AnNa is a combined oral contraceptive to prevent pregnancy. Each of 28 tablets contains two different female hormones, which are levonorgestrel (0.15 mg) and ethinylestradiol (0.03 mg), other 7 tablets contains only lactose and no hormones and they are called placebo tablets. Because of the small amount of hormones, AnNa is considered as low-dose contraceptive.
Indications: oral contraceptive
Side effects: like all medicine also AnNa can have side effects, although not everybody gets them. These can be depressed mood and mood changes, headache,nausea, abdominal pain, breast pain, breast tenderness, increase in body weight. Less common side effects are fluid retention, decreased sexual drive, migraine, vomiting, diarrhoea, rash, hives, breast anlargement. Rare side affects are hypersensitivity reactions, blood clot in a vein, blood clot in an artery, increased sexual drive, contact lens intolerance, erythema nodosum, eyrthema multiforme, breast secretion, vaginal secretion, decrease in body weight. If you notice any side effects not mentioned in this leaflet, please inform your doctor.
Contraindications: you should not use AnNa if you have any of the following conditions:
- if you have or have had in the past a blood clot (thrombosis) in a blood vessels of the leg, lung or other organs
- if you have or have had in the past a heart attack or stroke
- if you have or have ever had a condition that may be a first sign of heart attack or stroke
- if you have a disturbance of blood clotting (for example, protein C defficiency)
- if you have major surgery and your ability to move around is limited for a long period of time
- if you have a type of migraine called “migraine with aura”
- if you have diabetes mellitus with blood vessel damage
- if you have a serious risk factor, or several risk factors for developing thrombosis, this may also be a reason why you cannot use AnNa
- if you have or have had a pancreatitis associated with high levels of fatty substaces in your blood
- if you have jaundice (yellowing of the shin) or have (had) severe liver disease and your liver is not yet working normally
- if you have or have had a cancer that may grow under the influence of sex hormones (e.g. of the breast or the genital organs)
- if you have or have had a liver tumour
- if you have any unexplained vaginal bleeding
- if you are pregnant or think you might be pregnant
- if you are breastfeeding
- if you are allergic to any of the ingredients of AnNa
If anything on the above list applies to you, tell your doctor before starting to use AnNa. Your doctor may advise you to use a different type of pill or an antirely different method of birth control.
Important information: you may need to be kept under close observation if:
- you smoke
- you have diabetes
- you are overweight
- you have a high blood pressure
- you have a heart valve disorder or a certain heart rythm disorder
- you have an inflamation of your veins
- you have varicose veins
- you or someone in your close family has had a thrombosis, a heart attack or a stroke
- you suffer from migraine
- you suffer from epilepsy
- you or someone in your close family have or have had high cholesterol or triglycerides
- anyone in your close family has had a breast cancer
- you have a liver or gallbladder disease
- you have Crohn’s disease or ulcerative colitis
- you have systematic lupus eruthematosus
- you have haemolytic uraemic syndrome
- you have sickle cell disease
- you have an operation, or if your ability to move around is limited for a long period of time
- if you have recently given birth you are at an increased risk of blood clots. You should ask your doctor how soon after delivery you can start using AnNa.
- you have condition that occurred for the first time or got worse during pregnancy or previous use of sex hormones
- you have had any chloasma; if so, avoid too much exposure to the sun or ultaviolet light
If any of above conditions appear for the first time, come back or get worse while using the AnNa, you should contact your doctor.
Use and dosage: take your tablet at about the same time each day, with some liquid if necessary. Start with the number 1 tablet in the left-hand top corner (marked “Start”). Follow the direction of the arrows untill all 28 tablets have been taken. Doing this, you use all the large tablets first, and then continue with the smaller placebo tablets. A period should begin during the 7 days that you use the placebo tablets (the withdrawal bleed). Usualy it will start on day 2-3 after the last large tablet. Start taking your next pack immediately after the last placebo tablet, even if your period continues. This means that you will always start new packs on the same day of the week, and also that you have your withdrawal bleed on about the same days, each month.
Missed dose: if you miss a dose of AnNa tablets, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. If you forget to take a tablet for more than 12 to 24 hours, irregular bleeding may occur.
Package Contents: 1 calendar pack of 28 tablets, 21 tablets with female hormones (Levonorgestrel, Ethinylestradiol) each, 7 tablets with lactose only (placebo tablets) – total 28 tablets in one box.
Active ingredient: levonorgestrel 0.15 mg, ethinylestradiol 0.03 mg (21 tablets), lactose (7 tablets)
Manufacturer: Thai Nakorn Patana Co., Bangkok, Thailand
Storage: keep Mercilon in its calender blister until used. Store at room temperature below 30°C, keep away from direct sunlight and do not refrigerate.