Rigevidon

What is Rigevidon?

Rigevidon is a type of combined oral contraceptive pill. It contains oestrogen and progesterone and is prescribed to prevent pregnancy and to treat irregular, heavy periods.

How does Rigevidon work?

Rigevidon contains synthetic versions of the hormones oestrogen (ethinylestradiol) and progesterone (levonorgestrel). These hormones over-ride your natural menstrual cycle and work in three ways: by preventing the release of an egg from the ovaries (ovulation), thickening the mucus surrounding the womb entrance to make it harder for sperm to get through, and thinning the womb lining to reduce the likelihood of a fertilised egg being implanted.

How effective is Rigevidon?

When taken correctly, Rigevidon is more than 99% effective in preventing pregnancy. Like all other hormonal contraceptives, Rigevidon does not protect against sexually transmitted diseases (STDs).

When does Rigevidon start to work?

If you start the pill during your period you will be protected from pregnancy immediately, unless you have a short menstrual cycle and your period comes every 23 days of less. If you have a short menstrual cycle or start the pill after the fifth day of your period, you will not be protected straight away and will need to use additional contraception until you have taken the pill for seven days.

Active ingredients

The active ingredients in Rigevidon are levonorgestrel and ethinylestradiol.

Inactive ingredients

The inactive ingredients in Rigevidon are colloidal anhydrous silica, magnesium stearate, talc, maize starch, lactose monohydrate, sucrose, calcium carbonate, titanium dioxide (E171), copovidone, macrogol 6000, and povidone carmellose sodium.

Rigevidon dosage

Each pill contains 150 micrograms of levonorgestrel and 30 micrograms of ethinylestradiol. Take 1 pill per day for the first 21 days out of 28, then start again.

How to start taking Rigevidon

Always start taking Rigevidon as instructed by a doctor or pharmacist. If you are not taking any other oral contraceptive already, start taking Rigevidon on the first day of your period. If you are switching from a different combined contraceptive pill, start taking Rigevidon the day after you take the last pill of the strip from your previous contraception without leaving a gap. If you are switching from a progesterone only pill, you can stop taking it at any time and start Rigevidon the next day.

If you are switching to Rigevidon from the contraceptive injection or implant, start taking Rigevidon on the day your injection is due, or on the day after you have your implant removed. You will need to use an additional form on contraception for the first seven days of taking Rigevidon.

How to take Rigevidon

Try and take Rigevidon at the same time each day. To help you remember, try and make this a part of your routine, for example, take your pill first thing in the morning, or before you go to bed each night. Each pack of 21 Rigevidon pills is marked with a calendar which you should follow, taking each pill on the marked day. When you finish the pack, you will have 7 days when you do not take a pill, during which time you will have a bleed simulating a natural period. You should start your next pack immediately after the 7 day gap, even if you are still bleeding.

How to use Rigevidon for period delay

If you are taking Rigevidon and wish to delay your period, you can take your next pack the day after finishing your last pack without leaving a break. You can safely take 3 packs back-to-back in this way, although you may experience some breakthrough bleeding.

What should I do if I took a pill too late?

Although you are recommended to take your pill at the same time each day, if you take it within 24 hours of our normal time there is no need to worry. However, if 12 hours have passed since your normal time you may need to use additional contraception to protect you from pregnancy. 

What should I do if I missed a pill?

If you forget to take a pill, take it as soon as you remember. If you take it within 12 hours of your normal time, you will still be protected against pregnancy and can take your next pill at the normal time. If 12 hours has passed before you remember to take your pill, you may not be protected against pregnancy and must use additional contraception. If you miss more than one pill, ask your doctor for advice. You may experience some breakthrough bleeding.

