Estradiol and Dienogest (Oral)

A birth control pill, Estradiol and Dienogest is a combination medication containing estrogen and progestin.

Overview

Estradiol and Dienogest is a combination medication of Estradiol valerate and dienogest. This medication contains estrogen and progestin, which are two types of hormones that prevent an egg from developing fully in a reproductive system. This makes the egg unable to accept a sperm, which prevents fertilization.

Estradiol and Dienogest is a form of birth control pill, prescribed to prevent patients from getting pregnant. Estradiol and Dienogest is also prescribed to treat and prevent heavy menstrual bleeding that may not be caused by any diagnosed condition or disease.

Conditions Treated

  • Pregnancy
  • Heavy menstrual bleeding

Type Of Medicine

  • Tablet
  • Estrogen
  • Progestin
  • Contraceptive

Side Effects

Mild Side Effects

In addition to the desired therapeutic effects for which Estradiol and Dienogest is prescribed, some patients may experience unwanted side effects which are usually mild and do not require medical attention. These side effects are a result of your body getting used to the medication, and should subside or go away during the course of treatment. If these side effects do not go away, become worse, or you find that they are becoming bothersome, check with your doctor. Your health care professional may be able to suggest a treatment or regimen that can help you reduce or prevent these side effects.

Some patients taking Estradiol and Dienogest may experience dermatological side effects such as:

  • Pimples or acne on the skin
  • Blemishes on the skin
  • A discoloration of the skin with a brown and patchy appearance

Some patients taking Estradiol and Dienogest may experience other side effects such as:

  • Increased weight or unexplained weight gain

Serious Side Effects

Some patients taking Estradiol and Dienogest may experience unwanted side effects which may need medical attention. These side effects can lead to serious health problems, or may be symptoms of serious health problems which the Estradiol and Dienogest may have triggered. If you experience any of these side effects while taking Estradiol and Dienogest, contact your doctor immediately. You may require medical attention.

Some patients taking Estradiol and Dienogest may experience respiratory side effects such as:

  • An unpleasant and persistent odor on the breath
  • Shortness of breath
  • A tight feeling in the chest
  • Difficulty in breathing normally
  • Troubled breathing when the patient is at rest
  • Difficulty in swallowing or troubled swallowing
  • Chest pain or discomfort in the chest
  • Breathing that is noisy or rattles
  • Wheezing
  • Sudden and unexplained shortness of breath

Some patients taking Estradiol and Dienogest may experience gastrointestinal side effects such as:

  • Pain in the stomach or in the abdomen
  • Bloating in the stomach or in the abdomen
  • Pain in the upper right area of the abdomen or stomach
  • Discomfort, aching, or a feeling of heaviness in the stomach or pelvis area
  • Loss of appetite
  • Nausea
  • Vomiting
  • Vomit that has blood in it, or vomiting of blood or bloody material

Some patients taking Estradiol and Dienogest may experience eliminatory side effects such as:

  • Unusually dark urine
  • Stools with the color and consistency of clay
  • A decrease in the amount of urine produced
  • Blood in the stool

Some patients taking Estradiol and Dienogest may experience dermatological side effects such as:

  • Redness of the skin
  • Itching on the skin
  • A rash
  • Skin or eyes that become yellow (jaundice)
  • Irritation on the skin
  • Hives on the skin
  • Large swellings that resemble hives on the face, lips, tongue, throat, mouth, and eyelids, or extremities such as the hands, feet, legs, or genitalia
  • Red lumps under the skin that are painful or tender to the touch, especially on the legs
  • Swelling on the face, eyelids, or lips, or in the extremities such as the hands, the feet, or the lower legs

Some patients taking Estradiol and Dienogest may experience side effects that pertain to the reproductive system such as:

  • Irregular menstrual periods
  • Menstrual bleeding that comes earlier than expected or that lasts for longer than usual
  • Pain, tenderness, or discomfort in the breast
  • Pain in the pelvic area
  • Vaginal discharge that is thick and white with a mild odor or a lack of odor
  • Itching on or around the genital area

Some patients taking Estradiol and Dienogest may experience neurological side effects such as:

  • Dizziness
  • Unusual weakness or tiredness
  • Anxiety
  • Changes in vision
  • A sudden loss of coordination
  • Slurred speech
  • Fainting or loss of consciousness

Some patients taking Estradiol and Dienogest may experience side effects that involve pain or weakness, such as:

