Hormonal contraceptive "Silhouette": reviews, instructions for use

In this medical article you can familiarize yourself with the drug Silhouette. The instructions for use will explain in what cases these tablets can be taken, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Silhouette, from which you can find out whether the medicine for contraception in healthy women helped in therapy in adults and children, for which it is still prescribed. The instructions list analogues of Silhouette, prices of the drug in pharmacies, as well as its use during pregnancy.

The oral contraceptive medicine is Silhouette. The instructions for use indicate that the tablets have antiandrogenic properties.

pharmachologic effect

Siluet is an oral combination drug that has an antiandrogenic effect. The drug contains ethinyl estradiol and dienogest. The contraceptive effect is due to several factors. The most important is the inhibition of ovulation. Suluet is able to increase the viscosity of cervical mucus, change the peristalsis of the fallopian tubes and the structure of the endometrium.

The combination of ethinyl estradiol and dienogest has an antiandrogenic effect, which is based on a decrease in the concentration of androgens in plasma. Taking a combination of ethinyl estradiol and dienogest can lead to the elimination of symptoms of mild to moderate acne and has a positive result for seborrhea.

Pharmacodynamics of “Silhouette”: general contraceptive and specific therapeutic effect

"Silhouette" is an effective medicine of a new generation, which belongs to the group of monophasic low-dose contraceptives.
It is produced by a Romanian pharmaceutical company and is a structural analogue of a COC called “Janine”, which has the same medicinal properties. Unlike the latter, “Silhouette” is more accessible to women in our region due to its affordable price.

The definition of “Monophasic” means that the concentration of the two active ingredients remains constant in each tablet, regardless of the day of the menstrual cycle. “Low-dose” means that the dosage of dienogest in it is higher than in other related pharmacological subgroups (“microdose” drugs).

https://youtu.be/h2p69kh5ux8

Instructions for use

Silhouette tablets are taken orally, one daily, in the prescribed order for 21 days. Tablets from the new package are taken after a week's break. At this time, withdrawal bleeding appears.

• When switching from other combined drugs, start taking it after the usual break.
• If the drug is being taken for the first time, you should start taking it on the 1st day of menstruation.
• If a pill is missed and the missed time is less than 12 hours, there is no need to worry about a decrease in contraceptive protection. However, you need to take the pill quickly. Reception cannot be interrupted for more than 7 days.
• After an abortion in the first trimester, they begin to take it immediately. After birth - on the 21st day.

The instructions contain complete information on how to take the drug in other situations, how to delay withdrawal bleeding and in which cases additional contraceptive measures are necessary.

Analogs

Level 4 ATC code matches:
Ovidon

Rigevidon

Non-Ovlon

Mercilon

Yarina Plus

Yarina

Miniziston 20 fem

Novinet

Microgynon

Janine

Lindineth

Cyclo-Proginova

Regulon

Logest

Midiana

Femoden

Jess Plus

Jess

Zoely

Analogs of Belara: Vidora, Vidora Micro, Dayla, Darilia, Jess, Jess Plus, Difenda, Evra, Janine, Jastinda, Lindinet 20, Lindinet 30, Logest, Marvelon, Mercilon, Midiana, Milanda, Modell Anti, Modell Tin, Naadin, Novinet , Regulon, Rigevidon 21 +7, Silest, Simitsia, Femoden, Yarina, Yarina Plus.

Contraindications

Contraindications to Silhouette are:

• pancreatitis with hypertriglyceridemia;
• vaginal bleeding;
• jaundice and congenital hyperbilirubinemia;
• malignant diseases of the mammary glands or genital organs;
• migraine;
• severe dyslipoproteinemia, arterial hypertension, retinopathy, angiopathy;
• venous and arterial thromboembolic diseases;
• thromboembolism and thrombosis;
• severe liver dysfunction;
• porphyria;
• smoking in women over 35 years of age;
• sickle cell anemia;
• period of pregnancy and lactation;
• lactose deficiency, lactase intolerance, glucose-galactose malabsorption;
• intolerance to the components of the product;
• liver tumors;
• epilepsy.

