Juliet 35ED Tablets 28

  Information General Information Consumer Medicine InformationIntroductionThis leaflet answers some common questions about Juliet-35ED. The information and instructions it contains may be different to information for other oral contraceptives you may have taken in the past. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.All medicines have risks and benefits. Your doctor has weighed the risks of you taking Juliet-35ED against the benefits they expect it will have for you.If you have any concerns, or are unsure about taking this medicine, ask your doctor or pharmacist for more advice.Keep this leaflet with the medicine.You may need to read it again.What is Juliet-35ED?Juliet-35ED is a combined oral contraceptive, commonly known as a ‘birth control pill’ or ‘the Pill’.It is used for the treatment of signs of androgenisation in women, such as severe acne (involving inflammation of nodularity or risk of scarring) where prolonged oral antibiotics or local treatment alone has not been successful or idiopathic hirsutism of mild to moderate degree.Juliet-35ED will also prevent pregnancy.You may also experience the following benefits:More regular and shorter periods and a decrease in the amount of blood you lose each month.A decrease in anaemia (iron deficiency).A decrease in period pain.Some medical conditions such as pelvic inflammatory disease, ovarian cysts, ectopic pregnancy and disorders of the uterus (womb), ovaries and breast are less common in women using oral contraceptives.How Juliet-35ED worksWhen taken correctly, it prevents you from becoming pregnant in several ways:Inhibiting the egg release by stopping it maturing.Changing the cervical mucus consistency, making it more difficult for the sperm to reach the egg.Changing the lining of the uterus, making it less suitable for implantation.What Juliet-35ED looks likeJuliet-35ED comes in a box containing either 1 or 3 blister packs. Each blister pack contains 21 beige active tablets and 7 white inactive tablets. The blister pack is marked with days of the week next to each tablet.IngredientsEach beige active tablet contains 35 micrograms of ethinyloestradiol and 2 milligrams of cyproterone acetate (as the active ingredients). Each beige tablet also contains:LactoseMaize starchPovidoneMagnesium stearateSucroseMacrogol 6000Calcium carbonateTalc purifiedGlycerolTitanium dioxideIron oxide yellowGlycol MonanateWater purifiedEach white inactive tablet contains:LactoseMaize starchPovidoneMagnesium stearateSucroseMacrogol 6000Calcium carbonateTalc purifiedGlycerolWater purifiedGlycol montanateTitanium dioxideBefore you take Juliet-35EDConsult your doctorTell your doctor if you are planning to become pregnant or are breast-feeding.Tell your doctor ifyou have allergies to any other medicines, foods, preservatives or dyesyou smokeyou are overweightanyone in your immediate family has had blood clots in the legs (thrombosis), a heart attack, a stroke, breast cancer or high cholesterol.Tell your doctor if you have, or have haddiabeteshigh blood pressureheart valve disorders or certain heart rhythm disordersinflammation of your veins (superficial phlebitis)varicose veinsmigraineepilepsyAsk your doctor to check if you havehigh cholesterol or triglyceridesliver diseasegall bladder diseaseCrohn’s disease or ulcerative colitis (chronic inflammatory bowel disease)systemic lupus erythematosus (SLE - a disease affecting the skin all over the body)haemolytic uraemic syndrome (HUS - a disorder of blood coagulation causing failure of the kidneys)sickle cell diseasea condition that occurred for the first time, or worsened during pregnancy or previous use of sex hormones (e.g. hearing loss, a metabolic disease called porphyria, a skin disease called herpes gestationis, a neurological disease called Sydenham’s chorea)chloasma (yellowish-brown pigmentation patches on the skin, particularly of the face) - if so, avoid too much exposure to the sun or ultraviolet radiationhereditary angio-oedema - you should see your doctor immediately if you experience symptoms of angio-oedema, such as swollen face, tongue and/or pharynx and/or difficulty swallowing, or hives together with difficulty in breathing.If any of the above conditions appear for the first time, or recur or worsen while using Juliet-35ED, you should contact your doctor.When you must not take itDo not take Juliet-35ED if you have an allergy toany medicine containing ethinyloestradiol and/or cyproterone acetate.any of the ingredients listed at the start of this leaflet.Some of the symptoms of an allergic reaction may include:shortness of breathwheezing or difficulty in breathingswelling of the face, lips, tongue or other parts of the bodyrash, itching or hives on the skin.Do not take Juliet-35ED if you have or have had a blood clot inthe blood vessels of the legs (deep vein thrombosis)the lungs (pulmonary embolism)the heart (heart attack),the brain (stroke)other parts of the body.Do not take Juliet-35ED if you are concerned about an increased risk of blood clots. Blood clots are