What is included in the Mala-D oral contraceptive package?

Appeared in: MP CHO -2021 (Shift 1st)

Explanation

Mala-D is a widely used combined oral contraceptive in India, designed for a 28-day cycle.
Each pack contains 21 active hormonal pills containing Levonorgestrel (a progestin) and Ethinyl Estradiol (an estrogen).
The pack also includes 7 placebo pills, which are iron (ferrous fumarate) tablets, to be taken in the last week of the cycle.
This 21/7 regimen is standard for many combined oral contraceptives to ensure continuous daily intake, which improves user compliance and effectiveness.
The iron tablets help replenish iron stores that may be depleted during menstruation.

Option A: This option suggests a 25/3 split of hormonal and iron pills. This is not the standard formulation for Mala-D or most other 28-day combined oral contraceptives.
Option B: This option suggests a 22/6 split. While some oral contraceptive formulations might have 22 active pills, the standard Mala-D pack contains 21.
Option D: This option suggests a 20/8 split. This is an incorrect ratio for the standard 28-day Mala-D pack.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Composition of Mala-D oral contraceptive as background academic context rather than a clinical decision trigger.
The 21/7 regimen is designed to mimic a natural menstrual cycle (by allowing for withdrawal bleeding) while providing highly effective contraception.
Including iron tablets in the placebo week is a key public health strategy, especially in India, where iron-deficiency anemia is prevalent among women of reproductive age.
Patient education is crucial. Nurses must instruct users to take one pill every day without fail, even during menstruation, to maintain contraceptive protection and the habit of daily intake.

How to Approach the Question

This is a factual recall question about a specific medication's formulation.
Identify the keywords in the question: 'Mala-D', 'oral contraceptive package', and 'included'.
Recall the standard composition of combined oral contraceptive (COC) pills provided under national health programs in India.
Most COCs follow a 28-day cycle, which consists of hormone-containing pills and placebo pills.
The most common regimen is 21 days of active hormonal pills followed by 7 days of placebo pills.
Evaluate the given options to find the one that matches the 21/7 split. Option C (21 OCP and 7 Iron tablets) correctly represents this standard.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 194-196

E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 375-377

Practise the full MP CHO -2021 (Shift 1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.