Side effects

Frequently encountered adverse reactions that the drug Siluet can cause:

• increased appetite;
• weight gain;
• headache;
• decreased mood;
• menstrual-like bleeding;
• nausea, vomiting;
• backache;
• pain in the mammary glands, their enlargement;
• cramps of the calf muscles;
• venous thromboembolism.

Less commonly observed:

• abdominal pain;
• tinnitus, hearing impairment;
• phlebeurysm;
• vaginitis and fungal infections;
• allergic reactions;
• flu-like symptoms;
• anemia;
• diarrhea, gastritis;
• insomnia;
• acne;
• tachycardia;
• increased excitability;
• blurred vision, dry eye mucosa;
• arthralgia, muscle pain;
• dizziness;
• sinusitis, bronchitis;
• weakness.

By

Children, pregnancy and breastfeeding

Siluet is not prescribed during pregnancy and breastfeeding. If pregnancy is detected during use, the drug should be discontinued immediately. However, extensive epidemiological studies have not shown an increased risk of developmental defects in children born to women who received sex hormones before pregnancy, or teratogenic effects when sex hormones were inadvertently taken in early pregnancy.

Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is contraindicated during lactation. Small amounts of sex steroids and/or their metabolites may be excreted in milk.

Reviews from women over 40 with endometriosis

I was diagnosed with endometriosis at the age of 30-35, after the birth of my second son. There was a strong hormonal imbalance, there was a need to prescribe oral contraceptives, the doctor prescribed Klaira. After 3 months, I took the tests again, the background stabilized, and the signs of growths became much smaller, I conclude that the drug helps.

40-45 years is the time when you are no longer planning a pregnancy, but chronic diseases are getting worse, which is what happened to me with endometriosis. I underwent an examination, there is no reason for surgical intervention yet, I was prescribed Klaira tablets, and then Ovestin suppositories. I haven’t taken hormone tests again yet, but I note that the pain in the lower abdomen has gone away, and my periods pass easily and unnoticed (it only lasts 2-3 days).

Prilepskaya V.N. (2010). "Guide to contraception." M.: “MEDpress-inform”.

Prilepskaya V.N., Chernysheva E.S. “Levonorgestrel-containing drugs in the treatment and prevention of gynecological diseases” (2009). "NTsAGiP im. Academician V.I. Kulakov."

Adamyan L.V., Sonova M.M., Tikhonova E.S. et al. (2011). "Medical and social aspects of genital endometriosis." "Problems of Reproduction."

Kuznetsova I.V. (2008). "Endometriosis: pathophysiology and choice of treatment tactics." "Gynecology".

About the author : Borovikova Olga Igorevna

An integral element of the treatment of endometriosis is the use of hormonal drugs, which are selected strictly according to indications. Qlaira for endometriosis is one of the possible treatment options.

special instructions

Before you start using the contraceptive in question, it is important to make certain preparations. For example, you need to collect anamnesis (personal and family), and be sure to rule out pregnancy. It is important that blood pressure readings are normal and the results of the general examination are satisfactory.

The potential patient should have a good understanding of the risks associated with using the drug, how exactly it should be used and why it is so important. The frequency of regular gynecological examinations should be determined. In any case, they should be carried out at least once every six months.

A woman should be clearly aware that the oral contraceptives in question will not be able to protect her from any sexually transmitted infections, including HIV infection (AIDS). It is important to know that very often the use of this type of contraception leads to changes in the picture of the results of a number of laboratory tests.

Among them: biochemical indicators of kidney, thyroid, adrenal and liver function. Also, hormonal therapy can affect the level of transport proteins in plasma and the parameters of carbohydrate metabolism. Significant changes are naturally a cause for concern.

Does the use of the drug Silhouette (tablets) cause side effects in the form of impaired reaction and inability to drive vehicles? No. However, severe dizziness and significant temporary visual impairment may occur. It is important to take this into account when planning your activities so as not to endanger your life.

Price of birth control pills Silhouette

The cost of Silhouette contraceptives will vary depending on the city and point of sale. For example, in city pharmacies the price of a drug may be higher than its cost when ordering online.

