Cilique Pill

The Cilique Pill is a combined hormonal contraceptive pill. It contains 2 types of hormones, a progestogen (norgestimate) and an oestrogen (ethinylestradiol). If taken correctly, these 2 hormones work together as a safe and effective birth control, preventing pregnancy in more than 99% of people using them.

The Cilique contraceptive pill can also be used to make periods lighter and less painful. In some women, it may help with acne – however, there are also other acne treatments which are specifically approved for the condition.

Cilique tablets are taken daily for 21 days. These 21 days can then be followed by a 7-day pill break, when you may get a withdrawal bleed, similar to your normal period. Some women prefer to skip the 7-day break and take Cilique continuously, which is safe and effective to do.

What type of pill is Cilique?

Cilique is a combined pill. Unlike progestogen-only pills (also called mini pills), which contain only 1 type of hormone, the Cilique combined pill includes both a progestogen and an oestrogen. The combination of these hormones results in less chance of side effects related to taking progestogen alone, but might not be suitable for you, if you react very sensitively to oestrogen.

Each Cilique tablet contains 2 hormones, a progestogen and an oestrogen. Together, these 2 hormones adjust the natural level of hormones in your body. This results in 3 different changes that help in preventing pregnancy:

• the pill prevents ovulation, meaning there is no egg present in the womb to be fertilised
• it also thickens the cervical mucus, so that the sperm cannot enter the womb
• usually, the lining in the womb thickens during a period cycle, but the pill stops this thickening of the lining, so that a fertilised egg cannot implant into the womb

So, even if the first 2 actions fail and a fertilised egg is formed, since the womb lining is thinned, it would not survive to develop into an embryo.

How long does Cilique take to work?

How much time it takes for Cilique to start effectively preventing pregnancy depends on the day of your period cycle that you take your first tablet on.

Doctors advise you to take the first tablet on the first day of your period, which is also the first day of your cycle. If you start the pill on that day, you are protected right away.

You can also take the first tablet on the days 2 to 5 of your menstrual cycle and still be protected right away. If you start after day 5 of your period, it takes 7 days for Cilique to protect you reliably – during this time you should use a barrier method (such as a condom) as a contraceptive.

The Cilique combined pill is a very effective contraceptive. Combined pills are generally one of the most reliable forms of birth control when taken correctly with less than 1% of women using them getting pregnant per year. But, as with most contraceptives, it will be less effective if it’s not used exactly as advised. This is why in reality about 7% of women get pregnant per year while taking the contraceptive pill. The closer you follow the instructions on how to use Cilique, the lower your chance to get pregnant will be.

Is Cilique safe?

Yes, the Cilique birth control has been tested in many studies and is generally considered to be safe, if prescribed by a doctor. As with every medication, the Cilique pill might cause side effects. In this case they can include headaches or nausea. Most of the time, these side effects are mild and temporary.

It’s important to know that all combined pills slightly increase the risk of blood clots. If you don’t have any additional risk factors for developing blood clots, then your risk is still very low. On average, 2 out of 10,000 women not using any hormonal contraceptives will develop a blood clot per year. In people who use combined pills such as Cilique, 5 to 7 out of 10,000 women are affected.

Yes, you can buy Cilique and other contraceptive pills in the UK. They are available in sexual health clinics, some GP surgeries and in pharmacies (mini pills only).

Some mini pills containing only a progestogen are prescription-free (for example Hana). But for most contraceptive pills you will need a prescription from your GP or gynaecologist. You can also request prescription treatment online at ZAVA.

Where can I buy Cilique online?

You can buy Cilique online at ZAVA. To order contraceptive Pills online, we ask you to fill in a short questionnaire. One of our doctors will then review your answers and decide if Cilique is safe for you to use. If so, your order will be dispatched to your preferred address..

Can you buy Cilique without a prescription?

You will not be able to buy Cilique without a prescription. A doctor at ZAVA can prescribe Cilique for you. You’ll need to fill out a short online questionnaire which one of our doctors reviews to check if Cilique is right for you.

Take 1 Cilique pill once a day, at the same time each day, for 21 days in a row. The pills are small and easy to swallow, but we recommend taking them with a glass of water.

There are 21 pills in each Cilique foil blister strip, labelled with the days of the week to help you remember to take your pill. After 21 days, you should have a 7-day pill-free break.

