Synphase Tablets

What is Synphase and what is it used for?

Synphase is an oral contraceptive. It is a triphasic combined pill. When used correctly, it will provide 99% protection against pregnancy. Its two active ingredients, norethisterone and ethinylestradiol, prevent ovulation from occurring during the menstrual cycle. Synphase is 'triphasic' in that it alters the amount of norethisterone in one dose, depending on the point in the cycle. This more closely mimics the natural hormonal cycle, which reduces some of the side effects associated with many other oral contraceptives.

There are 21 Synphase pills in a pack. Once you have finished a pack, you will stop taking the pill for seven days. During this time you will have a normal bleed. Once seven days have passed, begin your next cycle of treatment.

How does Synphase work?

Pregnancy occurs when an egg released from the ovaries is fertilised by sperm. In a normal menstrual cycle, the ovaries release one egg each month - this is the process of ovulation. This process is controlled by the female sex hormones progesterone and oestrogen. Synphase contains two synthetic hormones, norethisterone and ethinylestradiol, which imitate these two natural hormones. They control the levels of each hormone in such a way that prevents an egg from being released. The Pill also makes it more difficult for sperm to reach the uterus, by thickening the fluid that is in the cervix.

During a regular menstrual cycle, the endometrium (the wall of the uterus) builds up in preparation for a fertilised egg. Synphase reduces the extent of this buildup, making it less likely that a fertilised egg will develop into an embryo. As a further result, periods become lighter. The triphasic course of norethisterone in Synphase reduces side effects by more closely imitating the natural hormonal cycle.

Alternatives to Synphase

Logynon is an alternative triphasic contraceptive pill containing different active ingredients to prevent pregnancy.

For more information surrounding alternative contraceptive options available from The Independent Pharmacy, including progesterone-only pills, combined pills and patches, why not take a look at our Contraception Advice page

Non-Medicinal Contraception Alternatives

• Female Condoms - Not only do they prevent pregnancy they also prevent STIs. There is currently only one brand available in the UK, called Femidom. Shown to be 95% effective.
• Male Condoms - Prevent pregnancy and also prevent STIs. Shown to be 98% effective.

Sources

• Synphase, Patient Information Leaflet: https://www.medicines.org.uk/e...
• https://www.nhs.uk/conditions/...
• https://www.nhs.uk/conditions/...

Synphase warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

Synphase is unsuitable for you if you have:

• An allergy to any of the ingredients of Synphase
• A history of heart attack or stroke
• A family history of blood clots
• A blood clotting disorder
• High-fat levels in the blood
• Any history of cancer of the breast, vagina, cervix or uterus
• Unexplained vaginal bleeding
• Severe migraines
• Severe liver disease

Synphase is unsuitable for you if you have suffered from any of the following problems while pregnant:

• Jaundice
• Pemphigoid gestationis (a rash involving blisters of the hands and feet)
• Pruritus

You may be advised not to take Synphase if you suffer from any of the following conditions:

• Migraines
• Epilepsy
• Cardiovascular disease
• Asthma
• High blood pressure
• Kidney disease
• Multiple sclerosis
• Diabetes
• Impaired liver function
• Varicose veins
• Any breast problems
• Depression
• Fibroids
• Muscle problems
• Irregular periods
• Gallstones
• Sickle-cell anaemia
• Chloasma
• Porphyria
• Otosclerosis

If you require any blood test, inform your doctor of which medicines you are taking - Synphase may alter the results of some blood tests.

Synphase and cancer

Do not use Synphase if you have breast cancer, or if you have had it before. Long-term use of hormonal contraceptives may slightly increase your chance of developing breast cancer. Once you have stopped using the Pill for at least 10 years, your risk levels will come back down. Women who are elderly and/or overweight are more vulnerable to breast cancer. Take care using Synphase if a close relative has suffered from breast cancer before. Check your breasts and nipples regularly for any changes or lumps. If you notice anything abnormal, visit your doctor as soon as you can.

Synphase may increase your chance of developing cervical cancer. For this reason, you should have regular smear tests while taking the Pill.

