Justima Dosage/Direction for Use

One pack (blister) contains 21 tablets. The day of the week to take the tablet is printed at the side of each tablet. If, for example, the patient start on Wednesday, the patient should take a tablet with "WED" at the side. Follow the arrow on the pack until the patient have used the 21 tablets.
The patient should then not take any tablet for 7 days. During theses 7 days when the patient do not take any tablets (called drug-free interval), the patient should menstruate. Menstruation. which can also be called withdrawal bleeding, usually starts on the 2^nd or 3^rd days of the drug-free interval.
On the eight day from taking the last Justima tablet (that is after 7 days drug-free interval), start the following pack, even if you have not stopped menstruating. This means that the patient should start the following package on the same day which the patient started the previous week and menstruation should occur during the same dates of every month.
If the patient used Justima as described, the patient is protected against pregnancy during the 7 days the patient does not take any tablet.
When can the patient start the first pack: If the patient have not taken any hormonal contraceptive in the previous month: Start taking Justima on the first day of cycle (that is the first day of menstruation). If the patient start taking Justima on the first day of menstruation, the patient will be immediately protected against pregnancy. The patient can also start from the second to the fifth day of the cycle, but the patient should use additional contraceptives (a condom for example) for the first 7 days.
Changing from another combined hormonal contraceptive, combined contraceptive vaginal ring or patch: The patient can start taking Justima the next day after the drug-free interval of the previous contraceptive vaginal ring or patch, follow the physician's recommendations.
Changing from a method based exclusively on progestogens (progestogen only tablets, injection, progestogen-releasing intrauterine device or implant): The patient can change from the progestogen only tablet whatever the patient like (if the patient had an implant or an intrauterine device, use the new tablet the day the patient remove it; if the patient used injections, use the new tablet on the day when the patient would have injected again), but it is recommended in all cases, to use additional protection (a condom for example) for the first 7 days of taking the tablets).
After Abortion: Follow the physician's recommendations.
After having a Child: The patient can start taking Justima between 21 and 28 days after having a child. If the patient start later, the patient should use a barrier contraceptive (a condom for example) for the first 7 days the patient take Justima.
If, after having a child, and have already had sexual relations before starting Justima (again), the patient must be sure that the patient is not pregnant or wait for the next period.
If the patient forgets to take Justima: If the patient forget to take a tablet in the 1^st, 2^nd or 3^rd rows, the patient should follow these instructions: If less than 12 hours late in taking a tablet, the protection from pregnancy is not reduced. Take the tablet as soon as remembered and the following tablets at the usual time.
If more than 12 hours late in taking a tablet, protection from pregnancy may be reduced. The more tablets forgotten to take, the greater risk of reducing the contraceptive effect.
The risk of reduced protection against pregnancy is highest if the patient forgets to take the tablet at the beginning of 1^st row and end of week 3-3^rd row in the pack. Consequently, the patient should adopt the following measures.
Forgetting to take more than one tablet in a pack: Consult the physician.
Forgetting to take one more tablet in week 1: Take the tablet forgotten as soon as the patient realized, even if this means taking two tablets at the same time. Continue taking the following tablets at the usual time and take additional precautions, for example a condom, for the next 7 days. If the patient has had sexual relations in the week before the patient forgot to take the tablet, there is a risk of becoming pregnant. In this case, consult the physician.
Forgetting to take one tablet in week 2: Take the tablet forgotten as soon as realized, even if this means taking two tablets at the same time. Continue taking the following tablets at the usual time. The contraceptive effect will not be reduced and the patient does not need to take additional precautions.
Forgetting to take one tablet in week 3: The patient can choose one of two possibilities: 1.Take the tablet the patient have forgotten as soon as the patient realized, even if this means taking two tablets at the same time. Continue taking the following tablets as the usual time. Start taking the next pack as soon as the current pack is finished.
The patient will probably have period (withdrawal bleeding) at the end of the second pack, but could also have some spots or bleeding when taking the second pack.
2. The patient can stop taking tablets from the current pack, have a tablet-free interval of 7 days (taking note that of the day the patient forget to take the tablet) and start a new pack on the fixed start date.
If the patient follows one of these two recommendations, the patient will be protected against pregnancy: If the patient have forgotten to take tablets and does not have a period during the tablet-free interval, the patient may be pregnant. In this case, the patient should consult the physician before continuing with the second pack.