Meliane (Ethinylestradiol, Gestodene)

• Meliane, a combined oral contraceptive, is used within the hormonal contraception pathway to prevent pregnancy.
• Contraception: prevention of unintended pregnancy in women of childbearing potential.
• Menstrual cycle regulation: reduction of menstrual bleeding and improvement of cycle regularity.
• Acne treatment: improvement of moderate acne associated with hormonal fluctuations.
• Dysmenorrhea relief: alleviation of painful menstrual cramps.

• Ethinylestradiol and Gestodene act together to suppress the hypothalamic‑pituitary‑gonadal axis, inhibiting the mid‑cycle surge of luteinising hormone and follicle‑stimulating hormone, thereby preventing ovulation. The estrogen component stabilises the endometrial lining, while the progestogen thickens cervical mucus and induces endometrial changes that reduce the likelihood of fertilisation and implantation.

Common Side Effects

• Nausea: mild to moderate stomach upset, especially during the first cycles.
• Breast tenderness: temporary swelling or discomfort of the breasts.
• Headache: occasional tension‑type or migraine‑like headaches.
• Spotting: irregular light bleeding between periods.
• Mood changes: fluctuations in mood or mild depressive symptoms.
• Weight gain: modest increase in body weight, often due to fluid retention.

Serious or Rare Side Effects

• Venous thromboembolism: deep‑vein thrombosis or pulmonary embolism.
• Arterial thrombosis: stroke or myocardial infarction.
• Hypertension: new‑onset or worsening high blood pressure.
• Liver tumor: benign hepatic adenoma.
• Severe allergic reaction: anaphylaxis, angioedema, or skin rash.
• Visual disturbances: sudden vision loss or blurred vision.

• Before prescribing Meliane, clinicians should evaluate individual risk factors and contraindications.
• Contraindications: known thrombophilia, estrogen‑dependent neoplasia, pregnancy, or lactation.
• Smoking: avoid use in women over 35 who smoke regularly.
• Cardiovascular risk: assess hypertension, diabetes, or hyperlipidaemia before initiation.
• Drug interactions: review concomitant medications that induce or inhibit CYP3A4 metabolism.
• Regular monitoring: periodic blood pressure and lipid profile checks are advisable.
• Store at ambient temperature: keep below 25°C, retain in the original packaging, and protect from moisture and light.

Meliane may interact with several medicines that alter hormone levels or clotting risk.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine, phenytoin): may markedly reduce contraceptive efficacy.
• Anticoagulants (e.g., warfarin): hormonal components can affect coagulation parameters.
• Certain antiretrovirals (e.g., efavirenz): may decrease plasma concentrations of the active ingredients.

Moderate Interactions (Monitor Closely)

• Antifungals (e.g., ketoconazole, itraconazole): can increase hormone levels, raising side‑effect risk.
• SSRIs (e.g., fluoxetine, sertraline): may enhance bleeding tendency.
• Herbal supplements (e.g., St. John’s wort): may lower contraceptive effectiveness.