22/12/2016 BirthControlPills(OralContraceptives)

BirthControlPills(OralContraceptives)
MedicallyreviewedonDec10,2016byL.Anderson,PharmD

Thebirthcontrolpillisapopularandhighlyeffectivemethodofbirthcontroliftakencorrectly.Thepillhasa<1%
failurerate(meaninglessthan1outof100womenunintentionallybecomepregnant)ifusedcorrectly.
However,forwomenwhomisstakingtheirpills,thefailurerategoesuptoroughly8%,or8outof100women
becomepregnantunintentionally.

Ifyouarenotlikelytoremembertotakeapilleachday,youprobablyshouldconsideralongeractingformof
birthcontrol,suchastheinjection,patch,implant,vaginalringorIUD.Roughly85%ofwomenwhodonot
usebirthcontrolandaretryingtogetpregnantwillconceivewithinoneyear.

Currently,birthcontrolpillsarefreewiththeAffordableCareAct,butthatmightchangeinthefuture.Birth
controlpillscanbeaffordable,dependinguponhealthinsurancecoverageandgenericavailability.Manybirth
controlpillsareavailablegenericallyandhavealowerpricediscussgenericavailabilityofbirthcontrolpills
withyourphysicianorpharmacistifcostisaconcern.Also,checkwithyourinsurancecompanybeforegettinga
prescriptiontodeterminewhichbirthcontrolpillsareontheirformulary.Ingeneral,youshouldbeabletoget
birthcontrolpillsfrom$10to$50permonthifyoupaycash,althoughtherearemanymoreexpensivebrands.
Again,ifyouhaveprescriptiondruginsurance,yourbirthcontrolmaybefreeundertheAffordableCareAct.

Advantagestobirthcontrolpilluse:

Lighterperiods,lessfrequentperiods,orpossiblynoperiodsatalldependinguponthetypeofpilltakenand
dosingschedule
Ifthebirthcontrolpillistakencorrectly,ithasahighlevelofeffectivenesstopreventpregnancy.
Thebirthcontrolpillcanlessenheavybleeding,painandseverityofendometriosisandfibroidtumors
Acneorpremenstrualdysphoricdisorder(PMDD)mayimprovewithsomebirthcontrolpills
Theuseofthebirthcontrolpillcanlowertheriskofpelvicinflammatorydisease,uterinecancerandovarian
cancer
Theprogestinonlyformsmaybeusedbywomenwhoarebreastfeedingorcannotuseestrogenforother
reasons

CombinationBirthControlPills
Allbirthcontrolpillsrequireaprescriptionfromahealthcareprovider.Combinationbirthcontrolpillsareavailable
in21daypacks,with21activetablets,or28daypackswith21activetablets,and7inactivetablets.Extended
cyclepillssuchasSeasoniquecontain84activetabletsand7inactivetablets.Theinactivepillsareincludedto
helpthewomanrememberwhensheshouldstartanewpackofpills.Iftheinactivepillsaremissed,thereisno
chancethiswouldresultinapregnancy.However,itisimportanttostartthenewpackandactivepillsonthe
correctday.

Combinationpillscontaintwohormones,progestinandestrogen,whiletheminipillscontainonlyprogestin.
Generally,combinationbirthcontrolpillsareslightlymoreeffectivethanprogestinonlybirthcontrolpills.
Combinationpillsmaycontaindifferentlevelsofhormonesthroughoutthemonth.

Examplesofbrandnamecombinationpillsinclude:Apri,Azurette,Caziant,Kariva,Velivet,Natazia,Gianvi,
Ocella,Yaz,Yasmin,Zarah,Beyaz,Safyral,Kelnor,Zovia1/35,Zovia1/50,Aviane,Levora,Portia,Trivora,
Junel,Microgestin,Necon,Nortrel,OrthoNovum,MonoNessa,Previfem,TriNessa,Cryselle,LowOgestrel,
Ogestrel.Seethechartinthissectionforadditionalbrandnames.

