Ethinyl Estradiol & Levonorgestrel

Levonorgestrel/ethinyl estradiol is a prescription birth control medication used to prevent pregnancy. It is a combination product that contains two hormones, levonorgestrel and ethinyl estradiol. These belong to a group of drugs called hormonal contraceptives. Hormonal contraceptives work to prevent pregnancy by stopping ovulation and by altering cervical mucus and the lining of the uterus.

This medication comes in tablet form and is taken at the same time once daily, with or without food.

Common side effects include nausea, breast tenderness, and vaginal bleeding between menstrual periods. 

Levonorgestrel/ethinyl estradiol is a prescription birth control medication used to prevent pregnancy.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

WARNING TO WOMEN WHO SMOKE

Do not take birth control pills if you:

• Smoke and are over 35 years old

• A history of heart attack or stroke
• A history of blood clots in the legs (thrombophlebitis), lungs (pulmonary embolism), or eyes
• A history of blood clots in the deep veins of your legs
• Chest pain (angina pectoris)
• Known or suspected breast cancer or cancer of the lining of the uterus, cervix, vagina, or certain hormonally-sensitive cancers
• Unexplained vaginal bleeding (until a diagnosis is reached by your healthcare provider)
• Yellowing of the whites of the eyes or of the skin (jaundice) during pregnancy or during previous use of the pill
• Liver tumor (benign or cancerous)
• Known or suspected pregnancy
• Heart valve or heart rhythm disorders that may be associated with formation of blood clots
• Diabetes affecting your circulation
• Uncontrolled high blood pressure
• Active liver disease with abnormal liver function tests
• Allergy or hypersensitivity to any of the components of this medication
• A need for surgery with prolonged bedrest

See "Inform MD" section. Tell your healthcare provider if you have ever had any of the conditions listed (your healthcare provider may recommend another method of birth control).

Birth control pills do not protect you against any sexually transmitted infection, including HIV, the virus that causes AIDS.

Like pregnancy, birth control pills increase the risk of serious blood clots, especially in women who have other risk factors, such as smoking, obesity, or age greater than 35. This increased risk is highest when you first start taking birth control pills and when you restart the same or different birth control pills after not using them for a month or more.

It is possible to die from a problem caused by a blood clot, such as a heart attack or a stroke. Some examples of serious blood clots are blood clots in the: 

• Legs (deep vein thrombosis)
• Lungs (pulmonary embolus) 
• Eyes (loss of eyesight)
• Heart (heart attack)
• Brain (stroke)

Women who take birth control pills may have a higher risk for:

• High blood pressure
• Heart attacks
• Stroke
• Gallbladder problems
• Rare cancerous or noncancerous liver tumors

All of these events are uncommon in healthy women.

If any of these adverse effects occur while you are taking oral contraceptives, call your healthcare provider immediately:

• Sharp chest pain, coughing of blood, or sudden shortness of breath (indicating a possible clot in the lung).
• Pain in the calf (indicating a possible clot in the leg).
• Crushing chest pain or heaviness in the chest (indicating a possible heart attack).
• Sudden severe headache or vomiting, dizziness or fainting, disturbances of vision or speech, weakness, or numbness in an arm or leg (indicating a possible stroke).
• Sudden partial or complete loss of vision (indicating a possible clot in the eye).
• Breast lumps (indicating possible breast cancer or fibrocystic disease of the breast; ask your doctor or healthcare provider to show you how to examine your breasts).
• Severe pain or tenderness in the stomach area (indicating a possibly ruptured liver tumor).
• Difficulty in sleeping, weakness, lack of energy, fatigue, or change in mood (possibly indicating severe depression).
• Jaundice or a yellowing of the skin or eyeballs, accompanied frequently by fever, fatigue, loss of appetite, dark-colored urine, or light-colored bowel movements (indicating possible liver problems).

The most common side effects of birth control pills are:

• Spotting or bleeding between menstrual periods
• Nausea 
• Breast tenderness
• Headache 

These side effects are usually mild and usually disappear with time.

Less common side effects are:

• Acne
• Less sexual desire
• Bloating or fluid retention
• Blotchy darkening of the skin, especially on the face 
• High blood sugar, especially in women who already have diabetes
• High fat (cholesterol, triglyceride) levels in the blood
• Depression, especially if you have had depression in the past. Call your healthcare provider immediately if you have any thoughts of harming yourself.
• Problems tolerating contact lenses
• Weight gain

This is not a complete list of possible side effects. Talk to your healthcare provider if you develop any side effects that concern you. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your healthcare provider about all medicines and herbal products that you take. Some medicines and herbal products may make birth control pills less effective, including: 

• barbiturates 
• bosentan
• carbamazepine 
• felbamate
• griseofulvin
• oxcarbazepine
• phenytoin
• rifampin 
• St. John’s wort
• topiramate

Use a back-up or alternative birth control method when you take medicines that may make birth control pills less effective.

• Birth control pills may interact with lamotrigine, an anticonvulsant used for epilepsy. This may increase the risk of seizures, so your healthcare provider may need to adjust the dose of lamotrigine.
• Women on thyroid hormone replacement therapy may need increased doses of thyroid hormone.

Birth control pills should not be taken during pregnancy. However, birth control pills taken by accident during pregnancy are not known to cause birth defects.

If you are breastfeeding, consider another birth control method until you are ready to stop breastfeeding. Birth control pills that contain estrogen, like this medication, may decrease the amount of milk you make. A small amount of the pill's hormones pass into breast milk.