FEMIPLAN-IS IT SAFE?USES,SIDE-EFFECTS,DOSAGE

What is Femiplan?

Femiplan is a birth control medicine used by women in many countries worldwide to prevent unwanted pregnancies. It is commonly addressed as the pill or OC’s(oral contraceptives).

The drug is available in 2 forms:

• As a pill for oral use
• As an injectable suspension

It is manufactured by Alpha Medical Manufacturers Ltd.

FEMIPLAN-IS IT SAFE?USES,SIDE-EFFECTS,DOSAGE

What is the Generic name(s)?
What is its composition?
How does it work?
What are its uses?
Who should not use this medicine??
How effective is this medicine?
What are the advantages of using this medicine?
Is it addictive?
What is the dosage?
How to use?
What if I miss a dose?
What to do in case of overdosage?
What to do if there is an allergic reaction?
Can I drive after taking it?
Can it be taken with food?
Can it be taken with an empty stomach?
Can it be taken with alcohol?
What are the side effects?
Does this medicine has any drug interactions?
What are the precautions I need to take?
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions
Reference

What is the Generic name(s)?

The pills are referred commonly as Estrogen[1]-Progesterone[2] pills, combined contraceptive pills[3] or simply by its name.

The injections have a generic name, Progestin[4].

What is its composition?

Femiplan Oral Pills:

Oral contraceptive is a combination of two hormones- progestin and estrogen. These pills are present in very low doses. They resemble the naturally found hormones, progesterone and estrogen respectively.

The placebo pills[5] in the pack are usually sugar pills.

Femiplan injections:

The suspension of the drug contains only one hormone, which is Progestin and it has actions like that of the natural hormone progesterone.

How does it work?

Femiplan releases estrogen and progestin all over the body which prevents the release of eggs from either one of the ovaries[6] i.e. it prevents ovulation[7]. There are other changes in the uterus[8] stimulated which prevents pregnancy[9]. The cervix of the womb, due to the action of the medicine produces thicker mucus which is comparatively lesser and this serves as an obstruction to the sperms for entry into the uterus. Also, the lining of the inner layer of the uterus becomes thick. This acts as a barrier for the fertilized egg[10] to implant on the uterus should ovulation occurs and the fertilization of egg happens.

What are its uses?

It is used as a birth control medicine by women to prevent pregnancy.

It does not provide any protection against sexually transmitted diseases[11] (STDs) including HIV/AIDS.

Who should not use Femiplan?

It is contraindicated in women with the following conditions:

• Hypersensitivity[12] to the medicine or any of the active ingredients or same medicine but with a different brand name.
• History of thrombophlebitis (blood clot)
• History or current condition of any estrogen-dependent cancer like cancer of the uterus, breast cancer[13], etc.
• Acute mononucleosis
• Any cerebrovascular disease
• Tumour of the liver
• Sickle cell disease[14]
• Coronary artery disease
• Undiagnosed vaginal bleeding which is abnormal
• Valvular heart disease
• Severe cirrhosis of the liver
• Women with diabetes for at least 20 years or a diabetic who developed its complications
• Vascular disease
• Angina[15]
• Gallbladder disease or history of gallbladder removal
• Significant blood pressure elevation
• History of stroke

If after starting the medicine treatment, these effects are seen, stop using the medicine immediately:

• Fertility or ovulation problems
• Weight gain of about 10 pounds after starting the pill
• Patients which are unable to consume the medicine according to instructions correctly
• If a regular menstrual cycle is not established.

How effective is this medicine?

This medication (in oral as well as injectable form), if used correctly and with strict adherence to guidelines, can cause pregnancy in only 1% of the population (out of 100 women taking this pill correctly, one can get pregnant).

What are the advantages of using this medicine?

Apart from protection against pregnancy, it has other benefits too:

Common advantages are:

1. They can also treat endometriosis (condition which menstrual pain and heavy bleeding).
2. It can decrease the risk of cancer in the colon, ovaries and uterus.
3. It is a private treatment.
4. No blood tests, pelvic exam, etc. are required.
5. It can protect against iron deficiency and anaemia.

