AdultPediatricDosage Forms and Strengths levonorgestrel oral/ethinylestradiol/ferrous bisglycinate tablet, monophasic 0.1mg/0.02mcg (21 tabs) plus 36.5mg ferrous bisglycinate (7 tabs) Oral Contraception Indicated for use by females of reproductive potential to prevent pregnancy Follow manufacturer's color-coding for sequence 1 active tab PO qDay for 21 days, then 1 Fe tab PO qDay on Days 22-28 Take tablets in the order directed on the blister pack Also see Administration Dosage Modifications Drug interactions Drugs or herbal products that may decrease the effectiveness of hormonal contraceptives (eg, phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, products containing St. John’s wort): Use an alternative method of contraception or a back-up method and continue backup contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability Coadministration with colesevelam: Separate doses by 4 hr Discontinue levonorgestrel oral/ethinylestradiol/ferrous bisglycinate prior to starting therapy with the combination drug regimen ombitasvir/paritaprevir/ritonavir, with or without dasabuvir; restart therapy ~2 weeks following completion of hepatitis C treatment (see Contraindications) