Cerazette Special Precautions

Cerazette, like all hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease.
Take special care with Cerazette: Tell the doctor before starting to use Cerazette if: the patient has ever had breast cancer; the patient has liver cancer, since a possible effect of Cerazette cannot be excluded; the patient has ever had a thrombosis; the patient has diabetes; the patient suffers from epilepsy (see Interactions); the patient suffers from tuberculosis (see Interactions); the patient has high blood pressure; the patient has or has had chloasma (yellowish-brown pigmentation patches on the skin, particularly of the face); if so, avoid too much exposure to the sun or ultraviolet radiation.
When Cerazette is used in the presence of any of these conditions, the patient may need to be kept under close observation. The doctor can explain what to do.
Decreased Bone Mass: Estrogens are important to maintain the strength of the bones. During the use of Cerazette, the concentration in the blood of the natural estrogen estradiol is comparable to the concentration seen in the first half of the natural cycle but is decreased in comparison with the second half of the natural cycle. It is not known whether this has an effect on the strength of the bones.
Breast Cancer: Regularly check the breasts and contact the doctor as soon as possible if the patient feels any lump in the breasts.
Breast cancer has been found slightly more often in women who take the Pill than in women of the same age who do not take the Pill. If women stop taking the Pill, the risk gradually decreases, so that 10 years after stopping the risk is the same as for women who have never taken the Pill. Breast cancer is rare under 40 years of age but the risk increases as the woman gets older. Therefore, the extra number of breast cancers diagnosed is higher if the age until which the woman continues to take the Pill is higher. How long she takes the Pill is less important.
In every 10,000 women who take the Pill for up to 5 years but stop taking it by the age of 20, there would be less than 1 extra case of breast cancer found up to 10 years after stopping, in addition to the 4 cases normally diagnosed in this age group. Likewise, in 10,000 women who take the Pill for up to 5 years but stop taking it by the age of 30, there would be 5 extra cases in addition to the 44 cases normally diagnosed. In 10,000 women who take the Pill for up to 5 years but stop taking it by the age of 40, there would be 20 extra cases in addition to the 160 cases normally diagnosed.
The risk of breast cancer in users of progestogen-only pills like Cerazette is believed to be similar to that in women who use the Pill, but the evidence is less conclusive.
Breast cancers found in women who take the Pill, seem less likely to have spread than breast cancers found in women who do not take the Pill. It is not known whether the difference in breast cancer risk is caused by the Pill. It may be that the women were examined more often, so that the breast cancer is noticed earlier.
Thrombosis: See the doctor immediately if the patient notices possible signs of a thrombosis (see also Patient Counselling Information).
Thrombosis is the formation of a blood clot, which may block a blood vessel. A thrombosis sometimes occurs in the deep veins of the legs (deep venous thrombosis). If this clot breaks away from the veins where it is formed, it may reach and block the arteries of the lungs, causing a so-called "pulmonary embolism". As a result, fatal situations may occur. Deep venous thrombosis is a rare occurrence. It can develop whether or not the patient is taking the Pill. It can also happen if the patient becomes pregnant.
The risk is higher in Pill-users than in non-users. The risk with progestagen-only pills like Cerazette is believed to be lower than in users of Pills that also contain estrogens (combined Pills).
Vaginal bleeding: Vaginal bleeding may occur at irregular intervals during the use of Cerazette. This may be just slight staining which may not even require a pad, or heavier bleeding, which looks rather like a scanty period and requires sanitary protection. The patient may also not have any bleeding at all. The irregular bleedings are not a sign that the contraceptive protection of Cerazette is decreased. In general, the patient needs not to take any action; just continue to take Cerazette. If, however, bleeding is heavy or prolonged consult the doctor.
Ovarian cysts: During the use of all low-dose hormonal contraceptives, small fluid-filled sacs may develop in the ovaries. These are called ovarian cysts. They usually disappear on their own. Sometimes they cause mild abdominal pain. Only rarely, they may lead to more serious problems.
Important information about some of the ingredients of Cerazette: Cerazette contains lactose (milk sugar). Contact the doctor before taking Cerazette, if the patient has been told by the doctor that she has intolerance to some sugars.
Driving and using machines: There are no indications of any effect of the use of Cerazette on alertness and concentration.