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22/12/2016 BirthControlPills(OralContraceptives)

Amonthlyperiodstilloccurswiththetraditional,combinationbirthcontrolpills.Womenmayalsochoosethe
extendedorcontinuousdosingbirthcontrolpill,inwhichaperiodonlyoccurs4timesayears(e.g.,Seasonique)
oriscompletelyeliminated(e.g.,Lybrel).Itisalsopossibletocompletelyeliminateperiodsbytakingonlythe
activepillscontinuouslyfromacombinationbirthcontrolpillpackage,andskippingtheinactivepills.Askyour
healthcareproviderifthiswouldbeagoodoptionforyou.

ProgestinonlyBirthControlPills(MiniPills)
Theprogestinonlyorminipillscontainonlynorethindroneandeachpillisactive.Whenyoufinishonepackof
progestinonlypills,youstartanotherpackthenextday.Withprogestinonlypillsyouwilleithergetyourperiod
inthefourthweek,getnoperiods,orhavespottingduringthemonth.Yourperiodsmaybeheavierorlighter.Do
notstoptakingyourprogestinonlypills.

Examplesofbrandnameprogestinonlypillsinclude:Camila,Errin,Heather,Jolivette,NoraBE.

WhatshouldIdoifImisstakingoneormorebirthcontrolpills?
Itiseasytoforgettotakeapillortomissapillatonetimeoranother.Butthecombination(estrogenand
progestin)pillsworksbestiftakeneverydayattheaboutthesametime.Theprogestinonlypills(minipills)
MUSTbetakenatthesametimeeachday(nomorethan3hourslate).Ifyoumissapill,youwillincreaseyour
chancesofreleasinganeggthatcouldbefertilized,andgettingpregnant.

Anytimeyoumissapillitisbesttouseabackupmethodofbirthcontrol,suchasacondomordiaphragmwitha
spermicide,oracontraceptivesponge.Yourchancesforgettingpregnantincreasedependinguponwhenyou
missedyourpillduringyourcycle.Checkwithyourhealthcareproviderformoreinformationaboutmissedbirth
controlpills.

Ifyoumissoneortwocombination(estrogenandprogestin)pills,takethemassoonasyouremember.Take
yournextpillattheregulartime.Thismeansifyoumisstwopills,youwouldtakebothmissedpillsatthesame
time,andthentakeyournextpillwheneveritisdue.Takingtwopillsatoncemaymakeyoufeelalittlesickto
yourstomach,butthatwillnotlastlong.Useabackupmethodofbirthcontrol,suchasacondom,spongeor
spermicideuntilyoufinishthepack,unlessyourhealthcareprovideradvisesotherwise.

Ifyoumissthreecombinationpillsinarow,callyourhealthcareprovider.Theymaywantyoutostopusingyour
currentbirthcontrolpackandstartanewpackwhileusingabackupmethodofbirthcontrol.

Youcouldbecomepregnantifyoumisstakingyourprogestinonlypill(minipill)bymorethan3hours.Ifyoumiss
takingoneminipill,takeitassoonasyouremember,andtakethenextpillattheregulartime.Continuetotake
theremainderoftheminipillsontheregularschedule.Useabackupmethodofbirthcontrol,suchasa
condom,spongeorspermicideforthenext48hours.

Ifyouarestillconfusedaboutwhattodoifyouhavemissedanybirthcontrolpills,useabackupmethodofbirth
controleachtimeyouhavevaginalintercourse,andtakeabirthcontrolpilleachdayuntilyoucantalktoyour
healthcareprovider.

WarningsforBirthControlPillUse
BirthcontrolpillsshouldNOTbeusedbywomenwhohaveahistoryofbreastcancer,endometrialcancer,
undiagnosedvaginalbleeding,livertumorsordisease,increasedclottingorstrokerisk,orifpregnant.

Smokingincreasestheriskofseriousheartsideeffectswhenusingacombinedestrogenandprogestinbirth
control,includingtheringorthepatch.CombinationestrogenandprogestinbirthcontrolshouldNOTbeusedin
womenover35yearsofagewhosmokeduetoanincreasedriskofrarebutserioussideeffects,suchasheart
attack,bloodclots,andstroke.

Womenofanyageshouldavoidcombinationhormonalbirthcontroliftheyhaveahistoryofuncontrolledhigh
bloodpressure,chestpain,diabetes,severeheadaches,heartorliverdisease,bloodclotsorstroke.

