What is this medication?
Contraceptive, estrogen and progestin combination
Brand Name US: Afirmelle, Altavera, Amethia, Amethyst, Ashlyna, Aubra, Aubra EQ, Aviane, Ayuna, Balcoltra, Camrese, Camrese Lo, Chateal, Chateal EQ, Daysee, Delyla, Dolishale, Enpresse-28, FaLessa, Falmina, Fayosim, Iclevia, Introvale, Jaimiess, Jolessa, Kurvelo, Larissia, Lessina, Levonest, Levora, Lillow, Lo Jaimiess, Lo Seasonique, Lutera, Marlissa, Orsynthia, Portia-28, Quarlette, Rivelsa, Seasonique, Setlakin, Simpesse, Sronyx, Trivora, Twirla, Tyblume, Vienva
Brand Name Canada: Alesse 21, Alesse 28, Alysena 21, Alysena 28, Aviane, Indayo, Min Ovral 21, Min Ovral 28, Ovima 21, Ovima 28, Portia 21, Portia 28, Seasonale, Seasonique, Triquilar 21, Triquilar 28.
“Alert: US Warning
Cigarette smoking increases the risk of serious cardiovascular events from hormonal contraceptive use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked.”
How does this medication work?
Levonorgestrel+Ethinyl Estradiol is a combination hormonal contraceptive that inhibits ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitary. The follicular phase FSH and midcycle surge of gonadotropins are inhibited. In addition, combination hormonal contraceptives produce alterations in the genital tract, including changes in the cervical mucus, rendering it unfavorable for sperm penetration even if ovulation occurs. Changes in the endometrium may also occur, producing an unfavorable environment for nidation. Levonorgestrel+Ethinyl Estradiol may alter the tubal transport of the ova through the fallopian tubes. Progestational agents may also alter sperm fertility.
How should I take this medication?
Usual (Oral): One tablet once daily
Schedule 1 (Sunday starter): Dose begins on first Sunday after onset of menstruation; if the menstrual period starts on Sunday, take first tablet that very same day. With a Sunday start, an additional method of contraception should be used until after the first 7 days of consecutive administration.
Schedule 2 (Day 1 starter): Dose starts on first day of menstrual cycle taking 1 tablet daily.
How to Take:
Contraception: Administer at the same time each day. Levonorgestrel+Ethinyl Estradiol may be initiated at any time during the menstrual cycle if it is reasonably sure the woman is not pregnant. Back-up contraception should be used for 7 days unless contraception is initiated within the first 5 days of menstrual bleeding or the woman abstains from sexual intercourse. Levonorgestrel+Ethinyl Estradiol may be started immediately following or within 7 days of a first or second trimester abortion, backup contraception is needed for 7 days unless contraception is started at the time of surgical abortion.
Emergency contraception: If vomiting occurs within 3 hours, a second dose should be taken as soon as possible; consider use of an antiemetic.
What should I watch for while using this medication?
When starting Levonorgestrel+Ethinyl Estradiol make sure your physician is aware of any allergies or medications you currently take, and prior medical history. The use of Levonorgestrel+Ethinyl Estradiol has been associated with an increased risk of cervical cancer, chloasma, cholestasis, hypertriglyceridemia, dyslipidemia, thromboembolic disorders including venous thromboembolism. Breakthrough or intracyclic bleeding and spotting may occur, especially during the first 3 months of therapy. In addition, occasional missed periods may occur. Levonorgestrel+Ethinyl Estradiol should be used with caution in patients with risk factors for cardiovascular disease such as hypertension, low HDL, high LDL, high triglycerides, older age, diabetes, women who smoke. Use with caution in patients with a history of depression, discontinue if serious depression recurs. Glucose tolerance may be impaired, use caution in women with diabetes or prediabetes. Do not use Levonorgestrel+Ethinyl Estradiol in patients with pre-existing hepatic tumors, liver cirrhosis, uncontrolled hypertension, headaches with focal neurological symptoms, or migraine headaches with or without aura if >35 years of age, complicated organ transplants, and systemic lupus erythematosus (SLE).
What if I miss a dose?
Take the pill as soon as you remember. Then take the rest of the pills like you normally would. To stay on schedule, this might mean that you have to take two pills in one day.
If vomiting or diarrhea occur, a back-up method of contraception may be needed.
Note: If all doses have not been taken on schedule and one menstrual period is missed, the possibility of pregnancy should be considered. If two consecutive menstrual periods are missed, pregnancy test is required before new dosing cycle is started.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Headache, breast tenderness and engorgement, nausea, application site reaction, increased blood pressure, anxiety, mood disorder, dizziness, fatigue, migraine, insomnia, malaise, acne vulgaris, pruritis, chloasma, contact dermatitis, erythema, skin irritation, menstrual disease, weight gain, change in libido, dyslipidemia, fluid retention, galactorrhea, premenstrual syndrome, abdominal pain, vomiting, diarrhea, abdominal distention, cholecystitis, dysmenorrhea, vaginal hemorrhage, vulvovaginal candidiasis, genital discharge, uterine spasm, vaginal dryness.
Note this is not a complete list of side effects, only the most common.
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