Description
How it works
Rigevidon is a combined hormonal contraceptive containing an oestrogen (ethinylestradiol) and a progestogen (levonorgestrel). Together they prevent pregnancy by:
- Stopping ovulation – the ovaries do not release an egg each month
- Thickening cervical mucus – makes it harder for sperm to enter the womb
- Changing the womb lining – makes it less likely that a fertilised egg could implant
When taken correctly, combined pills like Rigevidon have a very low failure rate (around 1% per year or less). Missing tablets, vomiting, diarrhoea or certain medicines can reduce effectiveness.
Rigevidon does not protect against sexually transmitted infections (STIs) or HIV – a condom is needed for that.
Who it may be suitable for
Rigevidon is used for oral hormonal contraception in women of reproductive age.
It may be suitable if you:
- Want an effective, reversible method of contraception
- Prefer a daily pill and regular, predictable withdrawal bleeds
- Have no major risk factors for blood clots, stroke or heart disease
Your prescriber will weigh up the benefits and risks based on your age, weight, medical and family history, and whether you smoke.
Who should not take Rigevidon
Rigevidon must not be used if any of the following apply:
- Current or previous blood clot in a leg, lung or other vein (DVT, PE, VTE)
- Known increased tendency to blood clots (e.g. Factor V Leiden, protein C/S or antithrombin deficiency)
- Major surgery with prolonged immobilisation, or very high risk of VTE
- Current or previous arterial disease, such as:
- Heart attack, angina
- Stroke or transient ischaemic attack (TIA)
- Migraine with focal neurological symptoms (migraine with aura)
- Diabetes with vascular complications, severe hypertension, or severe disturbances in blood fats
- Severe liver disease, current or past, as long as liver tests are not normal
- Liver tumours (benign or malignant), known or suspected
- Known or suspected hormone-dependent cancers (e.g. breast, genital tract)
- Unexplained vaginal bleeding
- Allergy to levonorgestrel, ethinylestradiol or any tablet ingredient
- Use of certain hepatitis C treatments (omebitasvir/paritaprevir/ritonavir/dasabuvir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir) – a different contraception is needed during these treatments
- Concomitant use of St John’s wort
Use with extra care / medical supervision
Extra caution and regular review are needed if you have:
- Obesity (BMI >30)
- Age over 35, especially if you smoke
- Family history of blood clots or heart attack/stroke at a young age
- High blood pressure or raised blood fats
- Diabetes
- Systemic lupus erythematosus (SLE), inflammatory bowel disease, sickle cell disease, or certain clotting/vascular conditions
- Migraine (any change in pattern or severity must be urgently assessed)
- Personal or family history of breast cancer or cervical cancer
- Liver or gallbladder disease
- History of cholestatic jaundice, severe itching in pregnancy, or problems with oestrogen in the past
- Angioedema, depression, hypertriglyceridaemia, Crohn’s disease or ulcerative colitis
Rigevidon is not indicated before puberty, and not intended during pregnancy. If pregnancy occurs, the pill should be stopped.
Breastfeeding women are generally advised to use another method until breastfeeding has stopped, as combined pills can reduce the amount and change the composition of breast milk.
Side Effects
Key facts about Rigevidon:
- Type: Combined oral contraceptive (COC)
- Active ingredients:
- 150 micrograms levonorgestrel
- 30 micrograms ethinylestradiol
- Tablet composition: Contains lactose (33 mg) and sucrose (22.46 mg) per tablet – not suitable if you have certain rare hereditary problems of galactose, lactose or fructose intolerance, or sucrase-isomaltase deficiency.
- Sodium: Essentially sodium-free (less than 23 mg per tablet).
- Storage: Store below 25°C, in the original packaging.
- Fertility after stopping: Periods and fertility usually return quickly, often in the first cycle or two after stopping the pill.
Important interactions – effectiveness may be reduced by medicines that increase hormone breakdown, such as:
- Certain epilepsy medicines (e.g. carbamazepine, phenytoin, phenobarbital, primidone, topiramate, oxcarbazepine, felbamate)
- Rifampicin, rifabutin and some other antibiotics
- Some HIV/HCV medicines (protease inhibitors, non-nucleoside reverse transcriptase inhibitors)
- Griseofulvin
- St John’s wort (herbal antidepressant) – contraindicated
Rigevidon can also influence levels of some other medicines, such as ciclosporin (increased levels) and lamotrigine (decreased levels).