Advantages of Femiplan oral pills are:

• Does not require help or permission of medical expert to stop the medicine when not required.
• Makes period regular and prevents heavy bleeding.
• It can prevent menstrual cramps during periods.
• It can treat acne and unwanted hair growth on the face and body.
• There is no delay in getting pregnant after stopping these pills.
• Can protect against ovarian cysts.

Advantages of Femiplan injections are:

• It does not require daily treatment. One injection every 3 months will work perfectly.
• In women with sickle cell anaemia, it reduces the formation of sickle cells.
• It can protect the body against uterine fibroids.

 Is it addictive?

Addiction would indicate physical dependence on the pill. This tendency has never been reported by women. However, these pills can make compensatory alterations in the body (in the pituitary gland, hypothalamus and ovaries) and after stopping this medicine, it may take some time to revert back to normal functioning of the body.

What is the dosage?

The dosage is always mentioned on the packet or will be informed by the doctor or pharmacist.

Dosage for the oral form

One pill every day each month. Consume the medicine with water or food.

Dosage for injection:

One injection every 12 weeks.

How to use?

Oral form

• One packet of Femiplan consists of 28 tablets in which 21 tablets are contraceptive pills and rest 7 are placebo pills during which menses occur.
• The actual pills are yellow in colour. The first pill should be started from the pill where ‘start’ is written.
• Each pill has to be taken at the same time of the day.
• The pills are not to be crushed, chewed, split or bitten. They are to be swallowed with either water, milk or food.
• After finishing the 21 yellow pills, the placebo pills are to be consumed which are brown in colour.
• The next pack has to be started when the very next day. There is no rest period.

Injection form

The suspension is injected into the muscle of the women. The area can be hip, upper arm or buttock. The liquid slowly releases into the bloodstream.

What if I miss a dose?

For Pills

For less than 3 hours:

The pill can be taken if the missed dose is remembered within 3 hours. The contraceptive will be fully effective.

For 3-24 hours

• Take your pill as soon as you remember. If two pills are taken for the same day, even then it is alright.
• Do not repeat this on a regular basis.
• Emergency contraception usually is not advised on this case but it should be taken if the pills are missed well early in the cycle or in pills marked 15-21 of the previous cycle.
• If still concern remains regarding pregnancy, talk to your gynaecologist or physician.

For 24-48 hours

• Consume the missed pill as soon as possible and this means taking two pills in a day.
• Like stated above, use emergency pill only if required and talk to your doctor regarding the issue.

For more than 48 hours:

• If it has been more than 48 hours after missing the dose, it is better to take two pills to make up for it. Do not consume more than two pills in a day.
• Till your remaining pills come back on track and are as per schedule (which is around 7 days), use other back up methods for contraception like condoms (male or female).

For injection

• Missing taking an injection in 12 weeks can lead to pregnancy if other contraceptives are not used when having intercourse.
• If unprotected intercourse has happened in less than 72 hours, it is advised to take an emergency contraceptive pill.
• Until the next injection, use other contraception methods.
• Side effects of missing the dosage for multiple months are bleeding, spotting and irregular heavy period.
• Due to wearing off of the injection, the hormones from the previous months will be removed from the body and will give rise to side effects like drowsiness, fatigue, tenderness in breasts, nausea and headaches. These effects will wear off once the body readjusts to injections.

What to do in case of overdosage?

In case of an overdose, usually, it is not something very serious. But it is essential to report to a doctor for emergency immediately or call the poison control centre.

Symptoms of overdose are:

• Rashes
• Discoloured urine
• Heavy vaginal bleeding
• Mood swings
• Drowsiness
• Severe headaches

Before reporting to the doctor:

Be informed about:

• The woman’s age, height, weight and condition
• The amount of pill swallowed.
• The time when the pill was consumed.
• Name of the pill with strength or carry the packet.

The doctor might run some tests and check for vital signs like breathing rate, pulse and blood pressure. Activated charcoal might be given too.

What to do if there is an allergic reaction?

• Allergic reaction to Femiplan is very uncommon. There could be a significantly higher risk of allergy in injection form as compared to the oral contraceptive. This is due to high concentration of Progestin in suspension of this medicine.
• In case of a reaction, go to the hospital immediately.
• Even you know that you have an allergy to this medicine or its active ingredients, switch to another medicine. Consult your doctor or gynaecologist to know which alternative medicine is to be used.
• To prevent an allergic reaction, instead of using a contraceptive, using other methods like Intrauterine devices (IUD’s).

