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About you

Have you discussed the contraceptive pill with your GP, practice nurse, GUM clinic health care professional in the last 12 months

Have you ever been told by a doctor, nurse or healthcare provider that you should NOT use an oral contraceptive pill, patch or ring?

Are you currently using any form of contraception?

e.g. pill, ring, patch, implant, coil or other. Please provide details

Have you previous used any form of contraception in the past?

e.g. pill, ring, patch, implant, coil or other. Please provide details

Have you ever experienced any of the following

  • Unexplained vaginal bleeding (when you’re not on your period) e.g. after sex or between periods
  • A severe headache associated with sickness and/or sensitivity to light
  • Jaundice (yellowing of the skin)

Your Health

Is your BMI under 35?

Do you smoke or have you given up smoking within the last 6 months?

Have you had your blood pressure checked in the last 12 months?

What was the value?

Normal: 90/60-140/90
Low: Below 90/60
High: Above 140/90

Do you have any allergies to medication or substances?

Answer ‘no’ if this does not apply to you

Are you taking any of the following medication?

  • Epilepsy (carbamazepine, felbamate, oxcarbazepine, phenobarbital, phenytoin, primidone, and topiramate)
  • Herbal medication for low mood (e.g. St. John’s Wort)
  • High blood pressure in the blood vessels of the lungs (bosentan);
  • High blood pressure (hypertension), angina or certain heart rhythm disorders (e.g. diltiazem).
  • Bacterial infections (e.g. clarithromycin, erythromycin)
  • Hepatitis C virus infection (e.g. boceprevir, griseofulvin, telaprevir)
  • HIV infections (e.g. efavirenz, nelfinavir, nevirapine, ritonavir);
  • Fungal infection (ketoconazole, itraconazole, fluconazole)

Are you taking any other medication, including other inhalers and tablets for asthma, or have you recently finished a course of medication?

This includes medication prescribed by your doctor, bought in the pharmacy or online, herbal supplements, or recreations drugs.

This includes tablets, patches, inhalers, injections, contraception and all other forms of medication

Answer ‘no’ if this does not apply to you

Do you suffer from any of the following conditions?

  • Blood clots (DVT Deep Vein Thrombosis of legs) (PE Pulmonary Embolism of lungs)
  • Cancer
  • Diabetes
  • Epilepsy
  • Heart Attack or Angina
  • High blood pressure
  • High cholesterol
  • Kidney disease
  • Liver disease
  • Migraines
  • Stroke

Do you suffer from any other medical problems?

For example, diabetes, heart problems, angina, irregular heart rhythm, overactive thyroid, etc

This also includes previous admissions to the hospital or any surgeries

Answer ‘no’ if this does not apply to you

Do you have a family history of any medical conditions?

  • Deep Vein Thrombosis (DVT)
  • Pulmonary Embolism (PE)

Are you pregnant or breast feeding, think you may be pregnant or planning to have a baby?

Important information to know

I understand that if I am just starting this treatment, I should also use an extra method (such as condoms) for the next 7 days

I understand it is important to take the contraceptive pill every day at the same time in order to for it to be effective.

I understand that I should contact a doctor or pharmacist if I miss a pill or vomit in the first 4 hours after taking the pill to find out if I still protected against pregnancy.

I understand that if I miss two pills, I am no longer protected against pregnancy and will need to use extra protection (e.g. condoms) for the next 7 days

I understand that medication, e.g. antibiotics, can cause the contraceptive pill to be less effective and I should let my doctor/nurse/dentist know before they prescribe new medication for me.

I understand it is important to have regular STI checks, at least once yearly, and sooner if changing sexual partners

I understand the importance of regular smear tests. Cervical screening is offered to detect changes in a woman’s cervix that could develop into cervical cancer. It is done every 3 years for women aged 25-49 and every 5 years from 50-64 years.

I understand it is important to check my breasts regularly and contact my doctor as soon as possible if I feel any new lumps in the breasts

I will contact a doctor immediately if I experience unexplained shortness of breath, chest pain or suddenly collapse

I will contact a doctor immediately if I notice pain, swelling and tenderness in one leg (usually the calf).

AGREEMENT

We strongly recommend that you inform your GP of any treatment you receive. Would you like e-Surgery to do this in your behalf?

