Midiana: instructions for using birth control pills

Currently, hormonal contraceptives are considered one of the most reliable methods for preventing unwanted pregnancy. In most cases, the effectiveness of their use is almost 100%. Among all contraceptive drugs, preference is given to combined oral contraceptives. A classic representative of this type of contraception is a drug called Midiana.

pharmachologic effect

Mechanism of action of COCs
The drug Midiana belongs to oral hormonal contraceptives and has antiandrogenic, antimineralocorticoid effects.

The mechanism of action of COCs (combined oral contraceptives) is based on inhibition of the ovulatory process. Changes occur in the endometrium at the structural and functional level.

This effect of the drug Midiana in the form of birth control pills is possible due to the interaction of the two active components ethinyl estradiol and drospirenone. Their pharmacokinetic processes are different.

Drospirenone is not completely absorbed in the stomach. Its maximum accumulation in the blood is observed after 7 or 14 hours.

Cleansing the body of this substance of the Midian birth control pills occurs through the kidneys and with feces.

Ethinyl estradiol, on the contrary, is completely absorbed in a short period of time. It leaves the body along with urine and feces.

Pharmacodynamics and pharmacokinetics

The contraceptive effect is based on the interaction of factors, among which the most important are inhibition of ovulation and structural and functional changes in the endometrium .

Midiana is a combined oral contraceptive thanks to its active substances ethinyl estradiol and drospirenone . In addition, drospirenone in a therapeutic dose has antiandrogenic and weak antimineralocorticoid properties, however, it does not have estrogenic, glucocorticoid, or antiglucocorticoid activity, which makes drospirenone similar in pharmacological profile to natural progesterone .

Regarding pharmacokinetics : the biotransformation of drospirenone and einyl estradiol occurs differently. Drospirenone is not completely absorbed when taken orally; bioavailability is within 76-85%, regardless of diet. Its maximum concentration in serum after the first dose is 37 nanograms per ml after several hours; in the first cycle, an equilibrium concentration of 60 nanograms per ml is established after 7-14 hours. The decrease in serum concentration occurs in 2 phases by binding to serum albumin .

Metabolites of drospirenone are represented by acidic forms formed during the opening of the lactone ring. The average apparent volume of distribution is about 3.7 liters per kg, metabolic rate. clearance - 1.5 ml/min/kg. The elimination process occurs exclusively in trace amounts in unchanged form; metabolic are excreted by the kidneys and through the intestines in an approximate ratio of 1.2:1.4 with a half-life of 40 hours.

Unlike drospirenone, ethinyl estradiol is absorbed quickly and completely when taken orally, with an absolute bioavailability of 45%. The maximum concentration after the first dose is reached after a few hours and is 30 mcg. The significant 1st pass effect was found to occur with wide interindividual variability, with the apparent volume of distribution typically being 5 liters per kg and approximately 98% of the compounds being bound to plasma proteins. Ethinyl estradiol is capable of inducing the synthesis of globulin that binds sex hormones and transcortin in the liver. Metabolism occurs completely with a metabolic clearance rate of 5 ml/min/kg, 0.02% of the dose passes into breast milk, metabolic products are excreted by the kidneys and through the intestines in a stable ratio of 4 to 6 with an excretion half-life of 1 day and an elimination half-life of 20 hours.

Composition and release form

Midiana tablets are white in color and convex on both sides.
The drug Midiana is produced in the form of birth control pills.

The oral contraceptive contains two active components in the form of drospirenone in the amount of 3 mg/1 tablet and ethinyl estradiol - 0.03 mg/tablet.

In the production of Midiana birth control pills, additional components are used:

• Magnesium stearate;
• Lactose monohydrate;
• Corn starch;
• Pregelatinized corn starch;
• Povidone K-25;
• The shell is film.

Indications for use

The drug Midiana in the form of birth control pills is used for contraception.

They are considered more beneficial for women who suffer from:

1. Swelling;
2. Hormone-dependent fluid retention;
3. Excess weight;
4. Seborrhea;
5. Acne.

Photos of problems for which the use of the drug Midiana will be useful:

Swelling

Seborrhea

Fluid retention

Acne

Excess weight

Contraindications

The drug Midiana in tablet form has certain contraindications:

• Intolerance to one of the components of the contraceptive;
• Damage to deep veins by thrombosis;
• Thromboembolism of the pulmonary artery;
• Myocardial infarction;
• Angina;
• Transient ischemic attack;
• Uncontrolled arterial hypertension;
• Atrial fibrillation;
• Damage to heart valves with complications;
• Cerebrovascular diseases;
• Postoperative period with long immobilization;
• Smoking in women over 35 years old;
• Diabetes;
• Dyslipoproinemia;
• Severe hypertriglyceridemia;
• Pancreatitis of the pancreas;
• Lack of certain substances in the body: protein type C/S, antithrombin III;
• Severe or aggravated liver diseases;
• The presence or suspicion of malignant neoplasms in the organs of the reproductive system;
• Vaginal bleeding of unknown origin;
• Migraine;
• Lactase deficiency;
• Galactosemia.

