Cerelle

Cerelle is a contraceptive pill, taken by women to prevent pregnancy. It is a progestogen-only pill (POP), or mini pill. Mini pills contain progestogen only. This is different to other contraceptive pills, known as combined pills. Combined pills contain both oestrogen and progestogen.

Cerelle contains the progestogen desogestrel.

Unlike combined pills, Cerelle can be taken by women who cannot tolerate oestrogen. You can also take Cerelle if you are breastfeeding.

You will need to take 1 Cerelle pill every day to prevent pregnancy:

• try and take your pill at around the same time each day
• think about a time of day that is convenient and easy to remember
• swallow the Cerelle pill whole with water

Each strip of Cerelle is printed with arrows and days of the week on the strip to help you keep track:

• each time you start a new strip, take a pill from the top row marked with the appropriate day
• follow the arrows – this will make it easier to check if you have taken your pill on any given day
• when you have finished a strip, start a new one next day - you shouldn’t wait for a period

Taking Cerelle for the first time

If you have not taken any other hormonal contraceptive in the past month:

• take your first Cerelle pill durings the first 5 days of your period
• if you do not start taking Cerelle until day 6, you will need to use an additional method of contraception (such as condoms) for the first 2 days to prevent pregnancy

What to do if you miss a pill

If you forget to take a Cerelle pill, take it as soon as you remember. Take the next pill at the normal time. This may mean taking 2 pills in 1 day.

If you are less than 12 hours late taking the missed Cerelle pill:

• you will not need to use additional contraception to prevent pregnancy

If you are more than 12 hours late taking the missed pill:

• you will need to use an additional method of contraception for the next 2 days to prevent pregnancy
• if you have had unprotected sex in the past 2 days, you should use emergency contraception
• if you want to take emergency contraception, speak to your doctor or pharmacist

If you have vomiting or diarrhoea within 3 to 4 hours of taking a Cerelle pill, you may not be protected against pregnancy. You will need to follow the instructions above for missing a pill to prevent pregnancy.

Stopping Cerelle

You can stop taking Cerelle at any time. If you stop taking Cerelle, you will no longer be protected from getting pregnant.

Cerelle works in 2 ways to prevent pregnancy. The main way it works is by preventing an egg cell from ripening.

Cerelle also works by preventing sperm from reaching the womb. This happens because when you take Cerelle, the mucus at the entrance to your womb (the cervix) thickens.

Cerelle does not protect you from sexually transmitted infections (STIs).

Cerelle is 99% effective at preventing pregnancy when taken within the same 12 hour window every day.

You will need to make sure that you take a Cerelle pill every day, ideally at around the same time each day. If you forget to take a pill, make sure you follow the instructions on what to do after missing a pill.

Some women experience side effects with Cerelle. These are usually mild, and not everyone has them.

Common side effects of Cerelle:

• change in mood
• decrease in libido (sex drive)
• depression
• headache
• nausea
• acne
• breast pain
• irregular periods or no periods
• increase in body weight

Uncommon side effects of Cerelle:

• vaginal infection
• difficulty wearing contact lenses
• vomiting
• hair loss
• painful periods
• ovarian cyst
• tiredness

Vaginal bleeding

You may have vaginal bleeding at irregular intervals when you take Cerelle. It may be very light, or it can be heavier, like a period. You may have no bleeding at all. If you have irregular bleeding it does not mean that Cerelle is not working. If you have heavy or prolonged bleeding, you should speak to your doctor.

If you experience any side effects whilst taking Cerelle or are concerned about any side effects, you should speak with your doctor. You can also report any side effects through the MHRA (Medicines and Healthcare products Regulatory Agency) Yellow Card scheme.

Cerelle can be taken by women who wish to prevent pregnancy or cannot tolerate oestrogens.

Cerelle should not be taken by women under the age of 18.

You should not take Cerelle if you are pregnant, or think you might be.

You can take Cerelle if you are breastfeeding, but you should speak to your doctor before you start taking it.

You should not take Cerelle if you have:

• an allergy to desogestrel or any of the other ingredients
• thrombosis (blood clot)
• unexplained vaginal bleeding
• jaundice or liver disease in the past and your liver function has not returned to normal
• a type of cancer that may be affected by hormones such as progestogens (including some types of breast cancer)

If any of these conditions appear whilst you are taking Cerelle, you should speak to your doctor straight away.

You should speak to your doctor before taking Cerelle if you:

• have diabetes, cancer of the liver, tuberculosis, high blood pressure, epilepsy, or depression or mood changes
• have or have ever had breast cancer, thrombosis, or chloasma (yellow brown patches on the skin, especially on the face)

Before starting Cerelle, you should tell your doctor about any other medications you are taking, or have taken in the previous 3 months.

When taken at the same time, some medicines may make Cerelle less effective or lead to unexpected bleeding. This includes medicines used to treat:

• epilepsy, for example primidone, phenytoin, carbamazepine, oxcarbazepine, felbamate, topiramate and phenobarbital
• tuberculosis, for example rifampicin and rifabutin
• HIV infections, for example ritonavir, nelfinavir, nevirapine and efavirenz
• Hepatitis C and some other infectious diseases, for example boceprevir and telaprevir
• high blood pressure in the blood vessels of the lungs (for example bosentan), angina and some heart rhythm disorders (for example diltiazem)
• some bacterial infections (for example clarithromycin and erythromycin) and fungal infections (for example ketoconazole, itraconazole and fluconazole)
• depressive mood, for example the herbal remedy St. John’s Wort)

If you are taking other medicines or herbal products, you may need to use an additional method of contraception. Your doctor or pharmacist will be able to advise you on this.

Cerelle may affect other medicines. For example, Cerelle may increase the effect of medicines containing ciclosporin, and decrease the effect of lamotrigine. You should let your doctor know about any other medicines you are taking so they can let you know what you need to do.

If you are not sure if Cerelle is suitable for you, you may wish to consider taking a different mini pill (such as Noriday or Norgeston) or a combined pill (such as Microgynon or Yasmin).

There are a range of oral contraceptives available from ZAVA. A doctor will recommend the best option for you, based on your questionnaire answers.

Cerelle and Cerazette both contain the same active ingredient: 75 micrograms of desogestrel. The other ingredients in Cerelle and Cerazette are different. This includes the core of the pill tablet and the coating.

Cerazette is the original brand version of desogestrel. Because Cerelle and Cerazette contain the same active ingredient, they have the same effectiveness. Cerelle is usually cheaper than Cerazette.

If you’re sick within two hours of taking a pill, take another pill as soon as you can keep it down. As long as the replacement pill is taken within the 12-hour window, you’ll still be protected against pregnancy.

Cerelle and other progestogen-only pills can sometimes cause irregular periods. They can also cause you to miss periods or your periods may also stop or become lighter. Cerelle is more likely than traditional POPs to cause bleeding more often, bleeding for longer, or bleeding less often in the first 3 months.

Speak to your doctor if your periods don’t settle down after a few months, if you notice a new change in your bleeding pattern after 3 months, if you have bleeding after sex or pain during sex, or if you have changes to your vaginal discharge. It’s unlikely that you’re pregnant if you’ve taken your pill properly, but you might want to take a pregnancy test too.

Cerelle doesn’t affect the production of breast milk, and there’s no evidence to suggest that taking it while you’re breastfeeding can harm your baby.