Mala-N is an oral contraceptive pill containing levonorgestrel and ethinyl estradiol. It is supplied free through public health centers. The pill is taken daily for 21 days, followed by a 7 day break when menstruation occurs, then a new packet is started on the 5th day of the next period. Mala-N works by preventing ovulation. It is nearly 100% effective but requires motivation and discipline to take the pill daily. Certain medical conditions and other factors can make some women unsuitable for the pill. Potential side effects include nausea, headaches, and changes to periods.

1. Drug use in
Midwifery and
Obstetrical
Presented by- Atul Yadav
(RN,RM)

3. Definition of Mala-N:-
• It is an oral contraceptive and one of the major
spacing method of contraception.
• Mala-N is a low dose oral pill supplied under the
programme under the brand name of Mala N. It
contains
• Levonorgestrol .....0.15 mg
• Ethinyl estradiol ............. 0.03 mg.
• Mala-N is supplied free of cost through all PHCS,
urban family welfare centres, etc.

4. Mode of intake of Mala-N:-
• A packet of oral pills contains 28 pills of which 22 are
contraceptive pills and the remaining 7 are iron-tablets. The
first course of the pills should be started strictly on the 5th
day of the menstruation continuing it as day No. 1. Then
daily one tablet should be taken from the packet as
indicated by arrows on the pack till all the pills are
consumed. The pill is given orally for 21 consecutive
days followed by a break of 7 days/iron tablet during which
menstruation occurs. New packet should be started from
the 5th day of menstruation. The instructions issued with
the packet should be closely followed.

5. Mode of Action of Mala-N:
• The mechanism of action is to prevent the release of
the ovum from the ovary. This is achieved by blocking
the pituitary secretion of gonadotropin that is
necessary for ovulation to occur.
• Advantages of Mala-N:
• a. Almost 100% effective.
• b. No interference with sexual habits or relationships.
c. Reversible method.

6. Cont…
• Disadvantages of Mala-N:
• a. Prior medical examinations in necessary before
starting the pills.
•
b. Requires strong motivation and self discipline
to be able to take the pill daily.
•
c. All women are not fit for pill intake because of
certain contraindications.
•

7. Contraindications of Mala-N:
• a. Pregnancy.
•
b. Women over 35 years of age.
•
c. Medical conditions such as high blood
pressure, diabetes, chronic liner disease or cancer
of breasts or genitals.
•
d. Nursing/lactating mothers during the first 12
months.

8. Side effects of Mala-N:
• a. Nausea
• b. Vomiting
• c. Weight gain
• d. Dizziness
• e. Headache
• f. Inter-menstrual bleeding
• g. Spotting
• h. Tender breasts
• i. Pill may induce high blood pressure or cause
cardiovascular complications.