Tablets for oral use
Each pack Marvelon consists of 21 tablets.
Each tablet contains:
desogestrel (a progestagen) 0,15 mg, ethinylestradiol (an estrogen)
Marvelon is a combined oral contraceptive preparation containing as active
substances the estrogen ethinylestradiol and the progestagen desogestrel.
Clinical studies have revealed that oral contraceptive preparations
containing ethinylestradiol and desogestrel lack undesirable metabolic
effects which are considered to be due to the androgenic activity of some
progestagens in oral contraceptives.
When taken according to the recommended dosage scheme Marvelon suppresses
the hypophyseal gonadal function and thereby ovulation. In addition, it
induces a regular uterine bleeding which, with respect to amount of flow and
duration, resembles a normal menstrual bleeding. Usually this bleeding
starts two or three days after the intake of the last tablet and is
painless. In clinical trials, Marvelon showed a very low pregnancy rate, a
good cycle control, a low incidence of side-effects and, as a result, a low
Dosage and administration
The first tablet of the first pack is taken on the first day of
menstruation. This also applies when changing over from another brand of
oral contraceptive. One tablet is taken daily at the same time, without
interruption for 21 days, followed by a 7-day tablet-free period.
Each subsequent pack is started after the 7-day tablet-free period has
After delivery administration can be started on the first day of the first
spontaneous menstruation. If it is necessary to start earlier, e.g.
immediately after delivery, additional contraceptive precautions are
necessary for the first 14 days of tablet intake.
After a miscarriage or abortion administration should start immediately. In
this way no additional contraceptive precautions are required.
N.B. Additional information on directions for use, changing from
another oral contraceptive, missed tablets, delay of menstruation, etc. is
given in the section: 'Information for the User'.
• Cardiovascular or cerebrovascular disorders, e.g. thrombophlebitis and
thromboembolic processes, or a history of these conditions.
• Severe hypertension.
• Severe liver disease or a history of this condition if the results of
liver function tests have failed to return to normal; cholestatic jaundice;
a history of jaundice of pregnancy or jaundice due to the use of steroids;
Rotor syndrome and DubinJohnson syndrome.
• Known or suspected estrogen-dependent tumours.
• Endometrial hyperplasia.
• Undiagnosed vaginal bleeding.
• Hyperlipoproteinaemia, especially in the presence of other risk factors
predisposing to cardiovascular disorders.
• A history during pregnancy or previous use of steroids of severe pruritus
or herpes gestationis.
Use during pregnancy and breast-feeding
This drug is contraindicated during pregnancy.
Estrogen/progestagen-containing oral contraceptives may affect the quality
and reduce the quantity of milk produced. A small proportion of the active
substances may be excreted in the milk.
Warnings and precautions
• If any signs of thromboembolic processes occur, treatment should be
• Smoking increases the risk of contracting vascular diseases, a risk
increasing with age. In addition, this risk is probably slightly greater in
users of estrogencontaining oral contraceptives than in non-users. Women
over approximately 35 years of age should therefore be advised to stop
smoking if they want to use this preparation.
• In patients using estrogen-containing preparations, the risk of deep-vein
thrombosis may be temporarily increased when undergoing major surgery or
• In the presence of severe varicose veins, the benefits of
estrogen-containing preparations must be weighed against the possible risks.
• Treatment should be discontinued if the results of liver function tests
• Hepatic cell adenomas have been reported very rarely in women using oral
contraceptives. The adenoma may present itself as an abdominal mass and/or
with the signs and symptoms of acute abdominal pain. A bleeding hepatic cell
adenoma should be considered if the patient has abdominal pain or signs of
• Chloasma is occasionally seen during the use of estrogen and/or
progestagencontaining preparations, especially in women with a history of
chloasma gravidarum. Women with a tendency to chloasma should avoid exposure
to the sun while taking this preparation.
• During the use of estrogen-containing oral contraceptives, depression may
occasionally occur. If this is accompanied by a disturbance in tryptophan
metabolism, administration of vitamin B6 might be of therapeutic value.
• The use of steroids may influence the results of certain laboratory tests.
• During prolonged treatment with estrogen and/or progestagen-containing
preparations periodic medical examination is advisable.
• Patients with any of the following conditions should be monitored: -
latent or overt cardiac failure, renal dysfunction, hypertension, epilepsy
or migraine (or a history of these conditions), since aggravation or
recurrence may occasionally be induced. during infections or anoxia,
estrogencontaining preparations may induce thromboembolic processes in
patients with this condition; - estrogen-sensitive gynaecological disorders,
e.g. uterine fibromyomata which may increase in size, and endometriosis
which may become aggravated during estrogen treatment.
When this product is taken according to the directions for use the
occurrence of pregnancy is highly unlikely. However, the reliability of oral
contraceptives may be reduced when:
• the tablets have not been taken in accordance with the directions for use
e.g. one or more tablets have been missed.
• gastro-intestinal disturbances with diarrhoea and/or vomiting have
occurred within 4 hours of tablet-intake.
• other drugs (see paragraph `Interactions') are used concomitantly.
If withdrawal bleeding fails to occur and none of the above mentioned events
has taken place, pregnancy is highly unlikely and oral contraceptive use can
If, however, any of these events has occurred, tablet intake should be
discontinued and pregnancy excluded before oral contraceptive use can be
Marvelon tablets should be taken orally. In view of this, chemical
interaction of the active ingredients with other substances can be left out
of consideration. Possible physiological incompatibilities are stated under
Irregular bleeding and reduced reliability may occur when oral
contraceptives are used concomitantly with drugs such as anticonvulsants,
barbiturates, antibiotics (e.g. tetracyclines, rifampicin, etc.), activated
charcoal and certain laxatives. Oral contraceptives may diminish the glucose
tolerance and increase the need for insulin or other antidiabetic drugs in
The following adverse reactions have been
associated with estrogen and/or
• Genito-urinary tract
post-medication amenorrhoea, changes in cervical secretion, increase in size
of uterine fibromyomata, aggravation of endometriosis, certain vaginal
infections, e.g. candidiasis.
tenderness, pain, enlargement,
• Gastro-intestinal tract
nausea, vomiting, cholelithiasis,
• Cardiovascular system
thrombosis, rise of blood
chloasma, erythema nodosum, rash.
discomfort of the cornea if
contact lenses are used.
headache, migraine, mood changes.
fluid retention, reduced glucose
tolerance, change in body weight.
The toxicity of both desogestrel and ethinylestradiol is very low. Therefore
with Marvelon toxic symptoms are not expected to occur when, e.g. by young
children, several tablets are taken simultaneously. Symptoms that possibly
may occur in this case are: nausea, vomiting and in young girls slight
vaginal bleeding. A specific treatment is probably not required, if
necessary supportive treatment can be given.
The tablet bears the name 'Organon' on one side and the code 'TR 5' on the