During these 7 pill-free days you are still protected, but you may have some withdrawal bleeding, a bit like a period. You should start your next strip of 21 pills after these 7 pill-free days, even if your bleeding has not stopped. If no bleeding appears, we recommend taking a pregnancy test before you start with the next blister.

You can take Cilique with or without food, but you should avoid grapefruit juice while taking Cilique – it can reduce the contraceptive protection of the pill.

Taking Cilique continuously, back-to-back

Taking Cilique with a pill-free break is how the manufacturers advise taking it, but it’s not the only option. You can skip your pill-free break and take your Cilique continuously. This means starting your next pack as soon as you finish your first.

Taking the contraceptive pill continuously has been shown to be just as safe and effective. It can be easier to manage continuous pill use, but it can be more expensive if you are paying for the extra pills you take instead of your pill-free break.

You can also try the extended approach which involves only taking a pill-free break every 3 months instead of every 21 days. This means you would only have around 4 period-like bleeds a year.

When to start taking Cilique pills?

It depends on what contraception method you were using prior to starting Cilique.

If you have not used any hormonal contraception in the month before:

It’s best to start on the first day of your period. This way you’ll be protected from pregnancy straight away.

You can also take the first Cilique tablet on day 2-5 of your period and still be protected right away. If you start after day 5, you should use an additional barrier method (such as a condom) for 7 days.

If you are using another combined hormonal contraceptive and want to switch to Cilique:

You can take your first Cilique tablet on any day of the 7-day hormone-free break, but at the latest on the 8th day after your last hormone-pill. This way you stay protected from pregnancy the whole time.

If you are using a mini pill and want to switch to Cilique:

When switching from a progestogen-only pill (mini pill), you can stop your previous pill on any day and take your first dose of the Cilique pill instead. You will need to use another contraceptive (such as a condom) for the first 7 days.

Who can take Cilique tablets?

Cilique birth control can be used by women of all ages between puberty and age 50. Because it works best when it’s taken every day at the same time, this should be possible for you – for women working in shifts this might be impractical. Please check the contraindications before you start Cilique.

Can you take Cilique continuously or without a break?

Yes, it’s possible to take Cilique continuously and have no break in between blister strips. This might be useful for you if you don’t want to take a pill-free break. But it also results in higher costs per month. Taking the combined pill continuously is just as safe and effective, though.

If you forget a pill, take it as soon as you remember and take the next one at the usual time too, even if it means taking 2 very close together. If you’re more than 24 hours late to take your pill, take one as soon as you remember and then go back to your normal schedule. You will still be protected.

If you miss 2 pills, especially if it’s the first week of a new pack, take a pill as soon as you can and then go back to your normal schedule. You will not be fully protected from pregnancy and you need to use extra contraceptive protection, like condoms, for 7 days.

If you missed pills and the period for using extra protection includes some of your pill-free break, skip the break altogether and move straight onto your next pack.

If you miss 2 pills in the first 7 days of your pack of pills and you had unprotected sex you’re at risk of pregnancy. You should use emergency contraception, like the morning after pill.

Some women experience contraceptive pill side effects with Cilique. In most cases they are mild and temporary.

“The side effects of Cilique are different for each person. A lot of them can go away within the first 3 months of using the pill. If they remain and interfere with your everyday life, I recommend you try another pill. Most people will find a pill that works for them eventually.” - Dr Babak Ashrafi, Clinical Lead for Service Expansion.

Very common Cilique side effects include:

• headache
• feeling sick or being sick
• diarrhoea
• vaginal bleeding or spotting between your pill-free weeks
• painful or unusual periods

Common Cilique side effects include:

• swollen hands, ankles or feet
• sleep disturbances
• stomach ache and constipation or bloating
• weight gain
• mood changes such as depression or feeling nervous
• acne or rash
• muscle spasms and pain in legs, arms or back
• breast tenderness or breast pain
• urinary tract infections or vaginal infections, such as thrush
• migraines
• (unusual) vaginal discharge
• absence of menstrual periods
• feeling weak

Uncommon Cilique side effects include:

• hot flushes
• appetite changes
• palpitations (fast or fluttering heartbeat, often harmless)
• itchy or red skin
• changes in hair growth, such as thinning of your hair or excessive hair growth
• vaginal dryness
• ovarian cysts
• muscle pain
• lower or higher libido
• dry eyes or changes to your vision
• body weight changes
• changes in skin colour
• feeling anxious or faint
• breast changes, such as fuller breasts or fluid coming from the nipples
• changes to the cells in your cervix
• tingling sensation or numbness

Rare Cilique side effects include:

• increased sensitivity to light
• inflammation of the pancreas (pancreatitis)
• increased sweating
• lumpy breasts
• feeling giddy
• faster heart beat
• loss of sex drive

Further side effects of Cilique with unknown frequency are listed in the patient information leaflet.

