Buy Jess Plus film-coated tablets No. 28 in pharmacies

Jess (Jazz)

Tablets based on estradiol. One tablet contains 20 mcg ethinyl estradiol and 3 mcg drospirenone. One package of the drug contains 28 tablets, of which 24 tablets are active, and 4 are placebo (neutral drug without drug effects). Active tablets are round, biconvex, light pink in appearance. On one side of the tablet, “DS” is engraved in a regular hexagon. The placebo tablets are white and have “DP” engraved on them.

The contraceptive effect is ensured by a complex of factors, among which the most significant is the suppression of ovulation. Also, as a result of Jess’s action, the cervical mucus changes, which loses its ability to pass sperm.

Positive side effects of taking Jess:

• regularity of the menstrual cycle;
• reducing the intensity of bleeding, reducing pain;
• reducing the risk of iron deficiency anemia;
• reducing the risk of developing endometrial and ovarian cancer;
• antiandrogenic effect, which is expressed in reducing the appearance of acne (blackheads), reducing the level of oily skin and hair.

Drospirenone, a synthetic analogue of progesterone, plays a very important role. It neutralizes the possible negative effects of estrogens and is similar in its biochemical and pharmacological profile to natural progesterone. For example, drospirenone counteracts weight gain, fluid retention in the body and the occurrence of edema; it also reduces the symptoms of PMS (premenstrual syndrome). The combination of ethinyl estradiol and drospirenone ensures very good tolerability of the drug.

Indications for prescribing Jess are:

• the need for a contraceptive with antimineralocorticoid and antiandrogenic effects;
• moderate manifestation of acne, increased oiliness of the skin of the face and scalp;
• treatment of severe premenstrual syndrome (PMS).

Contraindications:

• thrombosis (venous and arterial) and thromboembolism - if they are currently diagnosed or have occurred in history), as well as conditions that precede thrombosis (ischemic attacks, angina pectoris);
• migraine;
• diabetes mellitus with vascular complications;
• disorders of the cardiovascular system: lesions of the valvular apparatus of the heart, heart rhythm disturbances, diseases of the cerebral vessels or coronary arteries, hypertension;
• pancreatitis;
• liver failure and severe liver disease;
• benign or malignant neoplasms in the liver;
• renal failure;
• hormone-dependent malignant diseases or suspicion of them;
• vaginal bleeding of unknown origin.

Relative contraindications, which must be considered individually and taken into account when prescribing a contraceptive, are:

• smoking;
• thrombosis;
• myocardial infarction;
• diseases associated with cerebrovascular accidents that were observed in one of the closest relatives at a young age;
• obesity;
• high blood pressure (hypertension);
• migraine;
• heart valve diseases, heart rhythm disturbances;
• prolonged immobility, for example due to injury;
• upcoming surgery,
• diabetes.

During pregnancy and lactation, Jess should not be taken. If pregnancy is detected while taking a contraceptive, the drug should be stopped. However, it must be emphasized that large-scale clinical studies have not found any negative effects on the fetus in cases where sex hormones were taken through carelessness or due to ignorance about pregnancy in the early stages. Therefore, if such a situation arises, there is no need to panic - it is enough to simply cancel oral contraception and continue to monitor the pregnancy as usual.

Side effects of Jess may be as follows:

• periodic bleeding between menstruation (often observed in the first 2-3 months of use);
• development of thrombosis and thromboembolism.

Reception scheme

The tablets are taken sequentially, in the order indicated on the package, for 28 days, one tablet per day. Each subsequent package should be started the day after taking the last tablet from the previous package. Menstrual-like bleeding usually begins 2–3 days after starting placebo tablets and may not stop by the time you start taking the next pack of tablets.

Start of reception:

• If you have not taken any hormonal contraceptives in the previous month, the first Jess tablet is taken on the first day of the menstrual cycle, that is, on the first day of menstrual bleeding. It is possible to start taking it on days 2–5 of the menstrual cycle, but in this case it is recommended to additionally use barrier non-hormonal contraceptives for a week.
• When switching from other combined oral contraceptives, it is recommended to start taking Jess the next day after taking the last active tablet from the previous package. You can take a break between drugs, but it should not be more than seven days - for drugs whose packaging contains 21 tablets. If the drug contains 28 tablets, then you need to take the first Jess tablet the next day after taking the last inactive tablet of the previous drug.
• When switching from a vaginal ring or contraceptive patch, it is recommended to start taking Jess on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.
• The transition from the mini-pill to Jess can be done any day, without interruption.
• The transition to Jess from an implant or intrauterine contraceptive (Mirena) with gestagen is carried out on the day of its removal.
• The transition to Jess from an injectable contraceptive is carried out on the day when the next injection is due. Note! In cases of switching from a mini-pill, intrauterine contraceptive, implant, or injectable contraceptive within a week, it is necessary to additionally use a barrier method of contraception.

