Mercilon Dosage/Direction for Use

How to take Mercilon: The tablets must be taken in the order directed on the strip every day at about the same time with some liquid as needed. One tablet is to be taken daily for 21 consecutive days. Each subsequent strip is started after a 7-day tablet-free interval, during which time a withdrawal bleed usually occurs. This bleed usually starts on the second or third day after the last tablet and may not have finished before the next strip is started.
How to start taking Mercilon: No preceding hormonal contraceptive use [in the past month]: The first tablet should be taken on day 1 of the woman's natural cycle (i.e. the first day of her menstrual bleeding). Starting on days 2-5 is allowed, but in that case during the first cycle the use of a barrier method is recommended in addition for the first 7 days of tablet-taking.
Changing from another combined hormonal contraceptive (combined oral contraceptive (COC), vaginal ring, or transdermal patch): The woman should start with Mercilon preferably on the day after the last active tablet (the last tablet containing the active substances) of her previous COC, but at the latest on the day following the usual tablet-free (or placebo tablet) interval of her previous COC. If a combined contraceptive in the form of a vaginal ring or transdermal patch has been used, the woman should preferably start using Mercilon on the day of removal, but at the latest on the day on which the next ring or plaster would have been put in place. The hormone-free interval of the previous method should never be extended beyond its recommended length.
If the woman has used her previous combined hormonal contraceptive method consistently and correctly during the previous 7 days and if it is reasonably certain that she is not pregnant, she may also switch to Mercilon from her previous combined hormonal contraceptive on any day of the cycle.
Changing from a progestogen-only-method (minipill, injection, implant) or from a progestogen-releasing intrauterine system (IUS): The woman may switch any day from the minipill (from an implant or IUS on the day of its removal, from an injectable when the next injection would be due), but should in all cases be advised to additionally use a barrier method for the first 7 days of tablet-taking.
Following first-trimester abortion: The woman may start immediately. When doing so, she does not need to take additional contraceptive measures.
Following delivery or second-trimester abortion: For breastfeeding women, see Use in Pregnancy & Lactation.
Women should be advised to start on day 21 to 28 after delivery or second-trimester abortion. When starting later, the woman should be advised to additionally use a barrier method for the first 7 days of tablet-taking. However, if intercourse has already occurred, pregnancy should be excluded before the actual start of COC use or the woman has to wait for her first menstrual period.
Management of missed tablets: If the user is less than 12 hours late in taking any tablet, contraceptive protection is not reduced. The woman should take the tablet as soon as she remembers and should take the remaining tablets at the usual time.
If she is more than 12 hours late in taking any tablet, contraceptive protection may be reduced. The management of missed tablets can be guided by the following two basic rules: 1. tablet-taking must never be discontinued for longer than 7 consecutive days.
2. 7 days of uninterrupted tablet-taking are required to attain adequate suppression of the hypothalamic-pituitary-ovarian axis.
Accordingly the following advice can be given in daily practice: Week 1: The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. She then continues to take the remaining tablets at her usual time. In addition, a barrier method should be used for the next 7 days. If intercourse took place in the preceding 7 days, the possibility of a pregnancy should be considered. The more tablets are missed and the closer they are to the regular tablet-free interval, the higher the risk of a pregnancy.
Week 2: The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. She then continues to take the remaining tablets at her usual time. Provided that the woman has taken her tablets correctly in the 7 days preceding the first missed tablet, there is no need to use extra contraceptive precautions. However, if this is not the case, or if she missed more than 1 tablet, the woman should be advised to use extra precautions for the next 7 days.
Week 3: There is a high risk of reduced reliability because of the approaching tablet-free interval. However, by adjusting the tablet-intake schedule, reduced contraceptive protection can still be prevented. By adhering to either of the following two options, there is no need to use extra contraceptive precautions, provided that in the 7 days preceding the first missed tablet the woman has taken all tablets correctly. If this is not the case, the woman should be advised to follow the first of these two options and to use extra precautions for the next 7 days as well.
1. The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. She then continues to take the remaining tablets at her usual time. The next strip must be started as soon as the current strip is finished, i.e., there should be no gap between strips. The user is unlikely to have a withdrawal bleed until the end of the second strip, but she may experience spotting or breakthrough bleeding on tablet-taking days.
2. The woman may also be advised to discontinue tablet-taking from the current strip. She should then have a tablet-free interval of up to 7 days, including the days she missed tablets, and subsequently continue with the next strip. If the woman has missed tablets and subsequently has no withdrawal bleed in the first normal tablet-free interval, the possibility of a pregnancy should be considered.
Advice in the case of gastrointestinal disturbances: In the case of severe gastrointestinal disturbance, absorption may not be complete and additional contraceptive measures should be taken.
If vomiting occurs within 3-4 hours after tablet-taking, the advice concerning missed tablets, as previously given in Management of missed tablets, is applicable. If the woman does not want to change her normal tablet-taking schedule, she has to take the extra tablet(s) needed from another strip.
How to delay a period or shift periods: Delaying a period is not an indication for the product. However, in exceptional cases, to delay a period, the woman should continue with the tablets in another strip of Mercilon without a tablet-free interval. The period can be delayed for as long as desired, but no longer than until the end of the second strip. During the extension the woman may experience breakthrough bleeding or spotting. Regular intake of Mercilon is resumed after the usual 7-day tablet-free interval.
To shift her period to another day of the week than the woman is used to with her current scheme, she can be advised to shorten her next tablet-free interval by as many days as she likes. The shorter the interval, the higher the risk that she does not have a withdrawal bleed and will experience breakthrough bleeding or spotting during the second strip (just as when delaying a period).
Paediatric patients: The safety and efficacy of Mercilon in adolescents under the age of 18 years have not been studied.