Qlaira

What is Qlaira?

Qlaira is an effective and reliable combined contraceptive pill. Each strip contains 28 pills: 26 active and 2 inactive pills. Qlaira is taken every day without a break and is known as a quadriphasic pill. That means the 26 active pills are divided into 4 doses to closely mimic the natural menstrual cycle. The pills must be taken in the correct order to be effective.

Qlaira contains synthetic versions of the hormones oestrogen and progesterone, specifically estradiol valerate and dienogest. The fact that it contains 4 different-dose pills and 2 inactive pills makes it different from many other combined pills that contain a single dose. It is important that the pills are taken in the correct order to be effective.

The use of Qlaira also makes periods lighter and reduces prolonged bleeding problems in women. When used correctly, the contraceptive pill is more than 99% effective at preventing unwanted pregnancy. However, when factors such as taking the pill incorrectly, missing a pill, or sickness and diarrhoea are considered, it is closer to being 91% effective.

How Does Qlaira Work?

Qlaira is a hormonal contraceptive that works by interfering with the natural menstrual cycle to prevent pregnancy. Qlaira has two active ingredients, estradiol valerate and dienogest, which are analogues of naturally occurring female sex hormones oestrogen and progesterone, respectively.

The active ingredients found in Qlaira are different from those of other synthetic hormones used in other hormonal contraceptive pills. The active ingredients break down in the body into forms identical to the natural hormones produced by the body, rather than into synthetic analogues found in other pills.

Qlaira works by altering hormone levels during the menstrual cycle. By doing this, they can prevent the ovaries from releasing an egg (ovulation) to be fertilised by sperm.

Additionally, Qlaira also protects you from pregnancy by thickening the mucus at the cervical opening, making it difficult for sperm to penetrate the mucus lining and enter the womb to fertilise the egg. It also thins the lining of the uterus, making it difficult for a fertilised egg to implant.

Together, the effects of Qlaira reduce the chances of becoming pregnant and help to regulate the menstrual cycle.

How to Take Qlaira

Each strip of Qlaira contains 28 tablets, 26 of which are active and 2 are inactive. These inactive tablets are white and do not contain any of the active ingredients. Each pill should be swallowed whole with water. You can take them with or without food, but they must be taken at the same time each day.

Each pack includes:

• 2 dark yellow pills containing 3 mg of estradiol valerate
• 5 medium red pills that have 2 mg estradiol valerate and 2 mg dienogest in each
• 17 light yellow pills containing 2 mg estradiol valerate and 3 mg dienogest
• 2 dark red pills containing 1 mg estradiol valerate
• 2 white pills, which are inactive and contain no hormones

To take Qlaira, you need to:

1. Choose the weekday sticker strip that starts with the day you start taking Qlaira. For example, if you start on a Monday, use the weekday sticker strip that starts with ‘MON’.
2. Stick the weekday sticker strip along the top of the Qlaira wallet where it says “Place weekday sticker strip here”, so that the first day is above the tablet marked 1.
3. Take 1 pill each day, following the direction of the arrows on the pack until all 28 pills have been taken.
4. You will usually have a withdrawal bleed, similar to a period, when you start taking the second dark red or the white tablets.
5. Start the next pack straight away without a break.

If you are unsure about how to take Qlaira, consult a clinician. Instructions can also be found in the patient information leaflet enclosed with your medicine.

What Should I Do if I Forget to Take Qlaira?

If you forget to take Qlaira, what you need to do will depend on which pills you have missed.

If you miss a white tablet, you can skip it as it does not contain any active substances. However, you must throw away the missed tablet so that the number of days you take the tablets is not increased, as this could increase the risk of pregnancy. Continue taking the next pills as usual.

If you have missed any of the active pills, what you will need to do depends on which pills you missed and how late you are taking them.

If you are less than 12 hours late taking a tablet, take the missed pill as soon as you remember and then continue taking the pills at the usual time. Your contraceptive protection will not be reduced.

If you are more than 12 hours late taking a pill, use the information below to decide what to do.

Days 1 to 9

If you have had sex in the 7 days since your last pill, contact your doctor straight away, as this could impact what you should do next.

