Qlaira tablets are a type of hormonal contraception commonly known as 'the pill' or combined oral contraceptive pill. Qlaira tablets contain two active ingredients, estradiol valerate and dienogest. These are synthetic versions of the naturally occurring female sex hormones, oestrogen and progesterone. Estradiol is a synthetic version of oestrogen that is metabolised in the body to a form of oestrogen that is naturally found in the body. Dienogest is a synthetic form of progesterone.
Combined oral contraceptives like Qlaira work by over-riding the normal menstrual cycle. In a woman's normal menstrual cycle, levels of the sex hormones change throughout each month. The hormones cause an egg to be released from the ovaries (ovulation) and prepare the lining of the womb for a possible pregnancy. At the end of each cycle, if the egg has not been fertilised the levels of the hormones fall, causing the womb lining to be shed as a monthly period.
The daily dose of hormones taken in the pill work mainly by tricking your body into thinking that ovulation has already happened. This prevents an egg from ripening and being released from the ovaries each month.
The hormones also increase the thickness of the natural mucus at the neck of the womb, which makes it more difficult for sperm to cross from the vagina into the womb and reach an egg. They also change the quality of the womb lining (endometrium), making it less likely that a fertilised egg can implant there.
Taking the contraceptive pill usually results in lighter, less painful and more regular menstrual bleeding. This means it is sometimes prescribed for women who have problems with particularly heavy, painful or irregular periods.
Qlaira tablets consist of four types of active tablets, each type containing a slightly different dose of hormones. The two dark yellow tablets contain 3mg estradiol, the five medium red tablets contain 2mg estradiol and 2mg dienogest, the 17 light yellow tablets contain 2mg estradiol and 3mg dienogest, and the two dark red tablets contain 1mg estradiol. There are also two inactive white tablets.
Qlaira tablets must be taken in the order specified on the pack, starting with the tablet marked one. The tablets also come with self-adhesive strips, each starting with a different day of the week. These are to show you on which day to take each tablet. Peel off a strip that starts with your starting day, eg, if you start the tablets on a Wednesday, use a strip that starts with 'Wed'. Stick the strip along the top of the strip of tablets, so that the first day is above the pill marked 'start'. You can now see on which day you have to take each tablet.
The purpose of the last two inactive tablets is that you get used to taking a pill at the same time every day and just take each packet back to back. This is unlike many other pills, where you have three weeks of taking pills, followed by a week off from pill taking.
You will still be protected against pregnancy while you are taking the inactive tablets, provided you took all the pills correctly, you start the next packet on time and nothing else happened that could make the pill less effective (eg sickness, diarrhoea, or taking certain other medicines - see below).
Qlaira tablets must be taken in the order specified on the pack, starting with the tablet marked one.
If you have not previously been using a hormonal contraceptive you should take the first tablet on day one of your menstrual cycle (the first day of your period). This will protect you from pregnancy straight away and you don’t need to use any additional contraception.
If you are changing from any other combined oral contraceptive pill to Qlaira, then you should take the first tablet of your Qlaira packet the day after you take your last active pill from your old pill packet. This will protect you from pregnancy straight away.
If you have previously been using the contraceptive vaginal ring (NuvaRing) or contraceptive skin patches (Evra) you need to start taking the Qlaira tablets on the day you remove the ring or patch. This will protect you from pregnancy straight away.
If you have previously been using a progestogen only contraceptive pill, known as the mini pill, you can change over to Qlaira on any day of the cycle, but you must use extra contraception such as condoms (or not have sex) for the first nine days of taking the Qlaira tablets.
If you are changing from other progestogen-only contraceptives, such as an implant (Implanon), a hormone releasing coil (Mirena IUS) or an injection (Depo-provera or Noristerat), Qlaira tablets should be started on the day the implant or IUS is removed, or on the day your next injection is due. You will need to use extra contraception such as condoms for the first nine days of taking the Qlaira tablets.
You can start taking this pill immediately after a miscarriage or abortion in the first trimester; you will be protected against pregnancy immediately.
If you have given birth and are not breastfeeding, or have had an abortion in the second trimester, you can start taking this pill at day 21 to 28 after the birth or second trimester abortion. You will be protected against pregnancy immediately and do not need to use extra contraception. If you start taking Qlaira later than 28 days after the birth or abortion, you will need to use extra contraception eg condoms for the first nine days of taking the Qlaira tablets. However, if you had unprotected sex after the birth or abortion and before starting Qlaira tablets, you should do a pregnancy test or wait until your first menstrual period before you start taking Qlaira, to make sure you are not already pregnant.