Always tell your prescriber and pharmacist that you are taking Rigevidon when starting or stopping any other medicines or herbal products.
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
Most side effects are mild and settle with time, especially in the first few months. Combined pills also carry some rare but serious risks that you should know about.
Commonly reported effects (may affect up to 1 in 10 users or more) include:
- Nausea or vomiting
- Abdominal pain or cramps, bloating
- Breast tenderness, pain or swelling
- Headache, including migraine in some women
- Mood changes, including low mood or depression
- Changes in libido (sex drive)
- Acne or skin changes
- Irregular bleeding or spotting, especially in the first few cycles
- Changes in periods – lighter, heavier, shorter, longer, or occasional missed bleed
- Fluid retention or swelling, weight changes (up or down)
Other possible side effects
- Vaginal infections, including thrush
- Changes in appetite
- Dizziness, nervousness
- Contact lens intolerance
- High blood pressure
- Glucose intolerance or worsening of existing diabetes
- Skin changes: rash, chloasma (brown patches, often on the face), hirsutism (extra hair), hair thinning or loss
- Gallbladder problems, jaundice, liver inflammation or abnormal liver tests
- Changes in blood fats (e.g. raised triglycerides)
Serious but less common risks (see doctor urgently or call emergency services):
- Blood clots in veins (VTE) – deep vein thrombosis or pulmonary embolism
- Signs: unexplained swelling, pain, warmth or redness in one leg; sudden chest pain, coughing (possibly with blood), sudden breathlessness, severe dizziness or fainting
- Stroke or TIA
- Sudden weakness or numbness (especially on one side), trouble speaking or understanding, sudden loss of vision, severe sudden headache
- Heart attack
- Chest pain or pressure, pain radiating to arm, jaw or back, shortness of breath, sweating, nausea
- Breast cancer or cervical cancer – the overall risk is slightly increased while using combined pills and gradually returns to normal over about 10 years after stopping
- Liver tumours – very rare but can cause severe upper abdominal pain and internal bleeding
Stop taking Rigevidon and seek urgent medical help if you develop symptoms of a blood clot, stroke, heart attack, severe abdominal pain, jaundice, or a very severe rash with blisters or peeling.
Directions
Rigevidon tablets are for oral use.
- Take one tablet every day for 21 days, in the order shown on the blister
- Take the tablet at about the same time each day, with a little water if needed
- After 21 days, have a 7-day tablet-free break
- You should have a withdrawal bleed (like a period) during this tablet-free week, usually starting 2–3 days after the last tablet
- Start the next strip after exactly 7 tablet-free days, even if you are still bleeding
If you take Rigevidon correctly, you are protected from pregnancy throughout the 21 days and the 7-day break.
When to start
If you haven’t used hormonal contraception in the last month
- Start on Day 1 of your natural cycle (the first day of bleeding). You are protected immediately.
- If you start on Day 2–5, extra contraception (e.g. condoms) is generally advised for the first 7 days of tablet-taking.
Switching from another combined pill, vaginal ring or patch
- Start the day after the last active tablet of your previous pill (do not wait after placebo pills), or
- The day after the usual tablet-free or placebo interval, or
- On the day the ring/patch is removed, or at the latest when the next ring/patch would have been due.
Switching from a progestogen-only method (mini-pill, injection, implant, IUS)
- Mini-pill: start Rigevidon the day after stopping the mini-pill
- Implant or IUS: start on the day of removal
- Injection: start on the day your next injection would be due
- Use extra contraception for 7 days after switching.
After a first-trimester abortion
-
You can start immediately; extra contraception is usually not needed.
After childbirth or second-trimester abortion
- Start on Day 21–28 if you are not breastfeeding.
- If you start later than Day 28, use extra contraception for 7 days.
- If intercourse has already occurred, pregnancy must be excluded, or you should wait until your first period.
How to delay or shift a withdrawal bleed
To delay a bleed:
- After finishing a 21-day strip, start the next strip without a 7-day break.
