What is microgestin 1 20 generic for

However, these cancers are extremely rare in the U. There have been clinical case reports of retinal thrombosis associated with the use of oral contraceptives. Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions. Appropriate diagnostic and therapeutic measures should be undertaken immediately. Extensive epidemiological studies have revealed no increased risk of birth defects in women who have used oral contraceptives prior to pregnancy Studies also do not suggest a teratogenic effect, particularly insofar as cardiac anomalies and limb reduction defects are concerned 61,62,64,65 , when taken inadvertently during early pregnancy.

The administration of oral contraceptives to induce withdrawal bleeding should not be used as a test for pregnancy. Oral contraceptives should not be used during pregnancy to treat threatened or habitual abortion.

It is recommended that for any patient who has missed two consecutive periods, pregnancy should be ruled out before continuing oral contraceptive use.

If the patient has not adhered to the prescribed schedule, the possibility of pregnancy should be considered at the time of the first missed period. Oral contraceptive use should be discontinued if pregnancy is confirmed. Earlier studies have reported an increased lifetime relative risk of gallbladder surgery in users of oral contraceptives and estrogens 66, More recent studies, however, have shown that the relative risk of developing gallbladder disease among oral contraceptive users may be minimal The recent findings of minimal risk may be related to the use of oral contraceptive formulations containing lower hormonal doses of estrogens and progestogens.

Oral contraceptives have been shown to cause glucose intolerance in a significant percentage of users Oral contraceptives containing greater than 75 mcg of estrogens cause hyperinsulinism, while lower doses of estrogen cause less glucose intolerance Progestogens increase insulin secretion and create insulin resistance, this effect varying with different progestational agents 23, However, in the non-diabetic woman, oral contraceptives appear to have no effect on fasting blood glucose Because of these demonstrated effects, prediabetic and diabetic women should be carefully observed while taking oral contraceptives.

A small proportion of women will have persistent hypertriglyceridemia while on the pill. An increase in blood pressure has been reported in women taking oral contraceptives 74 and this increase is more likely in older oral contraceptive users 75 and with continued use Data from the Royal College of General Practitioners 18 and subsequent randomized trials have shown that the incidence of hypertension increases with increasing concentrations of progestogens.

Women with a history of hypertension or hypertension-related diseases or renal disease 76 should be encouraged to use another method of contraception. If women elect to use oral contraceptives, they should be monitored closely, and if significant elevation of blood pressure occurs, oral contraceptives should be discontinued.

For most women, elevated blood pressure will return to normal after stopping oral contraceptives 75 , and there is no difference in the occurrence of hypertension among ever and never users. The onset or exacerbation of migraine or development of headache with a new pattern which is recurrent, persistent, or severe requires discontinuation of oral contraceptives and evaluation of the cause.

Breakthrough bleeding and spotting are sometimes encountered in patients on oral contraceptives, especially during the first three months of use. Non-hormonal causes should be considered, and adequate diagnostic measures taken to rule out malignancy or pregnancy in the event of breakthrough bleeding, as in the case of any abnormal vaginal bleeding.

If pathology has been excluded, time or a change to another formulation may solve the problem. In the event of amenorrhea, pregnancy should be ruled out. Some women may encounter post-pill amenorrhea or oligomenorrhea, especially when such a condition was preexistent. It is good medical practice for all women to have annual history and physical examinations, including women using oral contraceptives.

The physical examination, however, may be deferred until after initiation of oral contraceptives if requested by the woman and judged appropriate by the clinician.

The physical examination should include special reference to blood pressure, breasts, abdomen and pelvic organs, including cervical cytology, and relevant laboratory tests.

In case of undiagnosed, persistent or recurrent abnormal vaginal bleeding, appropriate measures should be conducted to rule out malignancy. Women with a strong family history of breast cancer or who have breast nodules should be monitored with particular care.

Women who are being treated for hyperlipidemia should be followed closely if they elect to use oral contraceptives. Some progestogens may elevate LDL levels and may render the control of hyperlipidemias more difficult. If jaundice develops in any woman receiving such drugs, the medication should be discontinued.

Steroid hormones may be poorly metabolized in patients with impaired liver function. Oral contraceptives may cause some degree of fluid retention. They should be prescribed with caution, and only with careful monitoring, in patients with conditions which might be aggravated by fluid retention.

