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There are certain forms of pulmonary hypertensionwhich are serious in nature and worsen with timeso much so that they are even fatal at timesIt also includes forms which are non curable in naturehoweverin order to improve the quality of lifesymptoms can be reduced with proper treatmentThe treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up careYour doctor might also need to change your treatment if it’s no longer effectiveHoweverwhen pulmonary hypertension is caused by another conditionyour doctor will treat the underlying cause whenever possible.
The management of missed tablets can be guided by the following two basic rulesTablet-taking must never be discontinued for more than 7 daysand 7 days of uninterrupted tablet-taking are required to attain adequate suppression of the hypothalamic-pituitary-ovarian axisIf the user is less than 12 hours late in taking a tabletcontraceptive protection is not reducedThe woman should take the tablet as soon as she remembers and should take further tablets at the usual timeWeek 1The user should take the last missed tablet as soon as she rememberseven if this means taking 2 tabs at the same timeShe then continues to take tablets at her usual timeIn additiona barrier method ega condomshould be used for the next 7 daysWeek 2The user should take the last missed tablet as soon as she rememberseven if this means taking 2 tabs at the same timeShe then continues to take tablets at her usual timeProvided that the woman has taken her tablets correctly in the 7 days preceding the 1st missed tabletthere is no need to use extra contraceptive precautionsHoweverif this is not the case or if she missed more than one tabletthe woman should be advised to use extra precautions for 7 daysWeek 3The risk of reduced reliability is imminent because of the forthcoming tablet-free intervalHoweverby adjusting the tablet-intake schedulereduced contraceptive protection can still be preventedBy adhering to either of the following 2 optionsthere is therefore no need to use extra contraceptive precautionsprovided that in the 7 days preceding the first missed tabletthe woman has taken all tablets correctlyIf this is not the casethe woman should be advised to follow the first of these 2 options and to use extra precautions for the next 7 days as wellThe user should take the last missed tablet as soon as she rememberseven if this means taking 2 tablets at the same timeShe then continues to take tablets at her usual timeThe next pack must be started as soon as the current pack is finished i.eno gap should be left between packsThe user is unlikely to have a withdrawal bleed until the end of the second packbut she may experience spotting or breakthrough bleeding on tablet-taking days.
A single delayed tablet should be taken as soon as possibleand if this can be done within 12 hours of the correct timecontraceptive protection is maintainedWith longer delaysadditional contraception is neededOnly the most recently delayed tablet should be takenearlier missed tablets being omittedand additional non-hormonal methods of contraceptionexcept the rhythm or temperature methodsshould be used for the next 7 dayswhile the next 7 tablets are being takenAdditionallythereforeif tablet(shave been missed during the last 7 days of a packthere should be no break before the next pack is startedIn this situationa withdrawal bleed should not be expected until the end of the second packSome breakthrough bleeding may occur on the days a tablet is takenbut this is not clinically significantIf the patient does not have a withdrawal bleed during the tablet-free interval following the end of the second packthe possibility of pregnancy must be ruled out before starting the next pack.
When the contraceptive action of GINETTE 35 is also to be employedit is essential that the above instructions be rigidly adhered toShould bleeding fail to occur during the tablet-free intervalthe possibility of pregnancy must be excluded before the next pack is started.
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