Important! In order not to encounter a counterfeit, you need to check the manufacturer of the tablets - it should be Gedeon Richter from Hungary.

Approximate cost of tablets:

• from 650 rubles per pack of 21 tablets,
• from 1450 rubles per pack of 63 tablets.

It is better to purchase a larger package for those girls for whom “Silhouette” suits. A small pack is convenient to buy for girls just starting to take oral contraceptives.

Drug interactions

A decrease in the effectiveness of contraception is observed when prescribed simultaneously with ampicillin, rifampicin and tetracycline, so barrier methods of contraception should be used at this time. After taking rifampicin, it is necessary to use additional contraception for a longer period (28 days).

Breakthrough bleeding may occur when taken concomitantly with hydantoin, carbamazepine, phenobarbital, rifampicin, efavirenz, rifabutin, ritonavir, nevirapine, felbamate, griseofulvin, and St. John's wort.

Compound

Qlaira is a contraceptive for sequential use from the class of gestagens and estrogens. The tablets contain two active components - estradiol valerate and dienogest.

Each pill is consumed according to the scheme, on different days and contains different amounts of active ingredients:

• yellow – estradiol 3 mg;
• pink – estradiol 2 mg, dienogest 2 mg;
• light yellow – estradiol 2 mg, dienogest 3 mg;
• red – estradiol 1 mg;
• white (placebo) - include only auxiliary components.

This composition of the tablets increases the effectiveness of treatment, since it adapts to the natural changes in the endometrial layer that occur during the monthly cycle. Find out whether boron uterus and suppositories help treat endometriosis.

How does the drug combine with other medications?

The silhouette gives a good therapeutic effect, but subject to all recommendations and precautions. There are some guidelines for combining the medicine with other drugs. The effectiveness of the drug is significantly reduced if therapy is combined with the following:

• Antidepressants and anti-anxiety drugs, for example, Primidone, Phenobarbital.
• Antibacterial agents of the tetracycline or ampicillin series.
• Herbal medicines based on St. John's wort.

Separately, it should be recalled that combining the drug with alcoholic beverages is not allowed.

If it is vital to take medications that reduce the effectiveness of Silhouette, then you should consider using additional contraception.

Treatment of endometriosis is very important for a woman's reproductive health. Which is better to prefer, “Janine” or “Silhouette”? It is advisable to discuss this issue with your doctor. Each woman’s body has its own characteristics; for some, one drug is effective, while for others it can cause a lot of side effects.

Reception scheme

The dosage and duration of taking Silhouette may vary, depending on the regimen used for the patient, which are as follows:

1. For the treatment of endometriosis, patients planning pregnancy are prescribed a standard regimen: 1 tablet per day for 21 days. After this, a break is taken for 7 days, after which therapy continues. The duration of treatment is 3 months. According to indications, the course can be re-prescribed. With this treatment, it is recommended to take additional contraceptive medications from the first day of your period.
2. For patients who are not planning a pregnancy, the following regimens are recommended: 42/7 – take Silhouette for 42 days, 7 days off;
3. 63/7 – 63 days of treatment, 7 days break;
4. 84/7 – continuous use for 84 days, 7 days break.

Depending on the prescribed tactics for taking Silhouette tablets, a woman should strictly adhere to the dosage prescribed by the doctor. After each course, you need to be examined by a doctor and consult about repeating the course.

If the patient misses taking the pill by less than 12 hours, the contraceptive properties of the drug do not change. The missed dose should be taken as quickly as possible as soon as a medication error is discovered. The next tablet can be taken at the scheduled time without any shifts or delays.

If a dose is missed for more than 12 hours, the likelihood of an unwanted pregnancy increases. At the same time, it is important not to take a break between courses for more than a week, because complete blunting of the hypothalamic-pituitary-ovarian system is observed only when taking the pills continuously for 7 days.

Since the drug is used not only for the treatment of gynecological pathologies, but also to normalize the cyclicity of menstruation, and also as a contraceptive, given the insufficient amount of verified data regarding the effect of the drug on the children's body, children are prohibited from taking the pills. The drug is prescribed only after the onset of the menstrual cycle.

