Rub - Mercy

Три-Мерси Drug photo

The description is actual on 24.04.2015

  • Latin name: Tri-Merci
  • ATH code: G03AB05
  • Active ingredient: Ethinylestradiol + dezogestret
  • Producer: N.V. ORGANON (Netherlands)

Structure

In 1 tablet of red color ethinylestradiol of 30 mkg also dezogestret 100 mkg.

In 1 tablet of yellow color ethinylestradiol of 35 mkg also dezogestret 50 mkg.

In 1 tablet of white color ethinylestradiol of 30 mkg also dezogestret 150 mkg.

Lactoses monohydrate, α-tocopherol, potato starch, povidone, stearic acid, silicon dioxide, a gipromelloz, a macrogoal, tal, dye, titanium dioxide — as excipients.

Release form

Tablets in a cover of three flowers (yellow, red, white on 7 pieces) No. 21.

Pharmacological action

Contraceptive.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The combined oral contraceptive (COOK). The mechanism of action is connected with ability to suppress release of hormones by gipotalamo-pituitary system. In a consequence of it production of follicle-stimulating and luteinizing hormones that causes reduction of the sizes of ovaries, suppression of an ovulation, change of an endometria (there is impossible an implantation), change of quality of a cervical secret (slime) which becomes insuperable to spermatozoa decreases. Provides these effects dezogestret gestagen which has low androgenic activity.

Skin, sebaceous glands and follicles react to increase of quantity of androgens the increased products of a skin secret, excess growth of hair and are sensitive to testosterone metabolite to dihydrotestosterone. Drug Three - Mercy reduces concentration of androgens: degidroepiandrosterona, androstendion, 3-α-андростендиола glucuronide. In this regard it possesses also positive impact on skin.

Content of ethinylestradiol provides influence on a menstrual cycle. The menstrual cycle is normalized, monthly become painless and not plentiful.

Prolonged use the COOK reduces risk of cancer of an endometria and an ovary.

Pharmacokinetics

Ethinylestradiol is quickly absorbed from a gastrointestinal tract. Cmax in blood is registered in 1-2 h. Bioavailability makes 60%. Has high ability to contact albumine. Equilibrium concentration is defined in 3-4 days of reception. Is exposed to a konjyugirovaniye in baking of a mucous small bowel. It is metabolized with formation of free metabolites of ikonjyugat with sulfates and glucuronides. Decrease in concentration in serum happens dvukhfazno, a final elimination half-life — 23 h. Metabolites are removed with bile imochy, the period of their semi-removal 24 hours.

Dezogestrel is also quickly absorbed from a gastrointestinal tract, turns in etonogestret. Cmax in blood is reached in 1,5 h. Bioavailability — 61-80%. Contacts albumine of serum and GSPG (40-70%). Only 4% of the general etonogestrel in serum are in a type of free hormone. It is completely metabolized. Concentration in blood decreases dvukhfazno. The final stage has an elimination half-life of 30 h. Metabolites by kidneys and through intestines are removed. At daily reception levels of an etonogestrel increase 2 times and the equilibrium state is reached in the second half of a cycle.

Indications to use

Protection from pregnancy.

Contraindications

  • arterial and venous thrombosis in the anamnesis and predisposition to them;
  • migraine with focal symptomatology;
  • disturbances of cerebral blood circulation;
  • diabetes mellitus;
  • pancreatitis;
  • serious illness and tumors of a liver;
  • dekompensirovanny heart disease;
  • atherosclerosis;
  • Ischemic heart disease, heavy arterial hypertension;
  • hormonedependent tumors;
  • metrorrhagias of not clear etiology;
  • endometriosis;
  • pregnancy;
  • breastfeeding;
  • Rotor syndrome;
  • Gilbert's syndrome;
  • angiopatiya;
  • retinopathies;
  • hypersensitivity to drug and components.

With care it is necessary to apply at a hypertrophic cardiomyopathy, fibrillation of auricles, superficial thrombophlebitis, a varicosity, intestines diseases.

Side effects

  • gastralgia, nausea, vomiting, cholestatic jaundice, itch;
  • ulcer colitis;
  • thrombembolia, thrombosis, thrombophlebitis;
  • headache, increase of the ABP, hypostases;
  • decrease or hearing loss;
  • dryness mucous eye, conjunctivitis, vision disorders;
  • morbidity and nagrubaniye of mammary glands;
  • the acyclic smeared allocations, change of vulval secretion;
  • knotty erythema;
  • increase in weight;
  • change of tolerance to glucose;
  • hyperpegmentation of face skin;
  • hypersensitivity reactions.

Rub - Mercy, the application instruction (A way and a dosage)

Pill is taken inside daily. The order of reception is specified on packaging. A yellow, red and white pill Three - Mercy needs to take in turn (tablets of every color for 7 days) on 1 tablet, in general 21 days.

Reception there begin with yellow tablets, then red and white tablets. After a break in 7 days begin reception of tablets from new packaging. During a break there is bleeding which can begin in 3 days after the last tablet and proceed during reception of new tablets.

How begin reception of contraceptive tablets?

