Swingo

Oral contraception and the recognised gynaecological indications for such oestrogen-progestogen combinations.

The decision to prescribe Swingo 30 ED should take into consideration the individual woman's current risk factors, particularly those for venous thromboembolism (VTE), and how the risk of VTE with Swingo 30 ED compares with other combined hormonal contraceptives (CHCs).

Tablets must be taken orally in the order directed on the blister package at about the same time every day, with some liquid if necessary.

First treatment cycle: 1 tablet daily for 28 days, starting on the first day of the menstrual cycle. 21 (small) active tablets are taken followed by 7 (larger) placebo tablets. Contraceptive protection begins immediately.

Subsequent cycles: Tablet-taking is continuous, which means that the next pack of Swingo 30 ED follows immediately without a break. A withdrawal bleed usually occurs when the placebo tablets are being taken.

Changing from 21-day combined oral contraceptives: The first tablet of Swingo 30 ED should be taken on the first day immediately after the end of the previous oral contraceptive course. Additional contraceptive precautions are not required.

Changing from a combined Every Day pill (28 -day pill): Swingo 30 ED should be started after taking the last active tablet from the previous Every Day pill pack. The first Swingo 30 ED tablet is taken the next day. Additional contraceptive precautions are not then required.

Changing from a progestogen-only pill (POP):

The first tablet of Swingo 30 ED should be taken on the first day of bleeding, even if a POP has already been taken on that day. Additional contraceptive precautions are not then required. The remaining progestogen-only pills should be discarded.

Post-partum and post-abortum use: After pregnancy, oral contraception can be started 21 days after a vaginal delivery, provided that the patient is fully ambulant and there are no puerperal complications. Additional contraceptive precautions will be required for the first 7 days of tablet taking to ensure adequate contraceptive cover if early ovulation has occurred. Since the first post-partum ovulation may precede the first bleeding, another method of contraception should be used in the interval between childbirth and the first course of tablets. After a first-trimester abortion, oral contraception may be started immediately in which case no additional contraceptive precautions are required.

Special circumstances requiring additional contraception

Incorrect administration: Errors in taking the 7 placebo tablets (i.e. the larger white tablets in the last row) can be ignored.

A single delayed active (small) tablet should be taken as soon as possible, and if this can be done within 12 hours of the correct time, contraceptive protection is maintained.

With longer delays in taking active tablets, additional contraception is needed. Only the most recently delayed tablet should be taken, earlier missed tablets being omitted, and additional non-hormonal methods of contraception (except the rhythm or temperature methods) should be used for the next 7 days, while the next 7 active (small) tablets are being taken. Therefore, if the 7 days additional contraception extend beyond the last active (small) tablet, the user should finish taking all the active tablets, discard the placebo tablets and start a new pack of Swingo 30 ED the next day with an appropriate active (small) tablet. Thus, active tablet follows active tablet with no 7 day break. In this situation, a withdrawal bleed should not be expected until the end of the second pack. Some breakthrough bleeding may occur on tablet taking days but this is not clinically significant. If the patient does not have a withdrawal bleed following the end of the second pack, the possibility of pregnancy must be ruled out before starting the next pack.

Gastro-intestinal upset: Vomiting or diarrhoea may reduce the efficacy of oral contraceptives by preventing full absorption. If vomiting or diarrhoea occurs within 4 hours of tablet-taking from the current pack should be continued. Additional non-hormonal methods of contraception (except the rhythm or temperature methods) should be used during the gastro-intestinal upset and for 7 days following the upset. If these 7 days extend beyond the last active (small) tablet the user should finish taking all the active tablets, discard the placebo tablets and start a new pack of Swingo 30 ED the next day with an appropriate active (small) tablet. In this situation, a withdrawal bleed should not be expected until the end of the second pack. If the patient does not have a withdrawal bleed at the end of the second pack, the possibility of pregnancy must be ruled out before starting the next pack. Other methods of contraception should be considered if the gastro-intestinal disorder is likely to be prolonged.

Children: Not applicable

Elderly: Not applicable