Qlaira

Qlaira is a combined oral contraceptive pill containing the active ingredients estradiol valerate (oestrogen) and dienogest (progesterone). It is used to prevent pregnancy and can also be used to improve heavy and painful periods. It contains different types of pills with different levels of hormones to mimic your natural cycle. This is different to many other combined pills, which contain the same dose throughout your 28-day cycle.

Qlaira works by mimicking your body's natural hormone levels to prevent pregnancy by:

• thickening the cervical mucus to stop sperm from getting through
• preventing ovulation by stopping an egg from being released from the ovaries
• thinning the lining of the womb to make it harder for a fertilised egg to implant

Qlaira is a quadriphasic pill. That means it has 4 types of active pills that contain a different amount of hormones over a 28-day cycle. It is designed to mimic the body’s natural menstrual cycle by gradually adjusting the hormone dose in the active pills, followed by 2 inactive pills.

Each active pill is a different colour depending on which level of hormone it contains. Each pack includes:

• 2 dark yellow pill containing 3mg of estradiol valerate
• 5 medium red pills containing 2mg estradiol valerate and 2mg dienogest
• 17 light yellow pills containing 2mg estradiol valerate and 3mg dienogest
• 2 dark red pills containing 1mg estradiol valerate
• 2 white pills containing no hormones, called inactive pills

How long does Qlaira take to work?

How long Qlaira takes to work will depend on when you take your first pill.

If you take Qlaira on day 1 of your period, you will be protected from pregnancy straight away. If you start taking Qlaira on any other day, or are changing from a different contraceptive, it takes 9 days for it to be effective, and you should use other methods of contraception, such as condoms, during that time to prevent pregnancy.

How effective is Qlaira?

Qlaira is more than 99% effective at preventing pregnancy when taken correctly. However, the pill is normally around 91% effective with regular, real-life use because of things like missed pills, sickness, or diarrhoea.

To take Qlaira, you should swallow 1 pill whole with water, with or without food, at the same time every day. Each Qlaira pack contains 28 pills, split into 4 types of active pills that contain different hormone amounts and 1 type of inactive pills without hormones. There are 26 active coloured pills that contain hormones and 2 inactive white pills that do not. To take Qlaira, you should:

1. Choose the weekday sticker strip of the same day you begin Qlaira. For example, if you start on a Monday, you should use the sticker strip that says ‘MON’. You should put this sticker on the top of the blister strip so that your first day is marked with ‘1’.
2. Take each pill on the day it is marked, in the correct order.
3. Take 1 pill every day for 28 days and then start a new pack without a break.

You may experience withdrawal bleeding around day 26 to 28 when you take the second dark red pill or the 2 white pills. You should start the next pack of Qlaira even if you are still bleeding.

If you forget to take any of the active pills (any colour but white), and are less than 12 hours late, you should take your pill as soon as you remember and will still be protected against pregnancy.

If you forget to take your Qlaira active pill and are more than 12 hours late, the day you missed the pill/s in your packet will decide on what to do next. Please follow the instructions in the table, check your patient information leaflet, and speak with a pharmacist or doctor if you’re still not sure.

You should not take more than 2 active pills on the same day.

Like all medications, Qlaira may cause some side effects. Not everyone will experience side effects, and they are usually mild.

Common side effects of Qlaira include:

• headache
• irregular bleeding
• feeling sick (nausea)
• acne
• breast discomfort/pain
• weight gain
• stomach pain

Uncommon side effects of Qlaira include:

• feeling hungry
• migraine
• mood changes, including low mood and depression
• hair loss
• increased blood pressure
• hot flush
• decreased libido (sex drive)
• fungal infections
• excessive sweating (hyperhidrosis), itching, or rash
• diarrhoea and/or vomiting
• dizziness
• tiredness or insomnia
• changes in your vision
• an increase in liver enzymes

Rare side effects include:

• candida infection (thrush)
• fungal infection of the skin (tinea versicolor)
• pelvic inflammatory disease
• oral herpes (cold sores)
• fluid retention
• blood clots
• allergic reaction
• eye problems, including dry eye, a vessel disease, inability to use contact lenses, and eye swelling
• breast cancer or cysts
• vertigo
• palpitations
• urinary tract infections (UTI) or pain
• bacterial inflammation of the vagina
• increase in certain blood fats (triglycerides)
• mood changes like anger, anxiety, and feeling unhappy
• an increase in libido
• feeling nervous or stressed
• nightmares
• feeling restless
• difficulty sleeping
• tiredness and feeling generally unwell
• fever
• reduced attention span
• pins and needles
• feeling giddy
• heart attack
• stroke, mini stroke, or temporary stroke-like symptoms
• low blood pressure
• bleeding in a varicose vein, inflammation in veins, or painful veins
• constipation
• dry mouth
• indigestion or heartburn
• liver nodules (focal nodular hyperplasia)
• pigmentation disorders, such as golden brown pigment patches (chloasma)
• chronic gallbladder inflammation
• male pattern hair growth and excessive hair growth
• skin conditions or disorders, such as dermatitis, neurodermatitis, dandruff, and oily skin
• pain in the back and jaw
• feeling heavy
• abnormal bleeding, such as bleeding during sex
• benign breast nodules
• breast discharge or spontaneous milk flow
• polyp and reddening on the neck of the womb
• genital discharge
• lighter or delayed periods
• rupture of an ovarian cyst
• vaginal odour
• burning or vulvovaginal discomfort
• swollen lymph nodes
• asthma
• difficulty in breathing
• nose bleeds
• chest pain
• abnormal smear from the neck of the womb

You can find a full list of side effects in the Qlaira patient information leaflet.

