Zelleta contraceptive pill

Zelleta is a contraceptive pill containing just 1 hormone: progesterone. It can prevent pregnancy when taken every day at the same time. It’s known under a few names, including the progesterone-only pill (POP) and the ‘mini pill’.

Zelleta is an option for people who cannot take oestrogens, perhaps because they are older than 35 and smoke, are breastfeeding, or have a high BMI.

It contains the active ingredient desogestrel, which is an artificial version of progesterone that acts in the same way as the natural female hormone progesterone. Zelleta is manufactured by Morningside Healthcare Ltd.

Zelleta does not protect against sexually transmitted infections (STIs). To stay safe from STIs, you should use extra protection like condoms.

Zelleta can prevent pregnancy by stopping eggs from being released from your ovaries. It also works to:

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

This combination is an effective contraception method and works over 99% of the time. 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 implant and grow.

How long does Zelleta last?

Zelleta will continue to work for as long as you take it, but you’ll no longer be protected from pregnancy as soon as you stop taking it. If you want to stop taking it to become pregnant, it can take several months for your hormones and periods to go back to how they were before.

Zelleta and menopause

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 menopause. Taking mini pills during menopause may increase the chance of irregular bleeding.

How long does Zelleta take to work?

When you first start taking Zelleta, it can either start working straight away, or you may need to wait for up to 7 days. This depends on whether you were taking contraception before and when in your menstrual cycle you start taking it.

If possible, we recommend starting Zelleta on the first day of your menstrual cycle (the first day of your period) as it will work straight away.

If you always take it correctly, Zelleta is a very effective contraceptive. Studies show that when mini pills like Zelleta are taken perfectly for 1 year, about 4 in 1,000 women will get pregnant. This means it’s over 99% effective.

For some people, Zelleta can do more than prevent pregnancy. Your doctor may prescribe it to reduce the pain you experience during your period and improve symptoms of premenstrual syndrome (PMS).

What can reduce the effectiveness of Zelleta?

It’s important to keep in mind that these results only apply to a perfect use of Zelleta. The effectiveness of Zelleta is reduced if you:

• miss a pill, and the effectiveness may reduce further if you miss several
• do not stick to your schedule by not taking it at the same time each day
• throw up or have diarrhoea after taking the pill, especially if you this carries on for longer than 24 hours

If you do miss a pill or have diarrhoea or vomiting, your patient information leaflet includes information on what to do so that you do not get pregnant.

➤ You can also find more detailed information in our guide on what to do if you forget to take your pill.

To effectively protect yourself from pregnancy, Zelleta needs to be taken once every day around the same time. Swallow each pill with a bit of water. Do not chew, split, or crush your pill.

Zelleta strips are labelled to help you to remember to take it every day, and each day of the week is labelled alongside a pill. Taking your pills while following the day of the week you’re on can make it easier to keep track. Once you have finished a strip of 28 pills, you should immediately start a new one on the next day. There is no pill-free break between strips, which means you must take Zelleta continuously.

If you have trouble remembering to take your pill, we recommend setting a reminder or alarm for your pill every day, because not taking it properly will reduce its effectiveness. You may prefer to try taking Zelleta at the same time you do something else out of habit, like brushing your teeth, to help you remember.

While taking the pill, you should have regular check-ups with your doctor where they will check your health, any side effects, and your blood pressure. This is to make sure the pill you’re taking is still the safest and best option for you. Pill checks are usually once a year, but may be more often if you have certain health conditions.

What if I miss a dose of Zelleta?

If you notice that you have missed your 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 pills 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 7 days. The more pills you forget, the higher the chance of pregnancy becomes.

Within the first week of taking Zelleta: Missing 1 or more pills during this time, especially if you had sex the week before starting it, could mean that you get pregnant. Speak to your doctor about emergency contraception if this is the case for you.

What if I take too much 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. If you think you have taken too much Zelleta, tell your doctor.

What if I throw up after taking Zelleta?

If you throw up or have severe diarrhoea within 4 hours of taking your Zelleta pill, it may not have been fully absorbed, and you’ll need to take another pill straight away. Take your next pill at your usual time. If you do not take another pill within 12 hours of your normal time, use additional contraception to prevent pregnancy for 2 days.

If you continue to have vomiting and/or severe diarrhoea, keep using another form of contraception until you’re better, and for 2 days after.

You can request Zelleta online with a prescription from a doctor by accessing a regulated online doctor service like ZAVA. You may also be able to get Zelleta prescribed from your GP, but this depends on which pills they have available. They may prescribe an alternative with the same active ingredient.

