Qlaira

Qlaira is a contraceptive pill used by thousands of women to prevent pregnancy.

Today there are many methods of contraception with different rates of effectiveness (often approaching 99%) and with variable practicality. The reason the pill is so popular today is both thanks to its extremely high levels of effectiveness, and its ease of use. Of all the pills on the market, Qlaira is an excellent solution to open up your sexuality without danger to your health, and without the risk of getting pregnant … as long as you learn the facts before you buy it!

Composition of the Qlaira contraceptive pill

Qlaira is a pill manufactured by Bayer laboratories and has been on the market since 2009.

It is an oestrogen-progestin hormonal contraceptive. Therefore, it is known as a combination pill, and has the distinction of containing a natural estrogenic hormone, whilst other combined pills contain synthetic oestrogen (often ethinylestradiol). This estrogenic hormone, estradiol valerate, is biologically identical to the one that the body naturally produces. As for the progestin used, dienogest, it is the only one that can tolerate the combination with natural oestrogen.

Qlaira comes in the form of a 28 quadri-phasic tablets. The composition of dienogest does not contain androgen, and the active ingredient content in Qlaira (maximum 3mg of oestrogen per 3mg of progesterone per tablet) makes it an estrogenic mini-pill.

The balance between the two hormones varies depending on the tablet and their order:

• The first 2 tablets in the packet are dark yellow, and each contains 3mg of estradiol, marked with the letters DD
• The 3^rd to the 7^th tablets are red, and each contains a dose of 2mg of estradiol and 2mg of dienogest, marked with the letters DJ
• The 8th to the 24th tablets are light yellow, each containing 2mg of estradiol and 3mg of dienogest, marked with the letters DH
• The 25th and 26th tablets are dark red and each contains 1mg of estradiol, marked with the letters DN
• The last 2 tablets (27th and 28th) are white and are placebos, marked with the letters DT

As for the Pearl index, it is 0.42 per 100 women, by only taking into account the failure of this contraceptive method on its own, and 0.79 per 100 women by taking into account handling and behavioural errors of the user.

If it is now classified as a 4th generation pill, but it may be ranked among the 2nd generation of oral contraceptives due to its benefit/risk balance.

Who is it for? The benefits of Qlaira

Qlaira has the advantage of making periods lighter and can even prevent them completely for some women. It is intended to treat heavy bleeding, so if you are prone to this, then trying Qlaria might be a good option. Many women also note the total cessation of periods, or only experiencing small traces of blood between periods (spotting).

Besides its effect on the volume of periods, it proves to be effective in reducing headaches, particularly during pre-menstruation, (catamenial migraines), which are both annoying and stressful for many women.

In addition, its anti-androgenic effect—caused by the natural oestrogen in Qlaira—and the progestogen’s total lack of androgenic activity make the pill effective against acne and prevent you from having an increased appetite. It, therefore, does not cause weight gain, unlike some pills. In fact, the oestrogenic climate of Qlaira is particularly suitable for women with a progestin profile (those with skin problems and hirsutism can occur).

It is also worth noting that it acts specifically on the uterine ecosystem. For example, it does not cause vaginal dryness, so the vagina stays lubricated. It also does not cause nausea or headaches. It is therefore considered as a therapeutic medication, capable of restoring the hormonal balance in women who experienced problems with their previous pill with hormonal imbalances or deficiencies. Thus Qlaira can be a much better option, globally.

When and how should Qlaira contraceptive pill be taken?

Qlaira is an original pill in terms of its active ingredients and also its method of administration. This pill should be taken continuously, every day, and you should take the pills methodically, following the order stated on the packet.

Indeed, the importance here is that the pills are dosed differently according to a scale throughout the month, with a decreasing dosage of oestrogen and a growing dosage of progesterone. This is because it closely follows the natural female menstrual cycle.

This also implies that you must take the pill at a precise, fixed time.

Thus, the user needs to pay special attention to their pattern and dosage.