If you did not have sex in the previous 7 days:

• Take the missed pill straight away and take the next one at the usual time, even if that means taking 2 in the same day.
• Continue taking your daily pills as usual.
• Use an additional method of contraception, such as condoms, for the next 9 days.

Days 10 to 17

• Take the missed pill straight away and take the next one at the usual time, even if that means taking 2 in the same day.
• Continue taking your daily pills as usual.
• Use an additional method of contraception, such as condoms, for the next 9 days.

Days 18 to 24

• Do not take the missed pill.
• Discard the current wallet.
• Take the first tablet of a new wallet.
• Continue taking one pill every day from the new wallet at the same time each day.
• Use an additional method of contraception, such as condoms, for the next 9 days.

Days 25 to 26

• Take this missed pill straight away.
• Take the next pill at the same time as usual, even if that means taking 2 pills in 1 day.
• Continue taking your pills as normal.
• You do not need additional contraception.

Days 27 to 28

• Throw away the missed tablet.
• Take the next pill at the usual time.
• If the last tablet in the current wallet is missed, continue taking the first tablet from the new wallet at the usual time.
• You do not need additional contraception.

If you have forgotten more than 1 coloured pill or forgotten to start a new wallet, contact your clinician straight away, as there could be a chance that you are pregnant, especially if you had sex in the 7 days before forgetting the tablet. You may want to take a pregnancy test as well.

What Should I Do if I Accidentally Take More Qlaira Than I Should?

Taking too many Qlaira tablets should not cause serious harm, but you may feel or be sick. Young girls may have some vaginal bleeding. If you take too many Qlaira tablets, contact your clinician for advice.

What Should I Do if I am Sick (Vomit) or Have Diarrhoea When Taking Qlaira?

If you are sick (vomiting) within 3 to 4 hours of taking an active tablet, or if you have severe diarrhoea, your body may not absorb all of the active ingredients.

After you are sick or have diarrhoea, take the next tablet as soon as possible. If you can, take it within 12 hours of when you would normally take your pill.

If this is not possible or more than 12 hours have passed, you should follow the forgotten pill advice.

How to Start Qlaira or Switch to Qlaira From Another Contraceptive Pill

If you are starting Qlaira and you have not used a hormonal contraceptive in the previous month, you can start Qlaira on day 1 of your period. If you start after day 1, you will need to use an additional method of contraception, like condoms, for 9 days.

If you are switching to Qlaira from another combined pill, start Qlaira the day after taking the last active pill of your previous pill.

If you are switching to Qlaira from a progesterone-only or mini pill, you can start Qlaira on any day, but you will need to use condoms for the first 9 days of using Qlaira.

Qlaira Side Effects and Cautions

Qlaira is a reliable pregnancy control pill, but like any medication, it can cause side effects. For further precautions, read the leaflet inside the pack before taking the medicine. If you have any underlying disease, consult a clinician.

This is not an exhaustive list of Qlaira side effects. Further information on the safety of Qlaira, including a full list of side effects, is available in the Patient Information Leaflet.

If you experience any side effects, whether listed above or in the patient information leaflet, please inform a clinician or ask a pharmacist for advice. You can also report any Qlaira side effects to the MHRA’s Yellow Card Scheme.

Allergic Reactions

Do not take Qlaira if you are allergic to estradiol valerate, dienogest or any of the other ingredients listed in the patient information leaflet.

If you experience the signs of an allergic reaction, stop taking Qlaira and seek immediate medical attention.

Signs of an allergic reaction include:

• Difficulty breathing or wheezing
• Dry, red and cracked skin
• Itchy, red, watery eyes
• Raised, itchy, red rash (hives)
• Swelling of the face, lips, tongue or throat
• Tightness of the chest
• Tummy pain, nausea, vomiting and diarrhoea

Risk of Blood Clots

Combined contraceptive pills, including Qlaira, slightly increase the risk of blood clots in users compared to people who do not take the combined pill.

