BNF for Children (BNFC) 2018-2019

eiiiiF 498

Ethinylestradiol with levonorgestrel

lINDICATIONS AND DOSE Contraception with 21 -day combined preparations| Menstrual symptoms with 21 -day combined preparations ▶BY MOUTH ▶Females of childbearing potential: 1 tablet once daily for 21 days; subsequent courses repeated after 7 -day interval, withdrawal bleeding occurs during the 7 -day interval, if reasonably certain woman is not pregnant, first course can be started on any day of cycle—if starting on day 6 of cycle or later, additional precautions (barrier methods) necessary duringfirst 7 days, tablets should be taken at approximately the same time each day Contraception with 28 -day combined preparations| Menstrual symptoms with 28 -day combined preparations ▶BY MOUTH ▶Females of childbearing potential: 1 active tablet once daily for 21 days, followed by 1 inactive tablet once daily for 7 days, withdrawal bleeding occurs during the 7 -day interval ofinactivetablets being taken, if reasonably certain woman is not pregnant,first course can be started on any day of cycle—if starting on day 6 of cycle or later, additional precautions (barrier methods) necessary duringfirst 7 days, tablets should be taken at approximately the same time each day. Subsequent courses repeated without interval

lUNLICENSED USEConsult product literature for the
licensing status of individual preparations.

lINTERACTIONS→Appendix 1 : combined hormonal
contraceptives

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Tablet
▶Ethinylestradiol with levonorgestrel (Non-proprietary)
Ethinylestradiol 30 microgram, Levonorgestrel
50 microgramEthinylestradiol 30 microgram / Levonorgestrel
50 microgram tablets| 6 tabletPs
▶Elevin(MedRx Licences Ltd)
150 microgramElevin 150 microgram/ 30 microgram tablets|
63 tabletP£ 29. 25 DT = £ 2. 82
▶Erlibelle(Actavis UK Ltd)
150 microgramErlibelle 30 microgram/ 150 microgram tablets|
63 tabletP£ 2. 82 DT = £ 2. 82
▶Leandra(Genesis Pharmaceuticals Ltd)
150 microgramLeandra 30 microgram/ 150 microgram tablets|
63 tabletP£ 2. 82 DT = £ 2. 82
▶Levest(Morningside Healthcare Ltd)
150 microgramLevest 150 / 30 tablets| 21 tabletP£ 0. 85
(Hospital only)| 63 tabletP£ 1. 80 DT = £ 2. 82
▶Maexeni(Lupin Healthcare (UK) Ltd)
150 microgramMaexeni 150 microgram/ 30 microgram tablets|
63 tabletP£ 1. 88 DT = £ 2. 82
▶Microgynon 30 (Bayer Plc)
150 microgramMicrogynon 30 tablets| 63 tabletP£ 2. 82 DT =
£ 2. 82

▶Ovranette(Pfizer Ltd) Ethinylestradiol 30 microgram, Levonorgestrel 150 microgramOvranette 150 microgram/ 30 microgram tablets| 63 tabletP£ 2. 20 DT = £ 2. 82 ▶Rigevidon(Consilient Health Ltd) Ethinylestradiol 30 microgram, Levonorgestrel 150 microgramRigevidon tablets| 63 tabletP£ 1. 89 DT = £ 2. 82

eiiiiF 498

Ethinylestradiol with norelgestromin

lINDICATIONS AND DOSE Contraception|Menstrual symptoms ▶BY TRANSDERMAL APPLICATION ▶Females of childbearing potential:Apply 1 patch once weekly for 3 weeks, applyfirst patch on day 1 of cycle, change patch on days 8 and 15 ; remove third patch on day 22 and apply new patch after 7 -day patch-free interval to start subsequent contraceptive cycle, subsequent courses repeated after a 7 -day patch free interval (during which withdrawal bleeding occurs)

lUNLICENSED USEConsult product literature for the licensing status of individual preparations. lINTERACTIONS→Appendix 1 : combined hormonal contraceptives lSIDE-EFFECTS ▶Common or very commonAnxiety.breast abnormalities. diarrhoea.dizziness.fatigue.gastrointestinal discomfort. increased risk of infection.malaise.mood altered.muscle spasms.skin reactions.uterine cramps.vaginal haemorrhage.vomiting.vulvovaginal disorders ▶UncommonAppetite increased.dyslipidaemia.insomnia. lactation disorders.oedema.photosensitivity reaction. sexual dysfunction ▶Rare or very rareEmbolism and thrombosis.gallbladder disorders.genital discharge.neoplasms.stroke.swelling ▶Frequency not knownAnger.angioedema.cervical dysplasia.colitis.contact lens intolerance.erythema nodosum.hepatic disorders.hyperglycaemia. hypertensive crisis.intracranial haemorrhage.myocardial infarction.pulmonary artery thrombosis.taste altered lDIRECTIONS FOR ADMINISTRATIONAdhesives or bandages should not be used to hold patch in place. If no longer sticky do not reapply but use a new patch. Changing to a transdermal combined hormonal contraceptive Changing from combined oral contraceptionApply patch on thefirst day of withdrawal bleeding; if no withdrawal bleeding within 5 days of taking lastactive tablet, rule out pregnancy before applyingfirst patch. Unless patch is applied onfirst day of withdrawal bleeding, additional precautions (barrier methods) should be used concurrently forfirst 7 days. Changing from progestogen-only method .from an implant, applyfirst patch on the day implant removed .from an injection, applyfirst patch when next injection due .from oral progestogen,first patch may be applied on any day after stopping pill For all methods additional precautions (barrier methods) should be used concurrently forfirst 7 days. After childbirth (not breast-feeding)Start 4 weeks after birth; if started later than 4 weeks after birth additional precautions (barrier methods) should be used forfirst 7 days. After abortion or miscarriageBefore 20 weeks’ gestation start immediately; no additional contraception required if started immediately. After 20 weeks’gestation start on day 21 after abortion or on thefirst day offirst spontaneous menstruation; additional precautions (barrier

BNFC 2018 – 2019 Contraception, combined 503

Genito-urinary system

7

BNF for Children (BNFC) 2018-2019

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