Zelleta (Desogestrel)

Zelleta is a contraceptive pill. People who are at risk of getting pregnant may be able to take these tablets every day and get protected against unwanted pregnancies.

It is important to note that Zelleta does not protect against sexually transmitted diseases. To stay safe from STIs, use extra protection like condoms.

Zelleta is a mini pill.

“We call a certain type of contraceptive pill a ‘mini pill’. Mini pills only contain progesterone as the active ingredient, for example the desogestrel in Zelleta – in contrast, combined pills contain oestrogen as well as progesterone. The 75 micrograms of desogestrel in the Zelleta mini pill still prevents pregnancy very effectively”, explains Dr. Babak Ashrafi, Clinical Lead for Service Expansion at ZAVA. “Pills like this can be an option for women who can’t take oestrogens, because they are older than 35 and smoke, breastfeeding or have a high BMI, for example.”

Mini pills with 75mcg of desogestrel, like Zelleta, prevent pregnancies by stopping eggs from being released from your ovaries. They can also:

• change the mucus at the opening of the womb, so sperm cells are actually unable to reach the womb
• thin the lining of the womb, making it harder for a fertilised egg to grow

This combination ensures effective contraception protection. Even if sperm cells reach the womb, there is no egg waiting to be fertilised. If an egg did get released and fertilised, it would still be unable to grow.

Zelleta can be prescribed for people who want to prevent pregnancy by using a hormonal type of contraception. It is particularly suitable for women who can’t or don’t want to take oestrogens.

If a doctor confirms the Zelleta mini pill is safe, it can be a good choice for people who:

• have high blood pressure
• are overweight
• have had a blood clot in the past
• are breastfeeding
• smoke
• are older than 35
• are prone to migraines with aura

If you always take it correctly, Zelleta is a very effective pill. Studies, like this analysis in the British Journal of Family Planning, have shown that these progesterone-only pills have a Pearl Index of 0.43 across all relevant age groups. This means that out of 100 women who use the mini pill perfectly for 1 year, about 0.43 get pregnant (or about 4 in 1,000 women). That translates to an efficacy of more than 99%.

It is important to keep in mind that these results only apply to a perfect use of Zelleta. If you miss pills, don’t stick to your schedule or throw up or have diarrhoea after taking a tablet, the mini pill may be less effective.

In 2010, a systematic review of the advantages and challenges of oestrogen-free hormonal contraception concluded that while the mini pill might lead to a more irregular bleeding pattern at the start of treatment, it is a very effective contraceptive method and can even help to treat menstrual problems.

For example, it can reduce the pain you experience during your period and improve symptoms of premenstrual syndrome (PMS). A 2022 observational study proved that progesterone-only contraceptive pills with desogestrel are just as effective in treating endometriosis-related pain as combined contraceptive pills.

Yes, if you would like to use or continue using Zelleta tablets, you can request them online or as in person. You can make your online request using an online doctor service like ZAVA. To use our service, you just need to fill out a short medical questionnaire. Our doctors will check your answers and check whether Zelleta is safe for you. If it is, your order will be delivered to your address.

The Zelleta pill has 3 main benefits for people who want to use hormonal contraception:

1. It doesn't contain oestrogen, so it's a good option if you can't or don't want to take oestrogen.
2. Zelleta is a very effective contraceptive pill and contains progesterone that prevents ovulation as well as changing the mucus at the entrance of the womb and making it harder to reach for sperm cells.
3. Zelleta can reduce any pain that comes from endometriosis or PMS.

To effectively protect against pregnancy, Zelleta tablets need to be taken once every day around the same time. You swallow each tablet with a bit of water. Do not chew, split or crush the tablets.

Zelleta strips are labelled to help you to remember to take tablets every day. Once you have finished a strip of 28 tablets, you should immediately start a new one on the next day. There is no pill-free period between strips.

When to start taking the Zelleta pill

When to take your first Zelleta pill depends on the contraceptive method that you’ve used so far.

Not switching from hormonal contraception:

If you haven’t used the pill or any other kind of hormonal contraceptive method up to this point, you can start with Zelleta when you get your next period. Ideally you’d take the first pill on the first day of your period, then you are immediately protected, even if you start it up to the first 5 days of your period. If you start at any point after day 5 of your period it takes a few days for Zelleta to be completely effective. In this case, we recommend that you use additional protection (like condoms) for the next 2 days.