Please write the name of your GP surgery below if you want us to let them know.

This will ensure that any new medication started by your GP will not interact with this treatment.

Answer ‘no’ if you do not want us to inform your GP

I agree to the following

  • I am 18 years of age or older
  • This treatment is for my use only
  • I confirm that I have understood all the questions asked and have answered all questions to the best of my knowledge.
  • I have read the patient information leaflet supplied with this medication
  • I will contact e-Surgery and inform my GP if I experience any side effects from this treatment or if there are any changes to my health
  • I have answered all questions truthfully and accurately.

I have read, understood and agree to abide by terms and conditions and privacy policy and cookie policy of e-Surgery

What is this?

Your answers form the basis of your medical consultation. It is important you are open and honest, so our doctors can ensure this medication safe and effective for you

Cilest

 

Cilest is known as a combined oral contraceptive. It it used to prevent pregnancy when taken as directed. Cilest contains a combination of Norgestimate and Ethinylestradiol.

Once you decide this is the right choice for you, complete a short questionnaire to help our GPs make sure this medication is safe for you to take. All prices include a private prescription from one of our UK registered GPs.

Clear

Important Facts About Cilest

Most frequent questions and answers about Cilest as a contraceptive pill

Cilest is a combined hormonal contraceptive pill, containing two types of female sex hormones, oestrogen and progestogen. These hormones prevent an egg from being released, so you can’t get pregnant. Cilest also makes the fluid in your cervic thicker, making it more difficult for sperm to enter the womb. 

The contraceptive pill Rigevidon prevents you from getting pregnant. 

Combined oral contraceptive pills such as Cilest do not protect you from sexually-transmitted infections (STIs), only condoms can help do this. 

You should not take Cilest if:

  • You have or have ever had a blood clot
  • You have a disorder affecting blood clotting
  • You need an operation, or are off your feet for a long time
  • If you have ever had a heart attack or stroke 
  • You have or have had angina pectoris
  • If you have any disease that may increase your risk of artery clots
  • If you have or have ever had a migraine with aura
  • if you have breast or liver cancer
  • You have or have had a severe liver disease
  • If you are being treated with antivirals
  • If you are allergic to any of the ingredients

As with any form of medication, Cilest has side effects. For a full list of side effects, please read the Patient Information Leaflet of Cilest.  Below are a few of the common side effects of taking Cilest:

  • Headache
  • Stomach problems
  • Bleeding between periods
  • Painful/unusual periods
  • Migraine
  • Swollen extremities
  •  Mood changes
  • Difficulty sleeping
  • Acne
  • Painful breasts
  • Urinary tract infections
  • Vaginal discharge
  • Weight gain
  • Feeling weak

For a full list of side effects, please read the Patient Information Leaflet of Cilest.

A common question asked, is “What happens if I miss a pill”?

If you miss taking the Cilest pill, you must take the last missed tablet as soon as you remember – Even if you have to take 2 Cilest tablets at the same time. Following this, you should continue taking tablets at the usual time of day.

If you miss the pill in the first week of taking you should also use a barrier method of contraception (e.g condom) for the next 7 days. Following the first week, it is not necessary to take further contraception measures.

You should take one Cilest tablet each day, and should take a pill whole with water at the same time each day.

The Cilest packet is marked with the day of the week, you should follow the arrow until the strip is empty (21 days). Following this, you have 7 days where you do not take any Cilest pills. 

You should keep Cilest tablets out the the sight and reach of children.

Do not use Cilest after the expiry date which is stated on the blister and carton after EXP. 

Do not throw away any unused Cilest pills via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Some medications can stop Cilest from working properly. Therefore if you are taking any of the following, talk to your doctor to discuss your options:

  • Epilepsy treatment
  • Bosentan
  • Anti-HIV medication
  • Hepatitis C medication
  • Aprepitant and fosaprepitant
  • Griseofulvin
  • Modafinil
  • Certain sedatives
  • St. John’s Wort
  • Metoclopramide
  • Charcoal
  • Colesevelam
  • Etoricoxib
  • Ciclosporin
  • Lamotrigine
  • Prednisolone
  • Selegiline
  • Theophylline
  • Tizanidine

Click here for a PDF copy of the patient information leaflet

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