1st administration:

• If you are taking Qlaira as your first pill for birth control, then you should take 1 pill from the packet on the 1st day of your period.
• If you are taking Qlaira straight after another combined oral contraceptive, take the first pill of Qlaira the day after the termination of your previous pill. However, when it concerns another combined hormonal contraceptive such as a vaginal ring or contraceptive patch, you must take 1 tablet of Qlaira on the day that you remove the device.
• If you are only using progestin contraceptives, you can take Qlaira at any time when you stop the other one. If it is an implant, for example, take the first tablet of Qlaira on the day of the planned replacement, even if it is an injection, take the tablet on the expected day of the new injection instead. After a progestogen-only method, you must also use a mechanical method of non-hormonal contraception for 9 days.

It is possible to take Qlaira immediately following a first-trimester abortion. However, after an abortion or childbirth in the second trimester, you cannot take the pill until 21 to 28 days after. If done after, you should consider a form of non-hormonal contraceptive for the next 9 days.

Common use of Qlaira:

In normal use, you must follow the pattern indicated by the packet without observing any interruption period. Bleeding (“periods”) will appear during the last pill of the packet and may continue until the beginning of a new packet.

Are there any side effects when taking Qlaira pills?

Qlaira has many advantages, but it is not without inconveniences, just like all contraceptive pills. The first being that this pill allows fewer oversights and discrepancies than its sisters. The risks of pregnancy are more likely in Qlaira than other pills, especially if one refers to the Pearl index for perfect use, and in normal conditions, lower. So it necessary to be rigorous when taking this pill.

In addition to these practical considerations, Qlaira can cause total cessation of periods (amenorrhea) which can be seen as an advantage or a disadvantage for some. However, it can also induce bleeding (genital bleeding outside of periods, spotting in small amounts). It can also cause abdominal pain, pre- or post-menstrual pains (dysmenorrhea) and nausea. Finally, breast pain can be experienced.

Risks and contraindications of Qlaira contraceptive pill

For now, the Qlaira pill is among the fourth generation pills. It should be prescribed after careful consideration (measuring blood pressure) and submission to a questionnaire on any possible history or presence of risk factors.

However, apart from these diagnosed and proven risks, there is no need to worry. The High Authority of Health recalled in a note from 2012*, that there are no studies that would provide evidence that the 3rd or 4th generation pills should be subject to “additional clinical tests on adverse effects” compared to 2nd generation pills.

The risks below are all contra-indications for women with predisposing conditions, previous history (hereditary or carriers of genetic abnormalities) or proven existence of the elements below:

Thrombosis

Qlaira Online: Venous thromboembolism and its risk factors

DVT	Circulatory disorders
Pulmonary embolism	Phlebitis
People on anticoagulants treatment who, firstly, exhibit blood disorders and secondly, have a teratogenic potential	Disorders of blood coagulation (activated protein C resistance or deficiency of protein C or S) and blood issues in general (anaemia, haemolytic uremic syndrome)

Arterial thromboembolism and its risk factors

Presence of antiphospholipid antibodies, anti-cardiolipin, lupus anticoagulant	Diabetes with vascular symptoms and increased lipid levels (deys lipoproteinemia)
Hypertension	Myocardial infarction
Strokes	Increased homocysteine levels (hyperhomocysteinemia, toxic amino acid)

Other risk factors for thromboembolic events:

Obesity	prolonged immobilisation, either after surgery or for example during air travel for more than 4 hours, especially in women with other additional risk factors
Smokers over 35 years	Women in a puerperal period
High glycemic rate requiring increased surveillance (particularly diabetic women)	The family history of hyperlipidaemia
Age

It is important to remember that all the pills have these risks, and you should be especially careful when you take a pill in general. This applies especially to women with multiple risk factors, who are at risk of thromboembolic problems and should not take the pill. For others, there is a questionnaire and in-depth research of risk factors carried out by a doctor who will give you permission to take Qlaira.