- You can continue into the second strip to delay bleeding, then take the usual 7-day break afterwards.
- Spotting or breakthrough bleeding may occur while taking tablets continuously.
To change the day your bleed starts, shorten (never lengthen) the tablet-free interval by the number of days you want to move it. A shorter break may mean you have no bleed but may see spotting in the next pack.
Missed a dose?
Contraceptive protection may be reduced if tablets are taken more than 24 hours apart.
If you are less than 12 hours late
- Take the missed tablet as soon as you remember
- Take the next tablet at the usual time
- You are still protected – no extra contraception needed.
If you are more than 12 hours late
Protection may be reduced. There are two basic rules:
- You should never have a break longer than 7 days between tablets
- You need 7 days of uninterrupted tablet-taking to fully suppress ovulation
Follow the advice below:
Week 1 (Days 1–7)
- Take the last missed tablet as soon as you remember, even if that means taking two tablets at once
- Continue the rest at the usual time
- Use extra contraception (e.g. condoms) for 7 days
- If you had sex in the previous 7 days, there is a risk of pregnancy – speak to a clinician about emergency contraception.
Week 2 (Days 8–14)
- Take the last missed tablet as soon as you remember (even if that means 2 at once)
- Continue tablets at the usual time
- If you took tablets correctly in the 7 days before the missed tablet, no extra contraception is needed
- If you missed more than one tablet, or are unsure, use extra contraception for 7 days.
Week 3 (Days 15–21)
Because the tablet-free week is near, the risk of reduced protection is higher. Choose one of the following:
- Continue without a break
- Take the last missed tablet as soon as you remember (even if two at once)
- Finish the strip as normal
- Start the next strip immediately with no tablet-free interval
- You might not bleed until the end of the second strip, but may have spotting.
- Stop the current strip early
- Stop taking tablets from the current strip
- Have a tablet-free break of up to 7 days (including the days you missed)
- Then start a new strip
If you miss tablets and no bleed occurs in the next tablet-free week, pregnancy must be ruled out.
Vomiting or severe diarrhoea
If vomiting or severe diarrhoea occurs within 3–4 hours of taking a tablet, absorption may be incomplete:
- Take another tablet from a backup strip as soon as possible (ideally within 12 hours of the usual time)
- If more than 12 hours pass, treat it as a missed tablet
- Use extra contraception while vomiting/diarrhoea persists and for 7 days after it settles if instructed.
FAQs
How effective is Rigevidon at preventing pregnancy?
When taken exactly as directed Rigevidon is over 99% effective at preventing pregnancy with fewer than 1 in 100 women becoming pregnant in a year, though typical use with occasional missed pills results in slightly lower effectiveness.
Does Rigevidon protect against STIs?
No, Rigevidon does not offer protection against HIV or other sexually transmitted infections, so you should use condoms to reduce your risk of STIs.
Will my periods change on Rigevidon?
You will usually experience a regular withdrawal bleed during the 7-day break and may find your periods become lighter and less painful, though spotting is common in the first few months and you should speak to a clinician if heavy bleeding persists.
What if I don’t get a bleed in the tablet-free week?
Pregnancy is unlikely if you have taken all tablets correctly without missing any or having illness, but you should perform a pregnancy test and consult a clinician if you miss a bleed twice in a row before starting your next strip.
Can I use Rigevidon to delay my period?
You can delay your period by starting the next 21-day strip immediately after the previous one while skipping the 7-day break, though you may experience some spotting while taking packs back-to-back.
I smoke – can I still take Rigevidon?
Combined pills increase the risk of blood clots and stroke, which is even higher for smokers over 35 who are usually advised to use a different method, so any smoker considering Rigevidon will require an individual risk assessment and be encouraged to quit.
What should I watch out for while taking Rigevidon?
You must seek urgent medical help and mention your pill use if you experience unilateral leg swelling, chest pain, difficulty breathing, severe headaches, jaundice, new breast lumps, or significant mood changes.
How long can I stay on Rigevidon?
Many women can use combined pills safely for years with regular check-ups provided they do not develop new risk factors like high blood pressure or migraines with aura, and your contraception should be reviewed by a medical professional at least once a year.
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