levonorgestrel/ ethinyl estradiol

Adult Dosing .

Dosage forms:  20 mcg EE 28-day monophasic pack; 20 mcg EE 28-day continuous monophasic pack; 30 mcg EE 28-day monophasic pack; 30 mcg EE 91-day monophasic pack; 20 mcg EE 91-day biphasic pack; 30 mcg EE 91-day biphasic pack; 28-day triphasic pack; 91-day quadriphasic pack

Dosage Form Details

[20 mcg EE 28-day monophasic pack]

Info: 0.1 mg/20 mcg x21 and inert tab x7

[20 mcg EE 28-day continuous monophasic pack]

Info: 0.09 mg/20 mcg x28

[30 mcg EE 28-day monophasic pack]

Info: 0.15 mg/30 mcg x21 and inert tab x7

[30 mcg EE 91-day monophasic pack]

Info: 0.15 mg/30 mcg x84 and inert tab x7

[20 mcg EE 91-day biphasic pack]

Info: 0.1 mg/20 mcg x84 and 0 mg/10 mcg x7

[30 mcg EE 91-day biphasic pack]

Info: 0.15 mg/30 mcg x84 and 0 mg/10 mcg x7

[28-day triphasic pack]

Info: 0.05 mg/30 mcg x6, 0.075 mg/40 mcg x5, 0.125 mg/30 mcg x10, and inert tab x7

[91-day quadriphasic pack]

Info: 0.15 mg/20 mcg x42, 0.15 mg/25 mcg x21, 0.15 mg/30 mcg x21, and 0 mg/10 mcg x7

Special Note

[additional info]

Info: see Oral Contraceptive Pill (OCP) Hormonal Activity and Therapeutic Equivalence table

contraception

[28-day monophasic or triphasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

dysfunctional uterine bleeding, moderate (off-label)

[30 mcg EE monophasic pack, acute phase]

Dose: 1 tab PO bid x5-7 days, then 1 tab PO qd until all active tabs given in 1 pack, skip inert tabs; Alt: 1 tab PO tid x3 days or until bleeding subsides, then 1 tab PO bid x3-5 days, then 1 tab PO qd until all active tabs given in 1 pack, skip inert tabs

[30 mcg EE monophasic pack, maintenance phase]

Dose: 1 tab PO qd; Info: may skip inert tabs for continuous cycle; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

dysmenorrhea (off-label)

[28-day monophasic or triphasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: may skip inert tabs for extended or continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: may skip inert tabs for continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

emergency contraception (off-label)

[20 mcg EE monophasic, biphasic, or quadriphasic pack]

Dose: 5 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: use levonorgestrel/ethinyl estradiol 0.1 mg/20 mcg tabs or 0.15 mg/20 mcg tabs; repeat dose if vomiting occurs w/in 3h

[20 mcg EE continuous monophasic pack]

Dose: 6 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: repeat dose if vomiting occurs w/in 3h

[25 mcg or 30 mcg EE-containing pack]

Dose: 4 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: use levonorgestrel/ethinyl estradiol 0.15 mg/25 mcg, 0.125 mg/30 mcg, or 0.15 mg/30 mcg tabs; repeat dose if vomiting occurs w/in 3h

endometriosis (off-label)

[28-day monophasic or triphasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: may skip inert tabs for extended or continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: may skip inert tabs for continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

renal dosing

[see below]

renal dz: not defined, caution advised

HD/PD: avoid use

hepatic dosing

[see below]

active hepatic dz: contraindicated

Peds Dosing .

Dosage forms:  20 mcg EE 28-day monophasic pack; 20 mcg EE 28-day continuous monophasic pack; 30 mcg EE 28-day monophasic pack; 30 mcg EE 91-day monophasic pack; 20 mcg EE 91-day biphasic pack; 30 mcg EE 91-day biphasic pack; 28-day triphasic pack; 91-day quadriphasic pack

Dosage Form Details

[20 mcg EE 28-day monophasic pack]

Info: 0.1 mg/20 mcg x21 and inert tab x7

[20 mcg EE 28-day continuous monophasic pack]

Info: 0.09 mg/20 mcg x28

[30 mcg EE 28-day monophasic pack]

Info: 0.15 mg/30 mcg x21 and inert tab x7

[30 mcg EE 91-day monophasic pack]

Info: 0.15 mg/30 mcg x84 and inert tab x7

[20 mcg EE 91-day biphasic pack]

Info: 0.1 mg/20 mcg x84 and 0 mg/10 mcg x7

[30 mcg EE 91-day biphasic pack]

Info: 0.15 mg/30 mcg x84 and 0 mg/10 mcg x7

[28-day triphasic pack]

Info: 0.05 mg/30 mcg x6, 0.075 mg/40 mcg x5, 0.125 mg/30 mcg x10, and inert tab x7

[91-day quadriphasic pack]

Info: 0.15 mg/20 mcg x42, 0.15 mg/25 mcg x21, 0.15 mg/30 mcg x21, and 0 mg/10 mcg x7

Special Note

[additional info]

Info: see Oral Contraceptive Pill (OCP) Hormonal Activity and Therapeutic Equivalence table

contraception

[28-day monophasic or triphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

dysfunctional uterine bleeding, moderate (off-label)

[30 mcg EE monophasic pack, acute phase, postmenarchal patients]

Dose: 1 tab PO bid x5-7 days, then 1 tab PO qd until all active tabs given in 1 pack, skip inert tabs; Alt: 1 tab PO tid x3 days or until bleeding subsides, then 1 tab PO bid x3-5 days, then 1 tab PO qd until all active tabs given in 1 pack, skip inert tabs

[30 mcg EE monophasic pack, maintenance phase, postmenarchal patients]

Dose: 1 tab PO qd; Info: may skip inert tabs for continuous cycle; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

dysmenorrhea (off-label)

[28-day monophasic or triphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: may skip inert tabs for extended or continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: may skip inert tabs for continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

emergency contraception (off-label)

[20 mcg EE monophasic, biphasic, or quadriphasic pack, postmenarchal patients]

Dose: 5 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: use levonorgestrel/ethinyl estradiol 0.1 mg/20 mcg tabs or 0.15 mg/20 mcg tabs; repeat dose if vomiting occurs w/in 3h

[20 mcg EE continuous monophasic pack, postmenarchal patients]

Dose: 6 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: repeat dose if vomiting occurs w/in 3h

[25 mcg or 30 mcg EE-containing pack, postmenarchal patients]

Dose: 4 tabs PO q12h x2 doses; Start: ASAP after unprotected intercourse; maximum efficacy w/in 72h, moderate efficacy w/in 120h; Info: use levonorgestrel/ethinyl estradiol 0.15 mg/25 mcg, 0.125 mg/30 mcg, or 0.15 mg/30 mcg tabs; repeat dose if vomiting occurs w/in 3h

endometriosis (off-label)

[28-day monophasic or triphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle or 1st Sunday after onset of menses; Info: may skip inert tabs for extended or continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[28-day continuous monophasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: day 1 of menstrual cycle; Info: D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

[91-day monophasic, biphasic, or quadriphasic pack, postmenarchal patients]

Dose: 1 tab PO qd; Start: 1st Sunday after onset of menses; Info: may skip inert tabs for continuous cycle if pain persists; D/C >4wk before, restart >2wk after surgery w/ VTE risk; restart >4wk postpartum or >6wk postpartum if breastfeeding

renal dosing

[see below]

renal dz: not defined, caution advised

HD/PD: avoid use

hepatic dosing

[see below]

active hepatic dz: contraindicated