Liza Dosage/Direction for Use

Preparation of the Pack: Take Liza tablet everyday, with some water if needed. The patient can take the tablets with or without food, but should take Liza approximately at the same time everyday.
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 starts 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 tablets for 7 days. During these 7 days when the patient do not take any tablets (called drug-free interval), she should menstruate. Menstruation which can also be called withdrawal bleeding, usually starts on the 2nd or 3rd day of the drug-free interval.
On the 8th day from taking the last Liza tablet (that is after the 7 day drug-free interval), start the following pack, even if the patient has not stopped menstruating. This means that the patient should start the following package on the same day which she started the previous week and menstruation should occur during the same dates of every month.
If the patient uses Liza as described, she is also protected against pregnancy during the 7 days the patient does not take any tablet.
When to Start the First Pack: If the Patient has not taken any hormonal contraceptive in the previous month: Start taking Liza on the 1st day of the cycle (that is the 1st day of menstruation). If the patient start taking Liza on the 1st day of the menstruation, she will be immediately protected against pregnancy. The patient can also start from the 2nd to the 5th day of cycle, but she should use additional contraceptive (eg, a condom) for the 1st 7 days.
Changing from Another Combined Hormonal Contraceptive, Combined Contraceptive Vaginal Ring or Patch: The patient can start taking Liza the next day after the drug-free interval of the patient's previous contraceptive (or after taking the last inactive tablet). When changing from a combined contraceptive vaginal ring or patch, follow doctor's recommendations.
Changing from a method based exclusively on progestogens (progestogen only tablet, injection, progestogen-releasing intrauterine device or implant): The patient can change from the progestogen only tablet whenever she like (if the patient had an implant or an intrauterine device, use the new tablet the day it was removed; if the patient used injections, use the new tablet on the day when she would have injected again), but it is recommended, in all cases, that the patient use additional protection (eg, a condom) for the first 7 days of taking the tablets.
After Abortion: Follow the doctor's recommendations.
After Having a Child: The patient can start taking Liza between 21 and 28 days after having a child. If the patient starts later, she should use a barrier contraceptive (eg, a condom) for the first 7 days the patient take Liza. If after having a child, the patient has already had sexual relations before starting Liza again, the patient must be sure that she is not pregnant or wait for the next period.
Seek the doctor's advice if the patient is not sure when to start.
If the patient is breastfeeding and wants to start taking Liza again after having a child. (See Use in lactation under Precautions.)
Missed Dose: If the patient is <12 hrs late in taking a tablet, the protection from pregnancy is not reduced. Take the tablet as soon as the patient realize and the following tablets at the usual time.
If the patient is >12 hrs late in taking a tablet, protection from pregnancy may be reduced. The more tablets that the patient has forgotten to take, the greater the 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 at 1st row and end of week 3 at 3rd row in the pack. Consequently, the patient should adopt the following measures (see figure).

Click on icon to see table/diagram/image

Forgetting to Take More Than One Tablet in a Pack: Consult the doctor.
Forgetting to Take One Tablet in Week One: Take the tablet as soon as the patient realize, even if this means that she has to take 2 tablets at the same time. Continue taking the following tablets at the usual time and take additional precautions eg, a condom, for the next 7 days. If the patient has had sexual relations in the week before she forgot to take the tablet, there is a risk of getting pregnant. In this case, consult the doctor.
Forgetting to Take One Tablet in Week Two: Take the tablet as soon as the patient realize even if this means that she has to take 2 tablets at the same time. Continue taking the following tablets at the usual time. The contraceptive effect will not be reduced and the patient do not need to take additional precautions.
Forgetting to Take One Tablet in Week Three: The patient can choose 1 of 2 possibilities: 1) Take the tablet as soon as the patient realize, even if this means that she has to take 2 tablets at the same time. Continue taking the following tablets at the usual time. Instead of having a drug-free week, start taking the next pack.
The patient will probably have the period (withdrawal bleeding) at the end of the 2nd pack, but the patient could also have some specks or bleeding when taking the 2nd pack.
2) The patient can also stop taking the tablets. Start a drug-free interval of 7 days (taking note of the day the patient forgot to take the tablet). If the patient wants to start a new pack on the fixed start date, the drug-free interval should be <7 days.
If the patient follows 1 of these 2 recommendations, she will be protected against pregnancy.
If the patient has forgotten to take a tablet and do not have a period during the drug-free interval, this could mean that the patient is pregnant. In this case, consult the doctor before continuing with the 2nd pack.
If the Patient is Sick or Have Bad Diarrhea: If the patient vomits 3-4 hrs after taking the tablet or the patient has bad diarrhea, there is a risk that the active ingredients have not been totally absorbed by the body. This is similar to what happens when the patient forget to take a tablet. After vomiting or having diarrhea, the patient must take a tablet from reserve pack as soon as possible. If possible, take it within 12 hrs of the usual time that the patient take the tablet. If this is not possible, or >12 hrs have passed, follow the advice in Missed Dose as mentioned previously.
Bleeding Between Periods: During the 1st month of using Liza, the patient may bleed unexpectedly (bleeding outside the drug-free interval). If the patient experience such bleeding for more than a few months, or they begin after a few months, the doctor must find the cause.
If The Patient Does Not Have a Period During the Drug-Free Interval: If the patient has taken all the tablets correctly, has not vomited or had bad diarrhea and has not taken any other medication, it is very unlikely she is pregnant.
If the patient does not have 2 consecutive periods, she could be pregnant. Go to the doctor immediately. Do not start taking the next pack until the patient is sure that she is not pregnant.
Delaying the Period: Although it is not recommended, the patient can delay the period (withdrawal bleeding) until the end of a new pack if she continues to take a 2nd pack of Liza instead of the drug-free interval. The patient may experience specks (drops of blood or stains) or bleeding when taking the 2nd pack. After the usual drug-free interval of 7 days, continue with the next pack. The patient should consult the doctor before deciding to delay the period.
Changing the First Day of Period: If the patient take the tablets according to instructions, the period (withdrawal bleeding) will start during the drug-free interval. If the patient has to change that day, she can do so by shortening (but never increasing) the length of the drug-free interval. For example, if the drug-free interval begins on Friday and wants to start on Tuesday (3 days before), the patient should begin a new pack 3 days before the patient normally would. If the patient makes the drug-free interval very short (eg, ≤3 days), she may not have withdrawal bleeding (a period) during this interval. Consequently, the patient could experience specks (drop of blood or stains) or bleeding.
If the patient is unsure how to proceed, consult the doctor for an examination.
If the Patient Stops Taking Liza: The patient can stop taking Liza whenever she wants. If the patient does not want to get pregnant, consult the doctor about other efficient birth control methods.
If the patient has any other doubt about using Liza, consult the doctor or pharmacist.