  • Pain in the ankles, in the knees or both
  • Discomfort or pain in the neck, jaw, back, or arms
  • Pain in the chest
  • Pain in the groin
  • Pain in the legs, especially the calves
  • Redness, swelling, or pain in the legs or the arms
  • Sudden and severe numbness or weakness in the leg or the arm
  • Pain, swelling, or stiffness in the joints

Some patients taking Estradiol and Dienogest may experience other side effects such as:

  • A fever, chills, or both at the same time or separately
  • An unusually slow or unusually fast heartbeat
  • Unusual sweating
  • A sensation or sound of pounding in the ears
  • Unusual weight gain

Dosage

The dosage and usage provided here for Estradiol and Dienogest is a standard provided by the manufacturer. Your doctor's instructions for taking your Estradiol and Dienogest may be different depending on your condition and situation. Always follow your doctor's specific instructions for your prescription first. Do not change the dose of your medication or the schedule on which you take your medication without first checking with your doctor.

Estradiol and Dienogest comes in tablet form. The tablets of Estradiol and Dienogest are dispensed in a blister pack that holds 28 days worth of medication. The tablets come in different colors, which correspond to the order in which you will need to take them. The order of the pills will be indicated on the blister pack.

Take your dose of Estradiol and Dienogest at the same time each day for maximum effectiveness. You may wish to take it at a set time such as when you go to bed, when you wake up, or at a meal with a set time. Your doctor can suggest other ways to help you remember to take your pills at a set time. Do not skip a dose or delay taking your daily dosage for more than 12 hours at a time, or your medication could stop being effective, resulting in a pregnancy.

Some patients taking Estradiol and Dienogest may need to begin taking this medication on the first day of their menstrual period. If your doctor directs you to wait until the first day of your menstrual period to take this dose, follow your doctor's directions. It is important to take this medication as scheduled and in the order prescribed even if you have missed a dose. Do not take your medication out of order or change the order in which you take your medication without consulting with your doctor.

Interactions

Drug interactions can change the way your medications work, making them less effective for the symptoms or conditions for which they were prescribed, and can increase your risk of serious side effects. Keep a list of all the drugs, medications, and supplements you take on a regular basis, whether they have been prescribed to you by a health care professional or are taken over the counter. Your doctor, pharmacist, or other health care professional can help you identify potential interactions with drugs.

Patients taking Estradiol and Dienogest should not ingest grapefruit or drink grapefruit juice or products made with grapefruit.

Some drugs and substances may interfere with the effectiveness of your hormonal birth control by reducing the amount of relevant hormones that are in your body, which can lead to pregnancy. If you are taking Estradiol and Dienogest, consult your doctor to see if it is safe for you to take:

  • Rifamycins, including rifampin and rifabutin
  • Modafinil
  • St. John's Wort or supplements that include St. John's Wort
  • HIV drugs, including ritonavir, nevirapine, and nelfinavir
  • Griseofulvin

Some drugs used to treat seizures may interfere with the effectiveness of your hormonal birth control by reducing the amount of relevant hormones that are in your body, which can lead to pregnancy. This includes:

  • Barbiturates
  • Carbamazepine
  • Felbamate
  • Phenytoin
  • Primidone
  • Topiramate

If you are taking any of these drugs while using Estradiol and Dienogest, contact your doctor.

Estradiol and Dienogest may interact with aromatase inhibitors such as:

  • Anastrozole
  • Exemestane
  • Letrozole

If you are taking any of these drugs at the same time as Estradiol and Dienogest, consult with your doctor for safety precautions.

Estradiol and Dienogest may interact with other drugs such as:

  • Ospemifene
  • Tamoxifen
  • Tranexamic acid

Check with your doctor before taking any of these drugs if you are using Estradiol and Dienogest.

Warnings

Beginning Estradiol and Dienogest

When you first begin to take Estradiol and Dienogest, your body will take at least 9 days to adjust to the medication so it will work effectively. For the first 9 days you are taking Estradiol and Dienogest, make sure you use an additional method of birth control such as condoms or a diaphragm, or spermicidal jelly. This will help to prevent pregnancy while your body is still adjusting to the Estradiol and Dienogest. Ask your doctor about additional birth control methods.

When you begin to use Estradiol and Dienogest, you may experience spotting, breakthrough bleeding, or light bleeding. This should subside or go away as your body gets used to the medication. If you experience heavier bleeding or bleeding that does not go away, contact your doctor.

