Continue typing to refine. No interaction was found with the co-administered ethinylestradiol.Etonogestrel serum levels decrease in two phases. If you stop taking this medicine too soon, your symptoms may return.This medicine works best when there is a constant amount in the blood or urine. Bioavailability is 62 - 81 %.Etonogestrel is bound to serum albumin and to sex hormone binding globulin (SHBG). The following interactions have been reported in the literature:Interactions can occur with medicinal or herbal products that induce microsomal enzymes, specifically cytochrome P450 enzymes (CYP), which can result in increased clearance reducing plasma concentrations of sex hormones and may decrease the effectiveness of combined oral contraceptives, including Mercilon. Mothers who are breast feeding should be advised not to use the combined pill since this may reduce the amount of breast-milk, but may be advised instead to use a progestogen-only pill (POP).After miscarriage or abortion administration should start immediately in which case no additional contraceptive precautions are required.When additional contraceptive precautions are required the patient should be advised either not to have sex, or to use a cap plus spermicide, or for her partner to use a condom.Rhythm methods should not be advised as the pill disrupts the usual cyclical changes associated with the natural menstrual cycle e.g. During the use of the second pack she may experience slight spotting or breakthrough bleeding but contraceptive protection will not be diminished provided there are no tablet omissions. The ethinylestradiol-induced increase in SHBG influences the distribution over the serum proteins, causing an increase of the SHBG-bound fraction and a decrease of the albumin-bound fraction. Store blisters in the original pouches.Push-through packs of 21 white tablets each. All rights reserved. MD Hi, I have been on Mercilon for 3 consecutive months now, I woke up this morning with a very bad pain and realized that I started bleeding 6 days to early. The most common salt form is the hydrochloride, except for doxycycline, which is available as doxycycline hyclate or monohydrate. Therefore, the use of CHCs should generally not be recommended until the nursing mother has completely weaned her child. Blood pressure should be measured and a physical examination should be performed, guided by the contraindications (see section 4.3) and warnings (see section 4.4). The additional breast cancers diagnosed in current users of COCs or in women who have used COCs in the last ten years are more likely to be localised to the breast than those in women who never used COCs. • A meta-analysis from 54 epidemiological studies reported that there is a slightly increased relative risk (RR = 1.24) of having breast cancer diagnosed in women who are currently using combined oral contraceptives (COCs). In the event of aggravation, or first appearance of any of these conditions or risk factors, the woman should be advised to contact her doctor to determine whether the use of Mercilon should be discontinued. Ethinylestradiol is primarily metabolized by aromatic hydroxylation but a wide variety of hydroxylated and methylated metabolites are formed, and these are present as free metabolites and as conjugates with glucuronides and sulfate. Only 2 - 4 % of the total serum drug concentrations are present as free steroid, 40 - 70 % are specifically bound to SHBG. Tablet-taking should be continued in the usual way. However, if this medicine upsets your stomach, your doctor may want you to take it with food.Do not take milk, milk formulas, or other dairy products within 1 to 2 hours of the time you take tetracyclines (except doxycycline and minocycline) by mouth. Women should be advised to contact their physician in case of mood changes and depressive symptoms, including shortly after initiating the treatment.Prior to the initiation or reinstitution of Mercilon a complete medical history (including family history) should be taken and pregnancy must be ruled out. Peak serum concentrations are reached at about 1.5 hours. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme, at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.There have been no reports of serious deleterious effects from overdose.