rare. Very occasionally blood clots may cause serious permanent disabilities, or may even be fatal.You are more at risk of having a blood clot when you take the Pill. But the risk when taking the Pill is less than the risk during pregnancy.Do not take Juliet-35ED if you are concerned about an increased risk of blood clots because of age or smoking. The risk of having a heart attack or stroke increases as you get older. It also increases if you smoke. You should stop smoking when using the Pill, especially if you are older than 35 years of age.Do not take Juliet-35ED if you have, or have hadangina pectoris or chest painsevere kidney insufficiency or an acute failure of your kidneymigraine, accompanied by visual symptoms, speech disability, or weakness or numbness in any part of your bodydiabetes mellitus with blood vessel damagepancreatitis (an inflammation of the pancreas) associated with high levels of fatty substances in your bloodjaundice (yellowing of the skin)severe liver diseasecancer that may grow under the influence of sex hormones (e.g. of the breast or the genital organs)benign or malignant liver tumourunexplained vaginal bleeding.Do not take this medicine if you are pregnant or think you might be pregnant.Do not take Juliet-35ED if you are breast feeding.Do not give this medicine to a child.Do not take this medicine after the expiry date printed on the pack, or if the packaging is torn or shows signs of tampering. If this medicine has expired or is damaged, return it to your pharmacist for disposal.If you are not sure whether you should start taking this medicine, talk to your doctor.Taking other medicinesTell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.Some medicines and Juliet-35ED may interfere with each other. These include:medicines used to treat tuberculosis such as rifampicin, rifabutinmedicines used to treat epilepsy such as phenytoin, primidone, barbiturates (e.g. phenobarbitone), carbamazepine, oxcarbazeipine, topiramate, felbamate, lamotriginemedicines used to treat HIV, such as ritonavir or nevirapineantibiotics (penicillin, ampicillin, erythromycin, tetracycline)medicines used to treat fungal infections, such as ketoconazole and griseofulvincyclosporin, an immunosuppressant medicineherbal medicines containing St John’s WortThese medicines may be affected by Juliet-35ED, or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.You may need to use additional barrier methods of contraception (such as condoms or a diaphragm) while you are taking any of these medicines and for some time after stopping them.Your doctor will be able to advise you about how long you will need to use additional contraceptive methods.Your doctor and pharmacist have more information on medicines that you need to be careful with or avoid while taking this medicine.How to take Juliet-35EDWhen to start taking Juliet-35EDIf you are starting Juliet-35ED after a natural cycle, and you have not used a hormonal contraceptive in the past month, start on the first day of your period, i.e. on the first day of your menstrual bleeding. Additional barrier contraceptive precautions (e.g. condom) must be used for the next 14 days.Your doctor will advise you when to start if youare taking Juliet-35ED after having a babyare breast-feeding - Juliet-35ED should not be usedhave had a miscarriage or an abortion.If you are switching to Juliet-35EDIf you are switching from a 28 day pack combined oral contraceptive, start taking Juliet-35ED on the day after taking the last active tablet in your previous Pill pack or immediately after finishing your last Pill (a withdrawal bleed may not occur until the end of the first pack of Juliet-35ED).Ask your doctor or pharmacist if you are not sure which the active tablets were in your previous Pill pack. Your previous Pill pack may have different colour tablets to those of Juliet-35ED.If you are switching from a progestogen-only Pill (minipill), stop taking the minipill on any day and start taking Juliet-35ED at the same time the next day. But make sure you also use additional barrier contraceptive precautions (e.g. condoms or a diaphragm) for the first 14 days of tablet-taking when having intercourse.If you are switching from an injectable or implant, start using Juliet-35ED when your next injection is due, or on the day that your implant is removed. Make sure you also use additional barrier contraceptive precautions (e.g. condoms or a diaphragm) for the first 14 days of tablet-taking when having intercourse.How to take Juliet-35EDTake your first tablet from the red area on the blister pack corresponding to the day of the week. Each blister pack is marked with the day of the week.Swallow the tablet whole with a glass of water. It does not matter if you take this medicine before or after food.You must take Juliet- 35ED every day at around the same time every day. You must take Juliet-35ED every day even if you do not have sex very often.Follow the direction of the arrows on the blister pack until all the tablets have been taken. If you do not understand the instructions on