Ladivella (Dienogest, Estradiol Valerate)

Ladivella, a combined oral contraceptive, is indicated for hormonal contraception in women.

• Prevention of pregnancy: provides reliable contraceptive protection for women of childbearing potential.
• Treatment of moderate acne: helps reduce acne lesions by regulating androgenic activity.
• Management of endometriosis symptoms: alleviates pain associated with endometriosis through hormonal suppression.

• Ladivella combines dienogest, a progestogenic agent, with estradiol valerate, an estrogen prodrug. The formulation suppresses the hypothalamic‑pituitary‑ovarian axis, preventing the mid‑cycle luteinising hormone surge and thus ovulation. It also induces cervical mucus thickening and endometrial changes that hinder sperm penetration and implantation.

Common side effects are generally mild and transient.

Common Side Effects

• Nausea: occasional stomach upset.
• Breast tenderness: mild discomfort in the breasts.
• Headache: mild to moderate intensity.
• Breakthrough bleeding: spotting between periods.
• Weight fluctuation: modest changes in body weight.
• Mood changes: irritability or mild mood swings.

Serious or Rare Side Effects

• Venous thromboembolism: blood clots in deep veins.
• Arterial thrombosis: clot formation in arteries.
• Hypertension: elevated blood pressure.
• Liver tumours: benign hepatic adenomas.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Visual disturbances: sudden changes in vision.

Before prescribing Ladivella, clinicians should evaluate individual risk factors and counsel patients on safe use.

• Thrombotic risk assessment: avoid in women with history of clotting disorders.
• Blood pressure monitoring: contraindicated in uncontrolled hypertension.
• Smoking status: discourage smoking in women over 35 years.
• Liver function review: caution in hepatic impairment.
• Drug history check: assess for interacting medications.
• Store at ambient temperature: keep in original packaging, protect from moisture.

Ladivella may have clinically relevant interactions that require attention.

Major Interactions (Avoid)

• Strong enzyme inducers (e.g., rifampin, carbamazepine): may reduce contraceptive efficacy.
• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Certain antiretrovirals (e.g., protease inhibitors): may alter hormone levels.

Moderate Interactions (Monitor Closely)

• Antiepileptic drugs (e.g., phenytoin): may decrease contraceptive effectiveness.
• Antibiotics such as griseofulvin: potential reduction in hormone concentrations.
• Herbal supplements (e.g., St. John’s wort): may lower plasma levels of active ingredients.