Benefits and Precautions of Azalia (Cerazette): A Mini Pill with Few Side Effects
Azalia (Cerazette) is an oral contraceptive that does not contain estrogen (follicular hormone), and it is known as a mini pill.
It can be taken even by those for whom the low-dose pill is not recommended, such as people who smoke or are breastfeeding.
With few side effects, it is a recommended pill for those who can take it at a set time every day.
Here we explain the benefits and precautions of Azalia, along with how to take it.
If you would like to know more about the mini pill, please see the article below.
– When taken correctly, Azalia (Cerazette) can be expected to provide a high contraceptive effect.
– With Azalia (Cerazette), taking it at the same time every day is important.
– Even those at high risk of side effects from the low-dose pill may be able to take Azalia (Cerazette).
– Oral contraceptives have no preventive effect against STIs, so using condoms or combining them with prevention medication is advisable.
Click any item in the table of contents to jump partway into the article.
What is Azalia (Cerazette)?
The low-dose pill combines estrogen and progestin together, whereas Azalia (Cerazette) is a pill that works with progestin only.
Taking 1 tablet at a set time every day provides a contraceptive effect, and when no doses are missed, it offers a contraceptive effect equivalent to that of the low-dose pill.
The Azalia we prescribe is a third-generation, monophasic contraceptive that provides its effect when taken every day.
It is a medication not approved in Japan, but it is commonly used overseas and its safety has been confirmed.
Benefits of Azalia (Cerazette)
The low-dose pill and Azalia (Cerazette) offer not only a high contraceptive effect but also benefits relating to menstruation and to hormonal balance.
In particular, Azalia (Cerazette) has few side effects and is recommended for those who will take it over the long term.
It can be taken with no break period
The low-dose pill has a break period (placebo), but Azalia (Cerazette) has no break period, so it can be taken without forgetting and is recommended for those who will take it over the long term.
Also, because menstruation does not occur while taking it, it is recommended for those with dysmenorrhea or heavy menstrual flow.
Almost no risk of thrombosis
Thrombosis refers to a condition in which a clot formed in the blood obstructs a blood vessel and causes damage.
With the low-dose pill, although the frequency is not high, the risk of thrombosis is said to increase due to the effect of the estrogen it contains.
Because Azalia (Cerazette) does not contain estrogen, it is said to carry almost no risk of thrombosis.
It can be taken even by those with migraine, those who smoke and older individuals
As noted above, because taking the low-dose pill has been pointed out to increase the risk of thrombosis, it was not recommended for those who already have a high risk of thrombosis.
However, with Azalia (Cerazette), even such individuals may be able to take it.
Azalia (Cerazette) can be taken even while breastfeeding
It can be taken even while breastfeeding.
In a study that examined the effects on children up to 2 and a half years old after 7 months of use while breastfeeding, no effects were reported.
There are two mini pill preparations, “Azalia (Cerazette)” and “Slinda”, and we carry both.
Azalia and Slinda Tablets 28 are both mini pills with no major differences, but because their components differ, the side effects that appear may differ.
Please refer to the table below and discuss with a doctor which product suits you.
From the link below, you can jump to a detailed blog about Azalia.
| Comparison item | Slinda Tablets 28 | Azalia |
|---|---|---|
| Component | Drospirenone | Desogestrel |
| Content | White tablets drospirenone 4㎎ Pale yellow tablets no active ingredient | Desogestrel 75μg |
| Method of Use | 28 days of continuous dosing with placebo) Taken once a day at a set time | 28 days of continuous dosing Taken once a day at a set time |
| Manufacture | Made in Japan | Made overseas |
| Contraceptive effect | High | High |
| Quitting smoking/breastfeeding | Possible | Possible |
| Characteristics | Because it is approved in Japan, it is covered by Japan's drug compensation system. Compared with Cerazette, Slinda Tablets have a longer drug half-life, so breakthrough bleeding is expected to be less likely to occur. | Because there is no placebo, there is no bleeding at a set period during use, but breakthrough bleeding can occur. Because it has been used overseas for many years, it has a track record of use. |
Precautions for Azalia (Cerazette)
When using Azalia (Cerazette), attention is needed on the following 2 points.
Take it at the same time every day
A deviation of around 3 hours is fine, but the more the timing deviates, the more likely breakthrough bleeding becomes and the lower the contraceptive effect. Also, frequently missing doses may reduce the effect.
If you take the tablet 12 hours or more after your usual dosing time, pregnancy may not be completely avoided, so combined use of condoms or other contraceptive devices is recommended for 7 days.
Breakthrough bleeding occurs easily
With Azalia (Cerazette), light bleeding may continue.
It is said to be especially common when starting the medication, but it can also occur during ongoing use.
The degree of bleeding also varies, from light bleeding that does not even require a panty liner to a small amount of bleeding resembling menstruation.
