Levonorgestrel and Ethinyl Estradiol

💊 What is Levonorgestrel and Ethinyl Estradiol used for?

• •The label says it is used by females of reproductive potential to prevent pregnancy. It does not protect against HIV or other sexually transmitted infections.

How it works

The label says this medicine contains two female hormones: levonorgestrel, a progestin, and ethinyl estradiol, an estrogen. The label does not explain the exact way the hormones prevent pregnancy. It notes that how well it works depends on how closely the pills are taken as directed.

How it is usually taken

• •The label says to take one tablet by mouth once a day, at the same time every day. Tablets are taken in the order shown on the Extended-Cycle Tablet Dispenser. The label says the first pack is started on a Sunday. Light blue to blue active tablets come first, followed by white to off-white inert tablets, which have no hormones. A period is expected during the white tablet week. Follow the instructions from your prescriber or pharmacist.

Comes as

• •Round, film-coated tablets in an Extended-Cycle Tablet Dispenser, a 13-week supply. Each pack has 84 light blue to blue active tablets, each with 0.15 mg levonorgestrel and 0.03 mg ethinyl estradiol, and 7 white to off-white inert tablets with no hormones.

⚠️ Levonorgestrel and Ethinyl Estradiol side effects

🛑 Who should not take Levonorgestrel and Ethinyl Estradiol, and who should be careful

The label says not to take it if

• 🚨You smoke and are over 35 years old.
• 🚨You have or had blood clots in the arms, legs, lungs, or eyes, including deep vein thrombosis or pulmonary embolism.
• 🚨You have had a stroke or a heart attack.
• 🚨You have certain heart valve problems or heart rhythm problems that can cause clots to form in the heart.
• 🚨You have a blood condition that makes your blood clot more than normal.
• 🚨You have high blood pressure that cannot be controlled by medicine, or high blood pressure with blood vessel problems.
• 🚨You have diabetes and are over 35, or have high blood pressure, kidney, eye, nerve, or blood vessel damage from diabetes, or have had diabetes for more than 20 years.
• 🚨You have certain severe migraine headaches with aura, or headaches with focal neurological symptoms.
• 🚨You have a current or past diagnosis of breast cancer, which may be sensitive to hormones.
• 🚨The label lists these as contraindications, meaning this medicine should not be used in these cases.

Tell your doctor before taking it if

• •Tell your prescriber if you smoke. The label says women over 35 who smoke should not use this medicine.
• •Tell your prescriber about any past or family history of blood clots, stroke, heart attack, or clotting disorders.
• •Tell your prescriber about high blood pressure, diabetes, high cholesterol, obesity, liver disease, gallbladder disease, or migraine headaches.
• •Tell your prescriber if you have a history of breast cancer.
• •The label says that a planned major surgery may require stopping the medicine at least 4 weeks before and until 2 weeks after surgery.
• •The label says that if you have just given birth, you should start no earlier than 4 weeks after delivery if you are not breastfeeding.
• •The label says this medicine does not protect against HIV or other sexually transmitted infections.
• •The label says that the risk of blood clots is highest during the first year of use and when restarting after a break of 4 weeks or longer.

🔀 Levonorgestrel and Ethinyl Estradiol with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •The label says enzyme inducers can make this medicine less effective or cause breakthrough bleeding. Examples include aprepitant, barbiturates, bosentan, carbamazepine, efavirenz, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, rifabutin, rufinamide, topiramate, St. John's wort, and certain protease inhibitors. The label says to use a back-up or alternative birth control method when these are used, and to continue backup for 28 days after stopping an enzyme inducer. The label says colesevelam significantly decreases the amount of ethinyl estradiol in the body. The label notes that no drug interaction studies were done with this specific product, so tell your pharmacist or prescriber about all medicines you take.

Alcohol and food

The label does not say.

🤰 Levonorgestrel and Ethinyl Estradiol in pregnancy and breastfeeding

Pregnancy

The label says this medicine is not used for contraception during pregnancy, so it should be stopped if pregnancy occurs. The label says studies have not found an increased risk of birth defects after exposure to combination birth control pills before conception or in early pregnancy.

Breastfeeding

The label says this medicine may reduce breast milk production. This is less likely once breastfeeding is well established. When possible, the label advises nursing women to use other birth control methods until they stop breastfeeding.

🗓️ Storage, missed doses and taking too much

Storage

The label begins its storage instruction with 'Store at 20,' but the rest of the instruction is cut off in this text. Check the carton or ask your pharmacist for the full storage directions.

If a dose is missed

The label says to follow the missed-pill instructions in the FDA-approved Instructions for Use, under the section 'What should I do if I miss any levonorgestrel and ethinyl estradiol tablets pills.' That section is not included in this text. Ask your pharmacist or prescriber for these steps.

If too much is taken

The label says there have been no reports of serious harm from overdose of oral contraceptives, including ingestion by children. It notes that an overdose may cause withdrawal bleeding and nausea.

🗒️ Questions to ask about Levonorgestrel and Ethinyl Estradiol

• Am I a good candidate for this birth control pill, given my age, smoking status, and health history?
• What should I do if I miss a pill, based on the Instructions for Use that came with my pack?
• Which medicines I take, including seizure medicines or St. John's wort, could make this pill less effective?
• What back-up birth control should I use for the first 7 days when I start, and when I start the next pack?
• What warning signs should make me stop the pill and call my doctor right away?
• Should I use a different birth control method while I am breastfeeding?
• How long after a planned surgery should I stop taking this pill?

❓ Levonorgestrel and Ethinyl Estradiol: frequently asked questions