- if no preceding hormonal contraception: for immediate contraception start taking pills within the first 5 days of your period starting. If you start at any other time, use additional contraceptive methods for the next 48 hours.
- if changing from a COC, start taking the new pills the day after you stop your old pill (on any day of your cycle). Additional contraception is not required.
- check with your doctor or pharmacist before starting or stopping any medicines, including herbal (particularly St John’s wort) and over-the-counter products
- if you vomit within 2 hours of taking a pill, take another pill as soon as possible
- if you are more than 3 hours late taking a pill, or if you have persistent vomiting or severe diarrhoea, the pill will not be as effective
- if you are late taking a pill take it as soon as you remember and take the next pill at the usual time (this may mean taking 2 pills on the same day or at the same time)
- continue with the daily pill and use another contraceptive method for the next 48 hours (if you have unprotected sex during this time, seek emergency contraception)

Question 2

What is Microlut®?

Answer 2

30mcg of levonorgestrel (4x28)