Qlaira is a newer type of the combined contraceptive pill. It is the first contraceptive pill to contain the ingredients estradiol valerate and dienogest which are versions of the female hormones estrogen and progesterone.
Qlaira works by overriding your natural menstrual cycle, releasing hormones into your bloodstream to prevent ovulation from occurring. This means that the ovaries won't release an egg each month. Qlaira also causes the mucus surrounding the cervix to thicken, stopping sperm from entering, and thins the womb lining to prevent a fertilised egg from attaching.
Qlaira is 99% effective when used correctly.
If you start taking Qlaira on the first day of your period it will work right away to protect against pregnancy. If you swap from a different combined pill, Qlaira will also have an immediate effect. In any other circumstance, you should use a barrier method of contraception for the first 9 days of taking Qlaira as you won't be protected from pregnancy immediately. For example, starting it after the first day of your period or if you're switching from a progesterone only form of contraception.
Qlaira is also approved for lighter, shorter periods where women usually experience shorter withdrawal bleeds in comparison to other brands of the pill. It may also ease the symptoms of PMS. The combined pill can also be used to treat acne and for managing endometriosis.
Qlaira can be used for period delay but you must ensure you take the tablets in the correct order as they contain different levels of hormones. To delay your period with Qlaira, skip the last four tablets in the pack (the two dark red and two white pills) and begin taking the 8th tablet in the next pack. This will delay your period until you reach the end of the pack.
If you wish to swap to Qlaira from a different type of the combined pill, start taking Qlaira the day after taking the last active pill in your current pack. You can also start taking Qlaira the day after the removal of a vaginal ring or patch. You can change from a progesterone only pill or contraceptive but you will need to use an additional method of contraception for the first nine days of taking Qlaira.
If you stop taking the pill you can get pregnant at any time. It's recommended to wait until your natural menstrual cycle returns before trying for a baby. A family planning clinic will be able to give you the advice and support you need to ensure you have a healthy pregnancy.
Your natural menstrual cycle should return within 2-3 weeks of stopping Qlaira but it can take 1-2 months. It will depend on your own body and how long it takes to adjust.
The active ingredients contained in Qlaira are estradiol valerate and dienogest.
The inactive ingredients are:
Other ingredients in the coloured active tablets are:
Tablet core: lactose monohydrate, maize starch, pregelatinised maize starch, povidone K25 (E1201), magnesium stearate (E572)
Tablet film-coating: hypromellose type 2910 (E464), macrogol 6000, talc (E553b), titanium dioxide (E171), iron oxide yellow (E172) and/or iron oxide red (E172)
Other ingredients in the white inactive tablets are:
Tablet core: lactose monohydrate, maize starch, povidone K25 (E1201), magnesium stearate(E572)
Tablet film-coating: hypromellose type 2910 (E464), talc (E553b), titanium dioxide (E171)
If you miss a pill, what to do next depends where you are in your cycle.
Days 1-9: take the missed pill as soon as you remember. If you have had sex within the previous 7 days of missing a pill you are at risk of pregnancy and should see a doctor right away. If not, continue to take the rest of your pills on time and use a barrier method of contraception for the next 9 days
Days 10-17: take the missed pill right away and continue with the rest of the pack as usual. This may mean taking more than one pill in the same day. Use an additional barrier method of contraception for the next 9 days
Days 18-24: skip the missed pill and begin the next pack right away. Use an additional barrier method of contraception for 9 days
Days 25-26: take the forgotten pill right away and continue with the rest of your pack as usual. Your contraception will not be affected
Days 27-28: leave the missed tablet and continue with Qlaira as usual. Your contraception will not be affected
If you have missed more than one pill, see a doctor or pharmacist right away.
If you take your pill later than usual then your contraception will not be affected and you do not need to do anything. If it has been more than 12 hours there is a risk that your contraception may not work as usual so it's recommended that you follow the instructions for a missed pill.
If you vomit within 3-4 hours after taking Qlaira the pill may not be effective. You should take another pill within 12 hours and then continue with the rest of the pack. If this isn't possible, treat it as a missed pill and follow the steps given for the corresponding day within your cycle. If you vomit after taking one of the white pills (the last two at the end of the pack) you do not need to do anything as they are empty placebo pills.
Qlaira is safe to take long term provided you don't have any underlying health issues which can be made worse by taking the pill. Taking the combined pill, such as Qlaira, increases the risk of blood clots. This is why it is important to have your blood pressure measured regularly and be fully aware of the potential side effects so that you can be aware of any possible warning signs.