After an abortion in the first trimester of pregnancy, you can start taking Jess immediately. There is no need for additional non-hormonal methods of contraception in this case.

After an abortion performed in the second trimester of pregnancy, it is recommended to start taking Jess on days 21–28. If reception is started later, it is necessary to additionally use a barrier method of contraception for a week. Also, if you start taking the drug later, you must make sure that the woman is not pregnant. This is done using ultrasound. If it is not possible to do an ultrasound, it is better to wait until your first menstruation.

After childbirth, you should proceed in the same way as after an abortion performed in the second trimester.

If you forget to take an inactive pill, you can ignore this omission. But the missed inactive tablet must be thrown away so as not to accidentally extend the period of taking tablets from one package.

If you forget to take an active pill, your further actions depend on how many hours you are late and in what period this happened.

If the gap in taking the drug is less than 12 hours, the contraceptive effect is not reduced. It is necessary to take the missed pill as soon as possible and continue to take pills based on your usual schedule.

If the missed period is more than 12 hours, the contraceptive effect may be reduced. The more pills you skip, and the closer the missed pills are to the placebo phase, the higher the chance of pregnancy.

In such a situation, you must always remember two fundamental rules:

1. Taking Jess should not be interrupted for more than 4 days.
2. The contraceptive effect is achieved after 7 days of continuous pill taking.

If the delay in taking active tablets is more than 12 hours (that is, more than 36 hours have passed since the last active tablet was taken), then depending on the period of the cycle, the following actions can be recommended:

From 1st to 7th day

Take the missed tablet immediately, even if this means taking two tablets at the same time. Then continue taking Jess according to your usual schedule. During the week it is necessary to additionally use a barrier method of contraception. If you had sexual intercourse within seven days before missing the pill, there is a possibility of pregnancy.

From 8th to 14th day

Take the missed tablet immediately, even if this means taking two tablets at the same time. Then continue taking Jess according to your usual schedule. If during the 7 days preceding the first missed pill, the dosage schedule was strictly followed, then there is no need to use additional contraceptive measures. Otherwise, as well as if two or more tablets are missed, the contraceptive effect is reduced. Therefore, it is recommended to use barrier methods of contraception for a week.

From the 15th to the 24th day

The contraceptive effect decreases as the period of taking inactive pills approaches. If during the week before missing the pill the dosage schedule was strictly followed, then you can follow one of the following regimens. There is no need for additional contraceptive measures. If the dosage schedule was violated, then it is necessary to use the first regimen and, in addition to this, barrier contraceptives for a week.

Possible dosage regimens.

1. Take the last missed tablet as soon as possible, even if this means taking two tablets at the same time. Next, Jess is taken according to the usual schedule - until the active tablets in the package run out. The four inactive tablets should be ignored and immediately proceed to the tablets in the next pack. In this case, menstrual-like bleeding is unlikely until the active tablets in the second package run out. But there may be spotting and breakthrough bleeding while taking the pills.
2. Stop taking pills from the current package and take a break for no more than four days, including days you missed pills. Next, you begin taking the drug from the new package. If bleeding does not occur during the break, pregnancy must be ruled out.

In cases where gastrointestinal disorders occur, absorption of the drug may be incomplete - therefore, additional contraceptive measures should be taken. If vomiting occurs within 4 hours after taking an active tablet, you should follow the recommendations for skipping tablets.

Jess

Use during pregnancy and breastfeeding

Jess® is not prescribed during pregnancy and breastfeeding.
If pregnancy is detected while taking Jess®, the drug should be discontinued immediately. However, extensive epidemiological studies have not shown any increased risk of developmental defects in children born to women who received sex steroids (including combined oral contraceptives) before pregnancy, or teratogenic effects when sex steroids were taken inadvertently in early pregnancy.

Existing data on the results of taking the drug Jess® during pregnancy are limited, which does not allow us to draw any conclusions about the effect of the drug on the course of pregnancy, the health of the newborn and the fetus. There are currently no significant epidemiological data on the drug Jess®.

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, so their use is not recommended until you stop breastfeeding. Small amounts of sex steroids and/or their metabolites may be excreted in breast milk.

Use for liver dysfunction

The drug is contraindicated in:

• liver failure and severe liver disease (until liver tests return to normal);
• liver tumors (benign or malignant) currently or in history.

Use for renal impairment

The drug is contraindicated in severe renal failure, acute renal failure.

special instructions

If any of the conditions/risk factors listed below currently exist, the potential risks and expected benefits of combined oral contraceptives should be carefully weighed on an individual basis and discussed with the woman before she decides to start taking the drug. If any of these conditions or risk factors worsen, intensify, or appear for the first time, a woman should consult her doctor, who may decide whether to discontinue the drug.

Diseases of the cardiovascular system

The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disease) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients suggest that this increased risk is predominantly present during the first 3 months.

