Cilest

What is Cilest?

Cilest is a type of combined contraceptive pill containing synthetic versions of the hormones oestrogen and progesterone. It is primarily used to prevent pregnancy, but in some cases, Cilest can also be used to delay periods and to reduce period pain. 

How does Cilest work?

Cilest is contraceptive pill for women which prevents unwanted pregnancies by releasing synthetic versions of the hormones oestrogen and progesterone into the womb. This prevents ovulation, thins the lining of the womb and creates a thicker mucus around the entrance to the womb to make it difficult for sperm to get through to fertilise an egg.

How effective is Cilest?

If taken correctly, Cilest is more than 99% effective at preventing pregnancy. Factors which affect it are forgetting to take it, stomach upsets and certain medications like antibiotics. 

When does Cilest start to work?

If you start Cilest on day 1-5 of your period it will start to work right away. If you wish, you can start it at any time during your cycle but you will have to use condoms for the first seven days if you take it outside of this time period.

Active Ingredients

The active ingredients in Cilest are the hormones norgestimate and ethinylestradiol. These are synthetic versions of the hormones estrogen and progestogen.

Inactive Ingredients

The inactive ingredients are lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, carnauba wax, polyethylene glycol, polysorbate 80, purified water, titanium dioxide and a dye called FD&C Blue No 2 Aluminium Lake (E132).

What should I do if I missed a pill?

If you have only missed one pill, or started your pack one day late, then just take your missed pill as soon as you remember. This won’t affect your protection and you can continue the rest of your pack as usual without needing additional contraception. If you miss more than one pill then you are at risk of pregnancy. Take the most recent missed pill as soon as you can and use condoms, or another form of contraception, for the next seven days. If you have had unprotected sex during this time you may need to seek out emergency contraception.

What should I do if I took a pill late?

As long as you take your pill within 24 hours of your scheduled time then you don’t need to do anything. Only the progesterone-only pill (or mini pill) is affected by taking it late.

How to take Cilest

You should take Cilest everyday for 21 days. The days of the week are marked on the pack to help you to remember to take it. When you reach the end of your pack do not begin the next one for another seven days. You should take it at the same time each day.

How to start taking Cilest

You should start taking Cilest at the beginning of your period, up to the fifth day. This means you will be protected right away. 

Contraindications

Cilest is not suitable for everyone. You may not be able to take it if: 

• You have high blood pressure, a history of blood clots or a family history of blood clots 
• You have had a heart attack or stroke in the past
• You have angina
• You have severe diabetes 
• You suffer from migraines with aura
• You have breast cancer 
• You have liver cancer
• You have a severe liver disease
• You are allergic to any of the ingredients in Cilest  

Cilest Side Effects

Women taking the pill are at an increased risk of developing a blood clot. Usually a doctor will measure your blood pressure and assess your medical history to make sure the pill is suitable for you first. It can also increase your risk of breast cancer. If you are worried about these side effects see your doctor. 

Common side effects when taking Cilest are:

• Headaches 
• Nausea 
• Breakthrough bleeding and spotting 
• Migraines 
• Mood changes
• Insomnia 
• Swollen hands, feet or ankles 
• Bloating 
• Acne 
• Breast pain
• Vaginal discharge
• Thrush 
• Lack of sex drive

Side effects usually disappear after the first few months. If they persist then you may want to discuss this with your doctor who can try you on a different type of contraceptive pill.  

Drug Interactions

There are certain medicines which interfere with the way Cilest works. These are:

• Some types of epilepsy medicines 
• Bosentan 
• Rifampicin and Rifabutin
• HIV medication 
• Boceprevir and Telaprevir for Hepatitis C
• Aprepitant and Fosaprepitant to prevent sickness
• Griseofulvin
• Modafinil
• Barbiturates
• St. John’s Wort
• Metoclopramide
• Charcoal
• Colesevelam
• Etoricoxib  

Cilest and Alcohol

Alcohol does not affect Cilest. 

Can you use Cilest for period delay?

You can use Cilest to delay your period by running two packs back to back. The combined pill is usually taken every day for 21 days and then you have a seven day break before starting the next pack. This is when you have your period. To delay your period, skip the seven day break. It is best to let your doctor know if you intend to do this. 

Cilest for non-contraceptive purposes

The combined pill has other benefits. These include making your periods lighter, less painful and more manageable. It can also be prescribed to treat acne and PMS. 

Switching Contraceptive Pill

If you are switching from another hormonal contraceptive, then you can start using Cilest right away and you’ll be protected against pregnancy. Your doctor or pharmacist will be able to give you advice specific to your situation. In some cases, you may need to use condoms until you have your first period while taking Cilest. 

Alternatives to Cilest

There are several different brands of the combined pill available such as Ovranette, Microgynon and Rigevidon. There are also different varieties of the mini pill. Other methods of hormonal contraception are available such as the IUS, implant, injection and patch. 

Cilest vs the mini pill

Cilest differs from the mini pill by containing oestrogen, in contrast to the mini pill which only contains progesterone. The mini pill is an option for women who cannot take Cilest or who experience side effects with it. The mini pill is often less effective as it must be taken within a specific time frame everyday. It also cannot be used to delay your period.

When are you protected after starting Cilest?

If you start taking Cilest in the first five days of your period you will be protected right away. Otherwise, you will need to wait seven days before you are protected from pregnancy.

When can I get pregnant after stopping Cilest?

After you stop taking Cilest, it can take a couple of months for your natural menstrual cycle to get back to normal. It’s recommended to wait until you have a natural period as your folic acid levels may be reduced after taking the pill. However, some women will fall pregnant as soon as they stop taking the pill. For others it takes longer. It’s important to remember that everyone is different and there are many factors which affect fertility. 

If I have vomited, will Cilest still work?

If you vomit within two hours of taking Cilest then it’s likely that your body has not absorbed it. If this happens, take another pill right away and continue with the rest of your pack. If you experience continued vomiting or diarrhoea then you should treat it as a missed pill and use additional methods of contraception for up to seven days after your stomach settles. Try and keep taking your daily pills if you can.  

Sources

• Patient Information Leaflet
• NHS > Combined Contraceptive Pill