Switching from the combined pill, vaginal ring or transdermal patch:

If you want to switch to a mini pill like Zelleta, you need to finish the current 28-day cycle of your pill or wait until your ring or patch needs to be removed. You can then start taking Zelleta on the day after your last tablet or on the day that you remove your vaginal ring or transdermal patch. You do not need additional protection.

Switching from an injection, implant or a hormonal intrauterine device (IUS):

If you want to switch from an injection, implant or a hormonal intrauterine device to Zelleta, you should take your first pill on the day that you would normally get your next injection or get your implant or hormonal intrauterine device removed. You do not need additional protection.

Switching from a different mini pill:

In order to switch between different types of mini pill, you don’t need to follow any special rules. Just take Zelleta when you’re due to take your next mini pill. You can start taking Zelleta on any day of your cycle.

Please note, if you’ve just had a baby, a miscarriage or an abortion or if you have any questions about how to switch to Zelleta, we recommend that you talk to a doctor. You can do this by messaging one of our doctors through your account.

How long does Zelleta take to work?

How long Zelleta takes to work depends on when you start taking it. If you are able to start on the first day of your period or on the day after taking the last combined pill of a month, you are immediately protected against pregnancy. If you start at a different time, it takes Zelleta 2 days to be completely effective. During those 2 days you should use extra protection, like condoms.

Missed pill: What should I do if I forget to take Zelleta?

If you notice that you have missed the pill, you need to check how much time has passed since you were originally supposed to take it:

• If it has been less than 12 hours: Take the pill as soon as you remember and then continue with your regular schedule – even if this means taking 2 tablets in 1 day. There’s no need for additional protection.
• If it has been more than 12 hours: Take the missed pill as soon as you remember – and then use additional protection (like condoms) for the next 2 days. If you have had unprotected sex the week before, there is a risk that you might get pregnant. The more pills you forget the higher this risk is. Please talk to your doctor, since emergency contraception might be an option for you.

Can I take Zelleta continuously (without a pause)?

Yes, taking Zelleta continuously is not a problem. Because it is a progesterone-only pill this is actually the intended way of using it. With these sorts of pills (mini pills) there is no pill-free interval in between strips.

What should I do if I take 2 or more doses of Zelleta?

If you have accidentally taken more pills than you should have, side effects like nausea or vomiting can occur, or can be a little stronger than usual. Serious side effects from taking too much Zelleta are unlikely.

What should I do if I vomit or have diarrhoea after taking Zelleta?

Vomiting or having diarrhoea up to 4 hours after having taken Zelleta can mean that your body hasn’t had enough time to absorb it. In these cases, you would not be completely protected from a pregnancy.

You should take another pill – at the very latest 12 hours after you have taken or normally take your Zelleta. Afterwards you can continue with your regular schedule.

If you take another pill later than 12 hours or you throw up or have diarrhoea after the second pill you need to use extra protection like condoms. Continue to use extra protection until 2 days after the last pill you took without throwing up or having diarrhoea.

How to stop taking Zelleta

If you decide that you want to stop using Zelleta, you should talk to a doctor. They can help you find an alternative that works better for you in the future and give advice about coming off the pill. If you get your pill through ZAVA, message one of our doctors through your patient account for advice.

What happens when you come off Zelleta?

“Please note that coming off the Zelleta pill (desogestrel) is going to mean that the contraceptive effect is gone 36 hours after your last dose – you will not be protected against pregnancy anymore”, says Dr. Babak Ashrafi, Clinical Lead for Service Expansion. “If you want to stop taking Zelleta because you want to get pregnant, we recommend that you start trying for a baby after you get your regular period. This allows for easier tracking of your fertility and a more reliable calculation of the date of conception.”

Contraindications: When should I not take Zelleta?

You should not take Zelleta if you

• have a history of blood clots (thrombosis)
• have or have had a severe liver disease and/or jaundice
• have or might have a type of cancer that is sensitive to sex-steroids
• currently have unexplained vaginal bleeding
• have an allergy to any of the ingredients in Zelleta

In these instances your doctor is not going to approve Zelleta for you.

During pregnancy you should not take Zelleta.

While you are breastfeeding, however, it is possible to use the Zelleta mini pill as your contraceptive method. A small amount of the active ingredient can be found in the milk, but studies have shown that this doesn’t have a harmful effect on your child.

