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Ethinyl Estradiol + Levonorgestrel (oral contraception)

Ethinyl estradiol + levonorgestrel are two synthetic hormones included in a form of oral contraception. Ethinyl estradiol is an estrogen while levonorgestrel is a progestin. Both work to prevent conception and pregnancy. This drug does not induce abortion.

Uses

What is Ethinyl Estradiol + Levonorgestrel used for?

Ethinyl estradiol + levonorgestrel is commonly used for contraception, dysmenorrhea, and premenstrual syndrome (PMS).

How should I take Ethinyl Estradiol + Levonorgestrel?

Read the directions on the packaging for complete information. Check the label and expiration date.

For oral dosage forms, swallow it whole without chewing, crushing, or dissolving it in liquid. It is best to take them at the same time each day.

How do I store Ethinyl Estradiol + Levonorgestrel?

Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using Ethinyl Estradiol + Levonorgestrel?

Caution should be observed in patients older than 40 years. When using the drug, it is recommended to conduct an annual gynecological cytology control.

Smoking can increase the frequency and severity of side effects.

When planning pregnancy, it should be discontinued 3 months before its intended use and the occurrence of non-hormonal method of contraception.

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

Pregnancy

This medicine is used to prevent pregnancy and should not be taken during pregnancy. However, if the pill fails or you miss pills and you do get pregnant while taking it, there is no evidence to suggest that the pills you have already taken will harm the baby. If you think you could be pregnant while taking this pill you should stop taking it and consult your doctor immediately.

Breastfeeding

The hormones in this pill can reduce the production of breast milk. For this reason, it is not recommended for women who are breastfeeding. It should not be used until weaning, or at least six months after the birth. Other methods of contraception are more suitable for women who are breastfeeding. Ask your doctor for advice.

Side Effects

What side effects can occur from Ethinyl Estradiol + Levonorgestrel?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Headache/ migraine
  • Breast tenderness and enlargement
  • Weight changes
  • Retention of water in the body tissues (fluid retention)
  • Vaginal thrush (candidiasis)
  • Change in menstrual bleeding (usually lighter periods or sometimes stopping of periods)
  • Menstrual spotting or breakthrough bleeding
  • Depression
  • Decreased sex drive
  • Rise in blood pressure
  • Skin reactions
  • Irregular brown patches on the skin (chloasma)
  • Steepening of corneal curvature (which may make contact lenses uncomfortable)
  • Disturbance in liver function
  • Gallstones
  • Blood clots in the blood vessels (e.g., DVT, pulmonary embolism, heart attack, stroke – see warnings above)

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ethinyl Estradiol + Levonorgestrel?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • CYP3A4 inducers
  • Ampicillin
  • Tetracycline
  • Other antibiotics
  • Coumarin
  • Prednisolone
  • Ciclosporin
  • Alprazolam
  • Chlordiazepoxide
  • Diazepam
  • Lorazepam
  • Oxazepam
  • Temazepam
  • St. John’s wort

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Ethinyl Estradiol + Levonorgestrel?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Food to avoid while taking this drug include:

  • Alfalfa
  • Black cohosh
  • Bloodroot
  • Chasteberry
  • Grapefruit
  • Hops (beer)
  • Licorice
  • Oregano
  • Saw palmetto
  • Soy products
  • Thyme
  • Wild yam

Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ethinyl Estradiol + Levonorgestrel?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Liver disease
  • Uncontrolled diabetes
  • Endocrine system disorders
  • Dyslipidemia
  • Hypertension
  • Cardiovascular disease
  • Cerebrovascular disease
  • Active smoker

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Take one pill every day, starting on the first day of your menstruation. If your pack contains 21 pills without placebo pills, take a 7-day break after finishing the last pill of the pack. Resume taking your pills after 7 days, even if you are still experiencing a withdrawal bleed or spotting. For 28-pill packs, take the placebo (e.g. iron) pills for 7 days then start a new pack.

What is the dose for a child?

There is no established pediatric dose. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Ethinyl Estradiol + Levonorgestrel available?

Ethinyl Estradiol + Levonorgestrel is available in the following brands, dosage forms, and strengths:

  • Femme 21 yellow tab each containing levonorgestrel 150 mcg, ethinyl estradiol 30 mcg, 7 brown tab each containing Fe fumarate 75 mg
  • Lady 21 beige tab each containing Levonorgestrel 150 mcg, ethinyl estradiol 30 mcg, 7 white tab each containing Lactose 40 mg
  • Logynon 21: 6 tablets with levonorgestrel 0.05 mg and ethinyl estradiol 0.03 mg + 5 tablets each with levonorgestrel 0.075 mg and ethinyl estradiol 0.04 mg
    plus 10 tablets each with levonorgestrel 0,125 mg and ethinyl estradiol 0,03 mg, plus 7 non-hormonal
    tablets
  • Minipil levonorgestrel 100 mcg + ethinyl estradiol 20 mcg
  • Nordette levonorgestrel 0.15 mg and ethinyl estradiol 30 mcg tablets
  • Protec 21 active white FC tab each containing levonorgestrel 150 mcg, ethinyl estradiol 30 mcg, 7 inactive brown tab each containing ferrous fumarate 60 mg
  • Safe Pill
  • Trinordiol

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

One pill missed

If you forget to take one pill, or start your new pack one day late, you should take the pill you missed as soon as possible, even if this means taking two pills at the same time. Then continue taking the rest of the pack as normal. You will still be protected against pregnancy and you don’t need to use extra contraception.

Two or more pills missed

If you forget to take two or more pills, or start your new pack two or more days late, you won’t be protected against pregnancy. You should take the last pill you missed as soon as possible, even if this means taking two pills at the same time. Leave out the other missed ones. Then continue to take your pills, one every day, as normal. You should either not have sex, or use an extra barrier method of contraception, e.g., condoms, for the next seven days.

If there are fewer than seven pills left in your pack after your last missed pill, you should finish the pack and then start a new pack straight away without a break. This means skipping your pill-free week.

If there are seven or more pills left in your pack after your last missed pill, you should finish the pack and have your seven-day break as usual before starting the next pack.

If you had unprotected sex in the seven days before you missed pills, you may need emergency contraception (the morning after pill). Ask for medical advice.

If you are confused about any of this, you can get individual advice for your circumstances from your doctor, pharmacist or local family planning clinic.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Levonorgestrel + Ethinylestradiol
https://www.mims.com/philippines/drug/info/levonorgestrel%20+%20ethinylestradiol?mtype=generic Accessed July 23, 2021

Lady https://www.mims.com/philippines/drug/info/lady Accessed July 23, 2021

Combination birth control pills https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282 Accessed July 23, 2021

Levonorgestrel And Ethinyl Estradiol (Oral Route) https://www.mayoclinic.org/drugs-supplements/levonorgestrel-and-ethinyl-estradiol-oral-route/side-effects/drg-20406441?p=1 Accessed July 23, 2021

Ethinylestradiol [Ethinyl Estradiol] and Levonorgestrel. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 23, 2021. http://online.lexi.com

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Written by Stephanie Nicole Nera, RPh, PharmD Updated 7 days ago
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