Women with a history of depression should be carefully observed and the drug discontinued if depression recurs to a serious degree. Contact lens wearers who develop visual changes or changes in lens tolerance should be assessed by an ophthalmologist.

Effects of Other Drugs on Oral Contraceptives 78 Rifampin: Metabolism of both norethindrone and ethinyl estradiol is increased by rifampin. A reduction in contraceptive effectiveness and increased incidence of breakthrough bleeding and menstrual irregularities have been associated with concomitant use of rifampin. Antibiotics: Pregnancy while taking oral contraceptives has been reported when the oral contraceptives were administered with antimicrobials such as ampicillin, tetracycline, and griseofulvin.

However, clinical pharmacokinetic studies have not demonstrated any consistent effect of antibiotics other than rifampin on plasma concentrations of synthetic steroids. Other: Ascorbic acid and acetaminophen may increase plasma ethinyl estradiol concentrations, possibly by inhibition of conjugation. A reduction in contraceptive effectiveness and increased incidence of breakthrough bleeding has been suggested with phenylbutazone. Oral contraceptive combinations containing ethinyl estradiol may inhibit the metabolism of other compounds.

Increased plasma concentrations of cyclosporine, prednisolone, and theophylline have been reported with concomitant administration of oral contraceptives. In addition, oral contraceptives may induce the conjugation of other compounds. Decreased plasma concentrations of acetaminophen and increased clearance of temazepam, salicylic acid, morphine, and clofibric acid have been noted when these drugs were administered with oral contraceptives.

Certain endocrine and liver function tests and blood components may be affected by oral contraceptives:. Increased thyroid binding globulin TBG leading to increased circulating total thyroid hormone, as measured by protein-bound iodine PBI , T 4 by column or by radioimmunoassay. Free T 3 resin uptake is decreased, reflecting the elevated TBG; free T 4 concentration is unaltered.

Sex-binding globulins are increased and result in elevated levels of total circulating sex steroids and corticoids; however, free or biologically active levels remain unchanged. Serum folate levels may be depressed by oral contraceptive therapy. This may be of clinical significance if a woman becomes pregnant shortly after discontinuing oral contraceptives. Small amounts of oral contraceptive steroids have been identified in the milk of nursing mothers, and a few adverse effects on the child have been reported, including jaundice and breast enlargement.

In addition, oral contraceptives given in the postpartum period may interfere with lactation by decreasing the quantity and quality of breast milk. If possible, the nursing mother should be advised not to use oral contraceptives but to use other forms of contraception until she has completely weaned her child. Safety and efficacy are expected to be the same for postpubertal adolescents under the age of 16 and for users 16 years and older.

Use of this product before menarche is not indicated. See patient labeling printed below. There is evidence of an association between the following conditions and the use of oral contraceptives, although additional confirmatory studies are needed:.

The following adverse reactions have been reported in patients receiving oral contraceptives and are believed to be drug-related:. The following adverse reactions have been reported in users of oral contraceptives and the association has been neither confirmed nor refuted:. Serious ill effects have not been reported following acute ingestion of large doses of oral contraceptives by young children. Overdosage may cause nausea, and withdrawal bleeding may occur in females.

The following non-contraceptive health benefits related to the use of oral contraceptives are supported by epidemiological studies which largely utilized oral contraceptive formulations containing estrogen doses exceeding 0.

The tablet dispenser has been designed to make oral contraceptive dosing as easy and as convenient as possible. The tablets are arranged in either three or four rows of seven tablets each, with the days of the week appearing on the tablet dispenser above the first row of tablets. Note: Each tablet dispenser has been preprinted with the days of the week, starting with Sunday, to facilitate a Sunday-Start regimen.

If the patient is using the Day-1 Start regimen, she should place the self-adhesive day label strip that corresponds to her starting day over the preprinted days. Important: The patient should be instructed to use an additional method of protection until after the first week of administration in the initial cycle when utilizing the Sunday-Start regimen. Two dosage regimens are described, one of which may be more convenient or suitable than the other for an individual patient.

For the initial cycle of therapy, the patient begins her tablets according to the Day-1 Start or Sunday-Start regimen.

With either regimen, the patient takes one tablet daily for 21 consecutive days followed by one week of no tablets. Sunday-Start Regimen: The patient begins taking tablets from the top row on the first Sunday after menstrual flow begins. When menstrual flow begins on Sunday, the first tablet is taken on the same day.