While taking the drug Midiana in the form of birth control pills, you should not breastfeed. One of the main contraindications is pregnancy.

For some diseases, oral contraceptives can be used, but caution must be exercised:

1. Controlled arterial hypertension;
2. Chloasma;
3. The period after childbirth.

Photos of cases when the drug must be used with caution:

Arterial hypertension

Chloasma

Postpartum period

Impact on the female cycle

Provided that the COC Median was taken correctly in previous courses, the absence of critical days should not be a cause of concern. Start the next course after 7 days of rest, during which menstruation should begin.

When using Median, irregular periods or bleeding between critical days may occur.

It’s quite easy to change from other methods to Mediana:

1. If the old product consisted of 28 tablets, start using the drug immediately after finishing the old brand of pills.
2. If the quantity is 21 tablets, start drinking immediately the next day or on the 8th day after the “rest”.

When switching from hormonal-containing contraceptives: mini-pill, uterine device, ring or patch, drink Median from the day when according to the plan you need to use a new patch or insert a ring. If you have an IUD, take the medicine on the day you remove it from the uterus. As a supplement, use parallel protection methods.

Side effects

Midian birth control pills can cause adverse reactions in some women.

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Drug interactions

Midian birth control pills, when taken simultaneously with drugs with the property of inducing microsomal enzymes, enhance the process of clearance of hormones of the reproductive system.

This negatively affects the abundance of menstruation and reduces the protective function of the oral contraceptive.

Birth control pills are dangerous to combine with such medications:

• Oxcarbazepine, barbiturates, topiramate, phenytoin, carbamazepine, ritonavir, primidone, felbamate, rifampicin, griseofulvin (accelerate the removal of hormones from the body);
• Blockers of HIV protease and reverse nucleoside transcriptase (affect metabolic processes in the liver);
• Penicillin and tetracycline antibiotics (reduce the amount of ethinyl estradiol in the body);
• Lamotrigine (reduces the content of the drug);
• Cyclosporine (increases the concentration of the main components).

Photo gallery of drugs:

Topiramate

Carbamazepine

Ritonavir

Primidon

Felbamate

Rifampicin

Griseofulvin

Lamotrigine

Cyclosporine

Phenytoin

The oral contraceptive Midiana increases the activity of Renin and the amount of aldosterone (hormone) in the blood plasma.

Instructions for use

There are some subtleties of taking the oral contraceptive Midiana.

Taking missed Midiana tablets

If the delay in taking the pill is less than 12 hours, contraceptive protection is not reduced. The woman needs to take the pill as soon as possible, the next pills are taken at the usual time.

If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. Tactics when skipping a drug dose are based on the following two rules:

1. Taking pills should not be stopped for more than 7 days.
2. To achieve adequate suppression of the hypothalamic-pituitary-ovarian axis, 7 days of continuous tablet use are required

Accordingly, the following advice can be given in daily practice:

Week 1

You should take the last missed tablet as soon as possible, even if this means taking two tablets at the same time. The next tablet is taken at the usual time. Additionally, a barrier method of contraception must be used for the next 7 days. If sexual intercourse took place within 7 days before missing a pill, the possibility of pregnancy must be taken into account. The more pills you miss and the closer this skip is to the 7-day break in taking the drug, the higher the risk of pregnancy.

Week 2

You should take the last missed tablet as soon as possible, even if this means taking two tablets at the same time. If a woman has taken the pills correctly over the previous 7 days, there is no need to use additional contraception. However, if she has missed more than 1 tablet, additional contraceptive measures must be used for the next 7 days.

Week 3

The likelihood of a decrease in the contraceptive effect is significant due to the upcoming 7-day break in taking pills. However, by adjusting the schedule for taking pills, you can prevent a decrease in contraceptive protection. If you follow any of the following two tips, you will not need additional methods of contraception if you have taken all your pills correctly in the previous 7 days before missing a pill. If this is not the case, she should follow the first of the two methods and also use additional contraception for the next 7 days.