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22/12/2016 BirthControlPills(OralContraceptives)

Cardiovascularrisksincreasewithage,weight,familyhistoryofheartdisease,andnumberofcigarettessmoked
perday(>15perday).Womenshouldtalktotheirhealthcareprofessionalabouttheirindividualriskprofile
beforedecidingwhichbirthcontrolmethodtouse.

Letyourphysicianknowifyouhavemigraineheadacheswhendiscussingbirthcontroloptions.

Thebirthcontrolpilldoesnotprotectagainstanyformofsexuallytransmitteddisease(STD),includingAIDS/HIV.
Amalelatexorfemalecondomshouldbeusedincombinationwithanyotherformofbirthcontrolifprotection
againstSTDsisneeded.

Breastfeedingmothersshouldavoidtheestrogenincombinedhormonalbirthcontrolasitmayreducemilk
supply.BirthcontroloptionsforbreastfeedingwomenincludeIUDs,progestinonlypills(minipills),theimplant
orthebirthcontrolshot.

CommonSideEffectswithBirthControlPills:
Spottingbetweenperiods
Possibleweightgain
Breastswellingortenderness
Nauseaorupsetstomach
Moodchanges

SeriousSideEffectswithBirthControlPills:
Blurredvision
Severestomachpain
Severeheadache
Swellingorpaininthelegs
Chestpain,heartattack,bloodclots,stroke

Otherwarningsandsideeffectsexistforbirthcontrolpills.Itisimportanttoreviewthespecificconsumer
informationforthebirthcontrolofchoiceanddiscussanyquestionsorconcernswithyourhealthcareprovider.

Tellyourhealthcareprovideraboutallothermedicationsyoutake,includingprescription,overthecounter,
vitaminandherbalsupplements.Certainmedicationsmaymakeyourbirthcontrollesseffective.Besuretohave
completedruginteractionrevieweachtimeyoustartanewmedication.

BirthControlPillOptions
GenericName BrandName(s) Description

Desogestrel/ethinyl Apri,Azurette,Caziant,Cyclessa,Desogen, Combinationprogestinand

estradiol Emoquette,Enskyce,Juleber,Kariva,Kimidess, estrogenpillCaziant,
Mircette,OrthoCept,Reclipsen,Velivet,Viorele, CyclessaandVelivetare
Solia,Cesia,Cyred triphasic

Dienogest/estradiol Natazia Quadraphasicprogestinand

valerate estrogenpill

Drospirenone/ethinyl Gianvi,Loryna,Nikki,Ocella,Syeda,Vestura, Drospirenonecontaining

estradiol Yasmin,Yaz,Zarah birthcontrolpillsmaybe
associatedwithahigherrisk
forrarebutseriousblood
clots(DVT,PE)thanother

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22/12/2016 BirthControlPills(OralContraceptives)

progestincontainingpills.
Womenshouldconsultwith
theirMDpriortousing
drospirenone.Drospirenone
ethinylestradiolisavailable
genericallyforaddedcost
savings.

Drospirenone/ethinyl Beyaz,Safyral Drospirenonecontaining

estradiol/levomefolate birthcontrolpillsmaybe
associatedwithahigherrisk
forrarebutseriousblood
clots(DVT,PE)thanother
progestincontainingpills.
Womenshouldconsultwith
theirMDpriortousing
drospirenonecontainsa
dailydoseoffolate
supplementationtolowerthe
riskofhavingrareneural
tubedefectsinapregnancy
occurringduringBeyazor
Safyraluse,orshortlyafter
stopping

Ethynodiol/ethinyl Kelnor,Zovia1/35,Zovia1/50 Monophasiccombination

estradiol progestinandestrogenpill
botharebrandedgeneric
versionsofDemulen
(Demulennolonger
marketed)

