Levonorgestrel Oral-Ethinyl Estradiol

  • Brand Name : Alesse
  • Drug Class : Estrogens/Progestins-HRT, Contraceptives, Oral, Estrogens/Progestins
  • Medical Author : Nazneen Memon, BHMS, PGDCR
  • Medical Reviewer : Divya Jacob, Pharm. D.
  • _eael_post_view_count : 10

What Is Levonorgestrel Oral/Ethinyl Estradiol and How Does It Work?

Levonorgestrel Oral/Ethinyl Estradiol is a prescription medicine used as contraception to prevent pregnancy in adults and postpubertal adolescents aged above 16 years after menarche.

Levonorgestrel Oral/Ethinyl Estradiol is available under the following different brand names: Altavera, Amethia, Amethia Lo, Amethyst, Ashlyna, Aubra, Aviane, Camrese, Camrese Lo, Chateal, Daysee, Elifemme, Enpresse, Falmina, Introvale, Jolessa, Kurvelo, Lessina 21, Lessina 28, Levonest, Levora, LoSeasonique, Lybrel, Marlissa, Microgynon, Nordette, Orsythia, Ovranette, Portia 21, Portia 28, Quasense, Quartette, Sronyx, Trivora 28, Seasonale, Seasonique, Setlakin, Lutera, Myzilra, FaLessa, FaLessa Kit, Delyla, Fayosim, Larissia, Lillow, Rivelsa, Vienva

What Are Dosages of Levonorgestrel Oral/Ethinyl Estradiol?

Adult dosage

Tablet, monophasic (Aubra, Aviane, Delyla, Falmina, Falessa, Falessa Kit, Larissia, Lessina, Lutera, Orsythia, Vienva)

  • Days 1-21: 0.1mg/20mcg
  • Days 22-28: Inert tablets
  • Days 22-28: folic acid 1 mg (Falessa Kit)

Tablet, monophasic (Altavera, Chateal, Kurvelo, Levora, Lillow, Marlissa, Nordette, Portia)

  • Days 1-21: 0.15mg/30mcg
  • Days 22-28: Inert tablets

Tablet, 91-day (Seasonale, Quasense, Introvale, Jolessa, Setlakin)

  • Days 1-84: 0.15mg/30mcg
  • Days 85-91: Inert tablets

Tablet, 91-day (Seasonique, Amethia, Ashlyna, Camrese, Daysee)

  • Days 1-84: 0.15mg/30mcg
  • Days 85-91: Ethinyl estradiol 10mcg

Tablet, 91-day (LoSeasonique, Amethia Lo, Camrese Lo)

  • Days 1-84: 0.1mg/20mcg
  • Days 85-91: Ethinyl estradiol 10mcg

Tablet, 91-day (Quartette, Fayosim, Rivelsa)

  • Days 1-42: 0.15mg/20mcg
  • Days 43-63: 0.15mg/25mcg
  • Days 64-84: 0.15mg/30mcg
  • Days 85-91: Ethinyl estradiol 10mcg

Tablet, triphasic (Elifemme, Enpresse, Levonest, Trivora 28)

  • Days 1-6: 0.05mg/30mcg
  • Days 7-11: 0.075mg/40mcg
  • Days 12-21: 0.125mg/30mcg
  • Days 22-28: Inert tablets

Tablet, continuous cycle

  • 0.09mg/20mcg

Contraception

Adult dosage

Monophasic

  • 1 active tablet orally daily for 21 days, then 1 inert tablet orally daily for 7 days (follow manufacturer’s color-coding for sequence)
  • 91-day
  • 1 combination tablet daily for 84 days, then either 1 inert tablet or 1 tablet of ethinyl estradiol 10 mcg for 7 days
  • First cycle begins on the first Sunday after the onset of menstruation; if menstruation begins on Sunday, the first combination tablet is taken that day, with subsequent tablets taken in the order specified on the dispenser
  • Use a non-hormonal backup method of contraception (eg, condoms and spermicide) for the first 7 days of treatment
  • Next and all subsequent 91-day courses of tablets are initiated without interruption on the same day of the week (Sunday), following the same schedule, with tablets taken at the same time of day on each day of active treatment

Triphasic

  1. Regimens vary; see package inserts (follow manufacturer’s color-coding for sequence)
  2. Continuous cycle
  3. 1 tablet orally daily at the same time each day, with no tablet-free interval

Missed Active Contraceptive Dose

Adult dosage

  • One active tablet missed
  • Take 1 tablet as soon as possible, or take 2 tablets on the following day
  • Alternatively, take 1 tablet, discard missed tablet, and continue taking subsequent tablets as scheduled
  • Use other forms of contraception for the next 7 days after a missed dose or until menses occur
  • Two active tablets missed consecutively
  • Take 2 tablets as soon as remembered and continue taking them as scheduled
  • Alternatively, take 2 tablets daily for the next 2 days and continue taking as scheduled
  • Missed 3rd week of cycle and patient is Sunday Starter: Take 1 pill every day until Sunday; discard rest of pack, and start a new pack that same day
  • Missed 3rd week of cycle and patient is day-1 starter: Discard rest of pack, and start a new pack that same day
  • Use other forms of contraception for the next 7 days after a missed dose or until menses occur
  • Menses may not occur this month; if menses do not occur for 2 consecutive months, contact the healthcare provider about the possibility of pregnancy
  • Three active tablets missed consecutively
  • Sunday starter: Take 1 pill every day until Sunday; discard the rest of the pack, and start a new pack that same day

Day-1 starter: Discard the rest of the pack, and start a new pack that same day

  • Use other forms of contraception for the next 7 days after a missed dose or until menses occur
  • Menses may not occur this month; if menses do not occur for 2 consecutive months, contact the healthcare provider about the possibility of pregnancy

Dosage Considerations – Should be Given as Follows: 

  • See “Dosages”

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