Can I drive after taking it?

There is no problem in driving after taking this medicine. But if you experience any of the side effects that interfere while driving like drowsiness and nausea, it is advised to not drive or do any activity that requires mental awareness.

Can it be taken with food?

Yes. Food, when consumed in moderate amount, are highly unlikely to interfere with the medicine. There have not been any studies that suggest that the action of the pills may get altered or reduced due to its consumption with food. But in theory, some foods taken in large quantities can affect the effectiveness of the drug.

These food products are:

• Liquorice
• yam
• Recombinant bovine growth hormone (RBGH) treated milk
• Soy

Can it be taken with an empty stomach?

To prevent nausea, it is advised to consume the contraceptive with food or milk.

 Can it be taken with alcohol?

Alcohol does not have any effect on Femiplan. But this medicine can affect the body water distribution which will alter the rate at which alcohol is eliminated. This will indicate that there is more alcohol level in blood then intended. Thus intoxication by alcohol will increase.

Also if you take alcohol with the pill and then vomit within 2 hours, the medicine might not get absorbed and it will not be effective. This could lead to the release of an egg (i.e. Ovulation).

What are the side effects?

Side effects might not be seen in every individual and will differ person to person. These are:

Of oral pills:

• Dizziness
• Nausea
• A headache
• Bloating
• Drowsiness
• Lightheadedness
• Stomach upset
• Changing in the bleeding pattern like spotting, light periods, heavy bleeding, no bleeding during periods, etc.

Report to your gynaecologist if you see the following side effects:

• Chest pain
• Pain in calf or groin
• A severe form of depression
• Lumps in breast
• Tingling or weakness in arms and lower limbs
• Shortness in breath
• Sudden severe headache
• Yellowing of eyes and skin

Of injection form:

• Changes in bleeding pattern and periods
• Drowsiness and dizziness
• Abdominal bloating and discomfort
• There can be a decrease in the density of bones
• Weight gain
• Changes in sex drive
• Mood changes
• Slight bruising where the shot of injection is given.
• Rarely, a dent can form where an injection is given.

Does this medicine has any drug interactions?

This medicine can interact with:

• Bexarotene
• Herbal remedies like St John’s Wort (Hypericum perforatum)
• Antibiotics including Tetracyclines, Macrolides, Penicillin, Chloramphenicol, Sulfas and Cephalosporins.
• Aprepitant
• Griseofulvin
• Few HIV protease inhibitors like Amprenavir, Ritonavir and Nelfinavir.
• Rifamycins like Rifampicin
• Dapsone
• Thyroid hormone drugs
• Bexarotene
• Medicines to treat seizures e.g. Phenytoin, Barbiturates, Carbamazepine, Topiramate and Primidone.
• Bosentan
• Anti-coagulants like Warfarin.
• Beta blockers like Esmolol, Metoprolol, etc.
• Prednisone like drugs
• Few benzodiazepines like Diazepam

What are the precautions I need to take?

• For protection against sexually transmitted diseases, use a condom.
• This drug is intended for women above 18 years of age.
• Store it at room temperature.
• Avoid long exposure to sunlight.
• Do not take the packet of oral pills if any one of the pills looks damaged or is missing.

Is it safe to use if I am pregnant?

There is no harm to fetus reported if the pregnant mother takes this medicine.

Is it safe to use if I am breastfeeding?

This drug can enter breast milk. Consult your doctor regarding taking this medicine while breastfeeding.

Can this medicine be given to children and infants?

No. This medicine should be kept out of reach from children.

Is this medicine available as over the counter product?

No. A prescription is required before buying this medicine.

Frequently asked questions

What is the cost of Femiplan?

A pack of 84 tablets cost around 35 dollars (around 2400 INR).

Can this medicine make me infertile?

No. This medicine will not alter your chances of getting pregnant.

Can this medicine and Postinor-2 be taken on the same day?

It is safe to take these drugs on the same day. They do not interfere with each other.

Can I get pregnant even when I am on this pill?

There is a very minor possibility that fertilization can happen while on pills. If you miss your periods, get a pregnancy test to confirm it.

Reference

Wikipedia page on Pregnancy

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