The last tablet in the dispenser will then be taken on a Saturday, followed by no tablets for a week 7 days. For all subsequent cycles, the patient then begins a new tablet regimen on the eighth day, Sunday, after taking her last tablet. Following this regimen, of 21 days on—7 days off, the patient will start all subsequent cycles on a Sunday.

Day-1 Regimen: The first day of menstrual flow is Day 1. The patient places the self-adhesive day label strip that corresponds to her starting day over the preprinted days on the tablet dispenser.

She starts taking one tablet daily, beginning with the first tablet in the top row. The patient completes her tablet regimen when she has taken the last tablet in the tablet dispenser. She will then take no tablets for a week 7 days. For all subsequent cycles, the patient begins a new tablet regimen on the eighth day after taking her last tablet, again starting with the first tablet in the top row after placing the appropriate day label strip over the preprinted days on the tablet dispenser.

Following this regimen of 21 days on—7 days off, the patient will start all subsequent cycles on the same day of the week as the first course. Likewise, the interval of no tablets will always start on the same day of the week. Tablets should be taken regularly with a meal or at bedtime.

It should be stressed that efficacy of medication depends on strict adherence to the dosage schedule. Special Notes on Administration Menstruation usually begins two or three days, but may begin as late as the fourth or fifth day, after discontinuing medication. If spotting occurs while on the usual regimen of one tablet daily, the patient should continue medication without interruption.

Two consecutive tablets are missed week 3 Sunday-Start Regimen:. The possibility of ovulation occurring increases with each successive day that scheduled tablets are missed.

While there is little likelihood of ovulation occurring if only one tablet is missed, the possibility of spotting or bleeding is increased. This is particularly likely to occur if two or more consecutive tablets are missed. In the rare case of bleeding which resembles menstruation, the patient should be advised to discontinue medication and then begin taking tablets from a new tablet dispenser on the next Sunday or the first day Day 1 , depending on her regimen.

Persistent bleeding which is not controlled by this method indicates the need for reexamination of the patient, at which time nonfunctional causes should be considered.

The ferrous fumarate tablets are present to facilitate ease of drug administration via a day regimen and do not serve any therapeutic purpose.

There is no need for the patient to count days between cycles because there are no "off-tablet days. Sunday-Start Regimen: The patient begins taking the first light-colored tablet from the top row of the dispenser labeled Sunday on the first Sunday after menstrual flow begins. When the menstrual flow begins on Sunday, the first light-colored tablet is taken on the same day. The patient takes one light-colored tablet daily for 21 days.

The last light-colored tablet in the dispenser will be taken on a Saturday. Upon completion of all 21 light-colored tablets, and without interruption, the patient takes one brown tablet daily for 7 days. Upon completion of this first course of tablets, the patient begins a second course of day tablets, without interruption, the next day Sunday , starting with the Sunday light-colored tablet in the top row.

Adhering to this regimen of one light-colored tablet daily for 21 days, followed without interruption by one brown tablet daily for seven days, the patient will start all subsequent cycles on a Sunday. Day-1 Start Regimen: The first day of menstrual flow is Day 1. She starts taking one light-colored tablet daily, beginning with the first light-colored tablet in the top row.

After the last light-colored tablet at the end of the third row has been taken, the patient will then take the brown tablets for a week 7 days. For all subsequent cycles, the patient begins a new 28 tablet regimen on the eighth day after taking her last light-colored tablet, again starting with the first tablet in the top row after placing the appropriate day label strip over the preprinted days on the tablet dispenser.

Following this regimen of 21 light-colored tablets and 7 brown tablets, the patient will start all subsequent cycles on the same day of the week as the first course. Special Notes on Administration Menstruation usually begins two or three days, but may begin as late as the fourth or fifth day, after the brown tablets have been started. In any event, the next course of tablets should be started without interruption. If spotting occurs while the patient is taking light-colored tablets, continue medication without interruption.

If the patient forgets to take one or more light-colored tablets, the following is suggested:. The possibility of ovulation occurring increases with each successive day that scheduled light-colored tablets are missed. While there is little likelihood of ovulation occurring if only one light-colored tablet is missed, the possibility of spotting or bleeding is increased.

This is particularly likely to occur if two or more consecutive light-colored tablets are missed. If the patient forgets to take any of the seven brown tablets in week four, those brown tablets that were missed are discarded and one brown tablet is taken each day until the pack is empty.

