Melitta (Ethinylestradiol, Gestodene)

Melitta, a combined oral contraceptive, acts on the hormonal regulation of the menstrual cycle to prevent pregnancy.

• Prevention of pregnancy: provides reliable contraceptive protection for women of childbearing potential.
• Menstrual cycle regulation: helps establish a predictable monthly cycle and reduce irregular bleeding.
• Dysmenorrhea relief: lessens menstrual pain associated with ovulatory cycles.

• Ethinylestradiol and gestodene work together to suppress the hypothalamic‑pituitary‑ovarian axis, inhibiting the mid‑cycle surge of luteinising hormone (LH) and follicle‑stimulating hormone (FSH). This prevents ovulation, thickens cervical mucus to impede sperm penetration, and induces endometrial changes that reduce the likelihood of implantation.

Common side effects are generally mild and transient, reflecting the hormonal activity of the preparation.

Common Side Effects

• Nausea: mild stomach upset, often resolves with continued use.
• Headache: tension‑type or migraine‑like discomfort.
• Breast tenderness: temporary swelling or soreness.
• Spotting or breakthrough bleeding: irregular bleeding between periods.
• Weight fluctuation: mild fluid retention or appetite changes.
• Mood changes: irritability or mild depressive symptoms.

Serious or Rare Side Effects

• Venous thromboembolism: deep‑vein thrombosis or pulmonary embolism.
• Hypertensive crisis: sudden, severe increase in blood pressure.
• Liver dysfunction: jaundice or abnormal liver enzymes.
• Allergic reaction: rash, itching, swelling, or anaphylaxis.
• Visual disturbances: blurred vision or retinal vein occlusion.
• Gallbladder disease: inflammation or stones.

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

• Contraindications: active thromboembolic disease, known estrogen‑dependent tumor, or severe uncontrolled hypertension.
• Smoking: avoid in women over 35 who smoke, due to increased cardiovascular risk.
• Liver disease: use with caution in patients with hepatic impairment.
• Migraine with aura: consider alternative contraception because of stroke risk.
• Medication adherence: missed tablets can reduce efficacy; advise on backup methods.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Melitta may interact with other medicines that affect hormone metabolism or clotting pathways.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): markedly reduce contraceptive effectiveness.
• Anticoagulants (e.g., warfarin): may increase risk of thrombosis when combined with estrogen.

Moderate Interactions (Monitor Closely)

• Antidepressants (e.g., sertraline): may slightly increase plasma hormone levels.
• Antifungals (e.g., ketoconazole): can raise estrogen concentrations, potentially enhancing side effects.
• Herbal supplements (e.g., St. John's wort): may modestly decrease contraceptive efficacy.