Femodette

Femodette is a low-dose combined oral contraceptive containing gestodene and ethinylestradiol. It is prescribed for the prevention of pregnancy in women of reproductive age.

Femodette is one of the lowest-dose combined pills available, which may be associated with fewer oestrogen-related side effects for some women.

Gestodene is a third-generation progestogen that potently inhibits ovulation, thickens cervical mucus to impede sperm transport, and renders the endometrium less receptive to implantation.

Ethinylestradiol provides cycle control, prevents breakthrough bleeding, and complements the contraceptive action by suppressing follicle-stimulating hormone (FSH) release from the pituitary gland.

When taken correctly, combined oral contraceptives have a failure rate of less than 1 per cent per year.

With typical use (accounting for occasional missed pills, vomiting, or drug interactions), the rate rises to approximately 7 to 9 per cent per year.

Femodette does not protect against sexually transmitted infections; barrier methods are needed for that purpose.

Take one tablet daily at the same time each day for 21 consecutive days, followed by a seven-day tablet-free interval. A withdrawal bleed usually occurs during the seven-day break.

Start the next strip on the eighth day, regardless of whether bleeding has stopped.

If you are starting Femodette for the first time, begin on the first day of your menstrual period for immediate protection.

If you miss a pill by fewer than 12 hours, take it as soon as you remember and continue with the next pill at the usual time.

If more than 12 hours late, refer to the missed-pill rules in the patient leaflet, as additional contraceptive precautions may be necessary.

One tablet (gestodene 75 micrograms/ethinylestradiol 20 micrograms) daily for 21 days, followed by a seven-day tablet-free interval. The regimen is fixed-dose; there is no titration.

In cases of severe vomiting or diarrhoea within three to four hours of taking the tablet, absorption may be incomplete and the missed-pill guidance should be followed.

No dose adjustment is applicable. Femodette is not suitable for use before menarche or after menopause.

Common side effects (affecting more than 1 in 100 women) include headache, mood changes, breast tenderness, nausea, and changes in menstrual bleeding pattern.

Breakthrough bleeding or spotting is most common in the first three cycles and usually resolves.

Uncommon side effects include migraine, fluid retention, decreased libido, skin rash, and changes in body weight.

Rarely, chloasma (facial pigmentation) may develop, exacerbated by ultraviolet exposure.

Serious risks include venous thromboembolism (VTE), which occurs at a rate of approximately 9 to 12 per 10,000 woman-years with gestodene-containing pills, compared with about 2 per 10,000 in non-users.

Arterial events (myocardial infarction, ischaemic stroke) are very rare but may occur, particularly in women with additional risk factors such as smoking, hypertension, or older age.

Liver tumours and cervical and breast cancer have been reported rarely with combined pill use.

Stop Femodette and seek urgent medical advice if you experience sudden severe headache, chest pain, breathlessness, unilateral leg swelling, visual disturbance, or collapse, as these may indicate a thromboembolic event.

Smoking substantially increases the risk of cardiovascular complications, especially in women over 35; Femodette should not be prescribed to smokers in this age group.

Review the continued suitability of Femodette if you develop new risk factors such as hypertension or if your BMI increases significantly.

Femodette is contraindicated in women with current or past venous or arterial thromboembolism, known thrombophilic conditions, migraine with aura, uncontrolled hypertension, severe hepatic disease or liver tumours, diabetes with vascular involvement, known or suspected oestrogen-dependent malignancies, undiagnosed vaginal bleeding, and known or suspected pregnancy.

It should not be used by women over 35 who smoke.