Qlaira tablets are a type of hormonal contraception commonly known as 'the pill' or combined oral contraceptive pill.
Qlaira tablets contain two active ingredients, estradiol valerate and dienogest. These are synthetic versions of the naturally occurring female sex hormones, oestrogen and progesterone. Estradiol is a synthetic version of oestrogen that is metabolised in the body to a form of oestrogen that is naturally found in the body. Dienogest is a synthetic form of progesterone.
Combined oral contraceptives like Qlaira work by over-riding the normal menstrual cycle. In a woman's normal menstrual cycle, levels of the sex hormones change throughout each month. The hormones cause an egg to be released from the ovaries (ovulation) and prepare the lining of the womb for a possible pregnancy. At the end of each cycle, if the egg has not been fertilised the levels of the hormones fall, causing the womb lining to be shed as a monthly period.
The daily dose of hormones taken in the pill work mainly by tricking your body into thinking that ovulation has already happened. This prevents an egg from ripening and being released from the ovaries each month.
The hormones also increase the thickness of the natural mucus at the neck of the womb, which makes it more difficult for sperm to cross from the vagina into the womb and reach an egg. They also change the quality of the womb lining (endometrium), making it less likely that a fertilised egg can implant there.
Taking the contraceptive pill usually results in lighter, less painful and more regular menstrual bleeding. This means it is sometimes prescribed for women who have problems with particularly heavy, painful or irregular periods.
Each pack of Qlaira tablets contains four types of active tablets, each type containing a slightly different dose of hormones. The two dark yellow tablets contain 3mg estradiol, the five medium red tablets contain 2mg estradiol and 2mg dienogest, the 17 light yellow tablets contain 2mg estradiol and 3mg dienogest, and the two dark red tablets contain 1mg estradiol. There are also two inactive white tablets.
Qlaira tablets must be taken in the order specified on the pack, starting with the tablet marked one.
The tablets also come with self-adhesive strips, each starting with a different day of the week. These are to show you on which day to take each tablet. Peel off a strip that starts with your starting day, e.g., if you start the tablets on a Wednesday, use a strip that starts with 'Wed'. Stick the strip along the top of the strip of tablets, so that the first day is above the pill marked 'start'. You can now see on which day you have to take each tablet.
The purpose of the last two inactive tablets is that you get used to taking a pill at the same time every day and just take each packet back to back. This is unlike many other pills, where you have three weeks of taking pills, followed by a week off from pill taking.
You will still be protected against pregnancy while you are taking the inactive tablets, provided you took all the pills correctly, you start the next packet on time and nothing else happened that could make the pill less effective (e.g. sickness, diarrhoea, or taking certain other medicines).
You should try and take your pill at the same time every day to help you remember to take it. The tablets can be taken either with or without food.
Qlaira tablets must be taken in the order specified on the pack, starting with the tablet marked one.
If you have not previously been using a hormonal contraceptive you should take the first tablet on day one of your menstrual cycle (the first day of your period). This will protect you from pregnancy straight away and you don’t need to use any additional contraception.
If you are changing from any other combined oral contraceptive pill to Qlaira, then you should take the first tablet of your Qlaira packet the day after you take your last active pill from your old pill packet. This will protect you from pregnancy straight away.
If you have previously been using the contraceptive vaginal ring (NuvaRing) or contraceptive skin patches (Evra) you need to start taking the Qlaira tablets on the day you remove the ring or patch. This will protect you from pregnancy straight away.
If you have previously been using a progestogen only contraceptive pill, known as the mini pill, you can change over to Qlaira on any day of the cycle, but you must use extra contraception such as condoms (or not have sex) for the first nine days of taking the Qlaira tablets.
If you are changing from other progestogen-only contraceptives, such as an implant (Implanon), a hormone releasing coil (Mirena IUS) or an injection (Depo-provera or Noristerat), Qlaira tablets should be started on the day the implant or IUS is removed, or on the day your next injection is due. You will need to use extra contraception such as condoms for the first nine days of taking the Qlaira tablets.
You can start taking this pill immediately after a miscarriage or abortion in the first trimester; you will be protected against pregnancy immediately.
If you have given birth and are not breastfeeding, or have had an abortion in the second trimester, you can start taking this pill at day 21 to 28 after the birth or second trimester abortion. You will be protected against pregnancy immediately and do not need to use extra contraception.
If you start taking Qlaira later than 28 days after the birth or abortion, you will need to use extra contraception e.g. condoms for the first nine days of taking the Qlaira tablets. However, if you had unprotected sex after the birth or abortion and before starting Qlaira tablets, you should do a pregnancy test or wait until your first menstrual period before you start taking Qlaira, to make sure you are not already pregnant.
Medicines and their possible side effects can affect individual people in different ways. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. The following are some of the side effects that are known to be associated with Qlaira:
- Nausea and vomiting.
