Ethinylestradiol with norgestimate

STARTING — no preceding hormonal contraceptive use in the last month: start on the 1st day of the menstrual cycle (first day of menstrual bleeding). If menstruation has already begun, Cilique may be commenced up to day 5 of the menstrual period provided additional contraceptive precautions are taken for the first 7 days of tablet taking. SWITCHING — from a combined contraceptive (COC, vaginal ring or transdermal patch): start the next day after the last active tablet of the previous pack, but no later than the day after the usual tablet-free or placebo-tablet period; for a ring or patch, start preferably on the day of removal, at the latest when the next application would have been due. From a progestin-only method or progestogen-releasing IUS: may change from progestogen-only pills any day, taking the first tablet the day after any POP tablet; from an implant or IUS start the day it is removed; from injections start when the next injection is due — in all these cases also use a barrier method for the first 7 days. AFTER PREGNANCY — following a first-trimester abortion, may be used immediately with no additional method needed. Following delivery or a second-trimester abortion, start at day 21 to 28 after delivery or second-trimester abortion; if starting later, use a barrier method for the first 7 days (exclude pregnancy first if intercourse has already occurred). Note the increased risk of thromboembolic disease when oral contraceptives are given in the immediate postpartum/post-miscarriage period. Postpartum (not breast-feeding): may start on the first day of the first spontaneous menstruation or 3 weeks after delivery, whichever comes first. MISSED TABLETS — missing a tablet by less than 12 hours does not diminish contraceptive protection: take the tablet as soon as remembered and continue as usual. Missing a tablet by more than 12 hours can diminish protection; tablet-taking should never be interrupted for longer than 7 days, and 7 days of uninterrupted tablet-taking are needed to suppress the hypothalamic-pituitary-ovarian axis. Week 1: take the last missed tablet as soon as remembered (even if two tablets at once), continue at the usual time, and use a barrier method for the next 7 days; consider pregnancy if intercourse occurred in the previous 7 days. Week 2: take the last missed tablet as soon as remembered and continue as usual; no additional precautions if the preceding 7 days were taken correctly, otherwise (or if more than 1 tablet was missed) use another method for 7 days. Week 3: either (1) take the last missed tablet as soon as remembered, continue as usual and start the next pack immediately with no gap (a withdrawal bleed is unlikely until the end of the second pack, and spotting or breakthrough bleeding may occur), or (2) discontinue the current pack, have a tablet-free interval of up to 7 days including the missed days, then continue with the next pack — no additional precautions are needed if the preceding 7 days were taken correctly, otherwise follow option 1 plus another method for 7 days. Consider pregnancy if no withdrawal bleed follows in the first normal tablet-free interval. DELAYING MENSTRUATION — when all tablets of the strip have been taken, a new strip can be started and tablets taken for the number of days needed, followed by 7 tablet-free days (the SPC extract is truncated at this point — clinician to confirm from the SPC). PAEDIATRIC — no paediatric posology is stated in this SPC section (§4.2 is headed 'Adults').