Other indications against taking Qlaira:

Women with severe hepatic impairment, and those with a history or who have already got a serious liver disease (infection, malignancy or benign)	Women who have had or have a TB disease of the skin (such as lupus), especially as drug interactions with anti-tuberculous treatments are harmful
Women with recurrent nausea, susceptible to be intolerant to oestrogen	Women with strong and repetitive migraines with neurological signs
Women who have had pancreatitis or history of it, and those with high triglycerides or history of hypertriglyceridemia, (the pill may increase the rate and risk of creating pancreatitis)	Women who have had or a have a history of hormone-dependent cancers (related to breasts and genitals)
Recurrent vaginal bleeding and whose origin remains unexplained	Women who have had or a history of jaundice, especially during or following pregnancy

Thus without giving into paranoia and panic, regular medical monitoring and attention from you will have a positive impact on your health, and will provide the best conditions to take your pill. Indeed, being aware of the symptoms and signs of a risk listed above is useful and effective for immediate support. If you need to check, call your doctor immediately and stop the pill.

The symptoms that need attention:

Possible signs of venous thrombosis and pulmonary embolism are usually located in the leg areas: you might feel pain along with a vein, both standing or walking. You can see unusual swelling in the leg or foot, with or without a hot sensation in a leg, with possible changes to its colour.

The first possible signs of a pulmonary embolism manifest themselves at a respiratory level, with breathing difficulties linked to acceleration and sudden breathlessness, or a sudden cough with or without blood. Secondly, you can see signs at a thoracic level, in the form of severe chest pain, and sudden cardiac acceleration. Finally, all of this may be associated with feelings of dizziness and collapse.

Possible signs of a stroke are first seen in motor parts of the body, whether the tongue has difficulty speaking and has some confusion or the limbs have difficulty moving, or there are a sudden numbness and paralysis of a limb or the face, located on a part of the body.

Signs can also be seen in the brain, with dizziness and feeling of vertigo—with or without loss of balance—and coordination problems. These can lead to unconsciousness, with convulsions or without. Other signs are violent migraines and brutal headaches that are sudden, prolonged and repetitive. You should also be careful if you notice a sudden loss of vision, whether your blindness is temporary and partial, or total and prolonged.

Also, if you observe these symptoms, act quickly:

• Discomfort, pressure and radiating pain in the chest, back or left arm
• suffocation
• Hot flushes

Paying attention to these things can, therefore, change everything, however, do not panic and do not systematise symptoms that may have a different origin. Whatever it is, you should consult your doctor immediately, as a precaution.

Finally, interactions with other drugs are also part of the precautions, insofar as the following drugs can significantly reduce the efficiency and activity of the contraceptive pill.

If you must take one of these drugs, you must consider taking a non-hormonal contraceptive method in addition to Qlaira:

• Sleeping pills and barbiturates (primidone)
• Drugs for superficial fungal infections of the hair, nails and skin (containing griseofulvin)
• Antiepileptic drugs (phenytoin, carbamazepine)
• Anti-tuberculosis therapy (rifampicin)
• Some plants used for herbal purposes (St. John’s wort)

What if I forget to take my pill?

Again, Qlaira is an original pill in terms of its rhythm of administration, which follows the evolutionary dosage regimen of pills. Therefore, oversights for taking the contraceptive pill are not desired, and you should pay special attention, even for women accustomed to taking the pill.

If you remember in less than 12 hours, take the missed tablet immediately and continue taking the next pill at the normal time. There is no risk of pregnancy and no need for additional contraceptive precautions.

If you remember after 12 hours, the action you should take will depend on the point in the cycle:

> If the missed pill is between the 1st and the 17th tablet:

• whether a dark yellow pill [1-2]
• or a red pill [3-7]
• or a light yellow pill [8-17]

Take the tablet as soon as you remember,

Take the next tablet at the fixed and regular time, even if it means having to take two tablets at once or at very short intervals. Treatment then continues normally.

Take a non-hormonal method of contraception (your choice of mechanical contraception e.g. condoms) for 9 days.

> If the missed pill is a light yellow pill between [18-24]:

Do not take the missed pill. Throw away the current pack.