The overall risk of VTE in patients taking low-dose combined oral contraceptives (<50 mcg ethinyl estradiol) is 2-3 times higher than in non-pregnant patients not taking combined oral contraceptives, however, this risk remains lower than the risk VTE during pregnancy and childbirth. VTE can be life-threatening or fatal (in 1-2% of cases).

VTE, manifested as deep vein thrombosis or pulmonary embolism, can occur with the use of any combined oral contraceptives.

It is extremely rare that when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing or walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.

Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, incl. with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; sense of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may be misinterpreted as symptoms of other more or less severe events (eg, respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. Symptoms of a stroke: sudden weakness or loss of sensation in the face, arm or leg, especially on one side of the body, sudden confusion, problems with speech and comprehension; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the extremities, acute abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or behind the breastbone; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be life-threatening or fatal.

The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases:

• with age;
• in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years of age);
• for obesity (BMI more than 30 kg/m2);
• if there is a family history (for example, venous or arterial thromboembolism ever occurred in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
• with prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of planned surgery, at least four weeks before it) and not resume use for two weeks after the end of immobilization;
• with dyslipoproteinemia;
• with arterial hypertension;
• for migraines;
• for diseases of the heart valves;
• with atrial fibrillation.

The possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial. The increased risk of thromboembolism in the postpartum period should be taken into account.

Peripheral circulatory disorders may also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis) and sickle cell anemia.

An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (<50 mcg ethinyl estradiol).

Tumors

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. The connection with the use of combined oral contraceptives has not been proven. Controversy remains regarding the extent to which these findings are related to screening for cervical pathology or to sexual behavior (lower use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies found that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking combined oral contraceptives (relative risk 1.24). The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. The observed increased risk may be due to earlier diagnosis of breast cancer in women using combined oral contraceptives, the biological effects of oral contraceptives, or a combination of both factors. Women who have used combined oral contraceptives have clinically less severe breast cancer than women who have never used them.

In rare cases, during the use of combined oral contraceptives, the development of benign, and in extremely rare cases, malignant liver tumors, which in some cases led to life-threatening intra-abdominal bleeding, was observed. If severe abdominal pain, liver enlargement, or signs of intra-abdominal bleeding occur, this should be taken into account when making a differential diagnosis.

Tumors can be life-threatening or fatal.

Other states

Clinical studies have shown no effect of drospirenone on serum potassium concentrations in patients with mild to moderate renal failure. There is a theoretical risk of developing hyperkalemia in patients with impaired renal function with an initial potassium concentration at ULN who are simultaneously taking medications that lead to potassium retention in the body. However, in women at increased risk of developing hyperkalemia, it is recommended that plasma potassium concentrations be determined during the first cycle of taking Jess®.

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.

Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant increases have rarely been reported. However, if a persistent, clinically significant increase in blood pressure develops while taking combined oral contraceptives, these drugs should be discontinued and treatment of arterial hypertension should be initiated. Taking combined oral contraceptives can be continued if normal blood pressure values ​​are achieved with antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their relationship with taking combined oral contraceptives has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described during the use of combined oral contraceptives.

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.

Acute or chronic liver dysfunction may require discontinuation of combined oral contraceptives until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives.

Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (<50 mcg ethinyl estradiol). However, women with diabetes should be closely monitored while taking combined oral contraceptives.

Chloasma can sometimes develop, especially in women with a history of pregnancy chloasma. Women prone to chloasma should avoid prolonged exposure to the sun and ultraviolet radiation while taking combined oral contraceptives.

Laboratory tests

Taking combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma transport protein levels, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond normal values.

Drospirenone increases plasma renin and aldosterone activity, which is associated with its antimineralocorticoid effect.

Medical examinations

Before starting or resuming the use of the drug Jess®, it is necessary to familiarize yourself with the woman’s life history, family history, conduct a thorough general medical examination (including measuring blood pressure, heart rate, determining BMI) and gynecological examination (including examination of the mammary glands and cytological examination of cervical mucus), and exclude pregnancy. The scope of additional studies and the frequency of follow-up examinations are determined individually. Typically, follow-up examinations should be carried out at least once a year.

The woman should be warned that combined oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Reduced efficiency

The effectiveness of combined oral contraceptives may be reduced if active tablets (light pink) are missed, vomiting and diarrhea occur, or due to drug interactions.

Poor control of the menstrual cycle

While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular bleeding should be assessed only after an adaptation period of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, careful evaluation should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding during a break from taking the active tablets (light pink). If combined oral contraceptives are taken as directed, the woman is unlikely to be pregnant. However, if combined oral contraceptives have not been taken regularly before or if there are no consecutive withdrawal bleeds, pregnancy should be ruled out before continuing to take the drug.

Impact on the ability to drive vehicles and operate machinery

Not found.