You should start taking Qlaira on the first day of your period. Choose the weekday sticker which states the correct day of the week on which you are starting the pill and place it on the pill strip where it reads 'place weekday sticker strip here.' This is the first tablet in the pack and they must be taken in the correct order.
Qlaira is taken everyday of the month. There are 26 active pills and 2 inactive pills in each pack. Each pill should be taken at the same time each day. When you reach the end of the pack, start the next one the following day. Do not take a 7 day break like other types of the combined pill. You will usually begin your withdrawal bleed around day 24-26 and you should always start your new pack on time, even if you are still bleeding. You will still be protected against pregnancy on the days you take the inactive pills.
The 2 dark yellow tablets contain 3mg of estradiol valerate.
The 5 medium red tablets contain 2mg of estradiol valerate and 2mg of dienogest.
The 17 light yellow tablets contain 2mg of estradiol valerate and 3mg of dienogest.
The 2 dark red tablets contain 1mg of estradiol valerate.
To use Qlaira to delay your period, skip the last four tablets in your current pack (these are the two dark red and two white tablets) and begin with day 8 of the next pack-skipping the first 7 pills. There are 4 types of active pills within each pack of Qlaira, each containing different doses of hormones. This is why they must be taken in a specific order for Qlaira to work correctly.
Common side effects include:
No menstrual bleeding
Uncommon side effects may include:
Decreased sex drive
High blood pressure
Increased enzymes in the liver
Irregular vaginal bleeding
pain during sex
Fibrocystic breast disease
Changes to blood pressure
Rare side effects may include:
Pelvic inflammatory disease
Urinary tract infections
Bacterial infection of the vagina
Increase in triglycerides
Increased sex drive
Pins and needles
Poor tolerance of contact lenses
Low blood pressure
Worsening of varicose veins
Excessive hair growth
Back or jaw pain
Swollen lymph nodes
Abnormal smear test
You should not take Qlaira if:
You have ever had a blood clot
You have a condition which affects your blood clotting
You need to have an operation or will be off your feet for a long time
You have ever had a heart attack or stroke
You have ever had angina pectoris
You have severe diabetes with blood vessel damage
You have very high blood pressure
You have very high levels of fat in the blood
You have hyperhomocysteinaemia
You have ever had a migraine with aura
You have ever had liver disease and your liver function has not yet returned to normal
You have ever had a liver tumour
You have ever had breast cancer or cancer of the genital organs
You have unexplained vaginal bleeding
You are allergic to any of the ingredients
Extra care should be taken if:
You have a family history of breast cancer
You have liver or gallbladder disease
You have jaundice
You have diabetes
You have depression
You have inflammatory bowel disease
You have systemic lupus erythematosus
You have haemolytic uraemic syndrome
You have sickle cell anemia
You have hypertriglyceridaemia
You have recently given birth
You have superficial thrombophlebitis
You have varicose veins
You have epilepsy
You have a condition which first appeared during pregnancy or previous use of hormonal contraceptives
You have ever had chloasma
You have hereditary Angioedema
You have cardiac or renal insufficiency
Certain medications can interfere with Qlaira and cause it to be less effective. These include:
Hepatitis C medications
St John's wort
Tell your doctor if you are taking any of these medications as Qlaira may not be suitable for you.
The mini pill only contains the progesterone hormone as opposed to both estrogen and progesterone. It is safe to take for most women, for example if you have high blood pressure or other health risks which make the combined pill a risky choice. The mini pill is also taken every day of the month but it does not control your period in the same way as the combined pill. Some women may experience irregular periods when taking it. Your doctor will assess your medical history and discuss the most suitable hormonal contraception for you.
Qlaira is the only combined pill available in the UK which contains the ingredients estradiol valerate and dienogest. This makes it slightly different to the other types of the pill available on the market. Other popular brands of the pill include Microgynon, Rigevidon, Ovranette and Cilest, all of which are available to order from Dr Felix. If you find it difficult to remember to take the pill everyday, the vaginal ring or patch may be a better alternative. The mini pill, or progesterone only pill, is a good option for women who are unable to take the combined pill or for those who are sensitive to estrogen. Long term reversible methods of contraception are available from your GP or a family planning clinic. These include the hormonal or copper coil, the implant and injection. Condoms are the only method of contraception which also protect against STIs.
Patient Information Leaflet https://www.medicines.org.uk/emc/product/6536/pil
NHS> The Combined Pill https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/