Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464
Information last reviewed 13/02/2021
Dose |
One tablet, taken once per day, at the same time each day |
Type of Medicine |
Hormonal contraceptive |
Mechanism |
Prevents ovulation, thickens mucus to make it harder for sperm to reach eggs, and prevents egg attachment to the uterus |
Available Size |
84 tablets |
Available Strengths |
2mg/3mg |
Active Ingredient |
estradiol valerate and dienogest. |
Price |
From 42p per tablet |
Side Effects |
Can include period pain, irregular bleeding, weight gain, breast tenderness and pain, abdominal pain, acne, mood changes, thrush, migraine, nausea and vomiting |
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 oestrogen and progesterone.
Qlaira is known as a ‘phasic’ pill, meaning that pills contain different levels of hormones depending on the day. Qlaira has four ‘phases’, and women who take Qlaira have shorter and less intense periods of bleeding compared with monophasic combined contraceptive pills.
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 implanting.
Qlaira is over 99% effective when used correctly. However not all women are able to take the pill perfectly, so in reality, if 100 women take the pill over the course of a year, around 9 will fall pregnant. For maximum effectiveness, ensure that you take the pill perfectly as directed, and use extra contraceptive methods if you make a mistake or experience vomiting or diarrhoea.
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 hormonal contraceptive pill, or from a combined hormonal contraceptive patch or ring, 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 progestogen-only form of contraception.
Qlaira is also approved for the treatment of heavy menstrual bleeding as it typically results in lighter, shorter periods. It may also ease the symptoms of premenstrual syndrome (PMS). This pill can also be used to treat acne and for the management of endometriosis.
If you wish to swap to Qlaira from a different type of 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 will be protected from pregnancy straight away.
If you are changing from a progestogen-only pill to Qlaira, you will need to use an additional method of contraception such as condoms for the first nine days of taking Qlaira.
Qlaira is not commonly known to cause any form of severe allergic reactions that might present as trouble breathing, dizziness, itching/swelling of the face or rashes. If you do notice these symptoms after taking the medication please seek immediate medical attention.
The active ingredients contained in Qlaira are estradiol valerate and dienogest.
The inactive ingredients vary between the different colours of the tablet.
Most of the tablets contain the following: lactose monohydrate, maize starch, pregelatinised maize starch, povidone K25 (E1201), magnesium stearate (E572), hypromellose type 2910 (E464), macrogol 6000, talc (E553b), titanium dioxide (E171), iron oxide yellow (E172) and/or iron oxide red (E172)
The white inactive tablets also contain:
lactose monohydrate, maize starch, povidone K25 (E1201), magnesium stearate(E572), hypromellose type 2910 (E464), talc (E553b), titanium dioxide (E171)
If you miss a pill, what to do next depends on where you are in the pack.
If you have missed more than one pill, see a doctor or pharmacist right away. You will probably need to use additional contraception for a few days.
If you take your pill a little later than usual, your contraception will not be affected and you do not need to do anything. However, if a pill is taken more than 12 hours late, 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 of the same day from a new packet 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 placebo pills and do not contain any active ingredients.
Qlaira is a fairly new combined pill so there are not much long-term data on Qlaira specifically, however, it's safe to take other combined pills long-term provided you don't have any underlying health issues which can be made worse by taking the pill.
One of the main risks of taking the combined pill, such as Qlaira, is that it increases the risk of blood clots. You should have your blood pressure checked before you start any combined hormonal contraceptive, and at least once every 12 months.
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”. Tablets must be taken every day in the correct order. You will need to have your blood pressure and BMI checked prior to starting Qlaira to ensure it is safe for you.
Qlaira is taken every day. 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. Most users will have a 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.
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 of the new pack. Tablets must be taken in the correct order.
Common side effects include:
Uncommon side effects may include:
Rare side effects may include:
You should not take Qlaira if you:
Extra care should be taken if you have:
Certain medications can interfere with Qlaira and cause it to be less effective. These include:
You should consult your doctor before starting Qlaira if you are taking any medications, including herbal remedies, over the counter medications, or recreational drugs as Qlaira may not be suitable for you.
The mini-pill only contains a progestogen hormone whereas Qlaira contains both an oestrogen and a progestogen. For this reason, Qlaira is not suitable for some people, for example, those with high blood pressure, migraines, or other health risks. The mini pill is also taken every day of the month but it does not control your period in the same way as a combined pill. Some women may experience irregular periods or no periods at all with a progestogen-only pill whereas, with a combined pill, most women will experience a regular bleed. 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 combined 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 every day, the vaginal ring or contraceptive patch may be a better alternative.
The mini-pill, or progestogen-only pill, is a good option for women who are unable to take the combined pill or for those who are sensitive to oestrogen.
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 that also protects against STIs.
Qlaira can be used for the 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 your current pack (the two dark red and two white pills), skip the first 7 tablets in a new pack and begin by taking the 8th tablet in the new pack. This will delay your period until you reach the end of the new pack.
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.
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