Indications 

Natazia is a combination oral contraceptive (COC) indicated for use by women to prevent pregnancy. 

Comprising of dienogest (a progestin) and estradiol valerate (an estrogen), Natazia functions by inhibiting ovulation and altering the cervical mucus to impede sperm entry while also modifying the uterine lining to prevent pregnancy. 

Uses and Dosage 

Before taking Natazia and with each refill, carefully review its medication guide and patient information leaflet. Should you have any inquiries, consult with your physician or pharmacist. 

The pill pack of Natazia includes 26 colored active pills and 2 white non-medicated reminder pills. Take one active pill daily at a consistent time for 26 days, followed by one reminder pill for 2 days. Menstruation should occur during the fourth week. Begin a new pack after the last reminder pill, regardless of menstruation status. Consult a doctor if menstruation does not occur. 

Follow the specific order of the tablets as indicated on the blister pack and avoid skipping or delaying intake by more than 12 hours. To alleviate stomach upset or nausea caused by this medication, taking it after dinner or before sleeping may be beneficial. 

In instances of intense vomiting or diarrhea, the medication’s absorption may be incomplete, necessitating additional contraceptive measures. If vomiting or diarrhea occurs within 3-4 hours of taking a colored tablet, it should be treated as a missed tablet. 

The initial intake of Natazia may vary per individual: 

• For first-time use of Natazia without transitioning from other contraceptives, start taking it on the first day of menstrual bleeding and use a non-hormonal contraceptive as a backup for the first 9 days. 
• Postpartum women who do not breastfeed or have had a second-trimester abortion should begin taking Natazia no earlier than 4 weeks after delivery to minimize the risk of thromboembolism.   
• If a patient starts Natazia postpartum without having a period, a pregnancy evaluation is necessary, and an additional form of contraception should be used until Natazia has been taken for 9 consecutive days. The potential occurrence of ovulation and conception before starting this medication should also be considered. 
• When switching from a different birth control pill, begin taking Natazia on the first day of your menstrual period. 
• If you were previously taking progestin-only pills, start taking Natazia on the day you would have taken your next scheduled pill. 
• When switching from a birth control implant, intrauterine device (IUD), vaginal ring, or skin patch, start taking Natazia on the day of removal. 
• When switching from a birth control injection, take Natazia on the day of your scheduled injection. 

For optimal results, adhere to a consistent schedule when taking Natazia, ensuring a 24-hour interval between doses.  

Continue taking Natazia daily, regardless of spotting, bleeding, stomach discomfort, or do not anticipate pregnancy. Refrain from discontinuing intake without consulting your doctor. 

Side Effects 

Listed below are the potential adverse effects of Natazia. Inform your doctor promptly if any of these symptoms persist or worsen. 

Common Side Effects 

• Light vaginal bleeding or spotting 
• Nausea (especially in the initial months of medication) 
• Vomiting 
• Breast pain or tenderness 
• Weight gain 
• Contact lens-related issues 

Serious Side Effects 

• Signs of a stroke: 
  • Sudden numbness or weakness (particularly on one side of the body) 
  • Sudden severe headache 
  • Slurred speech 
  • Vision or balance problems 
• Signs of a blood clot: 
  • Chest pain 
  • Sudden cough 
  • Wheezing 
  • Coughing up blood 
  • Swelling or warmth in one or both legs 
• Heart attack symptoms: 
  • Chest pain or pressure 
  • Pain radiating to the jaw or shoulder 
  • Nausea 
  • Sweating 
• Liver problems: 
  • Severe stomach pain 
  • Fever 
  • Fatigue 
  • Loss of appetite 
  • Dark urine 
  • Clay-colored stools 
  • Jaundice (yellowing of the skin or eyes) 
• Sudden and severe pelvic pain 
• Change in the pattern or severity of migraine headaches 
• Swelling in hands, ankles, or feet 
• Breast lump 
• Signs of depression: 
  • Sleep problems 
  • Weakness 
  • Fatigue 
  • Mood changes 

Tell your doctor immediately if you experience any of the severe side effects above. 

Allergic Reactions 

Although rare, a severe allergic reaction to Natazia may occur. Seek immediate medical help if any of the following symptoms arise: 

• Rash 
• Swelling or itching, particularly in the face, tongue, and throat 
• Severe dizziness 
• Trouble breathing  

This list does not contain all the potential side effects of Natazia. If any unlisted effects are experienced, tell your doctor right away. 

Cautions 

Natazia is a highly effective oral contraceptive for birth control when taken as directed. However, it does not provide protection against HIV infection (AIDS) or other sexually transmitted diseases. 

Before taking Natazia, inform your doctor and pharmacist if you have any known hypersensitivities, especially to: 

• Estradiol 
• Dienogest 
• Any estrogens (e.g., mestranol) 
• Any progestins (e.g., norethindrone, desogestrel) 
• Other medications 
• Any ingredients present in Natazia tablets 

To ensure Natazia is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• High blood pressure 
• High cholesterol or triglyceride levels (blood fat) 
• Overweight condition 
• Depression 
• Diabetes 
• Underactive thyroidGallbladder disease 
• Seizures or epilepsy 
• Jaundice (yellowing eyes/skin) during pregnancy or while using hormonal birth control methods (e.g., pills, patches) 

Natazia should not be used if any of the following conditions are present:  

• Uncontrolled high blood pressure 
• Heart disease 
• Blood-clotting disorder 
• Circulation problems 
• Diabetic complications affecting the eyes or kidneys 
• Abnormal vaginal bleeding 
• Liver disease 
• Liver cancer 
• Severe migraine headaches 
• Active smoking combined with being over 35 years old 

Certain products may have interactions with Natazia, including: 

• Aromatase inhibitors (e.g., anastrozole, exemestane, letrozole) 
• Ospemifene 
• Tamoxifen 
• Tranexamic acid 

To minimize the risk of such drug interactions, inform your doctor and pharmacist about all medications, vitamins, supplements, and herbal products you are currently or planning to use. 

Some medications can potentially reduce the effectiveness of Natazia by lowering the levels of birth control hormones in the body. This can increase the risk of pregnancy. Examples of such drugs include: 

• Griseofulvin 
• Modafinil 
• Rifamycins (e.g., rifampin, rifabutin) 
• Ritonavir 
• St. John’s wort 
• Drugs used for seizures (e.g., barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate) 
• HIV drugs (e.g., nelfinavir, nevirapine) and others 

Inform laboratory personnel and all medical professionals of Natazia usage, as it may affect specific lab tests (e.g., clotting factors, thyroid) and yield inaccurate results. 

The use of Natazia can result in pigmentation changes, particularly on the face. If you have previously experienced skin color alterations while on oral contraceptives or during pregnancy, avoid exposure to natural or artificial sunlight while taking them. Protective measures such as sunscreen, sunglasses, and clothing should be utilized. 

If you are nearsighted or wear contact lenses, you may experience vision issues or difficulties with wearing your contact lenses while using Natazia. In such cases, contact your eye doctor for assistance. 

The use of Natazia during pregnancy is contraindicated. In the event of pregnancy or two consecutive missed periods, discontinue use and inform your physician.  

Breastfeeding while taking Natazia is not recommended, as the hormones present in this contraceptive can be transferred to breast milk and potentially pose risks to a nursing infant. It may also impede breast milk production.