Can I buy Zelleta online?

Yes, if you would like to start or continue taking Zelleta, you can request it online, using a regulated doctor service like ZAVA, by simply:

1. Filling out a short medical questionnaire.
2. Our doctors will check your answers and check whether Zelleta is suitable for you.
3. If Zelleta is suitable and approved, your order will be delivered to your chosen address in discreet packaging.
4. You can message one of our doctors if you have any questions while taking Zelleta through your private patient account. You can also quickly and easily order a repeat prescription when you need it.

Can I buy Zelleta over the counter?

No, Zelleta is a prescription-only pill. You’ll need a prescription from a doctor to get it online or in a pharmacy.

If you’re looking for an over-the-counter alternative, Hana is another mini pill that contains the same active ingredient desogestrel, in the same dose (75mcg). The only differences are the brand name, packaging, and some of the inactive ingredients.

Can I get Zelleta on the NHS?

Yes, you can get the mini pill from the NHS, usually after having an in-person consultation with your GP or at a sexual health clinic.

NHS guidelines state pills containing 75mcg of desogestrel be offered first, however, as Zelleta is branded, it’s more likely they’ll offer you a generic version. The generic version of Zelleta works in the same way but may have different inactive ingredients.

Zelleta can cause side effects, although not everybody will get them.

A common side effect of Zelleta is vaginal bleeding, which may happen at irregular intervals and is most likely within the first few months of taking it, or if you miss pills. This can be anything from very light to heavier bleeding, which feels like a period. You may also not have any bleeding at all. This is not a sign that Zelleta is not working, and you should continue to take it as prescribed. If bleeding is heavy or prolonged, speak to your doctor.

Common side effects (affecting more than or equal to than 1 in 100 people) include:

• mood changes
• depressed mood
• decreased sex drive (libido)
• headache
• feeling sick (nausea)
• acne
• breast pain
• irregular or no periods
• weight increase

Uncommon side effects (affecting less than 1 in 100 people) include:

• infection of the vagina
• difficulties in wearing contact lenses
• being sick (vomiting)
• hair loss
• painful periods
• ovarian cysts
• tiredness

Rare side effects (affecting less than 1 in 1000 people) include:

• skin conditions such as rash, hives, or painful blue-red skin lumps (erythema nodosum)

Serious side effects include a severe allergic reaction. You or someone else should call 999 straight away if you have symptoms such as:

• a swollen face, tongue, or throat
• difficulties swallowing
• hives
• difficulties breathing
• reduced consciousness

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in the patient information leaflet.

Zelleta and breast cancer

The risk of breast cancer is slightly higher when taking the contraceptive pill and this risk increases with age. More research is needed into progesterone-only pills like Zelleta, though it’s thought that the risk is similar or lower than oestrogen pills (the combined pill).

Research shows that out of 10,000 people taking the contraceptive pill for up to 5 years:

• around 1 extra case is reported when the pill is stopped before age 20
• around 20 extra cases are reported when the pill is stopped before age 40

Zelleta and blood clots

The risk of a blood clot is higher in people taking the contraceptive pill but no higher than the risk in pregnant women. Mini pills like Zelleta are thought to be lower risk compared to oestrogen-containing pills but more research is needed.

Before you take Zelleta, a healthcare professional needs to make sure that your risk of blood clots is low. It’s important to tell your doctor of your medical history, and any history of blood clots in your family.

If you’re due to have surgery or will be immobile for any reason, speak to your doctor. You will need to stop taking Zelleta during this time as your risk of blood clots will be higher.

How long do Zelleta side effects last?

The side effects of Zelleta typically last between a few weeks to a few months, although they may last longer. This is because it takes time for your body to get used to the change in hormones. Taking it properly at the same time each day, without missing pills, can help your body get used to it.

What to do if you get Zelleta side effects

Mild side effects are common and should subside. We suggest waiting for your body to adjust, and in the meantime for:

• nausea or vomiting – take your pill at night and not on an empty stomach
• spotting or irregular periods – take your pill at the same time each day and use pantyliners until it becomes more regular or stops
• headaches – take over-the-counter painkillers like paracetamol or ibuprofen
• breast tenderness – wear a supportive bra, apply a warm compress, and take painkillers
• acne – practice good skin care and speak to your doctor if this is severe or long-lasting
• increased body weight – eat a healthy, balanced diet and get plenty of exercise each week (around 150 minutes per week)
• vaginal infection – speak to your doctor or pharmacist to get the correct treatment

Some people taking Zelleta have reported feeling depressed. Depression can be serious and may sometimes lead to suicidal thoughts. If you get symptoms of depression and you are struggling to manage, speak to your doctor or a mental health support line as soon as possible.

