Microstad (Ethinylestradiol, Levonorgestrel)

Microstad, a combined hormonal contraceptive, acts on the reproductive endocrine system to prevent pregnancy.

• Contraception: provides reliable prevention of pregnancy when taken as prescribed.
• Menstrual cycle regulation: helps establish a more predictable menstrual pattern.
• Dysmenorrhea management: can reduce menstrual pain associated with ovulatory cycles.

• Ethinylestradiol and levonorgestrel work together to suppress the mid‑cycle surge of luteinising hormone and follicle‑stimulating hormone, thereby inhibiting ovulation. The estrogen component stabilises the endometrium, while the progestogen thickens cervical mucus and alters endometrial development, creating an environment unfavorable for fertilisation and implantation.

Microstad may cause a range of adverse reactions, most of which are mild and transient.

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 mild to moderate headaches.
• Weight fluctuation: slight increase or retention of fluid.
• Mood changes: mild irritability or mood swings.
• Breakthrough bleeding: spotting between periods, especially early in therapy.

Serious or Rare Side Effects

• Deep vein thrombosis: blood clot formation in the legs or pelvis.
• Pulmonary embolism: clot migration to the lungs, a medical emergency.
• Stroke or transient ischemic attack: rare cerebrovascular events.
• Myocardial infarction: rare heart attack, particularly in high‑risk women.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Hepatic dysfunction: abnormal liver function tests or jaundice.

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

• Medical assessment: screen for history of thromboembolic disease, cardiovascular disorders, or uncontrolled hypertension.
• Smoking status: avoid use in women over 35 who smoke, due to increased clot risk.
• Liver function: assess hepatic health, as impaired metabolism can alter drug levels.
• Pregnancy testing: confirm non‑pregnant status before initiation.
• Store at ambient temperature: keep below 25°C, in the original packaging, protected from moisture and light.

Microstad can interact with several medicines that affect hormone metabolism or increase clot risk.

Major Interactions (Avoid)

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin, phenobarbital): may markedly reduce contraceptive efficacy.
• Rifampicin: strong inducer of hepatic enzymes, decreasing hormone levels.
• Certain HIV protease inhibitors: can alter hormone concentrations, affecting effectiveness.

Moderate Interactions (Monitor Closely)

• Antibiotics such as tetracycline or metronidazole: may slightly lower hormone levels, requiring backup contraception.
• Antifungal agents (e.g., fluconazole): can increase hormone exposure, potentially enhancing side effects.
• St. John’s wort: herbal inducer that may reduce contraceptive effectiveness.