Mini pills like Zelleta are a good choice for long-term contraception. If the pill is suitable for you and you stay healthy, you can take Zelleta until your menopause. Taking mini pills during menopause can increase the chance of irregular bleeding and hot flashes.

Zelleta might increase your risk of developing a blood clot, but your risk will not be as high as it is while taking a combined pill (containing oestrogen as well as progesterone). Even then the increase in risk is small and only an issue if you already have a risk of or history of blood clots.

If you develop signs of thrombosis while taking Zelleta, such as pain and/or swelling in one of your legs or pain in your chest, you should see a doctor immediately.

Taking Zelleta may cause some side effects, especially when you first start the contraceptive pill. These include:

Common Zelleta side effects:

• irregular periods or no periods
• changes in mood
• depression
• headaches
• nausea
• breast pain
• acne
• less sexual drive (libido)
• weight gain

Uncommon side effects of Zelleta contraceptive pill:

• painful periods
• hair loss
• vomiting
• difficulties in wearing contact lenses
• infections of the vagina
• ovarian cysts
• tiredness

If you feel that any of the side effects you experience affect your day-to-day life, you should speak to your doctor. If necessary, they can help you find an alternative that suits you better.

For a complete list of Zelleta’s possible side effects you can check the patient information leaflet.

Some other medications can interact with Zelleta. These interactions could either lead to the pill not being completely effective or an additional risk of side effects. This is why you should always tell your doctor about all of the medications you’re currently taking or planning to take when requesting Zelleta treatment.

There are known interactions between the Zelleta 75-micrograms-tablets and medications that treat:

• stomach upset
• depressive moods
• tuberculosis
• epilepsy
• high blood pressure, angina or heart rhythm disorders
• high blood pressure in the lungs’ blood vessels
• HIV infections
• Hepatitis C virus infections
• other infections, including bacterial and fungal infections

At the moment there are no known interactions of Zelleta tablets with food or drink. You can take Zelleta with or without food. Alcohol doesn’t affect the pill directly but can make throwing up or diarrhoea more likely, which could affect your contraception.

The active ingredient in the Zelleta contraceptive pill is 75 micrograms of desogestrel.

Secondary ingredients are:

• lactose anhydrous
• all-rac-α-tocopherol
• povidone
• potato starch
• silica colloidal anhydrous
• stearic acid

Because Zelleta contains lactose the contraceptive pill is not suitable for vegans and might not be a good choice for people with lactose intolerance.

Zelleta is not the only mini pill available in the UK – there are several alternatives that can be a good choice if you want to try a different option.

Zelleta and Cerelle

Cerelle is a mini pill with the same active ingredient in the same dosage as Zelleta (75mcg of desogestrel). This means that when it comes to efficacy, side effects and interactions it will be very similar to Zelleta. The secondary ingredients are slightly different – some people might tolerate Cerelle better.

Zelleta and Cerazette

Just like Zelleta and Cerelle, Cerazette is oestrogen-free. It also contains 75 micrograms of desogestrel and is therefore a very similar mini pill. Secondary ingredients differ slightly and might lead to slight changes in tolerability.

There are several websites that allow patients to rate and review different contraceptive pills. They are a good resource to check if you want to compare your experience to other people’s and find the best contraceptive pill for you.

Zelleta as a contraceptive pill is rated :

• 2.7 out of 5 at thelowdown.com

Would you like to find out more about how our patients review our service? Have a look at ZAVA reviews!

How should I store Zelleta?

You should always make sure to keep Zelleta out of the reach of children. Apart from that, no special storage conditions are necessary.

How should Zelleta be disposed of?

If you stop taking Zelleta, you should speak to your pharmacist about the correct disposal of the remaining pills. You should avoid throwing them in your wastewater or household waste.

What does Zelleta look like?

Each Zelleta pill is a round, uncoated and biconvex (rounded oval shape that sticks out on top and underneath) tablet. It is debossed (engraved) with ‘152’ on one side and is plain on the other.

What pack sizes is Zelleta available in?

Zelleta is available in boxes of 1, 3, 6 or 13 strips of tablets. Each strip contains 28 pills.

Information about the manufacturer

Marketing Authorisation Holder

Morningside Healthcare Ltd., Unit C, Harcourt Way, Leicester, LE19 1WP

Manufacturer

Morningside Pharmaceuticals Limited, 5 Pavilion Way, Loughborough, LE11 5GW, UK