Ethinyl Estradiol; Levonorgestrel tablets
What do ethinyl estradiol; levonorgestrel tablets do?
ETHINYL ESTRADIOL/LEVONORGESTREL products are effective as oral contraceptives (birth control pills or “the pill”). These products combine natural or synthetic estrogens and progestins, similar to the natural sex hormones (estrogen and progesterone) produced in a woman’s body. Ethinyl estradiol is an estrogen and levonorgestrel is a progestin. These products can prevent ovulation and pregnancy. In general, a combination of estrogen and progestin works better than a single-ingredient product. After consultation with a health care professional, this combination of products can be used under specific circumstances for emergency contraception after unprotected sex, contact your health care prescriber for information. Ethinyl estradiol/levonorgestrel tablets can also help regulate menstrual flow, treat acne, or may be used for other hormone related problems in females. The type and amount of estrogen and/or progestin may be different from one product to another.
What should my health care professional know before I use ethinyl estradiol; levonorgestrel?
They need to know if you have or ever had any of these conditions:
• blood clots
• blood sugar problems, like diabetes
• cancer of the breast, cervix, ovary, uterus, vagina, or unusual vaginal bleeding that has not been evaluated by a health care professional
• gallbladder disease
• heart or circulation problems
• high blood pressure
• liver disease
• menstrual problems
• migraine headaches
• tobacco smoker
• an unusual or allergic reaction to estrogen/progestin, other hormones, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
How should I use this medicine?
• For routine prevention of pregnancy:
Take ethinyl estradiol/levonorgestrel pills by mouth. Before you start taking these pills decide what is a suitable time of day and always take them at the same time of day and in the order directed. Swallow the pills with a drink of water. Take with food to reduce stomach upset. Do not take more often than directed.
Most products contain a 21-day supply of pills containing the active ingredients. Some products contain an additional 7 pills containing iron or inactive ingredients to be taken during the week of menstruation; this reduces the chance of missing the first day of the next cycle. Most products are to be started on the first Sunday after you start your period or on the first day of your period. You may need to ask your health care provider which day you should start your packet.
• For emergency prevention of pregnancy:
Take ethinyl estradiol/levonorgestrel pills by mouth. You will need to follow the instructions provided by your health care provider exactly. You will be told what product and how many pills of that product you should take for each dose. Take the first dose as soon as you can after having unprotected sex, preferably in the first 24 hours, but no later than 72 hours (3 days) after the event. You MUST take the second dose 12 hours after you take the first dose. Do not take any extra pills. Extra pills will not decrease your risk of pregnancy, but may increase your risk of side effects.
• For all uses of this medicine:
Before starting this medication, read the paper on your prescription provided by your pharmacist. This paper will tell you about the specific product you are taking. Make certain you understand the instructions.
Keep an extra month’s supply of your pills available to ensure that you will not miss the first day of the next cycle.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose?
If you miss a dose of an emergency contraceptive prescription, or vomit the dose within an hour of taking it, you MUST contact your health care professional for instructions.
Try not to miss a dose of your regular birth control prescription. If you do, it may be necessary to consult your prescriber or health care professional. The following information describes only some of the ways that missed doses can be handled.
For all cycles:
If you miss one dose, take it as soon as you remember and then take the next pill at the regular time as usual. You may take 2 tablets in one day. If you miss two doses (days) in a row, take 2 tablets for the next 2 days, then, continue with your regular schedule. Whenever 1 or 2 doses are missed, you should use a second method of contraception for the next 7 days in addition to taking the pills. If you miss three doses in a row, you should notify your physician or other health care professional for instructions. You will probably need to throw away the rest of the tablets in that cycle pack and start over. Another method of contraception should be used until at least 7 doses have been taken in the new cycle. Missing a pill can cause spotting or light bleeding. Make sure that no more than 7 days pass at the end of the 21 day cycle, before you start your next pack of pills.
Follow the same directions as above for the first 21 days of the schedule. If you miss 1 of the last 7 pills, you can either double the dose or skip it, but it is important to start the next month’s cycle on the scheduled day.
What other medicines can interact with ethinyl estradiol; levonorgestrel?
• antibiotics or medicines for infections, especially rifampin
• barbiturate medicines for producing sleep or treating seizures (convulsions)
• grapefruit juice
• medicines for anxiety or sleeping problems, such as diazepam or temazepam • medicines for mental depression
• medicines for diabetes, including troglitazone and pioglitazone
• mineral oil
• ritonavir or other medicines for the treatment of the HIV virus or AIDS
• soy isoflavones supplements
• St. John’s wort
• tamoxifen or raloxifene
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check before stopping or starting any of your medicines.
What side effects may I notice from taking ethinyl estradiol; levonorgestrel?
Severe side effects are relatively rare in women who are healthy and do not smoke while they are taking oral contraceptives. On average, more women have problems due to complications from getting pregnant than have problems with oral contraceptives. Many of the minor side effects may go away as your body adjusts to the medicine. However, the potential for severe side effects does exist and you may want to discuss these with your health care provider.
The following symptoms or side effects may be related to blood clots and require immediate medical or emergency help:
• chest pain
• coughing up blood
• dizziness or fainting spells
• leg, arm or groin pain
• severe or sudden headaches
• stomach pain (severe)
• sudden shortness of breath
• sudden loss of coordination, especially on one side of the body
• swelling of the hands, feet or ankles, or rapid weight gain
• vision or speech problems
• weakness or numbness in the arms or legs, especially on one side of the body
Other serious side effects are rare. Contact your health care provider as soon as you can if the following side effects occur:
• changes in vaginal bleeding during your period or between your periods
• headaches or migraines
• increases in blood sugar, especially if you have diabetes
• increases in blood pressure, especially if you are known to have high blood pressure
• symptoms of vaginal infection (itching, irritation or unusual discharge)
• tenderness in the upper abdomen
• yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your health care provider if they continue or are bothersome):
• breakthrough bleeding and spotting that continues beyond the 3 initial cycles of pills
• breast enlargement, tenderness, unusual discharge or milk production
• mild stomach upset
• mood changes, anxiety, depression, frustration, anger, or emotional outbursts
• increased or decreased appetite
• increased sensitivity to sun or ultraviolet light
• skin rash, acne, or brown spots on the skin
• weight gain
If you are taking this medicine for emergency prevention of pregnancy, it is common to have nausea, headache, abdominal pain or cramping, breast tenderness and dizziness. You may vomit. If you throw-up within 1 hour of taking your dose, you will need to contact your health care professional for instructions. If any of the other side effects are severe or continue, contact your health care professional. After you finish your prescription, it is common for you to have changes in your next period, or to have spotting. If you do not get a period within 21 days of taking your prescription, you should see your health care professional and get a pregnancy test.