Precautions and warnings

Use with caution in the following situations: if you have hormone-dependent cancers, a history of ectopic pregnancy, trouble absorbing nutrients, functional ovarian cysts, active liver disease, or problems with jaundice—especially jaundice during pregnancy. Also be careful if you have heart or kidney problems, diabetes, asthma, epilepsy, migraines, depression, or if you are breastfeeding. Conditions that worsen with fluid retention, high calcium levels, heart or gallbladder disease, abnormal blood fats (especially due to family history), or are at higher risk of blood clots, breast cancer, uterine fibroids, or liver tumors also call for caution.

Extra care is needed if you have a family history (first-degree relative) of artery disease, blood pressure readings at or above 140/90 mmHg, are over 35 years old, or have a BMI between 30-39. If you have migraines without aura that are controlled by medication, caution is also required.

If you experience vomiting, diarrhea, or missed doses, or if you are taking other medications that might interfere, you may need extra contraception precautions.

It's important to take this medication at the same time each day.

Drug Interactions

Drugs that increase CYP3A4 activity can lower the levels or effects of certain medicines, such as aminoglutethimide, carbamazepine, nafcillin, nevirapine, atazanavir, nelfinavir, phenobarbital, phenytoin, lamotrigine, rifamycins, griseofulvin, and ritonavir. Antibiotics like ampicillin, tetracycline, and others can make some drugs less effective. Estrogens can reduce how well coumarin anticoagulants work. Some medications may slow down the breakdown of prednisolone and ciclosporin. They may also lower how quickly alprazolam, chlordiazepoxide, and diazepam are cleared from the body, but speed up the removal of lorazepam, oxazepam, and temazepam.

Contraindications

These conditions are situations where certain treatments (such as hormonal contraceptives) should **not** be used:

- Pregnancy
- Unexplained vaginal bleeding
- Severe artery disease, or a strong family history of high cholesterol
- Liver tumors or liver problems
- History of a certain rare blood disorder called porphyria
- Recent removal of a molar pregnancy (hydatidiform mole)
- Past or current breast cancer (unless for some cases of metastatic disease)
- Blood clots or blood clotting disorders
- Tumors that depend on estrogen for growth
- Smoking 40 or more cigarettes a day
- Age over 50 years
- Diabetes with complications
- Body mass index (BMI) over 39 kg/m²
- Migraines with specific symptoms lasting over 72 hours (even with treatment), or migraines treated with ergot drugs
- Blood pressure over 160/100 mmHg
- Past “mini-strokes” (TIA) without headaches
- Systemic lupus erythematosus (SLE)
- Gallstones
- History of hemolytic uremic syndrome
- Itching during pregnancy (pruritus)
- Cholestatic jaundice (a type of liver problem)
- Movements problems (chorea), worsening hearing loss (otosclerosis), or a certain skin disease (pemphigoid)
- Breastfeeding in the first 6 months after childbirth

If any of these apply, it's important to avoid using this treatment and consult with your healthcare provider for safer options.

Mode of actions

Combined hormonal contraceptives prevent ovulation by affecting hormones from the pituitary gland, specifically lowering the levels of luteinising hormone (LH) and follicle stimulating hormone (FSH) through a negative feedback mechanism. If ovulation does occur, these contraceptives make it harder for sperm to reach the egg by thickening the cervical mucus. They also change the lining of the uterus (endometrium) to reduce the chances of a fertilized egg attaching, and may alter the movement of eggs through the fallopian tubes.

Dosage & Administration

Adult: PO Monophasic combined OC: As tab containing levonogestrel 150-250 mcg and ethinylestradiol 30 mcg: 1 tab once daily. Triphasic combined OC: Levonorgestrel 50-125 mcg + ethinylestradiol 30-40 mcg: 1 tab once daily.

Pregnancy & Lactation

This medicine must not be used during pregnancy. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict two effective types of birth control starting one month before and during treatment and for three years after stopping this medicine. Discuss with your doctors if you are not sure which types of birth control are effective for you. You must need to take pregnancy tests regularly during your treatment with this medicine and for at least three years after taking this medicine. If it seems that you do become pregnant stop taking this medicine and call your doctor immediately. If you really become pregnant, miss a menstrual period, or have sex without using two forms of birth control. In some cases, your doctor can prescribe emergency contraception to prevent pregnancy. People on this medicine should not donate blood during the treatment and for three years afterward.

This medicine is also contraindicated breast milk. Breastfeeding is not recommended while using this medication and for three years afterward.

Pack Size & Price