Ethinylestradiol and Levonorgestrel are combined in this medicine.
Ethinylestradiol + Levonorgestrel is a combination oral contraceptive (birth control pill). This medicine is used to prevent pregnancy in women of reproductive age.
This medicine may be used to treat other conditions as decided by your doctor.
Take Ethinylestradiol + Levonorgestrel exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Try to take it at the same time each day.
Ethinylestradiol + Levonorgestrel is available as a conventional tablet or a chewable tablet.
If you are taking the chewable tablet, the tablet should be chewed and not swallowed whole.
If you missed a dose and it is within 12 hours of your usual schedule, take the missed dose and return to your normal dosing schedule.
If you are more than 12 hours late, take the missed dose as soon as you remember (even if this means taking 2 doses in 1 day) and return to your normal dosing schedule. You may also need to use additional birth control methods, for the next 7 days.
Discuss with your doctor or pharmacist on how to properly manage your missed dose.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- current or history of blood clot formation e.g. deep vein thrombosis (blood clots in your leg veins), pulmonary embolism (blood clots in a lung artery), history of heart attack or stroke
- with risk factors of blood clot formation e.g. severe or uncontrolled high blood pressure, high cholesterol level, prolonged immobilisation
- hereditary or acquired blood clotting disorders
- heart valve or heart rhythm disorders that may be associated with the formation of blood clots
- unexplained vaginal bleeding
- current or history of breast cancer and other sex hormone-sensitive cancers
- current or history of pancreatitis (inflammation of the pancreas) with high cholesterol level
- liver disease e.g. liver tumours
- migraine (severe throbbing or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound)
as Ethinylestradiol + Levonorgestrel may not be suitable for you.
Do not take this medicine if you are pregnant or if you think that you are pregnant. If you become pregnant while being treated with this medicine, alert your doctor immediately. Ethinylestradiol + Levonorgestrel may cause harm to your unborn child.
Do not take this medicine with medicines used to treat hepatitis C. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- history of chloasma gravidarum (discolouration of the skin especially on the face or neck during pregnancy)
- risk factors for heart disease e.g. high cholesterol or triglyceride levels
- diabetes
- depression
- hereditary angioedema (an inherited disorder characterised by swelling of the limbs, face, or airways)
- systemic lupus erythematosus (an autoimmune disease that causes inflammation)
- kidney disease
Let your doctor know if you are breastfeeding.
Ethinylestradiol + Levonorgestrel does not lower the risk of getting HIV infection or any other sexually transmitted diseases. Ensure that you use proper precautions to avoid getting these diseases.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
If you are going for certain laboratory tests (e.g. liver, kidney, or thyroid function test), inform your doctor that you are taking Ethinylestradiol + Levonorgestrel.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. cholesterol/sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure before and during treatment.
- Regular monitoring of signs and symptoms of depression, unusual vaginal bleeding, and changes in vision may also be needed.
Ethinylestradiol + Levonorgestrel may cause any of the following side effects: headache, nausea, vomiting, stomach pain, tiredness, pimples, rash, and decreased sex drive.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- pain, swelling and tenderness in your leg accompanied by redness and warmth
- breathlessness, chest pain, irregular heartbeat
- yellowing of the skin or eyes, fever, loss of appetite, dark coloured urine
- sudden partial or complete blurring or loss of vision
- recurrent, persistent, or severe migraine
- changes in the nipple, lumps in the breast, dimpling of the skin
- golden brown pigment patched on the skin especially on the face and neck
- unusual vaginal bleeding
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Ethinylestradiol + Levonorgestrel with medicines used in hepatitis C combination therapy such as ombitasvir, paritaprevir, ritonavir, dasabuvir, glecaprevir, pibrentasvir, sofosbuvir, velpatasvir, and voxilaprevir.
Inform your doctor or pharmacist if you are taking or using any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. topiramate, felbamate, primidone, phenytoin, phenobarbital, carbamazepine, oxcarbazepine, lamotrigine
- rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
- bosentan (medicine to treat high blood pressure in the blood vessels leading to the lungs)
- medicines for HIV infection e.g. nelfinavir, efavirenz, nevirapine
- aprepitant (medicine to treat nausea and vomiting caused by chemotherapy)
- medicines for fungal infection e.g. griseofulvin, voriconazole
- ciclosporin (medicine used in organ transplant or certain immune diseases)
- tizanidine (muscle relaxant)
- theophylline (asthma medicine)
- etoricoxib (medicine for pain and inflammation)
- erythromycin (antibiotic)
- medicines for heart disease e.g. diltiazem, verapamil
- ascorbic acid (vitamin C)
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Ethinylestradiol + Levonorgestrel.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Protect from light.
Medicines must not be used past the expiry date.
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