Progestin-only contraceptive tablets

About progestin-only contraceptive tablets

Progestin-only contraceptive tablets (also known as progestogen-only contraceptive tablets) are sometimes called POPs or the 'minipill'. They are commonly used when combination oral contraceptives, which also contain estrogen, are not suitable. They can be safely taken if you are breastfeeding.

Progestin-only contraceptive tablets contain a progestin (a man-made female sex hormone) called norethindrone which is similar to the progesterone hormone made naturally by your ovaries.

Norethindrone works mainly by thickening the mucus made by the neck of the womb (cervix). This makes it very difficult for sperm to travel through the cervix and into the womb (uterus) in order to fertilize an egg. They also affect the lining of the womb so that it does not become thick enough for an egg to attach and grow. Norethindrone also has some effect on the ovaries, and ovulation (the release of an egg each month) may not occur as often.

Before taking progestin-only contraceptive tablets

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking progestin-only contraceptive tablets it is important that your physician knows:

• If you think you might be pregnant.

• If you have any problems with the way your liver works.

• If you have a problem with your arteries, called arterial disease.

• If you have systemic lupus erythematosus (an inflammatory condition, often called SLE).

• If you have had breast cancer or a cancer that you have been told is dependent on a sex hormone.

• If you have an ovarian cyst, or any vaginal bleeding other than your normal monthly period.

• If you have a rare inherited blood disorder called porphyria.

• If you have a condition that interferes with the absorption of food (such as coeliac disease, cystic fibrosis or pancreatitis).

• If you have ever had a depressive illness.

• If you have ever had an ectopic pregnancy or if you have developed yellowing of your skin or the whites of your eyes (jaundice) during a pregnancy.

• If you smoke.

• If you have ever had an allergic reaction to a medicine.

• If you are taking any other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines. This is because some medicines interfere with the way contraceptives work. In particular, medicines for epilepsy and medicines for treating fungal infections, as well as the herbal preparation St John's wort, can reduce the effectiveness of the minipill.
  

How to take progestin-only contraceptive tablets

• Before you start taking the tablets, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the brand of minipill you have been given, and also a full list of side-effects which you may experience from taking it.

• Take one tablet each day, starting on day one of your cycle (the first day of your menstrual period). If you have just had a baby, you may be asked to start taking it straightaway.

• Norethindrone tablets are taken every day, including when you are having a menstrual period. When you finish one pack, start another pack the next day.

• You can choose a time of day to take your tablet that suits you, but you should take them at the same time, every day. It is important not to be late taking your doses and not to miss any.

• If you do forget to take your tablet on time, take it as soon as you remember, and then take the next dose at your usual time.

• If you are more than three hours late in taking a tablet, you are not protected against pregnancy. In this case, continue to take your tablets each day as normal, but you must also use an additional method, such as a condom, for the following two days.

Getting the most from your treatment

• To help decide whether progestin-only contraceptive tablets are suitable for you, your physician will assess your general health. Make sure you attend your regular appointments with your physician. This is especially important if you have an existing medical condition, as your health may need to be more closely monitored.

• Important: if you vomit or have diarrhea it can reduce the effectiveness of progestin-only contraceptive tablets. If you vomit within two hours of taking a tablet, take another straightaway. If the vomiting continues or if you have severe diarrhea, you must use additional contraceptive precautions such as a condom while you are ill and for two days after you recover.

• If at any time you suspect that you may be pregnant, stop taking the tablets and make an appointment to see your physician as soon as possible.

• Some medicines can reduce the effectiveness of norethindrone. These include medicines for epilepsy, medicines to treat fungal infections, the herbal preparation St John's wort, and medicines used to treat tuberculosis (TB). Make sure your physician knows about any other medicines you are taking, and if you buy any medicines 'over the counter', always ask your pharmacist for advice.

Can progestin-only contraceptive tablets cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with progestin-only contraceptive tablets. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your physician or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your physician or pharmacist.

How to store progestin-only contraceptive tablets

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.
  

Important information about all medicines