the blister pack, ask your doctor or pharmacist for help.Always start a new blister pack on the same day of the week as your previous pack.If you miss a tabletIf you miss a tablet and take the missing tablet within 12 hours of missing it, you will be protected against pregnancy. If you are more than 12 hours late follow these detailed instructions:For Juliet-35ED to be most effective, beige active tablets need to be taken uninterrupted for 7 days. If you have been taking the beige active tablets for 7 uninterrupted days and miss a beige active tablet, take the missed tablet as soon as you remember, then go back to taking your medicine as you would normally, even if this means taking two tablets in one day. You will be protected against pregnancy.The chance of pregnancy after missing a beige active tablet depends on when you missed the tablet. There is a higher risk of becoming pregnant if you miss a tablet at the beginning or end of a pack.If after taking your missed tablet you have less than 7 days of beige active tablets left in a row, you should finish the active tablets in your pack but skip the white inactive tablets Start taking the beige active tablets in your next pack corresponding to the correct day of the week. This is the best way to maintain contraceptive protection. However, you may not have a period until the end of the beige active tablets of the second pack. You may have spotting or breakthrough bleeding on tablet-taking days.If you have been taking the beige active tablets for less than 7 days and miss a beige active tablet, take the missed tablet as soon as you remember, then go back to taking your medicine as you would normally, even if this means taking two tablets in one day. In addition, you should also use additional barrier contraceptive precautions (e.g. condoms or a diaphragm) for the next 7 days. If you have had sexual intercourse during that time, there is a possibility of pregnancy and you may need emergency contraception.If you forget to take more than one beige active tablet, seek advice from your doctor or pharmacist about what to do.If you have had sexual intercourse in the week before missing your tablets, there is a possibility of becoming pregnant.If you vomit within 3-4 hours or have severe diarrhoea after taking a beige active tablet, the active ingredients may not have been completely absorbed. This is like missing a tablet. Follow the advice for missed tablets.If you forget to take a white inactive tablet, take it as soon as you remember and take the next tablet at the usual time.You are still protected against pregnancy because the white tablets do not contain any active ingredients.Ask your doctor or pharmacist to answer any questions you may have.(Please refer to diagram on last page of this leaflet for a Summary of advice if you missed a tablet more than 12 hours ago)If you take too much (overdose)If you think that you or anyone else may have taken too much Juliet-35ED, immediatelytelephone your doctor or the Poisons Information Centre (telephone 13 11 26 in Australia or 0800 poison or 0800 764 766 in New Zealand) for advice, orgo to the Emergency Department at your nearest hospital.Do this even if there are no signs of discomfort or poisoning. You may need medical attention.While you are using Juliet-35EDWhat you must doTell any doctors, dentists and pharmacists who treat you that you are taking this medicine.Have regular check ups with your doctor When you are using the Pill, your doctor will tell you to return for regular check ups, including getting a pap smear test. Your doctor will advise how often you need a pap smear test. A pap smear test can detect abnormal cells lining the cervix. Sometimes abnormal cells can progress to cancer.If you are about to start on any new medicine, remind your doctor and pharmacist that you are taking Juliet-35ED.If you are going to have surgery, tell the surgeon or anaesthetist beforehand that you are taking this medicine. The risk of having deep venous thrombosis is temporarily increased as a result of an operation or immobilization (for example, when you have your leg or legs in plaster or splints). In women who use the Pill, the risk may be yet higher. The excess risk of thrombosis is highest during the first year a woman uses a combined oral contraceptive. Your doctor may tell you to stop taking the Pill several weeks before surgery, or at the time of immobilization, and when you can start taking the Pill again. If you notice possible signs of a thrombosis, stop taking the Pill and consult your doctor immediately.Consult your doctor if you develop high blood pressure while using Juliet-35ED – you may be told to stop using it.If you become pregnant while taking this medicine, tell your doctor immediately.If you have unexpected bleeding and it continues, becomes heavy, or occurs again, tell you doctor. When using these tablets for the first few months, you can have irregular vaginal bleeding (spotting or breakthrough bleeding) between your periods. You may need to use sanitary protection, but continue to take