Synphase and blood clots

You may be more susceptible to blood clots while taking Synphase, especially during the first year of use. Talk to your GP before having any operation while taking the Pill. You may need to stop using Synphase to avoid the increased risk of a blood clot in advance of the operation. You are also at a heightened risk of developing a blood clot if you:

• Smoke
• Are obese
• Have a family history of blood clots
• Do not exercise regularly
• Have had a miscarriage in the past
• Have recently given birth

Synphase and other medicines

The following medicines may impact the effectiveness of Synphase:

• Epilepsy medicines (e.g. carbamazepine, phenytoin)
• St John's Wort
• HIV medicines (e.g. nelfinavir, ritonavir)
• Certain antibiotics (e.g. rifabutin, rifampicin)
• Certain antifungal medicines (e.g. griseofulvin)
• Modafinil

Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform your doctor of medicines you are taking or intend to take.

How to take Synphase

Synphase can be prescribed by The Independent Pharmacy and bought by adults over the age of 18 years.

• Synphase is for oral use only.
• For the first 7 days, you will take blue tablets which contain 0.5mg norethisterone.
• For the next 9 days, you will take white tablets which contain 1mg norethisterone.
• For the final 5 days, you will take blue tablets again.
• Take your first tablet, next to the correct day of the week, from the top row of the pack and follow the directions of the arrows printed on the pack.
• After 21 days, have a 7-day pill-free break, where you should expect to have a bleed.
• Start your new pack, after your 7 days pill-free, on the same day of the week that you started your previous pack.

For full details on how to take Levest, please read the Patient Information Leaflet thoroughly.

Starting Synphase

If you have not used any contraceptive with hormones in the previous month:

Start Synphase on the first day of your period. Starting Synphase on the first day of your period means you are immediately protected against pregnancy and do not need to use additional barrier contraceptives.

If you start Synphase any time after day 1 of your period you must use additional barrier contraceptives such as condoms for 7 days.

Switching from another combined hormonal contraceptive pill:

Start Synphase the day after your last pill from your previous pill packet. Do not have a 7-day pill-free break. If you start Synphase after your 7-day break you will need to use an additional barrier contraceptive such as condoms for 7 days.

Changing from a progestogen-only pill, injection, implant or a progesterone-releasing IUD:

You may switch to Synphase, any convenient day, from the progestogen-only pill, from the day of removal of an implant or an IUD and the due date of the injection. In all of these cases, you must use an additional barrier contraceptive such as condoms for 7 days.

After having a baby:

You can start taking Synphase on day 21 after having a baby. If you start taking Synphase later than day 21 you must use an additional barrier method of contraception such as condoms for the next 7 days. You should not take any combined contraceptive pill if you are breastfeeding.

Synphase missed pill

If you forget to take your daily Synphase tablet or you are sick or have diarrhoea within 3-4 hours after taking your tablet, take it as soon as you remember or when you feel better, even if this means taking 2 tablets on the same day.

If you are more than 12 hours late taking your Synphase tablet:

• You will not be protected from getting pregnant and should use additional barrier contraception such as a condom for 7 days.

You are at more risk of becoming pregnant if you miss multiple tablets within one packet or if the missed pill is at the start or the end of your packet. If you think you are at risk of being pregnant while taking Synphase you should speak to a doctor for advice as soon as possible.

If you are less than 12 hours late taking your Synphase tablet:

• You will be protected from getting pregnant. You will not need to use additional contraception.

Synphase ingredients

The active ingredients contained in Synphase are:

• 7 Blue tablets - 0.5mg norethisterone, 35mcg ethinylestradiol
• 9 White tablets - 1mg norethisterone, 35mcg ethinylestradiol
• 5 blue tablets - 0.5mg norethisterone, 35mcg ethinylestradiol

Synphase also contains the following inactive ingredients: Maize starch, polyvidone, lactose, magnesium stearate. The blue pills also contain the colouring E132.

Synphase side effects

In the same way as other medicine, Synphase can cause some people to experience side effects. The most commonly reported side effects are usually mild but if you are bothered by them or are concerned you should speak to a doctor or pharmacist for advice.

Most commonly people who take Levest report the following side effects:

• Feeling sick
• Abdominal cramps
• Headaches
• Breast tenderness
• Weight gain or fluid retention
• Mood changes
• Change in sex drive
• Irregular bleeding
• Increased blood pressure

If you experience an allergic reaction or severe side effects while taking Synphase you should seek immediate medical attention from a doctor or your nearest emergency department.

For full details on reported side effects associated with taking Synphase please read the Patient Information Leaflet.