Brevinor

Brevinor Information

Brevinor preparation offers a constant low dose of ethinyloestradiol with a variable dose of norethisterone. Oestrogenic, progestational and antigonadotrophic characteristics are revealed by the endocrine profile of these combinations. BREVINOR produces a contraceptive effect primarily by suppressing the hypothalamic pituitary system resulting in prevention of ovulation. The oestrogen compound, ethinyloestradiol, acts by suppressing secretion of follicle stimulating hormone (FSH), resulting in prevention of follicle development and the rise of plasma oestradiol which is thought to be the stimulus for releasing luteinising hormone (LH). The progestogenic compound, norethisterone, primarily acts by inhibiting the preovulatory rise of LH. Long-term administration of combination type oral contraceptives may also produce a direct effect on ovarian steroidogenesis or the response of the ovary to gonadotrophins. Although the primary mechanism of action is inhibition of ovulation, alterations in the genital tract including changes in the cervical mucus (which increases the difficulty of sperm penetration) and the endometrium (which reduce the likelihood of implantation) may also contribute to contraceptive effectiveness

Brevinor Warnings

The physician should be alert to the earliest manifestations of thrombotic disorders and medication should be discontinued immediately should any of these occur. Thromboembolic disorder and other vascular problems including cerebrovascular disorders and myocardial infarction may persist following termination of oral contraceptives. The risk of thrombotic and cardiac effects from oral contraceptives increases with age, especially for women over the age of 35 years, and is aggravated by cigarette smoking. The risk of vascular disease is dose related. Oral contraceptive medication should be discontinued at least six weeks prior to and 2 weeks after elective surgery because of the danger of thrombosis. If there is a sudden, partial or complete loss of vision or if there is a sudden onset of proptosis, retinal thrombosis, or diplopia medication should be discontinued and examination made. If examination reveals papilloedema or retinal vascular lesions the medication should be discontinued. The onset or exacerbation of migraine or the development of headaches of a new pattern which is recurrent, persistent or severe, requires discontinuation of oral contraceptives and evaluation of the cause. Diarrhoea or vomiting can jeopardise the contraceptive effect by affecting absorption. Organic disease should be excluded when breakthrough bleeding appears for the first time in women who have been previously well controlled and in all cases of irregular vaginal bleeding. Recovery of fertility may be delayed following use. Before prescribing oral contraceptive physical examination is desirable including especially breasts, pelvis and liver. Annual physical examinations are also recommended. Under the influence of oral contraceptives pre-existing uterine fibroids may increase in size. Benign or malignant hepatic tumours have been associated with oral contraceptive use. The use of oral contraceptives has also been associated with a possible increased incidence of gall bladder disease. Acute renal failure, malignant hypertension, and haemolytic uraemic syndrome have been associated with the use of oral contraceptives. Susceptible women may experience a rise in blood pressure during therapy. Discontinue oral contraceptives during prolonged periods of bed rest. The use of oral contraceptives has been associated with an increased risk of Breast Cancer particularly at a young age. This increased relative risk appears to be related to duration of use. The use of oral contraceptive may cause fluid retention. Patients with conditions such as diabetes, hypertension, epilepsy, migraine, asthma and cardiac or renal dysfunction require careful observation whilst on oral contraceptive therapy. Patients with a history of emotional disorders, especially the depressive type are more prone to have a recurrence of depression while taking oral contraceptives. Medication should be discontinued if serious depression recurs. Active ingredients of oral contraceptives have been detected in milk of mothers receiving these medicines and the effect on breast-fed infants is unknown. Suppression of lactation may occur. Patients with diseases affecting calcium or phosphorus metabolism should be carefully observed. Because oestrogens may hasten epiphyseal closure oral contraceptives should be used judiciously in young patients in whom bone growth is not complete. Oral contraceptives may cause alterations in lipid metabolism. A decrease in glucose tolerance occurs in a significant number of patients on oral contraceptives.

Brevinor Side Effects

The following side effects have been reported and are believed to be related to oral contraceptives: Thrombophlebitis, arterial thromboembolism, pulmonary embolism, myocardial infarction, cerebral haemorrhage, cerebral thrombosis, mesenteric thrombosis, retinal thrombosis, hepatic adenomas, carcinomas or benign liver tumours, nausea, vomiting, gastrointestinal symptoms (such as abdominal cramps and bloating), breakthrough bleeding, breast changes (tenderness, enlargement, secretion) spotting, changes in menstrual flow, amenorrhoea, temporary infertility after discontinuation of treatment, changes in menstrual flow, changes in cervical erosion and cervical secretions, amenorrhoea during and after treatment, anovulation post treatment, cholestatic jaundice, pruritus, allergic rash, photosensitivity, Alopecia, chloasma, melasma which may persist, erythema multiforme, erythema nodosum, haemorrhagic eruption, hirsutism, headache, migraine, dizziness, drowsiness, changes in appetite, change in weight (increase or decrease), diminution in lactation when given immediately postpartum, mental depression, reduced tolerance to carbohydrates, vaginal candidases, changes in corneal curvature (steepening), intolerance to contact lenses, impaired renal function

Brevinor Overdose

Overdosage may be manifested by nausea, vomiting, breast enlargement and vaginal bleeding. Serious ill effects have not been reported following acute ingestions of large doses of oral contraceptives by young children. There is no specific antidote and treatment should be symptomatic

Brevinor Usage Guidelines

To achieve maximum contraceptive effectiveness, Brevinor day must be taken as directed and at daily intervals not exceeding 24 hours. Women should be instructed to take the tablets at the same time every day, preferably at bedtime. Store below 25°C.

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