Rigevidon

What is Rigevidon?

Rigevidon is a type of combined oral contraceptive pill. It contains synthetic oestrogen and progestogen hormones 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. With typical use, the effectiveness is closer to 91%. 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 on the first day of your period you will be protected from pregnancy immediately. If you start it at any other time in your cycle, you will need to use condoms to protect against pregnancy for 7 days. It is best to start the pill at the start of your period to avoid unwanted breakthrough bleeding.

Active ingredients

The active ingredients in Rigevidon are 30 micrograms of ethinylestradiol and 150 micrograms of levonorgestrel.

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 21 days, take a 7-day pill-free break and 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 progestogen-only pill, you can stop taking it at any time and start Rigevidon the next day, but you’ll need to have additional contraceptive cover in the form of condoms for 7 days.

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 of 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, however as long as you take it within 12 hours of your scheduled time, your contraceptive cover will be effective. If you are more than 12 hours late in taking your pill, you should follow the instructions below for ‘what should I do if I missed a pill?’

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 or more have passed since the time you should have taken your pill, you may not be protected against pregnancy and must use additional contraception for 7 days. If you have had sex at the time of a missed pill, the possibility of pregnancy should be considered. If you missed a pill in the last 7 days of your pack, continue straight onto the next pack without taking a break. You are protected from pregnancy after 7 consecutive days of pill-taking.

If you miss more than one pill, use additional precautions and contact your doctor for advice.

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 vaginal candidiasis (thrush)
• 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
• Change in the appearance of the cervix (cervical ectropion)
• Change in vaginal discharge
• Fluid retention/oedema
• 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 (yellow-brown discolouration of the skin)
• The excessive hair growth or hair loss
• Altered levels of triglycerides (fats) in the blood

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

• Severe allergic reaction e.g. 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 red skin nodules)

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

• Benign or malignant liver tumours
• Aggravation of systemic lupus erythematosus (SLE)
• Aggravation of porphyria
• Exacerbation of chorea
• Inflammation of the optic nerve
• Blood clots in the blood vessels of the eye
• Aggravation of varicose veins
• Colitis (inflammation of the large bowel)
• Pancreatitis
• 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
• Are pregnant
• Have or have ever had a blood clot in a blood vessel of your legs (deep vein thrombosis), your lungs (pulmonary embolism) or any other organ
• Know you have a blood-clotting disorder, for instance, protein C deficiency, protein S deficiency, antithrombin-III deficiency, Factor V Leiden or antiphospholipid antibodies
• Need an operation or if you are off your feet for a long time
• Have ever had a heart attack or suffer from angina
• Have ever had a stroke or transient ischaemic attack (TIA/mini-stroke)
• Have or have ever had a migraine with aura
• Have severe diabetes with blood vessel damage
• Have uncontrolled high blood pressure
• Have a very high level of cholesterol or triglycerides
• Have hyperhomocysteinemia
• Have, have ever had, or are suspected of having breast cancer or cancer of the genital organs
• Have or have ever had a liver disease and your liver is still not normal
• Have or have ever had a tumour in the liver
• Have unexplained bleeding from your vagina
• Are over the age of 35 and you smoke

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
• Need an operation
• Have ever had problems with your heart or circulation such as high blood pressure, or if a close family member has been affected by similar conditions
• have an inflammation in the veins under the skin (superficial thrombophlebitis)
• have varicose veins
• Or your close family have ever had a blood clotting problem
• Have migraines
• Have diabetes
• Have Crohn’s disease or ulcerative colitis
• Have the inherited form of deafness known as otosclerosis
• Have a depressed mood
• Have the movement disorder Sydenham’s chorea
• Have a liver and/or gallbladder disease
• Have the inherited disease porphyria
• Have sickle cell anaemia 
• Have a blood disorder called haemolytic uraemic syndrome
• Have systemic lupus erythematosus SLE
• Have the rash known as herpes gestationis
• Have brown patches on your face and body (chloasma) 
• Have recently had a baby
• Are breastfeeding

Drug interactions

Rigevidon can interact with the following medications and concomitant use should be avoided:

• Hepatitis C medications e.g. ombitasvir, paritaprevir, ritonavir or dasabuvir
• Primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine lamotrigine, or other medicines  for treating epilepsy
• Rifampicin or other medicines for tuberculosis
• HIV medications including ritonavir, nevirapine and efavirenz
• Griseofulvin and other treatments for fungal infections
• Medicines used to treat arthritis
• Medicines used to treat high blood pressure
• The herbal remedy St John’s wort
• Medicines containing ciclosporin
• Theophylline
• Tizanidine

You should inform your prescriber of all the medications you usually take, and they can check there are no interactions.

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 brands of combined pill before finding one that is right for you. 

Alternatively, the progestogen-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 progestogen, the mini pill only contains progestogen. The mini pill has fewer health risks and side effects and may be suitable for women who can't take the combined pill due to other health complications. The mini pill is taken every day and often results in no bleeding or infrequent bleeding.

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 at least 3 months before deciding to switch. In most cases, switching is as 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 3–4 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 befo665re, your cycle will be one day shorter. If 12 hours or more have passed since the time you usually take your dose, or you’re unable to swallow pills without vomiting, you should use additional means of contraception to prevent pregnancy until you have been able to take 7 consecutive pills. If you are unwell towards the end of your pack, continue straight onto the next pack without taking a 7-day break.

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.

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

Rigevidon is an oral contraceptive that allows 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.