Levonorgestrel/Ethinyl Estradiol (By Mouth)
Ethinyl Estradiol (ETH-in-il es-tra-DYE-ole), Levonorgestrel (LEE-voe-nor-jes-trel)
Used to prevent pregnancy. This medicine is an oral contraceptive (birth control pill).
Aviane, Trivora-28, Alesse 28, Triphasil-21, Triphasil-28, Levora-28, Tri-Levlen, Nordette-28, Nordette-21, Enpresse-28, Levlite 28, Lessina 28, Levlen, Portia-28, Preven Emergency Contraceptive
There may be other brand names for this medicine.
When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to levonorgestrel or ethinyl estradiol, or if you are pregnant. Do not use this medicine if you have heart disease or related problems such as angina (chest pain), a blood vessel disorder, problems with your heart valves, or uncontrolled high blood pressure. If you have liver disease, diabetes, unusual vaginal bleeding, or headaches, make sure your doctor knows about these problems before you use this medicine. You should not use this medicine if you have breast cancer, liver cancer, or cancer of the uterus. Do not use this medicine if you have ever had a stroke, problems with blood clots, or jaundice (yellow skin or eyes) caused by pregnancy or birth control pills.
How to Use This Medicine:
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
- The schedule you follow for taking this medicine is different from the schedule for most other birth control pills. You will take active pills for 84 days in a row before you have a menstrual period. Your period will start during the 7 days you are taking the white inactive pills. This different schedule means you will have periods less often (about four times a year).
- Unless your doctor tells you to use a different schedule, start taking this medicine on the first Sunday after your menstrual period starts. If your period starts on a Sunday, start taking this medicine on that day. Then continue taking one pill each day in the order they appear in the package.
- The first time you use Seasonalereg;, you will need to use a second kind of birth control in addition to Seasonalereg; for the first seven days. Any time you miss taking your pills for two days or longer, you will need to use a second kind of birth control. Some other kinds of birth control include condoms, a diaphragm, or contraceptive foam or jelly.
- It is best to take your pill at the same time every day. Birth control pills work best when there is no more than 24 hours between doses. It is very important that you take this medicine on schedule every day.
If a dose is missed:
- If you miss one active pill, take it as soon as you can. Then take your next pill at the regular time. This means you may take two pills in one day.
- If you miss two active pills, take two pills as soon as you can. Then take two pills on the next day. Then go back to your regular schedule of taking one pill every day. Use another kind of birth control until you have been taking active pills for seven days in a row.
- If you miss three or more active pills, do not take the pills you missed. Go back to taking one pill every day, starting with the pill for the day you remember. For example, you may forget or miss taking your pills on Monday, Tuesday, and Wednesday. If this happens, take your Thursday pill (do not take the three you missed) and continue with your regular schedule. Use another kind of birth control until you have been taking active pills for seven days in a row.
- You could have light bleeding or spotting any time you do not take a pill on schedule. The more pills you miss, the more likely you are to have bleeding.
- If you miss any white inactive pills, throw away the missed pills and go back to your regular schedule.
How to Store and Dispose of This Medicine:
- Store the medicine at room temperature in the original container, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using St. John’s wort, rifampin (Rifadinreg;, Rifamatereg;), prednisolone, theophylline (Theo-Durreg;), temazepam (Restorilreg;), aspirin, morphine (MS Continreg;), clofibrate (Atromid-Sreg;), cyclosporine (Neoralreg;), seizure medicine (such as felbamate, phenobarbital, Dilantinreg;, Felbatolreg;, Tegretolreg;, Topamaxreg;, Trileptalreg;), medicines to treat HIV/AIDS (such as Agenerasereg;, Crixivanreg;, Invirasereg;, Norvirreg;, Viraceptreg;), or antibiotics (such as ampicillin, griseofulvin, tetracycline).
Warnings While Using This Medicine:
- Make sure your doctor knows if you are breast feeding, or if you have heart disease, high blood pressure, blood clotting problems, or High cholesterol or triglycerides in your blood. If you have migraine headaches, diabetes, or a history of depression, tell your doctor. People who have kidney disease or liver disease may need a different dose of medicine, so inform your doctor if needed. Make sure your doctor knows if you have breast lumps (nodules) or a family history of breast cancer, or if you have recently been pregnant.
- Very rarely, this medicine can cause serious side effects such as heart attack or stroke. You are much more likely to have these side effects if you smoke cigarettes, are overweight, are over 40 years old, or have certain health problems. Some health problems that might increase your risk of serious side effects are having diabetes, high blood pressure, or a family history of blood clotting problems or high blood cholesterol. Talk with your doctor if you think you might be at risk.
- You might have some light bleeding or spotting when you first start using this medicine. This is usually normal and should not last long. This bleeding is more common in women who use Seasonalereg; than women who use other kinds of birth control pills. However, if you have heavy bleeding or the bleeding lasts more than seven days in a row, call your doctor’s office. You should not have a “normal” menstrual period until you start taking the white inactive pills. The inactive pills are the last seven pills in your package.
- Call your doctor for a pregnancy test if your menstrual period does not start while you are taking the white inactive pills (the last seven pills).
- If you have vomiting or diarrhea, you might need to use another kind of birth control for a few days. Ask your doctor, nurse, or other health caregiver.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.Also, you may need to stop using this medicine for a few weeks before and after having surgery, or if you will be on bed-rest or otherwise inactive.
- Your doctor will need to check your progress at regular visits while you are using this medicine. These check-ups are usually every six months to one year. Be sure to keep all appointments.
- This medicine will not protect you from getting HIV, AIDS, or other sexually transmitted diseases. If this is a concern for you, talk with your doctor.
Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Breast lump
- Changes in vision, or bulging eyeballs
- Depression or other emotional changes
- Heavy vaginal bleeding or missed or late period
- Spotting for more than 7 consecutive days while taking the pink (active) pills
- Pain in your chest, lower leg (calf), or stomach
- Severe or unusual headache
- Sudden chest pain or trouble breathing
- Swelling in your hands, feet, or ankles
- Yellow skin or eyes
- Pain in upper stomach
If you notice these less serious side effects, talk with your doctor:
- Breast tenderness
- Nausea, vomiting
- Trouble wearing contact lenses
- Weight gain
Revision date: June 22, 2011
Last revised: by Dave R. Roger, M.D.
Drugs & Medications
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
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