Can Cilique cause any serious side effects?

Although rare, serious side effects can happen to people taking Cilique.

Call 999 immediately if you notice any of these:

• symptoms for a blood clot, such as shortness of breath, severe headache or migraine, swelling, redness or pain in one leg, pain and pressure in the chest, fainting or collapsing, or sudden loss of vision
• signs for an allergic reaction, such as hives, swelling in your face, mouth or throat, difficulty swallowing or breathing

If notice any of these you should get them checked as soon as possible:

• symptoms of severe liver problems (strong pain in upper belly, yellowing of skin/eyes
• increased blood pressure
• fits

Doctors also find breast cancer more often in people who use combined contraceptive pills like Cilique. But, it is still unclear if this is a side effect of the pill itself. It’s also possible that breast cancer is recognized in these women sooner, because they have check-ups at the doctor’s more often. This increase in breast cancer diagnoses decreases slowly for around 10 years after the pill is stopped and then the diagnosis rate returns to normal.

Everyone experiences coming off Cilique differently. Some might not have any symptoms and get back into their usual menstrual rhythm very quickly. In others, symptoms such as weight gain, mood swings or skin problems may occur. The body's hormone system sometimes needs a few months before it has readjusted and is back to normal. Learn more about it on our coming off the pill page.

Can Cilique cause blood clots?

Yes, your risk of developing a blood clot will be slightly higher if you take Cilique or any other hormonal contraceptive. But, even in people using the pill, blood clots still happen very rarely.

If you’re not pregnant or using any hormonal contraceptives, you’ll naturally have a very small risk of developing a blood clot. This affects about 2 in 10,000 women.

When you take a hormonal contraceptive like Cilique, that risk increases slightly to 5 to 7 in 10,000.

Your chance of blood clots will be higher if you:

• are overweight
• have major surgery
• are immobile or bedridden for a prolonged period
• have a history or family history of blood clots
• are above 35 years old
• recently gave birth
• smoke
• have high blood pressure
• have high fat levels in your blood
• have certain heart problems (valve disorder, atrial fibrillation)
• have diabetes with blood vessel complications
• have migraines, especially with aura

Your doctor will discuss with you if Cilique is the best contraceptive pill for you.

The Cilique 250/35 pill contains the active ingredients norgestimate (250mcg) and ethinylestradiol (35mcg).

Other Cilique ingredients include, maize starch, lactose, magnesium stearate (E470b) and indigo carmine (E132).

Each Cilique tablet contains 75.74mg Lactose – for most people with lactose intolerance this amount doesn’t cause any problems. If you react very sensitively to lactose, another contraceptive pill might be better for you.

How much oestrogen is in Cilique?

One Cilique Tablet contains 35mcg of ethinylestradiol (oestrogen), which counts as a moderate dose. The dose of oestrogen ranges from 15mcg to 30mcg in low-dose pills to up to more than 50mcg in high-dose pills.

You should not take Cilique if you:

• are allergic to ethinylestradiol, norgestimate or any of the ingredients listed in Cilique
• have a history of blood clots in any part of the body
• have a condition that affects your blood clotting
• need an operation or are bedridden for a longer time
• have a history of heart attack, stroke, angina pectoris or TIA (transient ischaemic attack)
• have a condition that increases your risk for blood clots, such as diabetes, high blood pressure or high cholesterol
• have liver cancer, breast cancer or other types of cancer which are affected by sex hormones
• have a history of a certain kind of migraine (migraine with aura)
• currently have or have recently had a severe liver disease
• have vaginal bleeding without a medical explanation
• have hepatitis C and are taking medication that might interact with Cilique (see the Cilique interactions section)

Some conditions require your doctor to discuss whether Cilique is the right contraceptive for you. You should speak to your doctor if you have:

