Ovranette

Ovranette is a combined oral contraceptive containing levonorgestrel and ethinylestradiol.

It is prescribed for the prevention of pregnancy and is one of the most widely used low-dose monophasic pills in the United Kingdom.

Levonorgestrel-containing pills are often recommended as a first-line combined oral contraceptive because of their well-established safety profile, including a lower risk of venous thromboembolism compared with pills containing newer progestogens.

Levonorgestrel suppresses ovulation by inhibiting the mid-cycle surge of luteinising hormone (LH).

It also thickens the cervical mucus, creating a barrier to sperm penetration, and renders the endometrial lining less receptive to implantation.

Ethinylestradiol provides complementary contraceptive action by suppressing follicle-stimulating hormone (FSH) and offers good cycle control with predictable withdrawal bleeds.

As a monophasic pill, every tablet in the strip contains the same dose of hormones, which simplifies use and makes it more straightforward to manage missed pills compared with multiphasic preparations.

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

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

If beginning Ovranette for the first time, start on the first day of your menstrual period for immediate protection.

If you miss a pill by fewer than 12 hours, take it straight away and continue as normal.

If you are more than 12 hours late, take the missed pill, continue the rest of the pack, and use condoms for the next seven days.

If fewer than seven tablets remain in the strip, start the next strip without a break.

One tablet daily for 21 days, followed by a seven-day break. Each tablet contains levonorgestrel 150 micrograms and ethinylestradiol 30 micrograms. The regimen is fixed-dose.

If vomiting or severe diarrhoea occurs within three to four hours of taking a tablet, follow the missed-pill guidance. No dose adjustment is applicable.

Ovranette is not suitable for use before menarche or after menopause.

Common side effects include headache, nausea, breast tenderness, mood changes, and breakthrough bleeding or spotting, particularly in the first three cycles.

Uncommon effects include migraine, fluid retention, decreased libido, weight fluctuation, and chloasma.

Skin changes such as acne may occur in some women, as levonorgestrel has mild androgenic properties.

Serious risks include venous thromboembolism (VTE), occurring at approximately 5 to 7 per 10,000 woman-years, which is lower than with pills containing desogestrel, gestodene, or drospirenone but higher than in non-users (approximately 2 per 10,000).

Arterial events such as myocardial infarction and stroke are very rare but are increased by smoking, hypertension, and older age.

Hepatic tumours and a small increase in breast and cervical cancer risk have been reported with combined pill use.

Stop Ovranette and seek urgent medical advice if you experience sudden severe headache, chest pain, breathlessness, unilateral leg pain or swelling, visual disturbances, or signs of stroke.

Smoking markedly increases the cardiovascular risk; women over 35 who smoke should not take Ovranette. Blood pressure should be checked before prescribing and at regular follow-up appointments.

Be aware that certain medications, including some anticonvulsants, rifampicin, and St John's Wort, may reduce the pill's effectiveness.

Ovranette is contraindicated in women with current or past venous or arterial thromboembolism, known thrombophilia, migraine with aura, uncontrolled hypertension, diabetes with vascular complications, severe hepatic disease or liver tumours, known or suspected oestrogen-dependent malignancy, undiagnosed vaginal bleeding, known or suspected pregnancy, and in smokers over the age of 35.