Melteva (Ethinylestradiol, Gestodene)

Melteva is a combined oral contraceptive that acts on the hormonal regulation of the menstrual cycle to prevent pregnancy.

• Prevention of pregnancy: provides reliable hormonal contraception for women of childbearing potential.
• Menstrual cycle regulation: helps achieve more predictable bleeding patterns.
• Reduction of ovarian cysts: decreases the formation of functional ovarian cysts.
• Management of endometriosis symptoms: alleviates pain associated with endometriosis.

• Ethinylestradiol and gestodene bind to estrogen and progestogen receptors, respectively, suppressing the hypothalamic‑pituitary‑ovarian axis. This inhibition prevents the mid‑cycle surge of luteinizing hormone, thereby blocking ovulation. The progestogen component also thickens cervical mucus and induces endometrial changes that reduce the likelihood of fertilisation and implantation.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Breast tenderness: transient swelling or discomfort.
• Headache: occasional tension‑type headache.
• Spotting or breakthrough bleeding: irregular bleeding between periods.
• Weight change: slight fluid retention or appetite variation.
• Mood changes: mild irritability or emotional fluctuations.

Serious or Rare Side Effects

• Venous thromboembolism: deep‑vein thrombosis or pulmonary embolism.
• Arterial thrombosis: stroke or myocardial infarction.
• Severe hypertension: sudden increase in blood pressure.
• Liver disorders: cholestatic jaundice or hepatic adenoma.
• Allergic reactions: rash, itching, or anaphylaxis.
• Severe depression or suicidal thoughts.

Before using Melteva, consider the following precautions:

• Contraindicated in pregnancy: avoid use during pregnancy.
• Smoking over 15 cigarettes per day: increased cardiovascular risk.
• History of thromboembolism: avoid due to clotting risk.
• Liver disease: use with caution; monitor liver function.
• Migraine with aura: contraindicated because of stroke risk.
• Store at ambient temperature below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Melteva may interact with several medicines that affect its efficacy or safety.

Major Interactions (Avoid)

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin): markedly reduce contraceptive effect.
• Rifampicin or other strong CYP3A4 inducers: decrease hormone levels, risking pregnancy.
• Certain antiretrovirals (e.g., efavirenz): lower plasma concentrations of the contraceptive.

Moderate Interactions (Monitor Closely)

• Broad‑spectrum antibiotics (e.g., ampicillin): may slightly reduce effectiveness; consider backup contraception.
• St. John’s wort: moderate enzyme induction can lower hormone levels.
• Antifungal agents (e.g., ketoconazole): may increase hormone concentrations, raising side‑effect risk.