Femigoa

Femigoa is a monophasic combination pill containing the progestin levonorgestrel and the estrogen ethinylestradiol. It is a 2nd-generation pill.

The pill offers protection against pregnancy and, compared with pills containing newer progestins, has a lower risk of thrombosis.

Femigoa is a generic and therefore an alternative to brand-name products with the same combination of active ingredients.

Femigoa works through three mechanisms:

1. Inhibition of ovulation: The hormones suppress ovulation by inhibiting the release of gonadotropins.

2. Cervical mucus: The mucus of the cervix becomes thicker and makes it harder for sperm to enter.

3. Endometrium: The lining of the uterus is altered.

With daily use, the Pearl Index is very low (0.1-0.9).

Femigoa is suitable for:

• Women without risk factors for thrombosis
• Women who prefer a well-established progestin
• Healthy women who do not smoke

• 0.03 mg ethinylestradiol
• 0.15 mg levonorgestrel
• 21 tablets per pack
• Monophasic preparation (all tablets identical)

• One tablet daily at the same time
• Take for 21 days, then a 7-day break
• A withdrawal bleed occurs during the break
• Start a new blister pack on day 8

Start: On the first day of your period for immediate protection.

Do not take in cases of:

• Thrombosis or risk of thrombosis
• Cardiovascular disease
• Liver disease
• Hormone-dependent tumors
• Pregnancy
• Smoking over the age of 35
• Migraine with aura

Common:

• Headache
• Nausea
• Breast tenderness
• Mood changes
• Breakthrough bleeding

Rare:

• Thromboembolism
• High blood pressure

Medicines that can weaken the contraceptive effect:

• e.g. rifampicin, rifabutin, barbiturates, epilepsy medicines (barbexaclone, carbamazepine, phenytoin, primidone, oxcarbazepine, topiramate, felbamate), griseofulvin, modafinil and some protease inhibitors (e.g. ritonavir)
• They can lead to breakthrough bleeding and contraceptive failure. During the entire treatment and for up to 28 days afterwards, you also need a barrier method (e.g. a condom). If the treatment continues beyond the end of a blister, start the next blister straight away without the usual break. With long-term treatment, you should preferably switch completely to a non-hormonal contraceptive method.
• Products containing St John's wort should not be used at the same time as Femigoa. Breakthrough bleeding and unintended pregnancies have been reported. The weakening of the contraceptive effect can last for up to 2 weeks after stopping St John's wort.
• Medicines that speed up bowel movement (e.g. metoclopramide) can reduce the absorption of the hormones.

Hepatitis C medicines:

• Femigoa must not be used together with medicines containing ombitasvir/paritaprevir/ritonavir and dasabuvir, glecaprevir/pibrentasvir or sofosbuvir/velpatasvir/voxilaprevir. Raised liver values (ALT) have been observed with this combination. Before starting such treatment, you must switch to a different contraceptive method (e.g. a progestin-only product or a non-hormonal method). Femigoa can be taken again 2 weeks after the end of this treatment.

Medicines that can change hormone levels:

• The following can increase them, for example: antifungals (itraconazole, voriconazole, fluconazole), macrolide antibiotics (clarithromycin, erythromycin), verapamil, diltiazem, atorvastatin, etoricoxib, ascorbic acid (vitamin C), paracetamol and grapefruit juice.
• Many protease inhibitors for HIV and hepatitis C (e.g. indinavir) and non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine) can increase or decrease hormone levels.

Effect of Femigoa on other medicines:

• Femigoa can increase the levels of other medicines, e.g. diazepam and some other benzodiazepines, ciclosporin, theophylline, melatonin, tizanidine and glucocorticoids.
• Femigoa can decrease the levels of other medicines, e.g. lamotrigine, morphine, lorazepam and some other benzodiazepines, and clofibrate.
• Your need for insulin or diabetes tablets may change.

Laboratory tests:

• The pill can change the results of certain laboratory tests, e.g. of liver, kidney, thyroid and adrenal cortex function as well as blood sugar and blood clotting values.