Levonorgestrel/ethinyl Altavera,Amethyst,Aviane,Canrese,Camrese Combinationprogestinand

estradiol Lo,Daysee,Enpresse,Falmina,Introvale, estrogenpillEnpresse,
Jolessa,Kurvelo,LoSeasonique,Lessina,Levlen, Myzilra,Triphasil,andTrivora
Levonest28,Levora,Lutera,Lybrel,Marlissa, aretriphasicIntrovale,
Myzilra,Orsythia,Portia,Quartette,Quasense, Jolessa,Quartette,
Seasonale,Seasonique,Sronyx,Triphasil21, QuasenseandSeasonale
Triphasil28,Trivora28 areextendedcyclepills
(periodoccursonlyonce
every3months)
LoSeasonique,Daysee,
Camrese,CamreseLo,and
Seasoniquearealso
extendedcyclepillsLybrel,
andit'sgenericversion
Amethystarecontinuous
cyclepill(noperiodsatall,
butspottingmayoccur)

Mestranol/norethindrone Necon1/50,Norinyl1/50 Combinationprogestinand

estrogenmonophasicpill

Norethindrone Aygestin,Camila,Errin,Heather,Jencycla, Progestinonlybirthcontrol

Jolivette,NorQD,NoraBE,OrthoMicronor pills(minipills)forusein
breastfeedingorhighriskfor
bloodclots.Musttakeatthe
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sametimeeachdayto
preventovulationandbe
mosteffectiveslightlyless
effectivethancombination
hormones.Generic,lower
costversionsof
norethindroneareavailable.

Norethindrone/ethinyl Alyacen1/35,Alyacen7/7/7,Aranelle,Balziva, Combinationprogestinand

estradiol Brevicon,Briellyn,Cyclafem1/35,Cyclafem estrogenpillNecon10/11is
7/7/7,Dasetta1/35,Dasetta7/7/7,EstrostepFe, biphasicAranelle,Alyacen
FemconFe,GeneressFe,Gildagia,GildessFe, 7/7/7,Cyclafen7/7/7,
Junel211.5/30,Junel211/20,JunelFe1.5/30, Dasetta7/7/7,EstrostepFe,
JunelFe1/20,Leena,Loestrin211.5/30,Loestrin Leena,Necon7/7/7,Nortrel
211/20,Loestrin24Fe,LoLoestrinFe,Loestrin 7/7/7,OrthoNovum7/7/7,
Fe1.5/30,LoestrinFe1/20,Microgestin1/20, TiliaFe,TriLegestFe,Tri
Microgestin1.5/30,MicrogestinFe1/20, Norinylaretriphasic.
MicrogestinFe1.5/30,Modicon,Necon0.5/35, Generic,lowercostoptions
Necon1/35,Necon10/11,Necon7/7/7,Norinyl areavailable.
1/35,Nortrel0.5/35,Nortrel1/35,Nortrel7/7/7,
OrthoNovum1/35,OrthoNovum7/7/7,Ovcon
35,Ovcon50,Philith,TiliaFe,TriLegestFe,Tri
Norinyl,Wera,Zenchant,ZenchantFe,Zeosa

Norgestimate/ethinyl Estarylla,MonoLinyah,MonoNessa,OrthoTri Combinationprogestinand

estradiol Cyclen,OrthoTriCyclenLo,OrthoCyclen, estrogenpillTriproducts
Previfem,Sprintec,TriEstarylla,TriLinyah,Tri aretriphasicgeneric,lower
LoEstarylla,TriLoSprintec,TriPrevifem,Tri costoptionsareavailable.
Sprintec,TriNessa

Norgestrel/ethinyl Cryselle,Elinest,Lo/Ovral28(discontinued),Low Combinationprogestinand

estradiol Ogestrel,Ogestrel estrogenpill

Forotheroptionsandbrandnames,alsosee:OralContraceptives

SeeAlso:
BirthControlPillsBenefitsvsRisks&SideEffects
BirthControlPillsBreakthroughBleeding
BirthControlPillsPeriods
EmergencyContraception
HormonalBirthControl(NonPillOptions)
Missedtakingyourbirthcontrolpill?
NonhormonalBirthControl
PermanentBirthControl
Sources
GiveTeensAccesstoEmergencyContraception,PediatriciansSay.https://www.drugs.com/news/giveteensaccessemergencycontraceptio
npediatricianssay41684.html
FDA.Drugs@FDA:FDAApprovedDrugProducts.AccessedDecember10,2016athttp://www.accessdata.fda.gov/scripts/cder/daf/

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