1. You should take the last missed tablet as soon as possible, even if this means taking two tablets at the same time. The next tablet is taken at the usual time. Taking tablets from a new package should be started as soon as the current package ends, that is, without a break between taking two packages. Most likely, there will be no withdrawal bleeding until the end of the second pack, but spotting or breakthrough uterine bleeding may occur on the days of taking the pills.
2. The woman may be advised to stop taking the tablets from this package. She should then stop taking the pills for 7 days, including days when she forgot to take the pills, and then start taking the pills from a new pack. If you miss taking pills and there is no “withdrawal” bleeding during the first drug-free interval, pregnancy must be ruled out.

special instructions

The drug Midiana in the form of birth control pills does not affect a woman’s body weight. If weight gain or loss occurs, this is a reason to consult a doctor.

The period of pregnancy is a contraindication to the use of the drug

Breastfeeding is also a contraindication to the use of oral contraceptives in the form of Midiana tablets.

During pregnancy and lactation

During pregnancy and lactation, the use of Midiana is contraindicated. If pregnancy occurs while using contraception, the drug should be discontinued immediately.

There is limited information about the lack of teratogenic effects and increased risk for the child and woman during childbirth with the unintentional use of combined contraceptives orally. In addition, they affect lactation and can reduce the amount and change the composition of breast milk, which can have a harmful effect on the baby.

Analogues substitutes

If necessary, the drug Midiana in the form of birth control pills is replaced with other contraceptives:

• Ovidone is created on the basis of two active components levonorgestrel and ethinyl estradiol in tablets. (Hungary).
• Yarina is available in tablets with drospirenone and ethinyl estradiol. (Germany).
• Rigevidone is produced in tablets based on levonorgestrel and ethinyl estradiol. (Hungary).
• Simitsia is produced in tablets with drospirenone and ethinyl estradiol. (Hungary).
• Non-Ovlon is produced in the form of dragees based on ethinyl estradiol and norethisterone. (Germany).
• Dailla - tablets with estrogen and drospirenone. (Hungary).

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Which is better: Yarina, Novinet or Midiana?

Yarina, Novinet and Midiana
If you compare Midiana and Yarina, they are essentially the same in composition, due to this, in their effect too.

The second drug is much easier to find, although its price is higher, which is why Yarina is more popular than the first birth control pills.

Midiana, in turn, has additional antimineralocorticoid and antiandrogenic effects, which are not present in Novinet.

For this reason, a specialist should choose, and not the woman herself.

Comparison of ease of use of Midiana and Diane-3i

This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.

The ease of use of Midiana is approximately the same as Diane-3. However, they are not convenient enough to use.

The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.

Last update date: 2019-09-19 06:00:48

Reviews from doctors

Chepel Valentina Rostislavovna, gynecologist : “I always treat my patients with respect. I don’t want to recommend them oral contraceptives that are ineffective or very expensive. Midian birth control pills are more difficult to find than their other analogues, but they are still possible. Their lower cost does not mean their quality is poor.”

Levakova Anna Bogdanovna, gynecologist : “It takes years of practice to say anything bad about a drug. It is for this reason that I cannot criticize the drug Midiana. As much as I work, it doesn’t suit very many people. When birth control pills were taken correctly, not a single woman became pregnant, which indicates the quality of the drug as a contraceptive.”

Reviews from women

Evgeniya, 29 years old : “For a long time I couldn’t decide whether to take hormonal contraceptives, because I’m overweight, have male-pattern hair and all that... For me, it turned out the other way around. I have been taking the drug Midiana in the form of birth control pills for a year now. In just a couple of months, mastopathy went away, acne stopped bothering me, and coarse hairs stopped growing on the body.”

Olga, 33 years old : “At first I liked the price, because similar contraceptive drugs are very expensive. Then I was pleased with the contraceptive effect. Even after missing an oral pill, pregnancy did not occur. I still haven’t gained weight, although a couple of kilograms won’t be extra in my case.”

Missing a medication

If you allow a gap in the course intake, follow the algorithm specified in the instructions:

1. Less than 12 hours have passed. The protective barrier remains effective. Drink the capsule further along the calendar scale.
2. Pass for more than 12 hours. Calculate how many pills you forgot to take. If this is 1 - 7 tablets (the first week of the course), take it and continue to drink further. Use additional contraceptive options.
3. If it is 8 - 14 pills (second week), take it. It is possible to take two capsules at the same time. In this case, there is no need to use condoms if the intake is strictly followed. The concentration of the drug in the body is already sufficient for this period.
4. If it is 15 - 21 tablets (third week), take the tablet, finish the blister and stop, start a new course. Provided that you have previously used Midiana correctly and there are no gaps, parallel contraceptives are not needed.
5. You missed a few capsules. Then take two tablets for 2 days, this way you will fill in the gaps and missing elements. If you miss three pills, take 2 pills three days in a row. Use barrier products during this time to prevent pregnancy.