Rigevidon side effects

Like all medicines, Rigevidon can cause side effects in some patients. Sometimes side effects which appear in the first few months disappear once your body adjusts. Common side effects, which may affect up to 1 in 10 people include:

• Vaginitis, including vginal candidiasis
• Mood swings, including depression
• Altered sexual desire
• Nervousness
• Dizziness
• Nausea and vomiting
• Abdominal pain
• Acne
• Breast pain, enlargement or discharge
• Painful menstruation
• Irregular bleeding
• No or reduced bleeding
• Abnormality of cervix
• Vaginal secretion
• Fluid retention/edema
• Changes in weight

The following uncommon side effects may affect up to 1 in 100 people:

• Changes in appetite
• Elevated blood pressure
• Abdominal cramps
• Bloating
• Rashes
• Chloasma
• Excessive hair growth
• Hair loss
• Altered blood fats, including increased triglycerides

Rare side effects (affecting up to 1 in 1 000 people) include:

• Severe allergic reaction, characterised by hives, swelling of the face, tongue or throat, or severe circulatory or respiratory failures. If this happens, stop taking Rigevidon and seek immediate medical attention.
• Glucose intolerance
• Eye irritation when wearing contact lenses
• Jaundice (yellowing of the skin)
• Erythema nodosum (painful reddish skin nodules)

Very rarely (1 in 10 000 cases) the following side effects may occur:

• Benignus or malignant liver tumour
• Aggravation of immune system disease (lupus)
• Aggravation of porphyria
• Exacerbation of chorea
• Inflammation of the optic nerve
• Blood clots in the blood vessels of the eye
• Aggravation of varicose veins
• Inflammation of the large intestine
• Inflammation of the pancreas
• Gallbladder disease
• Erythema multiforme
• A blood disorder called haemolytic uraemic syndrome (HUS)

The frequency of the following side effect cannot be estimated from the available data:

• Inflammatory bowel disease (Crohn’s Disease, ulcerative colitis)
• Hepatocellular injury 

Contraindications

Do NOT take Rigevidon if:

• You are allergic to ethinylestradiol, levonorgestrel, or any of the other ingredients of this medication
• You are pregnant
• You have or have ever had a blood clot in a blood vessel of your legs (deep vein thrombosis), your lungs (pulmonary embolism) or other organs
• You know you have a blood-clotting disorder, for instance protein C deficiency, protein S deficiency, antithrombin-III deficiency, Factor V Leiden or antiphospholipid antibodies
• You need an operation of if you are off your feet for a long time
• You have ever had a heart attack or stroke
• You have or have ever had a type of migraine called migraine with aura
• You have severe diabetes with blood vessel damage, very high blood pressure, a high level of cholesterol or triglycerides, or a condition known as hyperhomocysteinemia
• You have, have ever had, or are suspected of having breast cancer or cancer of the genital organs
• You have or have ever had a liver disease and your liver is still not normal
• You have or have ever had a tumour in the liver
• You have unexplained bleeding from your vagina

Before taking Rigevidon, speak to your doctor. They may wish to keep you under strict medical supervision if:

• You have elevated levels of fat in the blood (hypertriglyceridemia) or a positive family history for this condition
• You need an operation
• You or your close family have ever had problems with your heart or circulation such as high blood pressure
• You have an inflammation in the veins under the skin (superficial thrombophlebitis)
• You have varicose veins
• You or your close family have ever had a blood clotting problem
• You have a migraine
• You have diabetes
• You have Crohn’s disease or ulcerative colitis
• You have the inherited form of deafness known as otosclerosis
• You have a depressed mood
• You have the movement disorder Sydenham’s chorea
• You have a liver and/or gallbladder disease
• You have the inherited disease porphyria
• You have sickle cell anaemia 
• You have a blood disorder called haemolytic uraemic syndrome
• You have systemic lupus erythematosus SLE
• You have the rash known as herpes gestationis
• You have brown patches on your face and body (chloasma) 

Drug interactions

Do NOT take Rigevidon if you are taking medications containing ombitasvir, paritaprevir, ritonavir or dasabuvir for hepatitis C.

