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The eMC  

Last Updated 20 Nov 2013

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Marvelon tablets

Marvelon (Mar-vel-on) is a medicine which is used in contraception. Marvelon contains desogestrel/ethinylestradiol. It is supplied by Merck Sharp & Dohme Limited.

The information in this Medicine Guide for Marvelon varies according to the condition being treated and the particular preparation used.

Marvelon tablets

Information specific to Marvelon tablets when used in contraception

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Your medicine

Marvelon contains two hormones that are similar to the hormones oestrogen and progesterone that are produced by the body. Marvelon is used to prevent women from becoming pregnant. It works by preventing the release of eggs from the ovary. It may also change the lining of the uterus which makes it difficult for an egg to develop and also increase the thickness of vaginal fluid which can stop a sperm from reaching an egg.

Marvelon may increase the chances of developing blood clots or cancers such as breast cancer or cervical cancer. However, it may provide some protection against ovarian and endometrial cancer. You and your prescriber will need to weigh up the benefits and risks of taking Marvelon before you start to take it.

Hormonal contraceptives will only prevent a pregnancy if they are taken regularly. It is important you take this medicine at the same time each day. If you want immediate contraceptive cover then start to take Marvelon on the first day of your menstrual period. If you do not start taking Marvelon on the first day of your menstrual period you will need to take extra contraceptive precautions for at least seven days until Marvelon starts to work. For more information about starting Marvelon and if you need to take extra contraceptive precautions ask your prescriber, family planning nurse or read the patient information leaflet that comes with your medicine.

Once you have started to take Marvelon, you should take it once a day for 21 days. After this you should not take any more tablets for the next seven days. Start a new strip of Marvelon immediately after the seven day tablet-free break. During this break you will usually have a withdrawal bleed. If you do not have a withdrawal bleed during the tablet-free break and you have taken all your pills properly, you are very unlikely to be pregnant. But, if you miss two withdrawal bleeds in a row you should immediately contact your prescriber or family planning nurse. This is because there is a possibility that you could be pregnant and you must not take Marvelon during pregnancy.

In certain situations the effectiveness of Marvelon may be reduced and you will need to take extra contraceptive precautions. These situations include: missing a dose by more than 12 hours; taking other medicines that interact with Marvelon; having diarrhoea, vomiting or an upset stomach or any medical condition which interferes with the absorption of your medicine. If any of these situations occur during the last seven days of your strip you should not have a tablet-free break between strips of tablets. Start taking the next strip of tablets without a break.

As there is no gap between strips you will not have a withdrawal bleed at the end of the first strip. But you may have some menstrual bleeding while you are taking the second strip and you should have a withdrawal bleed once you finish the second strip. For more information about situations when the effectiveness of Marvelon may be reduced and when to take additional contraceptive precautions ask your prescriber, family planning nurse or read the patient information leaflet that comes with your medicine.

Marvelon does not provide protection against HIV or other sexually transmitted diseases. If you are at risk of HIV or other sexually transmitted diseases, you and your partner should use a condom during sexual activity.

Other information about Marvelon:

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should take. It also tells you how often you should take your medicine. This is the dose that you and your prescriber have agreed you should take. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

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When to take your medicine

Some medicines work best if they are taken at a specific time of day. Getting the most from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines. Make sure you follow any specific instructions given to you by your prescriber or that are in the Patient Information Leaflet that comes with this medicine.

In the case of Marvelon:

  • this medicine should be taken at the same time each day
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How to take your medicine

Some medicines have specific instructions about how to take them. This is because they work better when taken correctly. These instructions can include getting the right dose and special instructions for preparing the medicine.

In the case of Marvelon:

If you are having problems taking this medicine, you should talk to your prescriber or pharmacist. They may be able to give you advice on other ways to take your medicine or other medicines that are easier for you to take.

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Taking too much of your medicine

Taking extra doses of some medicines can be harmful. In some cases even one extra dose can cause you problems. If you take extra doses of your medicine, you must get medical advice immediately. You may need a test to assess the effect of taking extra doses. This is because the effects of taking too much medicine are very complex so it is very important that you seek medical advice.

Contact your prescriber, pharmacist, specialist clinic or call 111 for advice.

Make sure you take all of your medicine containers with you if you are advised to go to hospital.

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Stopping your medicine

If you are not having any problems with this medicine, do not stop taking it unless you no longer need this form of contraception or you are advised to stop taking it by your prescriber.

If you are in any doubt, contact your prescriber, pharmacist, specialist clinic or call 111.

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Looking after your medicine

The instructions on how you should keep your medicine are on the pharmacy label. You should keep your medicine in the original container. This will help to keep your medicine in the best condition and also allow you to check the instructions. Do not take the medicine if the packaging appears to have been tampered with or if the medicine shows any signs of damage. Make sure that the medicine is out of the sight and reach of children.

In the case of Marvelon:

  • do not store in temperatures above 25°C
  • store blisters in the pouches it came in

You must not take the medicine after the expiry date shown on the packaging. If you have any unused medicine, return it to your pharmacist who will dispose of it safely.

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Whether this medicine is suitable for you

Marvelon is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to determine whether or not the medicine is suitable and whether it must be prescribed with extra care
  • to check that this medicine is not having any undesired effects

Over time it is possible that Marvelon can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Marvelon has become unsuitable, it is important that the prescriber is contacted immediately.