• Crohn’s disease or ulcerative colitis
• high blood pressure or other problems with you heart, circulation or blood clotting
• hereditary or acquired angioedema – contact a doctor immediately if symptoms get worse
• diabetes
• liver or gallbladder problems
• had migraines in the past
• an autoimmune condition called systemic lupus erythematosus (SLE)
• a condition called porphyria
• high levels of fat in your blood
• had certain problems during previous pregnancy or pill use, such as itchy skin, yellowing of your skin or eyes, hearing problems or severe headaches
• a disorder of blood clotting called haemolytic uraemic syndrome
• just recently given birth
• sickle cell anaemia
• varicose veins
• an inflammation in the veins under the skin

Cilique is not suitable for you if you are breastfeeding and gave birth less than 6 weeks ago. Your doctor can advise you on contraceptives that you can use before the 6-week point. The mini pill can be a safe contraceptive to take after giving birth if you’re breastfeeding because even though a small amount of medication may come through in your breast milk, this won’t affect your baby.

Some medications can interact with Cilique and affect the way it works. Speak to your doctor or pharmacist if you are taking:

• vitamin C
• epilepsy treatment such as carbamazepine, phenytoin, topiramate or primidone
• treatment for HIV such as ritonavir or dasabuvir
• St John’s wort, an over the counter remedy for low moods
• charcoal
• treatment for tuberculosis or Hepatitis C (rifampicin, rifabutin, boceprevir or telaprevir)
• medication used to treat nausea in cancer patients (aprepitant or fosaprepitant)
• modafinil
• bosentan
• metoclopramid
• certain sedatives (barbiturates)
• etoricoxib
• antifungal medicines such as griseofulvin, fluconazole or ketoconazole
• treatment for high cholesterol, such as atorvastatin, colesevelam or rosuvastatin

Cilique can also affect the way other medications work. A complete list is included in the patient information leaflet.

There is a large variety of alternatives to the Cilique contraceptive pill available.

Combined pills, such as Cilique, contain both a progestogen and an oestrogen. They can help with strong menstrual symptoms and acne, but are less safe for women with a higher risk of blood clots.

• Yasmin pill
• Qlaira
• Millinette

Mini pills contain only 1 type of hormone, a progestogen. They are a good alternative for women who cannot or don’t want to take oestrogen.

• Cerazette
• Cerelle
• Norgeston

Most hormonal contraceptives are taken in the form of a pill, but there are also contraceptive patches, contraceptive injections and vaginal rings that can also be used to deliver contraceptive hormones. We offer Evra patches online, which can be an alternative to contraceptive pills like Cilique.

➤ If you are unsure which pill would best fit your needs, you can read more about at our What is the Best Contraceptive Pill for Me? page.

➤ Additionally, you can find extensive information on all contraceptive methods on our Guide to Different Types of Contraceptive Methods page.

The Cilest and Cilique contraceptive pills are almost the same. They contain the same types of hormones in the same dosage, but are produced by different manufacturers. Cilest has been discontinued, but Cilique is a good alternative.

Cilique vs. Yasmin - which one is better?

Cilique and Yasmin are both combined contraceptive pills, but have different types of progestogen. The progestogen in Yasmin, drospirenone, belongs to the 4th generation of progestogens. The norgestimate in the Cilique pill is a 3rd generation Progestogen. Both are safe and effective, but have slightly different non-contraceptive effects, such as androgenic hormones, which can affect acne or hair growth. Depending on your physiology and the effects you would like to have, you may prefer one or the other.

Different people experience the Cilique pill very differently. Each body reacts to hormones in their own way. While some women report only minor side effects or none at all, others have stronger side effects which cause them to switch to another pill. It always depends on your individual body what side effects you will have, if any. For many people it takes some trial and error before they find a pill they feel comfortable with.

Patient reviews online can show how other users of Cilique have experienced their treatment. Contraceptive treatment using the active ingredients in Cilique is rated:

• 5.2 out of 10 on drugs.com
• 3.4 out of 5 on webmd.com

The Cilique contraceptive pill is a safe and effective contraceptive method, preventing pregnancy in more than 99% of women using it perfectly. For some people Cilique has only minor side effects and they feel comfortable using it for longer periods. Other people tolerate Cilique less well and switch to another pill which works better for them. A lot of side effects only appear in the first 3 months of taking Cilique. If you are not happy about the side effects Cilique causes for you, you can usually switch to another pill anytime.