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Combined Hormonal Contraceptives (21-day regimen)

Drug Class: Commonly Known As: Category:
Oral Contraceptives Mercilon, Microgynon, Yasmin, Liza, Belara Adult

Combined Hormonal Contraceptives (21-day regimen) - Side Effects, Precautions, and Contraindications

What side effects can Combined Hormonal Contraceptives (21-day regimen) cause?

​Common side effects include:

  • Spotting or bleeding may occur between your periods during the first few months of taking oral contraceptives. However, if this continues after the third month, check with your doctor.
  • Nausea, vomiting, bloating and stomach cramps
    • Take the medication after food to reduce these side effects 
  • Breast tenderness 
  • Headache or migraine
    • You may take painkillers such as Paracetamol to manage headaches
  • Unable to tolerate contact lenses
  • Weight changes, mood swings
    • Take medication at the same time every day to avoid huge changes in the hormone levels in your body
  • Pigmentation of the skin
    • Apply sunblock when you are outdoors and avoid long hours of sun exposure

Inform your doctor if the side effects above become severe and bother you.

Using a combined hormonal medication increases a woman’s risk of developing blood clots compared to a woman not taking any combined hormonal contraception. The risk of developing blood clot in a vein is highest during the first year a woman uses the medication. Other risk factors of developing blood clots include smoking and obesity. However, the formation of blood clot is rare and the doctor would have considered the risks against the benefits before making the recommendation.

The symptoms of blood clot may include one or more of the following:

  • Any unusual sudden cough, breathlessness or difficulty in breathing
  • Severe pain in the chest which may reach the left arm
  • Severe pain in legs or swelling in either of your legs
  • Weakness or numbness in any part of your body
  • Change in your speech, including slurring of words
  • Change in your senses of hearing, smell or taste
  • Vision changes such as loss of vision or blurred vision

Other rare but serious effects that you may or may not experience:

  • Unusual, severe or long lasting headache or worsening of migraine
  • Dizziness or fainting
  • Severe pain in your abdomen
  • Dark urine or light coloured stools
  • Nausea and vomiting
  • Loss of appetite
  • Yellowing of eyes or skin

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Combined Hormonal Contraceptives (21-day regimen), what precautions must I follow?

​Inform your healthcare professional if:

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding
  • You are taking any other medications, including supplements, traditional medications and herbal remedies
  • You have a history of or current medical conditions such as liver problems, stroke, clotting disorders, heart diseases, migraine headaches, epilepsy (fits), diabetes or cancer
  • You are a smoker

What food or medicine must I avoid when I take Combined Hormonal Contraceptives (21-day regimen)?

​Some medications including antibiotics and antifungals may affect how the medication works or be affected by the medication.  Please inform your other healthcare professionals about this medication which you are taking if you are seeing them for other medical conditions. 

Combined Hormonal Contraceptives (21-day regimen) - Additional Information

  • Updated on Sunday, January 31, 2021
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup

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