Some patients who use Estradiol and Dienogest may experience diarrhea or vomiting within 3 to 4 hours of taking the medication. If you experience this, call your doctor or follow the instructions in the leaflet provided with the physical medication.

Some patients who use Estradiol and Dienogest may experience a feeling of sickness or nausea during the first few months of use. Your doctor may be able to suggest remedies for this nausea. If your nausea does not go away or becomes bothersome, check with your doctor as soon as possible.

Medical History

Before you start taking a regimen of Estradiol and Dienogest, make sure your doctor or pharmacist knows your medical history, with special attention to any relevant conditions or medical situations you have undergone in your life. Relevant conditions include:

  • A history of blood clots, especially in the eyes, lungs, and legs
  • Blood clotting disorders such as a deficiency in protein C or a deficiency in protein S
  • Abnormal results in a breast exam
  • High blood pressure
  • High cholesterol or high blood levels of triglyceride fats
  • Diabetes
  • Edema or swelling
  • A family history of angioedema
  • Depression
  • Problems or illnesses involving the gallbladder
  • Migraines or a history of severe headaches
  • Heart problems or diseases such as an irregular heartbeat, a heart attack, or heart valve disease
  • A history of jaundice or yellowing skin or eyes while previously pregnant or using hormonal birth control that mimics pregnancy such as pills or a patch
  • Unexplained vaginal bleeding
  • Thyroid problems or thyroid disease
  • Liver disease
  • Liver tumors
  • Kidney disease
  • A stroke
  • Cancer
  • Breast cancer
  • Endometrial cancer

Allergies

Before you start using Estradiol and Dienogest, let your doctor or pharmacist know whether you have any relevant allergies. This includes an allergy or intolerance to Estradiol or Dienogest on their own, other estrogen medications or products such as mestranol, or medications including progestins such as desogestrel or norethindrone, or any other medications or substances. Some patients may experience allergic reactions to inactive ingredients in the medication as well as to the active ingredients.

Estradiol and Dienogest can cause allergic reactions in some patients. Symptoms of a severe allergic reaction to Estradiol and Dienogest include:

  • A rash on the skin
  • Swelling or itching of the face, throat, or tongue
  • Difficulty in breathing
  • Severe dizziness

If you experience any of these symptoms while using Estradiol and Dienogest, contact your doctor immediately. You may need emergency medical assistance for a severe allergic reaction.

Diabetes

Estradiol and Dienogest may affect the blood sugar of patients who have diabetes. If you have diabetes and are taking Estradiol and Dienogest, make sure you check your blood sugar carefully on a regular basis. Share this information with your doctor. If you experience symptoms of high blood sugar such as increased urination or increased thirst while taking Estradiol and Dienogest, let your doctor know immediately. Your doctor may need to make changes to your regimen in order to control your blood sugar, such as an adjustment in your medication, your diet, or other lifestyle aspects.

Blood Clots

Estradiol and Dienogest can increase your risk of getting blood clots in certain circumstances. Let your doctor know if you will be sedentary for a long period of time while taking Estradiol and Dienogest. If you just had surgery or will be having surgery soon or will be in another situation in which you will be confined to a bed for an extended period of time, or if you are going on a long plane flight or will be confined to a chair for an extended period of time, your risk of getting a blood clot while using Estradiol and Dienogest is increased. You may need to take precautions or stop using Estradiol and Dienogest if you will be confined to a chair or bed for an extended period of time.

Exposure to Sunlight

Estradiol and Dienogest can cause melasma, or blotchy areas of dark pigmentation, on the face and skin of some patients using this medication. This condition may become more severe when exposed to sunlight. To reduce the incidence of melasma or other skin discolorations while using Estradiol and Dienogest, stay out of direct sunlight as much as possible. Limit time in the sun and stay in shady areas. Avoid using sun lamps or tanning booths. When you are outdoors, use sunscreen and wear clothing that protects you from the rays of the sun.

Vision Problems

Patients who wear contact lenses or have been diagnosed with nearsightedness may develop problems with vision while taking Estradiol and Dienogest. If you are nearsighted or wear contact lenses, monitor your ability to wear contact lenses and the efficacy of your vision and vision aids while taking Estradiol and Dienogest. If you experience any changes in your vision while taking Estradiol and Dienogest, contact your eye doctor as soon as possible.

Medical Tests

Estradiol and Dienogest can interfere with certain medical or laboratory tests, especially blood tests for clotting factors or tests for thyroid problems or function. This may cause a false test result in some patients. If you are having any medical tests done while taking Estradiol and Dienogest, make sure your health care professionals and laboratory personnel know that you are taking Estradiol and Dienogest.