The silhouette is contraindicated for pregnant girls.

In case of pregnancy, the pills should be discontinued as soon as possible. Practice shows that the use of Silhouette in the early stages of pregnancy does not in any way affect the embryo and its subsequent development, as well as in cases where the girl was treated with Silhouette before pregnancy.

Animal tests have shown that taking Silhouette during pregnancy has negative effects. But it cannot be said with certainty that the risk of all kinds of complications and pathologies observed in animals is also possible in humans.

The drug Silhouette and its taxes have an impact on lactation, because while taking such drugs, the production of breast milk and its composition decreases. Although in small quantities, the components of the tablets still penetrate into breast milk. Even small doses of the drug are enough to have a detrimental effect on the child.

Since the necessary studies have not been conducted to monitor the effects of the Silhouette drug on patients with kidney dysfunction, there is no reason to categorically prohibit tablets if the organ is not functioning properly. All the doctor needs to do is compare the benefits/harms of treatment with Silhouette and keep “problem” patients under control.

There are several different schemes for using the Silhouette. In the early stages of endometriosis, women with this problem rarely consult a gynecologist. Suspicion of the presence of the disease may arise during a routine examination or if the patient visits an antenatal clinic, for example, due to problems with conception. Ultrasound cannot confirm the diagnosis. Therefore, the only way to obtain reliable data is laparoscopy.

The initial stage of endometrial growth is stopped by standard use of the drug. This regimen is called 21 7. 1 tablet should be taken daily at the same time. They do this until the blister is empty - 21 days. Afterwards you need to take a week break (during this period standard menstrual bleeding will occur).

If the disease cannot be overcome during this time, taking the drug according to this regimen is extended to six months. To confirm a positive result, a comprehensive examination is carried out at the end of the recommended course.

If a woman does not plan to become pregnant in the near future, then you can use others,

prolonged drug treatment regimens. They are administered both for therapeutic purposes, to eliminate more persistent foci of endometriosis, and to prevent recurrence of the disease after treatment.

surgical treatment. Then the medicine is taken for a long time without interruption. Thus, you can drink it according to the following schemes:

• 42 days in a row, 7 days break;
• 63 days in a row, 7 days break;
• 84 days in a row, 7 days break.

The start of use should coincide with the first day of the female cycle. You need to take the medicine without skipping, 1 tablet per day. During the week's break, your period begins. With a prolonged course, spotting may occur. Sometimes menstrual-like bleeding occurs. According to the extended regimen recommended by the gynecologist, the product is used for several years. There can be no talk of planning a pregnancy during this period.

The doctor prescribes the drug Silhouette for endometriosis to each woman individually. The standard dosage and treatment regimen are described in the annotation for the drug.

When prescribing therapy, the doctor takes into account:

• whether pregnancy is planned in the near future;
• stage of development of the pathology;
• woman's health status.

At the initial stage of adenomyosis, after consulting a gynecologist, a woman begins to take the drug on the first day of the cycle. For six months, Silhouette should be taken according to the following scheme: for 21 days you need to take one tablet at a time, and then take a break for 7 days. And repeat everything again: take the medicine for 3 weeks, then take a break for 7 days. This is the standard dosage regimen.

If a woman is not planning a pregnancy soon, then the following options for cyclic treatment with Silhouette are possible:

• 42 days of taking pills plus 7 days off. That is, as soon as the blister with 21 tablets is finished, which must be taken in order one after another, without taking a break, the next day proceed to the next blister;
• 63 days with a seven-day break;
• 84 days and a week off the medication.

Violation of the pattern can lead to heavy uncontrolled bleeding. If a woman forgets to take another pill, it must be taken within 12 hours. When more time has passed, then:

• In the first week of taking the drug, you need to take another pill, even if you need to take 2 at once, and then according to the schedule. And for the next week you need to protect yourself from unwanted pregnancy with a condom;
• in the second and subsequent weeks you need to take another pill as soon as possible. An additional method of contraception is not required in this case.

In the first week of taking oral contraceptives, a barrier method of protection against unwanted pregnancy is additionally required.