You should not take Zelleta if you:

• are allergic to any of the ingredients
• are pregnant or are trying to become pregnant
• have a thrombosis – thrombosis is the formation of a blood clot in a blood vessel, commonly in the legs (deep venous thrombosis) or the lungs (pulmonary embolism)
• have or have had jaundice (yellowing of the skin) or severe liver disease and your liver function is not back to normal
• have or are suspected to have cancer that is sensitive to hormones, such as certain types of breast cancer
• have any unexplained vaginal bleeding

Tell your doctor before starting Zelleta if any of these conditions apply to you and speak to them immediately if any of these conditions appear for the first time while using it.

Let your doctor know before taking Zelleta if you have any other medical conditions, especially if you have:

• ever had breast cancer
• liver cancer
• ever had a blood clot
• diabetes
• epilepsy
• tuberculosis
• high blood pressure
• had chloasma (yellowish-brown pigmentation patches on the skin, particularly on the face) – if so, your doctor will advise that you avoid too much exposure to the sun or ultraviolet radiation

These conditions do not necessarily mean that you cannot take Zelleta, however, you may need to be kept under close observation.

Can I take Zelleta if I am pregnant or breastfeeding?

If you are pregnant you should not take Zelleta.

You can take Zelleta while breastfeeding, unlike the combined pill. A small amount of the active ingredient can be found in the milk, but studies have shown that this does not have a harmful effect on your child.

Zelleta and other medications

Zelleta can interact with certain medications, and this may make it less effective, unsafe, or increase the chance of unexpected bleeding. These includes medications used to to treat:

• epilepsy, including primidone, phenytoin, carbamazepine, oxcarbazepine, felbamate, topiramate, and phenobarbital
• tuberculosis, including rifampicin, and rifabutin
• HIV infections, including ritonavir, nelfinavir, nevirapine, and efavirenz
• Hepatitis C, including boceprevir and telaprevir
• other infectious diseases, such as griseofulvin
• high blood pressure in the blood vessels of the lung, such as bosentan
• certain bacterial infections, including clarithromycin and erythromycin
• fungal infections, including ketoconazole, itraconazole, and fluconazole
• stomach upset, such as medical charcoal
• depressive mood, such as the herbal remedy St Johns wort
• high blood pressure (hypertension), angina, or certain heart rhythm disorders, such as diltiazem

Zelleta may also interfere with how certain medications work, causing either an increase in effect, such as medicines containing ciclosporine, or a decrease in effect (such as lamotrigine).

If you’re taking medications or herbal products that might make Zelleta less effective, condoms or another barrier method should be used during sex. The effect of another medicine on Zelleta may last up to 28 days after you stop taking it. Your doctor can tell you if you need additional contraception and for how long. If you’re prescribed a new medication while taking Zelleta, let the prescribing doctor and your GP know.

Zelleta is not the only mini pill available in the UK – there are other types of progesterone-only contraceptive pills available from ZAVA or your GP, which may be more suitable for you.

Zelleta alternatives include:

• Cerelle (75mcg desogestrel, prescription only)
• Cerazette (75mcg desogestrel, prescription only)
• Hana (75mcg desogestrel, available over the counter without a prescription)
• Norgeston (30mcg levonorgestrel, an alternative progesterone and prescription only)
• Noriday (350mcg norethisterone, an alternative progesterone and prescription only)

➤ If you’re not sure which pill is the right choice, our guide on which is the best contraceptive pill for me explores the different contraceptive pills in more detail, so you can make your choice with confidence.

Zelleta vs 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 effectiveness, side effects, and interactions, it will be very similar to Zelleta. The secondary (inactive) ingredients are slightly different, so some people might tolerate one better than the other.

Zelleta vs 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 how you tolerate the medication.

How should Zelleta be stored?

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

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.

In which pack sizes is Zelleta available?

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

What does Zelleta look like?

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

Can I take Zelleta while breastfeeding?

Yes, Zelleta is safe to take while breastfeeding and is not known to have any harmful effect on your baby. You can start Zelleta straight away after giving birth.

Does Zelleta affect your periods?

Yes it can. Mini pills like Zelleta can cause periods to stop for some people. Others report that their bleeding becomes lighter, more frequent, or irregular. Speak to your doctor if you’re having consistent or heavy bleeding that does not go away when taking Zelleta.