Ethinyl Estradiol; Levonorgestrel tablets

What are ethinyl estradiol; levonorgestrel tablets?
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, these 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 I tell my health care provider before I take this medicine?
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
�depression
�fibroids
�gallbladder disease
�heart or circulation problems
�high blood pressure
�jaundice
�liver disease
�menstrual problems
�migraine headaches
�stroke
�systemic lupus erythematosus (SLE)
�tobacco smoker
�an unusual or allergic reaction to estrogen/progestin, other hormones, medicines, foods, dyes, or preservatives
�pregnant or trying to get pregnant
�breast-feeding

How should I use this medicine?
�For routine prevention of pregnancy:
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.

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.

Seasonale� has a 91-day supply of pills. This product has 84 pills with active ingredients and 7 inactive pills to be taken during the week of menstruation. This product allows you to only have 4 menstrual cycles per year.

Seasonique� has a 91-day supply of pills. This product has 84 pills containing both estrogen and progestin and 7 pills with estrogen only. The estrogen only pills are to be taken during the week of menstruation. This product allows you to have only 4 menstrual cycles per year.

�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.

91-day schedule:
If you miss one dose for the first 84 days of the schedule, take it as soon as you remember. Take the next pill at your regular time as usual, which means you may take 2 tablets in one day. If you miss 2 doses (days) in a row, take 2 tablets on the day you remember and 2 tablets the next day. Then, continue with your regular schedule. You could become pregnant if you have sex in the 7 days after you miss 2 doses in a row. You should use another method of birth control during the 7 days after you restart your pills. If you miss 3 doses (days) in a row, you will not take any of the 3 pills that you missed. Restart taking your pills for the actual day you restart. For example, if you resume taking the pill on Thursday, take the pill under 'Thursday' and do not take the missed pills. Keep taking 1 pill every day until you have completed all of the remaining pills in the pack. You may experience bleeding during the week following the missed pills. You could become pregnant if you have sex in the 7 days after you miss 3 doses in a row. You should use another method of birth control during the 7 days after you restart your pills. If you miss any of the last 7 pills, throw away the missed pills. You will not need a back-up method of birth control. Keep taking the scheduled pills until the pack is finished.

What drug(s) may interact with ethinyl estradiol; levonorgestrel?
�anastrozole
�antibiotics or medicines for infections, especially rifampin
�aprepitant
�barbiturate medicines for producing sleep or treating seizures (convulsions)
�bosentan
�carbamazepine
�caffeine
�clofibrate
�cyclosporine
�dantrolene
�doxercalciferol
�exemestane
�grapefruit juice
�hydrocortisone
�letrozole
�medicines for anxiety or sleeping problems, such as diazepam or temazepam
�medicines for mental depression
�medicines for diabetes, including troglitazone and pioglitazone
�mineral oil
�modafinil
�mycophenolate
�nefazodone
�oxcarbazepine
�phenytoin
�prednisolone
�ritonavir or other medicines for the treatment of the HIV virus or AIDS
�selegiline
�soy isoflavones supplements
�St. John's wort
�tamoxifen or raloxifene
�testolactone
�theophylline
�topiramate
�warfarin

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:
�breast tissue changes or discharge
�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
�vomiting
�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 tenderness
�mild stomach upset
�mood changes, anxiety, depression, frustration, anger, or emotional outbursts
�increased or decreased appetite
�increased sensitivity to sun or ultraviolet light
�nausea
�skin rash, acne, or brown spots on the skin
�tiredness
�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.

What should I watch for while taking ethinyl estradiol; levonorgestrel?
Visit your prescriber or health care provider for regular checks on your progress. You should have a complete check-up every 6 to 12 months. If you have any unusual vaginal bleeding contact your doctor or health care provider for advice. If you miss a period, the possibility of pregnancy must be considered. See your prescriber or health care professional as soon as you can.

Use an additional method of contraception during the first 7 days that you take these tablets.

If you stop taking these tablets and want to get pregnant, a return to normal ovulation can take some time. You may not return to normal ovulation and fertility for 3 to 6 months. Discuss your pregnancy plans with your health care provider.

If you are taking oral contraceptives for the treatment of acne, hirsutism (male-like hair growth), endometriosis or other hormone related problems, it may take several months of continued treatment to notice improvement in your symptoms or condition.

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are taking oral contraceptives, especially if you are more than 35 years old. You are strongly advised not to smoke.

Oral contraceptives can increase your sensitivity to the sun and you may burn more easily. Use sunscreen and protective clothing during long periods outdoors. Tanning booths should be used with caution.

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.

In some women, tenderness, swelling, or minor bleeding of the gums may occur. Notify your dentist if this happens. Brushing and flossing your teeth regularly may help limit this. See your dentist regularly and inform your dentist of the medicines you are taking.

You may get a vaginal yeast infection. If you have never had a yeast infection before, see your prescriber or other health care provider to confirm the problem. If you have had yeast infections in the past and are comfortable with self-medicating the problem, get and use a nonprescription medication to treat the yeast infection.

If you are going to have elective surgery, you may need to stop taking your contraceptive pills one month beforehand. Consult your health care professional for advice prior to scheduling the surgery.

Taking contraceptive pills does not protect you against HIV infection (AIDS) or any other sexually transmitted diseases.

Where can I keep my medicine?
Keep out of the reach of children.

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