Larissa (Dienogest, Ethinylestradiol)

Larissa, a combined oral contraceptive, acts on the hormonal regulation of the menstrual cycle and is indicated for the following conditions:

• Pregnancy prevention: provides reliable contraception for women of child‑bearing potential.
• Dysmenorrhea treatment: reduces menstrual pain and associated cramps.
• Menstrual cycle regulation: helps to establish regular menstrual bleeding patterns.

• Dienogest/Ethinylestradiol works by suppressing the hypothalamic‑pituitary‑ovarian axis, inhibiting the surge of luteinising hormone (LH) and follicle‑stimulating hormone (FSH) required for ovulation. The estrogen component stabilises the endometrial lining, while the progestogen component thickens cervical mucus and induces endometrial changes that impede implantation.

Larissa may cause a range of adverse reactions. Patients should be informed of both common and serious possibilities.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Breast tenderness: discomfort or swelling of the breasts.
• Headache: intermittent mild to moderate pain.
• Breakthrough bleeding: spotting between periods.
• Weight gain: modest increase in body weight.
• Mood changes: irritability or mood swings.

Serious or Rare Side Effects

• Venous thromboembolism: blood clots in deep veins.
• Arterial thrombosis: clot formation in arteries, potentially leading to stroke.
• Hypertension: elevated blood pressure.
• Hepatic adenoma: benign liver tumor.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Visual disturbances: sudden changes in vision.

Before prescribing Larissa, clinicians should consider several safety measures.

• Cardiovascular assessment: evaluate risk factors for thrombosis.
• Contraindication screening: avoid use in women with known estrogen‑dependent tumors.
• Smoking advice: counsel against smoking, especially in women over 35.
• Missed dose guidance: provide clear instructions for handling forgotten tablets.
• Blood pressure monitoring: check regularly during therapy.
• Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Larissa can interact with other medicines, altering its effectiveness or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may markedly reduce contraceptive efficacy.
• Other hormonal contraceptives: concurrent use can increase risk of hormonal side effects.
• Anticoagulants (e.g., warfarin): may enhance anticoagulant effect and increase bleeding risk.

Moderate Interactions (Monitor Closely)

• Antifungal agents (e.g., ketoconazole): may increase plasma levels of estrogen.
• Antiretroviral protease inhibitors: can affect hormone metabolism.
• Selective serotonin reuptake inhibitors (SSRIs): may slightly increase risk of bleeding.
• Diuretics: may alter fluid balance and affect blood pressure.
• Herbal supplements containing St. John’s wort: may decrease contraceptive effectiveness.