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  Information on Combined Oral Contraceptive Pills Download

1. Background information
	Combined oral contraceptive (COC) pills contain two synthetic hormones_ oestrogen and progestagen. It acts by suppressing ovulation.
	It is highly effective and the failure rate is less than 1 % if taken properly.
	It can be a 21-day regimen in which all pills contain hormones and users have to stop for 7 days on finishing each pack, or a 28-day regimen which includes 7 placebo pills and users can start a new pack immediately after finishing one.
	Clients should consult a doctor before commencing the pills.

2. Method of Administration
	Women should commence the pills within the first 5 days of menses and condoms are required for extra protection for 7 days.
	Pills should be taken at the same time everyday.
	Missed pills should be taken as soon as possible. If the missed pill is taken 12 hours later than the usual time, condoms should be used for the next 7 days (Please read the back page for further information).
3. Side Effects
	Some women may have nausea, vomiting, dizziness, headache, breast engorgement, weight gain, etc. shortly after starting COC pills. Most of these symptoms will subside of after a few weeks.
	You should consult a doctor if there is severe headache or dizziness, blurring of vision, chest pain, jaundice (yellow staining of sclera / skin), calf pain, etc.

4. Seek medical advice for any of the following condition:
	Having chronic illness (e.g. diabetes mellitus, hypertension) or taking long term medication (e.g. anti-epileptics, antidepressants)
	Taking medications (e.g. antibiotics may affect the contraceptive effect of COC pills so condom is required for additional protection)
	Family history of heart disease, stroke, thromboembolic disease or other illness

5. Follow-up
	Regular check up is required while you are taking COC pills.
Note for Missing Pills

Missing 1 or 2 hormonal pills
* Please take yesterday's missed pill immediately (throw away the other missed pills)
* Take the remaining pills as your usual schedule
* Menses will come as usual after finishing the active pills


Missing 3 or more hormonal pills
* Please take yesterday's missed pill immediately (throw away the other missed pills)
* Take the remaining pills as your usual schedule 
* Use condom for extra-protection and return to Maternal & Child Health centre for advice as soon as possible

Missing any of the inactive pills
* Discard the missed inactive pills and continue pill taking 

Please clearly record
(1)	Accurate dates of missing pills
(2)	Dates with sexual activity during the missing pill period and 2 week prior to facilitate our management


Family Health Service, Department of Health
FHS 26A (Rev. July 2005)
 
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Last revision date: 01 September 2006