How long do Qlaira side effects last

Qlaira pill side effects usually improve after the first few months as your body adjusts to the hormones.

What to do if you get Qlaira side effects

Most side effects of Qlaira can be treated easily at home. You can treat:

• breast and stomach pain by taking over-the-counter medications such as paracetamol or ibuprofen
• nausea by staying hydrated, eating small, frequent, bland meals, and speaking to a doctor or pharmacist if this is not getting better within a few days or is affecting your life
• headaches by getting plenty of rest, taking medications such as paracetamol or ibuprofen, and staying well hydrated
• fluid retention by reducing your salt intake and increasing water intake

If you are experiencing side effects that do not get better, are hard to deal with, or are impacting your daily life, you should speak with your doctor and discuss changing your contraception. If you get any serious side effects, including heart attack, blood clot, or stroke, call 999 straight away.

The Qlaira contraceptive pill may not be suitable or safe for everyone to take. If you have certain medical conditions or take certain medications, they may interact with Qlaira and make it less effective or unsafe.

You should not take Qlaira if you are pregnant or breastfeeding.

Medical conditions

Before you start taking Qlaira, you should speak to a doctor if you have:

• allergies to any of the medication ingredients
• problems with your heart
• problems with your kidneys
• liver disease, a liver tumour, or jaundice
• breast cancer, ovarian cancer, cervical cancer, or womb cancer (or a close family member has had one of these cancers)
• migraines with aura
• severe diabetes
• had recent surgery/given birth recently, or plan to have surgery soon
• very high levels of fat or cholesterol in your blood
• vaginal bleeding with an unknown cause
• hyperhomocysteinemia
• very high blood pressure
• angina
• family history of blood clots, or you’ve had blood clots before
• a condition that affects blood clotting
• had a heart attack or stroke
• problems with the blood vessels in your eyes
• inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
• varicose veins
• angiodema
• sickle cell anaemia
• depression
• SLE (also known as lupus)
• epilepsy
• developed a disease or rash for the first time during pregnancy

Medications

Certain medications can interact with Qlaira and may reduce its effectiveness. You should talk to your doctor before taking Qlaira if you are taking any medication for the treatment of:

• epilepsy such as primidone, carbamazepine, barbiturates, phenytoin, topiramate, or lamotrigine
• tuberculosis, such as rifampicin and rifabutin
• HIV or Hepatitis C, such as ritonavir and nevirapine
• fungal infections, such as griseofulvin or ketoconazole
• organ rejection, such as ciclosporin

You should also let your doctor know if you are taking any herbal medications such as St John’s wort.

Qlaira is a prescription-only medication that can be purchased online from a trusted pharmacy and is also available on the NHS.

Can I buy Qlaira online?

Yes, you can buy Qlaira online with Asda Online Doctor. To request the Qlaira pill online, you will first need to complete a short online health assessment for one of our doctors to review. You will then:

1. Place your order.
2. If approved, your order will be dispatched and sent to your home address in discreet packaging, or you can choose to collect it from your local Asda Pharmacy 4 hours after a doctor’s approval.
3. If your order is not approved, one of our doctors will contact you through your account with alternative treatment options.

Requesting the combined contraceptive pill online from us is easy, and there’s no need to visit a doctor face-to-face. So, you can get your medication quickly, without waiting for an appointment to become available.

Can I buy Qlaira over the counter?

No, you cannot buy Qlaira over-the-counter as it is a prescription-only medication that requires a doctor's approval.

Can I get Qlaira on the NHS?

Yes, you can get a prescription for Qlaira from the NHS, but you will need to make an appointment with your doctor to discuss whether it is the right option for you.

If you find that Qlaira is not a suitable contraceptive pill for you, there are several alternative options available.

Another phasic pill offered by Asda Online Doctor is Triregol, which contains 3 different types of pills containing different levels of the active ingredients ethinylestradiol and levonorgestrel.

Other combined contraceptive pills include:

• Yasmin, which contains 30 micrograms (mcg) of ethinylestradiol and 3mg of drospirenone
• Microgynon 30, Levest, and Rigevidon, which all contain 150mcg of levonorgestrel and 30mcg of ethinylestradiol
• Cilique, containing 250mcg of norgestimate and 35mcg of ethinylestradiol
• Gedarel, contains either 20mcg (low-dose oestrogen pill) or 30mcg of ethinylestradiol and 150mcg of desogestrel

If the combined pill is not suitable for you or you need a pill without oestrogen, the mini pill may be an alternative option for you. Some mini pill options include:

• Cerelle or Cerazette, which both contain 75mcg of desogestrel
• Noriday, contains 350mcg of norethisterone
• Norgeston, containing 30mcg of levonorgestrel