The risk of getting a blood clot in a vein is increased if:

• You are overweight (you have a BMI over 30)
• You need to have an operation or are going to be off your feet for a while
• One of your immediate relatives has had a blood clot in their leg, lung, or other organs
• You are over 35
• You gave birth less than a few weeks ago

You can find out more about the risk of blood clots while taking Qlaira in section 4.4 of the Summary of Product Characteristics, which you can view online.

Risk of Breast Cancer

There is some evidence to suggest that the combined pill slightly raises the risk of breast cancer. One UK study found that there is a relative increase of around 20 to 30% in breast cancer risk linked to current or recent use of either the combined oral contraceptive pill or the mini pill.

Qlaira and Depression

Some Qlaira users have reported depression or depressed mood when taking Qlaira. If you experience any mood changes, depression symptoms, or suicidal thoughts, contact your clinician for advice.

Qlaira Warnings and Interactions

Qlaira is not suitable for everyone. Some health conditions or medications may mean you cannot take Qlaira. When you choose Qlaira, a clinician will assess your suitability before prescribing it to ensure it is safe for you to take.

Do not take Qlaira if you:

• Are allergic to estradiol valerate, dienogest, or any other ingredients in the medicine
• Have ever had a blood clot in a blood vessel of your legs, lungs, or other organs
• Have a blood-clotting disorder
• Have ever had a heart attack or stroke
• Have or have ever had angina pectoris or a transient ischaemic attack (TIA)
• Have any issues that may increase your risk of a blood clot in an artery (severe diabetes with blood vessel damage, very high blood pressure, very high blood fat levels, hyperhomocysteinaemia)
• Have ever had migraine with aura
• Have or have ever had liver disease, and your liver function is not normal
• Have or have ever had liver tumours
• Have or have ever had cancer or suspected cancer of the breast or genital organs
• Have any unexplained vaginal bleeding

You should tell the clinician about any other medical conditions you have that are not listed here. The combined pill may not be suitable for you if you are over 35 and smoke; a mini pill may be a more suitable option.

Qlaira is not suitable if you are due to have elective surgery or are going to be off your feet for a while. This is due to the risk of blood clots associated with combined contraceptive pills. If you’re due to have an operation or have decreased mobility, consult your clinician for advice. You can always go back to taking Qlaira when it is safe and suitable to do so.

Qlaira and Other Medicines

Before starting Qlaira, it is important to tell your clinician if you are taking any prescribed, over-the-counter, or herbal medications, as some medicines can affect Qlaira’s blood levels, reduce its effectiveness, or cause unexpected bleeding. These include medicines used to treat:

• Epilepsy (primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate)
• Tuberculosis (rifampicin)
• HIV and hepatitis C (so-called protease inhibitors and non-nucleoside reverse transcriptase inhibitors such as ritonavir, nevirapine, efavirenz)
• Fungal infections (griseofulvin, ketoconazole)
• St John’s Wort

Qlaira may also affect:

• Cyclosporin
• Lamotrigine

Some hepatitis C combination treatments can cause increases in liver function tests in women taking the combined pill. Tell your clinician if you are taking any hepatitis C medications before taking Qlaira.

Lactose Intolerance and Qlaira

Qlaira contains lactose. Therefore, it is essential to consult your doctor or clinician before taking Qlaira if you are intolerant to any sugars.

Pregnancy and Breastfeeding

Do not take Qlaira if you are pregnant, think you might be pregnant or breastfeeding. Consult your doctor for additional guidance and information.

If you become pregnant while taking Qlaira, stop taking the contraceptive and speak to a clinician.

Other Safety Information

Always consult your clinician before you buy Qlaira online from Prescription Doctor.

Please inform our prescriber of all the medications you currently take, including those prescribed to you or bought over-the-counter, as well as any health or herbal supplements you take.

Do not take Qlaira past the expiry date printed on the packaging. The date refers to the last day of the specified month.

Never throw away medicine via household or water waste. Take any unwanted or expired medicine to your local pharmacy and ask them to dispose of it safely on your behalf.

Always store medicine out of sight and out of reach of children and pets.

Never share your medicine with anybody else, even if they are experiencing the same symptoms as you.

Frequently Asked Questions About Qlaira Pills