Start a new pack and take the first pill of this new pack immediately, as soon as the pill is remembered

Take a non-hormonal method of contraception (your choice of mechanical contraception e.g. condoms) for 9 days.

> If the missed pill is a dark red pill between [25-26]

Take the tablet as soon as you remember

Take the next pill, as usual, at the fixed and standard time. It may be that you take it at the same time or shortly after the missed tablet, it does not matter.

An additional contraceptive method is not required.

> If the pill is a white tablet between [27-28]

Do not take the missed tablet and be sure to throw it away to avoid prolonging the pause interval. Remember, these tablets are placebos.

Continue normally, i.e. take the next white pill at the normal and usual time

No additional contraception necessary.

These modes of action are useful if you miss 1 pill, but you have correctly followed the other pills during the cycle, without forgetting to repeat. If this were not the case, you should consider the risk of pregnancy.

If you have had sex seven days before the forgotten pill, especially if the said pill is at the beginning of a new pack (after the 2 white placebo tablets) or it is between day 3 and day 9 of the packet (numbers [3-7] of red or [8-9] of light yellow).

If you do not get any bleeding (the “period”) during the normal space of time (at the end of the pack or at the beginning of the new pack)

In general, if the forgotten pill is close to the white placebo pills.

You must then conduct a pregnancy test before continuing the contraception.

Finally, if you experience severe vomiting or diarrhoea within 3 hours of taking your usual tablet, it may be that this pill is expelled before its complete dissolution in the body. You must, therefore, take the next tablet, which will change the timing of your cycle.

If you want to avoid this disruption, you should take the same pill from a spare pack. Finally, if you cannot replace your tablet within 12 hours you should refer to the procedures based on the date of the forgotten pill.

How to buy Qlaira contraceptive pill online & in UK?

Like any contraceptive pill Qlaira requires a prescription. It is firstly necessary to make an appointment with your gynaecologist to perform a medical examination for the prescription.

Buy Qlaira in a UK pharmacy

Once you have your prescription you can then go buy Qlaira in a pharmacy. As you know, getting a medical appointment with the gynaecologist can be difficult to obtain, and it may take several weeks to several months. Renewal of your pill can therefore sometimes be impossible.

Buy Qlaira online in UK

Depending on the country in which you reside, it is also possible to buy Qlaira online. Various online clinics allow women to conduct a medical consultation remotely. Controlled by a doctor, if the consultation is validated, the patient will be able to receive their pill at home. It is recommended to be careful about what site you use before buying the pill.

You must also ensure that the country in which you reside authorises the purchase of prescription drugs online. Regulation is different from European countries.

What is the price of Qlaira online & in UK?

Like all birth control pills, Qlaira is only available on prescription. Pharmacists are then allowed to choose the price of the pill at will.  Pharmacists can then decide to increase or decrease the price of the pill based on their costs and margins. Be aware that the pill is not reimbursed by social security. Qlaira is relatively expensive for its users.

Qlaira price: Buy in a UK pharmacy

In pharmacies, the price of Qlaira varies from £20 to £30 for a month of contraception. It is also necessary to add the cost of the medical consultation at the gynaecologist’s to this price (ranging from £35 to £60.)

Qlaira price: Buy Qlaira Online in UK

Prices can be very competitive online depending on the website, and they range from £25 to £35 per month. Depending on the website, the prescription and the delivery charges are included.

Caution: Alfadoc always recommends that you go to your gynaecologist to perform a medical examination and obtain a prescription before you to purchase the contraceptive pill in pharmacies. However, if you wish to order online, beware of websites offering you low prices and promotions such as “cheap Qlaira” or “no prescription”. These sites often sell counterfeit drugs.

Sources

• Qlaira (estradiol, dienogest): Netdoctor
• Answers to your questions about Qlaira: Qlaira.com
• Side Effects of Qlaira: Healthcentre

Other information

Portugal	France
Poland

Medical review on January 18, 2021 by Dr. Davis Taylor