What is ethinyl estradiol and levonorgestrel?
Ethinyl estradiol and levonorgestrel contains a combination of female hormones that prevent
ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical
mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to
attach to the uterus.
Ethinyl estradiol and levonorgestrel are used as contraception to prevent pregnancy.
Ethinyl estradiol and levonorgestrel may also be used for other purposes not listed in this
medication guide.
What should I discuss with my healthcare provider before taking ethinyl estradiol and levonorgestrel?
This medication can cause birth defects.
Do not use if you are pregnant.
Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a
row. If you have recently had a baby, wait at least 4 weeks before taking birth control pills (6 weeks if
you are breast-feeding).
Do not use this medication if you have:
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a history of a stroke or blood clot;
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circulation problems (especially if caused by diabetes);
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a hormone-related cancer such as breast or uterine cancer;
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abnormal vaginal bleeding;
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liver disease or liver cancer;
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severe high blood pressure;
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severe migraine headaches;
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a heart valve disorder; or
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a history of jaundice caused by birth control pills.
Before using this medication, tell your doctor if you have:
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high blood pressure, heart disease, congestive heart failure, angina
(chest pain), or a history of heart attack;
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high cholesterol or if you are overweight;
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a history of depression;
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gallbladder disease;
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diabetes;
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seizures or epilepsy;
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a history of irregular menstrual cycles;
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a history of fibrocystic breast disease, lumps, nodules, or an
abnormal mammogram;
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uterine fibroid tumors;
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varicose veins; or
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tuberculosis.
The hormones in birth control pills can pass into breast milk and may
harm a nursing baby. This medication may also slow breast milk production. Do not use if you are
breast-feeding a baby.
How should I take ethinyl estradiol and levonorgestrel?
Take this medication exactly as it was prescribed for you. Do not take larger amounts, or take
it for longer than recommended by your doctor. You will take your first pill on the first day of your
period or on the first Sunday after your period begins (follow your doctor's instructions).
You may need to use back-up birth control, such as condoms or a spermicide, when you first
start using this medication. Follow your doctor's instructions.
Some 28-day birth control packs contain seven "reminder" pills to keep you on your regular
cycle. Your period will usually begin while you are using these reminder pills.
Breakthrough bleeding may occur, especially during the first 3 months. Tell your doctor if
this bleeding continues or is very heavy.
Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack
the next day. You may get pregnant if you do not use this medication regularly.
If you need to have any type of medical tests or surgery, or if you will be on bed rest, you may
need to stop using this medication for a short time. Any doctor or surgeon who treats you should know
that you are using birth control pills.
Store this medication at room temperature away from moisture and heat.
What happens if I miss a dose of ethinyl estradiol and levonorgestrel?
Missing a pill increases your risk of becoming pregnant.
If you miss one "active" pill,
take two pills on the day that you remember.
Then take one pill per day for the rest of the pack.
If you miss two "active" pills in a row in week one or two,
take two pills
per day for two days in a row. Then take one pill per day for the rest of the pack. Use back-up birth
control for at least 7 days following the missed pills.
If you miss two "active" pills in a row in week three, or if you miss three pills in
a row during any of the first 3 weeks,
throw out the rest of the pack and start a new one
the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until
Sunday. On Sunday, throw out the rest of the pack and start a new one that day.
If you miss three "active" pills in a row during any of the first 3 weeks,
throw out the rest of the pack and start a new pack on the same day if you are a Day 1 starter. If you
are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the
pack and start a new one that day.
If you miss two or more pills, you may not have a period during the month.
If you
miss a period for two months in a row, call your doctor because you might be pregnant.
If you miss any reminder pills, throw them away and keep taking one pill per day until the pack
is empty. You do not need back-up birth control if you miss a reminder pill.
Where can I get more information about ethinyl estradiol and levonorgestrel?
Your pharmacist has information about ethinyl estradiol and levonorgestrel written for health professionals that you may read.
What are the possible side effects of ethinyl estradiol and levonorgestrel?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using this medication and call your doctor at once if you have any of these serious side
effects:
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sudden numbness or weakness, especially on one side of the body;
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sudden headache, confusion, pain behind the eyes, problems
with vision, speech, or balance;
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chest pain or heavy feeling, pain spreading to the arm or
shoulder, nausea, sweating, general ill feeling;
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a change in the pattern or severity of migraine headaches;
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nausea, stomach pain, loss of appetite, dark urine, jaundice
(yellowing of the skin or eyes);
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swelling in your hands, ankles, or feet; or
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symptoms of depression (sleep problems, weakness, mood
changes).
Less serious side effects may include:
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mild nausea, vomiting, bloating, stomach cramps;
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breast pain, tenderness, or swelling;
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freckles or darkening of facial skin;
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increased hair growth, loss of scalp hair;
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changes in weight or appetite;
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problems with contact lenses;
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vaginal itching or discharge;
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changes in your menstrual periods, decreased sex drive; or
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headache, nervousness, dizziness, tired feeling.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about ethinyl estradiol and levonorgestrel?
Do not use ethinyl estradiol and levonorgestrel if you are pregnant or if you recently had a
baby.
Do not use this medication if you have a history of stroke or blood clot, circulation
problems (especially if caused by diabetes), a hormone-related cancer such as breast or uterine cancer,
abnormal vaginal bleeding, liver disease or liver cancer, severe high blood pressure, migraine
headaches, a heart valve disorder, or a history of jaundice caused by birth control pills.
Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if
you smoke and are older than 35.
What should I avoid while taking ethinyl estradiol and levonorgestrel?
Do not smoke while using birth control pills, especially if you are older than 35. Smoking
can increase your risk of blood clots, stroke, or heart attack caused by birth control pills.
Birth control pills
will not
protect you from sexually transmitted
diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these
diseases.
What other drugs will affect ethinyl estradiol and levonorgestrel?
Some drugs can make birth control pills less effective, which may result in pregnancy. Before
using birth control pills, tell your doctor if you are using any of the following drugs:
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acetaminophen (Tylenol) or ascorbic acid (vitamin C);
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prednisolone (Orapred);
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theophylline (Respbid, Theo-Dur);
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cyclosporine (Neoral, Sandimmune, Gengraf);
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St. John's wort;
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an antibiotic;
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seizure medications;
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a barbiturate sedative such as secobarbital (Seconal), or
phenobarbital (Luminal, Solfoton); or
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HIV or AIDS medications.
This list is not complete and there may be other drugs not listed that can
affect birth control pills. Tell your doctor about all the prescription and over-the-counter medications
you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do
not start using a new medication without telling your doctor.
What happens if I have an overdose of ethinyl estradiol and levonorgestrel?
