Mercilon Dosage and Its Impact on Contraceptive Effectiveness

Taking an extra dose of Mercilon?

Hello Doctor,
I would like to ask a question.
I started taking Dailian on the first day of my period on August 16 for contraception.
However, I experienced some discomfort while taking Dailian, and after my period lasted for two weeks, I visited a gynecologist who switched me to Mercilon.
I took it twice a day for the first week and once a day for the following two weeks, but I continued to have light bleeding.
On September 12, I went for another consultation and was prescribed a hemostatic medication (Transamin) to take three times a day, but the bleeding persisted.

On September 13-14, I mistakenly thought I had missed a dose of my medication for 24 hours, which made me anxious, so I took two pills on September 14.
On September 16, I realized that I likely did not miss a dose (after rechecking the dates and the number of pills, I found that I was short by one pill), so I ended my medication a day early, finishing on September 18 instead of September 19.

1.
I would like to know if I should start the next pack of Mercilon on the fifth day after finishing the medication, which would be September 19, or if I should start a day earlier?
2.
Will this affect the contraceptive effectiveness?
Thank you for taking the time to read and answer my questions!

Niming, 30~39 year old female. Ask Date: 2022/09/19

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Hello! It is advisable to consult the prescribing physician for their opinion.
Thank you.

Reply Date: 2022/09/19

More Info

When it comes to understanding the dosage and effectiveness of Mercilon, a combined oral contraceptive pill, it’s important to consider several factors, including the timing of initiation, adherence to the regimen, and any potential interactions with other medications.
1. Starting the Next Pack: Based on your description, you initially started taking Mercilon on the first day of your menstrual cycle. After experiencing discomfort with another contraceptive (Diane), you switched to Mercilon. You mentioned that you finished the pack a day earlier than planned (on September 18 instead of September 19). Generally, for combined oral contraceptives like Mercilon, it is recommended to start the next pack immediately after finishing the current one, without any breaks. Therefore, you should start the new pack on September 19, as this is the standard practice. Starting on the fifth day after the last pill is not necessary; rather, you should continue taking the pills daily as prescribed.

2. Impact on Contraceptive Effectiveness: The effectiveness of Mercilon can be influenced by several factors, including missed doses and the timing of those doses. In your case, you were concerned about potentially missing a dose on September 14 but ended up taking two pills on that day. This is generally acceptable as a corrective measure for a missed dose, provided that you did not miss more than one pill in a row. However, taking two pills at once can sometimes lead to side effects, such as nausea or breakthrough bleeding, which you have experienced.

It’s also important to note that if you have been taking the pills consistently for at least seven days prior to any unprotected intercourse, the contraceptive effect should remain intact. However, if you had any doubts about adherence, especially with the bleeding you experienced, it would be wise to use a backup contraceptive method (like condoms) for at least seven days after any missed doses or irregularities in your pill-taking routine.

Additional Considerations:
- Breakthrough Bleeding: It’s not uncommon to experience breakthrough bleeding when starting a new contraceptive, especially if you have recently switched from another type. This can be due to hormonal adjustments your body is making. If the bleeding persists or becomes heavy, it’s advisable to consult your healthcare provider.

- Consultation with Healthcare Provider: Given your history of switching contraceptives and the ongoing bleeding, it would be beneficial to have a follow-up appointment with your gynecologist. They can provide personalized advice and may suggest alternative contraceptive methods if necessary.

- Medication Interactions: Always inform your healthcare provider about any other medications you are taking, including over-the-counter drugs and supplements, as these can affect the efficacy of hormonal contraceptives.

In summary, you should start your next pack of Mercilon on September 19, and as long as you have been taking the pills correctly, your contraceptive effectiveness should not be compromised. However, if you have any concerns about your bleeding or the effectiveness of your contraceptive method, do not hesitate to reach out to your healthcare provider for further guidance.

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