- Abdominal pain.
- Breast tenderness and enlargement.
- Weight changes.
- Retention of water in the body tissues (fluid retention).
- Vaginal thrush (candidiasis).
- Change in menstrual bleeding, usually lighter periods or sometimes stopping of periods.
- Menstrual spotting or breakthrough bleeding.
- Decreased sex drive.
- Rise in blood pressure.
- Skin reactions.
- Irregular brown patches on the skin, usually of the face (chloasma).
- Steepening of corneal curvature, which may make contact lenses uncomfortable.
- Disturbance in liver function.
- Blood clots in the blood vessels (e.g., DVT, pulmonary embolism, heart attack, stroke).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with Qlaira, please read the information provided with the medicine or consult your doctor or pharmacist.
This contraceptive pill will not protect you against sexually transmitted infections, so you may still need to use condoms as well.
Qlaira should be used with caution in:
- Women aged over 35 years.
- Women whose parent, brother or sister had a heart attack or stroke caused by a blood clot before the age of 45.
- Women with a parent, brother or sister who has had a blood clot in a vein (venous thromboembolism), e.g. in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism) before the age of 45.
- Women who are obese.
- Women with diabetes mellitus.
- Women with high blood pressure (hypertension).
- Women with heart failure.
- Women who use a wheelchair.
- Women with a history of inflammation of a vein caused by a superficial blood clot (thrombophlebitis).
- Women with anaemia caused by a hereditary blood disorder where abnormal haemoglobin is produced (sickle cell anaemia).
- Women with a history of severe depression, especially if this was caused by taking the pill in the past.
- Women with a history of migraines.
- Women with inflammatory bowel disease, e.g. Crohn's disease or ulcerative colitis.
- Women with a personal or family history of raised levels of fats called triglycerides in the blood (hypertriglyceridaemia).
- Women with raised levels of the hormone prolactin in their blood (hyperprolactinaemia).
- Women with an undiagnosed breast lump or gene mutations that are associated with breast cancer, e.g. BRCA1.
- Women with a history of irregular brown patches appearing on the skin, usually of the face, during pregnancy or previous use of a contraceptive pill (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking this contraceptive.
Qlaira should NOT be used in:
- Women who are breastfeeding (the combined pill shouldn't be taken until weaning or for six months after birth).
- Women who have ever had a blood clot in a vein (venous thromboembolism), e.g. in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
- Women with blood disorders that increase the risk of blood clots in the veins, e.g. antiphospholipid syndrome or factor V Leiden.
- Women having sclerosing treatment for varicose veins.
- Women with two or more other risk factors for getting a blood clot in a vein, e.g. family history of deep vein thrombosis or pulmonary embolism before the age of 45 (parent, brother or sister), obesity, smoking, long-term immobility.
- Women who have ever had a heart attack, stroke or mini-stroke caused by a blood clot in an artery.
- Women with angina, heart valve disease or an irregular heartbeat called atrial fibrillation.
- Women with moderate to severe high blood pressure (hypertension).
- Women who smoke more than 40 cigarettes per day.
- Women over 50 years of age.
- Women with severe diabetes, e.g. with complications affecting the eyes, kidneys or nerves.
- Women with two or more other risk factors for getting a blood clot in an artery, e.g. family history of heart attack or stroke before the age of 45 (parent, brother or sister), diabetes, high blood pressure, smoking, high cholesterol levels, obesity, migraines.
- Women who get migraines with aura, severe migraines regularly lasting over 72 hours despite treatment, or migraines that are treated with ergot derivatives.
- Women with breast cancer or a history of breast cancer (although the pill can be used if you have been free of cancer for five years and you don’t want to use non-hormonal methods of contraception).
- Women with abnormal vaginal bleeding where the cause is not known.
- Women with a long-term condition called systemic lupus erythematosus (SLE).
- Women with a history of excess of urea in the blood, causing damaged red blood cells (haemolytic uraemic syndrome).
- Women with active liver disease, e.g. liver cancer, hepatitis.
- Women with a history of liver disease when liver function has not returned to normal.
- Women with disorders of bile excretion that cause jaundice (e.g. Dubin-Johnson or Rotor syndrome).
- Women with gallstones.
- Women with a history of jaundice, severe itching, hearing disorder called otosclerosis, or rash called pemphigoid gestationis during a previous pregnancy, or previous use of sex hormones.
- Hereditary blood disorders known as porphyrias.
- Qlaira tablets contain lactose and should not be taken by women with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption or sucrase-isomaltase insufficiency.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using Qlaira and inform your doctor or pharmacist immediately.
The patient information leaflet (PIL) is a leaflet containing specific information about medical conditions, doses and side effects. You can download a copy of the PIL here:
Patient Info Leaflet