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Side-effects

A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks.

Once a medicine has been licensed, information on the medicine's effects, both intended and unintended, is continuously recorded and updated.

Some side-effects may be serious while others may only be a mild inconvenience.

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

Common: More than 1 in 100 people who take Marvelon:

  • breast pain or tenderness
  • changes in libido
  • changes in vaginal discharge
  • changes to weight
  • depressed mood
  • discharge from the breast
  • fluid retention
  • headaches - you or your carer must seek immediate medical advice if you have any of these symptoms: an unusually bad headache, if your headaches become worse, double vision or sudden changes to your eyesight, speech problems, aphasia , vertigo, collapse or have a seizure, weakness, sudden numbness on one side of your body, motor problems or stomach pain
  • intolerance to contact lenses
  • irregular vaginal bleeding
  • migraine - seek immediate medical advice if you get a migraine-type headache for the first time or if your migraine headaches become worse
  • nausea
  • raised blood pressure
  • skin problems
  • skin rash or rashes
  • vomiting - if you vomit within three to four hours of taking Marvelon you may need to take extra contraceptive precautions. For more information speak to your prescriber, family planning nurse or read the patient information leaflet that comes with this medicine

Rare: More than 1 in 10,000 people who take Marvelon:

  • certain types of autoimmune skin problems
  • chloasma - if you are prone to developing chloasma you should not expose your skin to sunlight or to ultraviolet radiation
  • chorea
  • Crohn's disease
  • decreased glucose tolerance
  • gallstones
  • hypersensitivity reactions
  • liver problems such as liver tumours or jaundice - seek immediate medical advice if you develop jaundice or have stomach pain
  • lupus or lupus-like problem
  • oestrogen sensitive cancers such as breast cancer or cervical cancer
  • otosclerosis-related hearing loss
  • pancreatitis
  • porphyria or porphyria-like reaction
  • thromboembolic problems such as heart attacks, strokes, deep vein thromboses or pulmonary embolisms - some of these may be fatal. Seek immediate medical advice if you suddenly develop breathing difficulties, have sudden chest pain which may spread to the left arm, painful or swollen legs or coughing
  • ulcerative colitis

The frequency of these side-effects is unknown:

  • diarrhoea - if you have diarrhoea after taking Marvelon, you may need to take extra contraceptive precautions. For more information speak to your prescriber, family planning nurse or read the patient information leaflet that comes with this medicine
  • may affect the results for certain tests
  • menstrual problems including bleeding or spotting in between menstrual periods. You must immediately contact your prescriber or family planning nurse if you do not have two withdrawal bleeds in a row or if you suddenly have bleeding or spotting after taking Marvelon for some time
  • some conditions may occur for the first time or get worse during treatment with Marvelon. If this happens to you, seek immediate medical advice. Examples include: gallstones, systemic lupus erythematosus, diabetes, depression, angioedema, heart or kidney problems

If you feel unwell or if you have concerns about a side-effect, you will need to seek advice. If you feel very ill, get medical help straight away. Contact your prescriber, pharmacist, nurse or call 111.

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Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Marvelon:

The following types of medicine may interact with Marvelon:

If you are taking Marvelon and one of the above medicines or types of medicines, make sure your prescriber knows about it.

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Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins.

Make sure you tell your prescriber the names of all the complementary preparations and vitamins that you are taking or are planning to take.

Your prescriber can then decide whether it is appropriate for you to take combinations that are known to interact.

In the case of Marvelon:

If you have been prescribed Marvelon you should only take something on the above list on the specific advice of your prescriber or pharmacist.

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Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

Like all medicines Marvelon can cause side effects. You should see how this medicine affects you and then judge if you are safe to drive or operate machinery. If you are in any doubt, talk to your prescriber.

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Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Marvelon:

  • there are no specific foods that you must exclude from your diet when taking Marvelon
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Alcohol

Alcohol can interact with certain medicines.

In the case of Marvelon:

  • there are no known interactions between alcohol and Marvelon
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Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Marvelon:

  • do not take this medicine during pregnancy
  • your prescriber will only start your treatment with Marvelon once they are certain that you are not pregnant. For more information talk to your prescriber

It is very important that you seek urgent medical advice if you become pregnant or think you have become pregnant while taking this medicine.

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Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Marvelon:

  • taking this medicine is not recommended while breast-feeding

Before you have your baby you should discuss breast-feeding with your doctor or midwife. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed.

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Ingredients of your medicine

Medicines contain active ingredients. They may also contain other, additional ingredients that help ensure the stability, safety and effectiveness of the medicine. They are also added to improve the medicine's taste and appearance and to make it easier to take. Some may be used to prolong the life of the medicine.

You should check that you are able to take the ingredients in your medicine, especially if you have any allergies.

Marvelon contains:

If you are not able to take any of the ingredients in your medicine, talk to your prescriber or pharmacist to see if they can suggest an alternative medicine. If you have reacted badly to Marvelon before, do not take Marvelon. Talk to your prescriber, pharmacist or nurse as soon as possible.

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Marvelon, Version 6, last updated 20 Nov 2013