Pregnancy

While Estradiol and Dienogest is often prescribed to prevent patients from getting pregnant for a specific amount of time, it can have deleterious effects on patients who plan to become pregnant or who may be pregnant.

After you stop using Estradiol and Dienogest, it may take longer for patients who want to become pregnant to successfully conceive. If you are taking or have recently stopped taking Estradiol and Dienogest and wish to become pregnant, consult your doctor to learn about possible risks or treatments.

Estradiol and Dienogest should not be used by patients who are currently pregnant. If you become pregnant or think you may have become pregnant while taking Estradiol and Dienogest, talk to your doctor as soon as possible to ensure your safety and proper procedure. If you have recently given birth, had an abortion, or otherwise ended a pregnancy in the preceding three months, it may not yet be safe for you to take a form of birth control that includes estrogen or a form of estrogen. Talk to your doctor about safe and reliable methods of birth control that are appropriate for you.

Estradiol and Dienogest can reduce the production of breast milk in a nursing parent. A small amount of Estradiol and Dienogest can pass into breast milk. This can have undesirable effects on an infant which is nursing. To see if it is safe for you to take Estradiol and Dienogest while nursing an infant, consult your doctor.

Switching From Other Birth Control Methods

Some patients using Estradiol and Dienogest may be switching over from a method of birth control that uses a combination of hormones, such as a patch, a vaginal ring, or another type of birth control pill. If you are unsure about your previous method of birth control, check with your doctor. When switching over from a birth control method that uses a combination of hormones, take the first dark yellow pill in your Estradiol and Dienogest blister pack on the first day you have your period; if you are using a patch or a vaginal ring, take this pill on the day the patch or vaginal ring is removed. If you are not using a patch or a vaginal ring and you do not have a period when quitting your other birth control, contact your doctor. You will need to use an additional method of birth control such as a condom or diaphragm, or spermicide solution, for the first 9 days after beginning your regimen of Estradiol and Dienogest.

Storage

Keep your Estradiol and Dienogest in the original blister pack for ease of use. Keep it in a closed container, and store at room temperature. Do not expose your Estradiol and Dienogest to temperatures below 59 degrees Fahrenheit or above 86 degrees Fahrenheit. Keep the medication away from moisture and direct light. Do not freeze Estradiol and Dienogest or expose it to extreme heat.

Make sure that children and pets cannot reach your Estradiol and Dienogest. Do not keep Estradiol and Dienogest that you are not taking any longer, or that is past its expiration date. Ask your doctor or pharmacist how to dispose of your Estradiol and Dienogest when you no longer need it or if it is expired. Your pharmacy or other medical facility may have a safe disposal program for medications that are hazardous when flushed down the toilet or disposed of in other conventional ways.

Summary

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Estradiol and Dienogest is a combination of progestin and estrogen, which is prescribed to prevent pregnancy or treat heavy menstrual bleeding.

Estradiol and Dienogest comes in tablet form and is provided in a blister pack of 28 tablets. Take these tablets in the order prescribed and on the days directed by your doctor. Patients taking Estradiol and Dienogest may need to take the first pill on the first day of their period, on the day other birth control methods are removed or stopped, or on the day other birth control methods would have been implemented.

The body may take at least 9 days to adjust to Estradiol and Dienogest. Patients are advised to use an additional form of birth control during that time.

Some patients taking Estradiol and Dienogest may experience mild side effects such as acne or blemishes on the skin, discolored skin, or increased weight gain.

Some patients taking Estradiol and Dienogest may experience more serious side effects, such as:

  • Difficulty breathing or shortness of breath
  • Pain or bloating in the stomach or abdomen
  • Loss of appetite or nausea
  • Vomiting, or vomit with blood in it
  • A rash, irritation, redness, hives, swelling, or itching on the skin
  • Irregular menstrual periods
  • Breakthrough bleeding or unusual discharge
  • Dark or scanty urine
  • Bloody stools or clay-colored stools
  • Dizziness, weakness, or tiredness
  • Anxiety
  • Changes in vision
  • Loss of coordination or slurred speech
  • Fainting
  • Pain, stiffness, numbness, or swelling of the muscles or joints
  • Fever or chills
  • A fast or slow heartbeat

If you experience any of these side effects while taking Estradiol and Dienogest, contact your doctor immediately.