Before taking Rigevidon, tell your doctor if you are taking any other medicines, including those purchased over the counter without a prescription. In particular, speak to your doctor if you are taking any of the following:

• Primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, or other medicines  for treating epilepsy
• Rifampicin or other medicines for tuberculosis
• Protease inhibitors an non-nucleoside reverse transcriptase inhibitors such as ritonavir, nevirapine and efavirenz for treating HIV and hepatitis C infection
• Griseofulvin and other treatments for fungal infections
• Medicines used to treat arthritis
• Medicines used to treat high blood pressure in the blood vessel in the lungs
• The herbal remedy St John’s wort
• Medicines containing ciclosporin
• The antiepileptic lamotrigine 
• Theophylline
• Tizznidine

Rigevidon and alcohol

It is safe to drink alcohol while taking Rigevidon.

Alternatives to Rigevidon

There are many different brands of combined oral contraceptives available in the UK, such as Microgynon, Cilest and Yasmin. Many women prefer a particular brand of contraceptive and all available types can be found online at Dr Felix. It is not uncommon to try a few different typed before finding on that is right for you. Alternatively, the progesterone-only pill, or mini pill, is suitable for women who cannot take the combined contraceptive pill, or who are particularly sensitive to oestrogen.

If you struggle with remembering to take your pill every day, a long-term reversible option, such as the contraceptive coil, implant or injection may be better for you. You can always speak to a healthcare expert about the different options available and which one might be right for you.  

Rigevidon vs the mini pill

While Rigevidon contains synthetic versions of both oestrogen and progesterone, the mini pill only contains progesterone. The mini pill is thought to have less health risks and side effects, and may be suitable for women who cant take the combined pill due to other health complications. The mini pill is taken every day and does not allow for a regular bleed. I can therefore not be used for period delay and may be less effective if not taken at the same time each day.

Switching contraceptive pill

Different types of contraceptive pill are better suited to different women, and it is common to try a few before finding the one that is best for you. It can take a while for your body to adjust, and it is normally recommended to try taking a pill for about 3 months before deciding to switch. In most cases, switching is a simple as starting your new pill the day after finishing a pack of your old pill without leaving a gap.  but you should check the package information and speak to a doctor if you are unsure.

Rigevidon for non-contraceptive purposes

Rigevidon is sometimes prescribed to women who have irregular or very heavy periods, and can also be used to treat acne.

Can you use Rigevidon for period delay?

Rigevidon can be used for period delay, but only if you have already been taking it for several weeks. Instead of taking a 7 day break at the end of a pack, you can take up to 3 packs back to back without leaving a gap for a bleed, although you may experience some breakthrough bleeding. It is not possible to use Rigevidon for period delay if you are not already taking it. In this case the best treatment for delaying your period is Norethisterone.

If I have vomited, will Rigevidon still work?

If you vomit within 4 hours of taking your Rigevidon pill, it is unlikely to have been successfully absorbed by your body and may not work. You should take another pill as soon as your stomach has settled and carry on as before, but if 12 hours has passed since the time you usually take your dose, you should use additional means of contraception to prevent pregnancy. Your cycle will be a day short in this case.

When can I get pregnant after taking Rigevidon?

It can take a few months to get pregnant when you stop taking Rigevidon, as it takes a while for your hormones to adjust and your menstrual cycle to return to normal. However, you are at risk of pregnancy as soon as you stop taking Rigevidon.

Is it safe to take Rigevidon for a long time?

If you have been taking Rigevidon for some time with no side effects, you should be able to continue using it for as long as you need with your doctor’s approval. Bear in mind that the safety of long-term use of contraceptive pills is different in women who smoke. Combined contraceptives in particular are generally safe for use in women over the age of 35.

When will my period start again after I stop taking Rigevidon?

Rigevidon is an oral contraceptive that allow a break for a bleed and when you stop taking it, you will experience what is known as a ‘withdrawal bleed’.Your next period after this is your first natural period, and most women experience this 2 to 4 weeks after stopping the pill. However, it can take longer for some women, and your periods may be irregular for a while.

Sources

• Patient Information Leaflet
• NHS > Combined Pill
• HealthLine > Long-term use of contraceptive pills