Laviola (Dienogest, Ethinylestradiol)

Laviola, a combined oral contraceptive, is used within the hormonal contraception family to manage reproductive health conditions.

• Contraception: prevention of unintended pregnancy in women of reproductive age.
• Menstrual cycle regulation: reduction of irregular bleeding and stabilization of cycle length.
• Management of dysmenorrhea: alleviation of menstrual pain associated with primary dysmenorrhea.

• Dienogest/Ethinylestradiol exerts its effect by suppressing the hypothalamic‑pituitary‑ovarian axis, which blocks the mid‑cycle surge of luteinising hormone and prevents follicular development, thereby inhibiting ovulation. The estrogen component stabilises the endometrial lining, while the progestogen component thickens cervical mucus, creating an environment hostile to sperm penetration and implantation.

Laviola may cause a range of adverse reactions. Patients should be informed of both frequent and less common events.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Breast tenderness: temporary swelling or discomfort.
• Headache: occasional mild to moderate pain.
• Breakthrough bleeding: spotting between periods.

Serious or Rare Side Effects

• Venous thromboembolism: blood clots in deep veins or lungs.
• Arterial thrombosis: clot formation in arteries leading to stroke or heart attack.
• Severe hypertension: sudden increase in blood pressure.
• Liver dysfunction: abnormal liver enzyme elevations or jaundice.

Before prescribing Laviola, clinicians should consider several safety aspects.

• Assess cardiovascular risk: evaluate personal or family history of thromboembolic events.
• Screen smoking status: avoid use in women over 35 who smoke.
• Review liver function: contraindicated in severe hepatic impairment.
• Consider drug interactions: avoid concomitant use with strong enzyme inducers.
• Store at ambient temperature: keep tablets in the original pack, protect from moisture and heat.

Laviola can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Enzyme inducers (e.g., rifampin, carbamazepine, phenytoin): may markedly reduce contraceptive effectiveness.
• Antifungal azoles (e.g., ketoconazole): can increase hormone levels, raising risk of side effects.

Moderate Interactions (Monitor Closely)

• Antiepileptics (e.g., valproate): may require monitoring of cycle control.
• Antihypertensives (e.g., ACE inhibitors): possible alteration of blood pressure control.
• Herbal supplements (e.g., St. John’s wort): may diminish contraceptive reliability.