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Drug Details

SCHERING PC4

• Drug Class Description
  Oestrogens / progestogens.
• Generic Name
  Ethinylestradiol [ethinyloestradiol], levonorgestrel
• Presentation
  Tablets, ethinylestradiol 50 microgram s, levonorgestrel 0.25 mg (as norgestrel 0.5 mg ).
• Description
  White s-c tablets.
• Indications
  Postcoital contraception within 72 hours of unprotected intercourse as an occasional emergency measure.
• Adult Dosage
  

  2 tablets taken as soon as possible after intercourse (up to a maximum of 72 hours); take 2 more tablets 12 hours after first dose. If vomiting occurs within 2 hours of either dose, take 2 more tablets.

• Contra Indications
  

  Overdue menstrual bleeding. Unprotected intercourse more than 72 hours previously in current menstrual cycle. Pregnancy.

  Thrombotic disorders and a history of these conditions; sickle cell anaemia; disorders of lipid metabolism; acute or severe chronic liver diseases; Dubin- Johnson syndrome; Rotor syndrome; previous or existing liver tumours; history during pregnancy of idiopathic jaundice or severe pruritus; history of herpes gestationis; mammary or endometrial carcinoma or a history of these conditions; abnormal vaginal bleeding of unknown cause; deterioration of otosclerosis during pregnancy; severe diabetes with vascular changes; hypersensitivity to any of the components of PC4.

• Special Precautions
  

  Only suitable as an occasional emergency measure. Repeated use of PC4 within a monthly cycle is to be avoided. Not effective if started later than 72 hours after coitus. Patients who still become pregnant should be monitored for ectopic pregnancy. General opininion, based on statistical evidence that users of combined oral contraceptives experience, more often than non- users, venous thromboembolism, arterial thrombosis, including cerebral and myocardial infarction, and subarachnoid haemorrhage.

  Full recovery from such disorders does not always occur and it should be realised that in a few cases they are fatal. Certain factors may increase risk of thrombosis, eg, smoking, obesity, varicose veins, cardiovascular diseases, diabetes and migraine.

  The suitability of Schering PC4 should be judged according to the severity of such case, and should be discussed with the patient before she decides to take it. Risk of arterial thrombosis increases with age - use of PC4 in the older age group, particularly those who are smokers, should be discouraged. Family history of thromboembolic disease at a young age (eg, DVT, heart attack or stroke).

• Interactions
  

  Rifampicin, tetracyclines, ampicillin, griseofulvin, barbiturates, phenytoin, primidone, carbamazepine, ethosuximide, chloral hydrate, dichloralphenazone, glutethimide.

• Adverse Drug Reactions
  Vomiting (impairs efficacy), nausea. Disturbed pattern of menstrual bleeding. Breast discomfort. Headaches.