A back-up birth control method is not required during this time. A new pack of tablets should be started no later than the eighth day after the last light-colored tablet was taken.

In the rare case of bleeding which resembles menstruation, the patient should be advised to discontinue medication and then begin taking tablets from a new tablet dispenser on the next Sunday or the first day Day-1 , depending on her regimen. If the patient has not adhered to the prescribed dosage regimen, the possibility of pregnancy should be considered after the first missed period and oral contraceptives should be withheld until pregnancy has been ruled out.

If the patient has adhered to the prescribed regimen and misses two consecutive periods, pregnancy should be ruled out before continuing the contraceptive regimen. After several months on treatment, bleeding may be reduced to a point of virtual absence. This reduced flow may occur as a result of medication, in which event it is not indicative of pregnancy. Available in packages of 6 dispensers. Each tablet contains 1. Each green tablet contains 1.

Single-dose kinetics. Clin Pharmacol Ther ; Contraception ; An investigation of the pharmacokinetics of ethynylestradiol in women using radioimmunoassay. Contraception ; Distribution and percentages of non-protein bound contraceptive steroids in human serum. J Steriod Biochem ; Fotherby K. Goldzieher JW. Hatcher RA, et al. Contraceptive Technology, Seventeenth Edition. New York: Irvington Publishers.

Stadel, B. New England Journal of Medicine , , Adam, S. Thorogood: Oral contraception and myocardial infarction revisited: The effects of new preparations and prescribing patterns. Mann, J. Inman: Oral contraceptives and death from myocardial infarction.

Vessey, M. Thorogood, and R. Doll: Myocardial infarction in young women with special reference to oral contraceptive practice. Lancet , , Slone, D. Shapiro, D.

Kaufman, L. Rosenberg, O. Miettinen, and P. Stolley: Risk of myocardial infarction in relation to current and discontinued use of oral contraceptives. Russell-Briefel, R. Ezzati, R. Fulwood, J. Perlman, and R. Murphy: Cardiovascular risk status and oral contraceptive use, United States, Preventive Medicine , , Goldbaum, G.

Kendrick, G. Hogelin, and E. Gentry: The relative impact of smoking and oral contraceptive use on women in the United States. Layde, P. Table 5 Lancet , , Knopp, R. Krauss, R. Roy, D. Mishell, J. Casagrande, and M. Increased risk of gallbladder disease, thromboembolic disorders. Adult Dosage: day products: 1 tab daily for 28 days; repeat. Children Dosage: Not applicable.

Boxed Warning: Cigarette smoking increases risk of serious cardiovascular events. Adverse Reactions: Hypertension, nausea, vomiting, breakthrough bleeding, amenorrhea, transient delay of ovulation after discontinuation, edema, chloasma, mastodynia, headache, intolerance to contact lenses. Enter Zip Code GoodRx. Each pack contains:. Most side effects of Junel Fe and Microgestin Fe are mild and often go away after a few weeks.

Others may be more serious and can require medical care. If you're still struggling with any mild side effects after you've been on Junel Fe or Microgestin for three months, another birth control brand or method may be a better fit. Talk to your doctor about your options. Our doctors are available to reassess and write a new prescription at any time at no cost to you —thanks to our Complete Care plan.

If you experience any of the serious side effects above, contact a doctor immediately. We make getting birth control easy, affordable and way less of a hassle than it's ever been. Your period will usually begin while you are using these reminder pills. You may have breakthrough bleeding, especially during the first 3 months.

Tell your doctor if this bleeding continues or is very heavy. If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you should know that you are using ethinyl estradiol and norethindrone. Follow the patient instructions provided with your medicine. Missing a pill increases your risk of becoming pregnant. If you miss 1 active pill, take 2 pills on the day you remember.

Then take 1 pill per day for the rest of the pack. If you miss 2 active pills in a row in Week 1 or 2, take 2 pills per day for 2 days in a row. Use back-up birth control for at least 7 days following the missed pills.

If you miss 2 active pills in a row in Week 3, throw out the rest of the pack and start a new pack the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that day. If you miss 3 active pills in a row in Week 1, 2, or 3 , throw out the rest of the pack and start a new pack on the same day if you are a Day 1 starter. If you miss 2 or more active pills, you may not have a period during the month.