Begin reception in the 1st day of periods. If reception is begun in 2-4 days of a cycle, it is necessary to apply barrier contraception within a week. Upon transition from another the COOK this drug is begun next day after an active tablet of the previous drug. Begin to accept right after removal of a transdermalny plaster or a vaginal ring.
Upon transition from monodrugs ("mini-drank", implants, injection forms) reception is begun in day of removal of an implant, in day of the next injection and next day after the termination "mini-drank". In all these cases the first week of reception of new drug use barrier contraception.

After the abortion which is carried out in the I trimester begin reception of this drug in day of abortion and other ways of contraception are not used.

After the delivery, the abortion which is carried out in the II trimester begin reception of tablets in 28 days after the delivery and 21 days after abortion. If administration of drug is begun in the terms exceeding above-stated it is necessary to apply barrier contraception within a week.

The application instruction Three - Mercy contains an explanation how to accept drug in case of the admission of the next tablet or for change of day of the beginning of periods. Having studied the instruction, carrying out it, it is possible to avoid unexpected situations.

At development of vomiting and diarrhea absorption of tablets is broken, and can be incomplete therefore other measures of contraception in addition are undertaken.

Overdose

Overdose is shown by symptoms: nausea, vomiting, the smeared allocations from a vagina (at young girls).

Treatment: sorbents are appointed, symptomatic therapy is carried out.

Interaction

Phenytoinum, barbiturates, Rifabutin, Felbamat, Carbamazepine, Rifampicin, Ritonavir, Okskarbazepin, Topiramat, Griseofulvin at co-administration cause increase in clearance of hormones. Decrease in contraceptive effect at reception of Ampicillin and tetracyclines. Against reception of all above-mentioned drugs it is necessary to use other methods of contraception.

Oral contraceptives reduce efficiency: Diazepam, anticoagulants, Lamotridzhinantidepressants, glucocorticosteroids, hypoglycemic means, Clofibratum. Increase efficiency of Cyclosporine.

Terms of sale

According to the recipe.

Storage conditions

To store in the dry place at a temperature up to 30 °C.

Period of validity

3 years.

Analogs

Coincidence on the ATH code of the 4th level:

Marvelon, Mersilon, Novinet, Regulon.

About Three - Mercy

From all types of contraception by the most effective reception of the combined oral contraceptives is. It is considered that the structure of three-phase contraceptives precisely imitates the content of hormones, as at a physiological menstrual cycle. Three-phase the COOK have three appearance of tablets and are accepted according to cycle phases.

Tablets for the second and third phase have an identical dose of estrogen, in tablets for the first phase the dose is a little higher. The dose of a gestagen gradually increases. Such selection of hormones provides maximum efficiency and at the correct reception of tablets approaches 100%. One of representatives three-phase the COOK is Three - Mercy, responses of doctors of which, considering all above, only positive.

Besides that drug has high degree of contraceptive reliability, it also has the expressed influence on skin and allows to solve cosmetic problems which concern many girls. It suppresses development of a skin secret, reduces fat content of skin and hair, promotes disappearance of acne rash. Especially sharply this problem arises during puberty. Low androgenic activity of this drug does it by choice drug for women with an acne, fat skin and the increased growth of hair. It differs in the optimum content of estrogen and a dezogestrel and slightly influences weight.

Further the list of three-phase oral contraceptives which differ at the price and the producer is provided: Loginon, to Sinfaza, Trikvilar, Tri-Leulen, Triaden, Triziston, Trister, Trinovum, Tri-Norinil, Trinordiol, Tri-regol, Trifazil-21.

From this list it is possible to pick up the contraceptive which is most suitable for you. Good tolerance and lack of by-effects means. It is better to address for this purpose the gynecologist who being guided by indicators of a hormonal phenotype (gestagenny or oestrogenic overweight) will pick up the corresponding drug. Drugs with gestagenny overweight are appointed to women at whom estrogen and vice versa prevail.

In general the COOK have advantages: allow to reduce premenstrual and menstrual pains, blood loss volume, normalize a menstrual cycle. Long reception of contraceptive hormonal means reduces risk of cancer of ovaries, mammary glands and a uterus. Nevertheless, these means are not deprived of side effects. In responses complaints to developing of nausea and vomiting, attacks of migraine, irritability, dizziness, emergence of hypostases which most often arise at the very beginning of administration of drug quite often meet. In cases of nausea and vomiting it is necessary to use gepatoprotektor against which these by-effects disappear.

Zdravzona

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  • Rub - Mercy tbl No. 21, Organonniderlandy
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Section: Contraceptives
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Education: Graduated from Sverdlovsk medical school (1968 - 1971) as "Paramedic". Graduated from the Donetsk medical institute (1975 - 1981) as "An epidemiologist, a hygienist". Passed postgraduate study in the Central scientific research institute of epidemiology Moscow (1986 - 1989). An academic degree – the candidate of medical sciences (degree is awarded in 1989, protection – the Central scientific research institute of epidemiology Moscow). Numerous advanced training courses are studied in epidemiology and infectious diseases.

Experience: Work as the manager of department of disinfection and sterilization of 1981 - 1992. Work as the manager of department of especially dangerous infections of 1992 - 2010. Teaching activity at Medical institute 2010 - 2013.

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