your tablets as normal. Irregular vaginal bleeding usually stops once your body has adjusted to the Pill, usually after about 3 months.If you have missed a period, but you have taken all your tablets, it is very unlikely that you are pregnant.Continue to take Juliet 35ED as usual, if after taking the beige active tablets at the right time, (without using any other medicines), you have not vomited or had severe diarrhoea.If you miss your period twice in a row, you may be pregnant and you should seek advice from you doctor. Do not start the next pack of Juliet 35ED until your doctor has checked that you are not pregnant.Juliet-35ED will not protect you from HIV-AIDS or any other Sexually Transmitted Diseases (STDs), such as chlamydia, genital herpes, genital warts, gonorrhoea, hepatitis B, human papilloma virus and syphilis.To protect yourself from STDs, you will need to use additional barrier contraceptives (e.g. condoms).What you must not doDo not take Juliet-35ED to treat any other conditions, unless your doctor tells you to.Do not give your medicine to anyone else.Do not stop taking your medicine or change the dosage without checking with your doctor.You may become pregnant if you are not using any other contraceptive and you stop taking Juliet-35ED, or do not take a tablet every day.Side effectsTell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Juliet-35ED. This medicine helps most people, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.Do not be alarmed by the following lists of side effects. You may not experience any of them.Ask your doctor or pharmacist to answer any questions you may have.Tell your doctor or pharmacist if you feel unwell. Other side effects not listed on the following pages may also occur in some people.If you notice any of the following side effects and they worry you, tell your doctor or pharmacist:nauseastomach painchanges in weightheadache, including migrainesmood changes, including depressionbreast tenderness or pain.The above list includes the more common side effects of your medicine. These are usually mild and lessen with time.If you experience any of the following, tell your doctor immediately, or go to the Emergency Department at your nearest hospital:sharp chest painbreathlessness and/or difficultly breathingpainful swelling in your leg(s)weakness, numbness or bad ‘pins and needles’ of an arm or legsevere stomach painsa bad fainting attack or you collapseunusual headaches or migraines that are worse than usualsudden problems with your speech or eyesightjaundice (yellowing skin or yellowing eyes)you cough up bloodbreast lumpsunexplained vaginal bleeding.The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.Cancer and the PillBreast cancer has been diagnosed slightly more often in women who use the Pill than in women of the same age who do not use the Pill. This slight increase in the numbers of breast cancer diagnoses gradually disappears during the course of the 10 years after women stop using the Pill.It is not known whether the difference is caused by the Pill. It may be that these women were examined more often, so that the breast cancer was noticed earlier.In rare cases benign liver tumours and, even more rarely, malignant liver tumours have been reported in users of the Pill. These tumours may lead to internal bleeding. Contact your doctor immediately if you have severe pain in your abdomen.Cervical cancer has been reported to occur more often in women who have been using the Pill for a long time. This finding may not be caused by the Pill, but may be related to sexual behaviour and other factors.How to store Juliet 35EDStorageKeep your tablets in the blister pack until it is time to take them.Keep your tablets in a cool dry place where the temperature stays below 25°C.Do not store Juliet-35ED in the bathroom or near a sink. Do not leave this medicine on a window sill or in the car. Heat and dampness can destroy some medicines.Keep Juliet-35ED where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.Contact detailsBayer Australia LimitedABN 22 000 138 714875 Pacific HighwayPymbleNSW 2073Australian Registration NumberAUST R 75554Date of PreparationThis leaflet was prepared in January 2008.Missed a pill?See information at end of this leaflet®registered trademark of the Bayer group, GermanySummary of advice if you missed a pill more than 12 hours agoSummary of advice if you missed a tablet more than 12 hours ago.Before missing your tablet, did you take beige active tablets for the previous 7 days?NoDid you have sex in the 7 days before missing the tablet?→NoTake the tablet missed AND use extra barrier precaution for 7 days YesSee your Doctor or Pharmacist for adviceYesDoes your pack still have 7 active beige tablets in a row to follow?→NoTake the tablet you missed AND complete taking the beige active tablets. Skip the white inactive tablets. Start your next pack with beige active tablets. YesTake the tablet you missed AND complete the pack as normal Miscellaneous Drug Interactions Warnings Common Uses Ingredients Directions Indications