Ovral (ethinyl estradiol/norgestrel)

Introduction

50 ug ethinyl estradiol (estrogen) plus 0.5 mg norgestrel (progestin)

Indications

• postcoital contraception (morning after pill)

* levonorgestrel 1.5 mg (One Step now advertised on WebMD) & ulipristal are used (see morning after pill)

Contraindications

pregnancy-category X

safety in lactation -

Dosage

• 2 tablets at 1st visit
• 2 tablets 12 hours later

Pharmacokinetics

elimination: liver

Adverse effects

• common (> 10%)
  • nausea, peripheral edema, breast enlargement, breast tenderness, anorexia, bloating
• not common (1-10%)
  • vomiting, diarrhea, increased libido, headache
• uncommon (< 1%)
  • intolerance to contact lenses, breast tumors, amenorrhea, alterations in mestrual flow, hypertension, thromboembolism, stroke, myocardial infarction, edema, depression, dizziness, anxiety, chloasma, melasma, rash, hyperglycemia, GI distress, increased serum triglycerides, increased LDL, cholestatic jaundice, increased susceptibility to Candida infection

• drug adverse effects of estrogens

Drug interactions

• barbiturates, carbamazepine, cyclosporine, griseofulvin, penicillins, phenytoin, rifampin, tetracyclines

• drug interaction(s) of beta-adrenergic receptor antagonists with oral contraceptives
• drug interaction(s) of NSAIDs with oral contraceptive

More general terms

• monophasic oral contraceptive
• ethinyl estradiol/norgestrel