The Qlaira packet contains 26 coloured active tablets and 2 white inactive tablets. These must be taken in the order specified on the pack.
You should try and take your pill at the same time every day to help you remember to take it.
If you forget to take one of the white inactive pills this doesn't matter. You will still be protected, just discard the missed inactive pill and continue to take your pills, one every day, as normal.
If you forget to take an active pill, you should take it as soon as you remember (even if that means taking two pills in one day) and then continue to take your pills, one every day, as normal. Don’t take more than two active pills in one day. If you miss more than one pill you should ask your doctor for advice.
If you are less than 12 hours late taking an active pill you will still be protected against pregnancy and don’t need to use any extra precautions.
If you are more than 12 hours late taking an active pill, you may not be protected against pregnancy. What to do next depends on where in the packet you missed the pill.
If you have forgotten to start a new packet of pills, or have forgotten to take a pill on day 1 to 9 of the packet, you should use extra contraception such as condoms for the next nine days, while continuing with normal pill taking. If you had unprotected sex within the previous seven days there is a possibility you could be pregnant and you should seek medical advice.
If you miss a pill on days 10 to 17 of the packet, then it is necessary to use extra contraception, such as condoms, for the next nine days, while continuing with normal pill taking.
If you miss a pill from days 18 to 24 of the packet, don’t take the missed pill, discard the current packet and start a new packet immediately. You will need to use extra contraception such as condoms for the next nine days.
If you miss a pill on day 25 to 26 of the packet, then the missed pill should be taken immediately and then the next pill at the usual time. In this case, no extra contraception is necessary.
If you miss a pill on days 27 or 28 this doesn't matter as these pills are inactive. You will still be protected, just discard the missed inactive pill and continue to take your pills, one every day, as normal.
If you are confused about any of this, you can get individual advice for your circumstances from your doctor, pharmacist, local family planning clinic, or by calling the fpa helpline on 0845 122 8690.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start taking this contraceptive. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to ensure that the combination is safe.
The following medicines speed up the breakdown of the hormones in this contraceptive by the liver, which makes it less effective at preventing pregnancy:
If you regularly take any of these medicines, this contraceptive is not recommended for you, because these medicines are likely to make this contraceptive ineffective at preventing pregnancy. You should talk to your doctor about other contraceptive options.
If you are prescribed a short course (up to two months) of any of these medicines, your doctor will probably recommend that you temporarily use a different form of contraception to prevent pregnancy. It is important to discuss your options with your doctor.
If you are prescribed rifampicin or rifabutin, an alternative method of contraception will always be recommended, because these two antibiotics make the pill so ineffective.
In the past, if you were prescribed an antibiotic other than rifampicin or rifabutin (eg amoxicillin, erythromycin, doxycycline) while taking the pill, the advice used to be that you use an extra method of contraception (eg condoms) while you were taking the antibiotic and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill while you take a course of antibiotic. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect the pill. This is the latest guidance from the Faculty of Sexual & Reproductive Healthcare. However, if you experience vomiting or diarrhoea as a result of taking an antibiotic you should follow the instructions for vomiting and diarrhoea described in the warning section above.
The emergency contraceptive ulipristal (Ellaone) has the potential to make the pill less effective. If you take Ellaone as an emergency contraceptive while you are taking Qlaira, you should use an additional method of contraception such as condoms for 16 days after you take it.
The weight loss medicine orlistat (bought without a prescription as Alli and prescribed as Xenical) can cause severe diarrhoea. If you take either of these medicines while taking Qlaira and get diarrhoea that lasts for more than 24 hours, you should follow the instructions for missed pills described above.
The pill may antagonise the blood sugar lowering effect of medicines for diabetes. If you have diabetes you should monitor your blood sugar and seek advice from your doctor or pharmacist if your blood sugar control seems to be altered after starting this contraceptive.
The pill may antagonise the effect of medicines used to lower high blood pressure. Your blood pressure will usually be checked periodically while you are taking the pill, but this is particularly important if you are also taking medicines for high blood pressure.
The pill may also antagonise the fluid-losing effect of diuretic medicines.
If you have an underactive thyroid gland (hypothyroidism) you may need an increased dose of your thyroid hormones while taking the pill. Your thyroid hormone levels should be regularly checked.
The pill may decrease the amount of the antiepileptic medicine lamotrigine in the blood. As this could increase the risk of seizures coming back or getting worse, the pill may not be recommended for women who take lamotrigine on its own for epilepsy.
The pill may increase the blood levels of the following medicines and this could possibly increase the risk of their side effects:
There are currently no other medicines available in the UK that contain both estradiol and dienogest as the active ingredients.