Ethinyl estradiol , Levonorgestrel

Details About Generic Salt ::  Ethinyl estradiol , Levonorgestrel 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

11A. CONTRACEPTIVE DRUGS in 11. REPRODUCTIVE SYSTEM
ETHINYL ESTRADIOL + LEVONORGESTREL
ESTROGEN & PROGESTOGEN | CONTRACEPTIVES
PK: A: Rapid D: Ethinylestradiol: 4.3 L/kg, levonorgesterol: 1.8 L/kg M: Liver E: Urine & feces

Indications & Dose: CONTRACEPTION PO Adult Schedules: Sunday starter (schedules 1) initiate dose on first sunday of menstruation (if starts on sunday take first tablet with same day) or Day 1 starter (schedules 2) start therapy on 1st day of menstruation. Dosages: 21 day pack: 1 tablet/day for 21 days followed by 7 drug free days, new course starts on 8th day or 28day pack: 1 tablet/day without interruption

Contra: Hypersensitivity, history of/current thrombophlebitis, thromboembolic disorders, CVD/CAD, valvular heart disease with complications, severe/uncontrolled HTN, thrombogenic rhythm disorder, hereditary/acquired thrombophilias, DM with vascular involvement, severe headache with focal neurological symptom, migraine headache with/without aura, known/suspected breast carcinoma, endometrial cancer, estrogen/progestin dependent neoplasms, undiagnosed abnormal genital bleeding, hepatic dysfunction/tumor, cholestatic jaundice of pregnancy, jaundice with prior combination hormonal contraceptives, major surgery with pronged immobilization, heavy smoking, renal disease, hepatic impairment

Precautions: vascular disease, HTN, DM, familial defects of lipoprotein metabolism, conditions that aggravate fluid retention/depression, history of migraine

ADR: Serious: migraine, gall bladder disease, increases the risk of thromboembolism/cerebral hemorrhage/cerebral thrombosis/HTN/mesenteric thrombosis/MI/venous thrombosis, increases the risk of hepatic adenomas/tumors, increases the risk of retinal thrombosis/pulmonary embolism, edema, varicose vein aggravation, vaginitis, fibroid enlargement, jaundice, chorea exacerbation, corneal steepening, anaphylactic reaction, SLE exacerbation, optic neuritis, auditory disturbances, Others: acne, dizziness, rhinitis, porphyria, endocervical hyperplasia, depression, rash, amenorrhea, breast enlargement, decreases glucose tolerance, menstrual changes, spotting, abdominal pain, abdominal bloating, nausea, vomiting

DDI: Serious Warfarin anticoagulant effect is abolished by drug, Clomipramine/Amitriptyline antidepressant effect is abolished by drug, Ciclosporin concentration increases, Amiloride/Acetazolamide/Furosemide/Hydrochlorothiazide/Spironolactone diuretic effect is abolished by drug, Insulin/Glibenclamide/Metformin hypoglycemic effect is abolished by drug, Atenolol/Amlodipine/Enalapril/Glyceryl Tri nitrate/Hydralazine/Isosorbide Dinitrate/Methyl dopa/Nifedipine/Propranolol/Sodium nitroprusside/Verapamil hypotensive effect is abolished by drug, Fluconazole leads to contraceptive failure, Hydrocortisone/Dexamethasone/Prednisolone level increases, Efavirenz/Carbamazepine/Griseofulvin/Nelfinavir/Nevirapine/Phenobarbital/Phenytoin/Rifampicin/Ritonavir reduces contraceptive efficacy

Monitor: Loss of vision, sudden onset of proptosis, diplopia, migraine, BP, signs/symptoms of thromboembolic disorder, depression, glucose level in DM, lipid profiles, vaginal bleeding

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