Even if there is bleeding, the contraceptive effect is still present, so you need to take it every day without interrupting.
If the bleeding becomes prolonged or the amount is heavy, please consult with a doctor.
Also, the following individuals may be unable to take oral contraceptives. Please consult with a doctor.
– Are pregnant or may be pregnant
– Have breast cancer or possible breast cancer
– Have a history of thrombosis
– Have a history of cardiovascular disease
– Have lactose intolerance or a lactose allergy
– Porphyria
– Have a history of bariatric surgery
– Are taking certain antiepileptic medications
How to Take Azalia (Cerazette)
Start taking it on the first day of menstruation, and thereafter take it at a set time.
Once you finish an entire sheet, start the next sheet without a break. Continue taking it even if bleeding continues.
If you are switching from the low-dose pill to Azalia (Cerazette), start taking Azalia (Cerazette) on the day after you take the last active tablet (the tablet containing hormones) of the low-dose pill you are currently taking.
Side effects such as nausea improve in most cases by continuing to take it.
If the side effects do not lessen even after finishing 1 sheet, please consult us.
When side effects appear, there is no problem with combining over-the-counter painkillers or anti-nausea medication. Taking it before bed may also make the side effects less bothersome.
Prices for Azalia (Cerazette) Testing and Prescription
For a first prescription at our clinic, you will first receive a doctor’s consultation.
As needed, pill blood sampling (blood coagulation sampling) is performed and the prescription is issued.
For prescriptions from the second time onward, a consultation is not mandatory. Please receive a consultation if you are concerned about side effects or have something to discuss.
Azalia (Cerazette): 1 box: 2,500 yen, 3 boxes: 7,000 yen, 6 boxes: 12,500 yen (all tax included)
– Pill blood sampling (performed as needed): 2,500 yen (tax included)
– For a first prescription, a consultation fee (initial consultation fee: 2,500 yen, follow-up visit fee: 1,000 yen (both tax included)) is required separately.
– Test results are sent by email approximately 3 to 4 days later.
– Students aged 25 or under receive a discount, so please bring your student ID.
In addition to the mini pill [Azalia (Cerazette) and Slinda], the types of pills we carry include the low-dose pill, the medium-dose pill, the contraceptive injection and emergency contraception.
If you are unsure which one you should take, please consult with a doctor or nurse when you visit.
– Low-dose pill (OC) ➡Low-Dose Pill (OC)
– Medium-dose pill (menstruation-shifting pill) ➡Medium-Dose Pill
– Emergency contraception (morning-after pill) ➡Emergency Contraception (morning-after pill)
Clicking through takes you to the detailed page.
About STI Prevention
Like the low-dose pill, Azalia (Cerazette) has a contraceptive effect but no preventive effect against STIs.
STIs are transmitted through mucous membrane contact such as sexual activity, so using condoms can substantially lower the infection rate.
Also, if the risk of infection is high, taking STI prevention medication together with Azalia (Cerazette) can lower the infection rate.
Frequently Asked Questions
Frequently asked questions about pills are summarized below.
Can it make it harder to become pregnant in the future?
If you stop Azalia (Cerazette), in most cases your natural menstrual cycle returns after 3 months. Once a normal menstrual cycle is restored, pregnancy is possible, and having taken Azalia (Cerazette) does not make it harder to become pregnant.
Is Azalia (Cerazette) covered by insurance?
Azalia (Cerazette) is a medication not approved domestically and is not covered by insurance.
What should I do if I miss a dose?
Take 1 tablet as soon as you notice the missed dose. Then take the next tablet at your usual dosing time. If you have missed a dose for 24 hours or more, take 2 tablets when you notice, and take the next tablet at your usual dosing time.
*If dosing deviates by 12 hours or more, the contraceptive effect is lost. Please combine another contraceptive method, such as using condoms, for 1 week.
Once I start taking it, do I have to take it for life?
You can stop at any time. Please note that there is no contraceptive effect after stopping.
Does bleeding mean it is not working?
Breakthrough bleeding does not indicate that Azalia (Cerazette) is not working. Usually no particular treatment is needed, and you should continue taking Azalia (Cerazette) as is.
If the bleeding is heavy or prolonged, please consult with a doctor.
<Dr. Daisuke Shiojiri>
Director of Personal Health Clinic, Doctor of Medical Science.
At the National Center for Global Health and Medicine (Shinjuku Ward, Tokyo) and at Personal Health Clinic, he provides correct, evidence-based knowledge on HIV, PrEP and other topics related to STIs and STI testing, along with care that stays close to patients' hearts.
Born in Japan but raised in Kenya, Africa, he also holds a medical license there and carries out medical assistance, educational assistance and other activities locally.
He also sees patients at our clinic as a part-time doctor.
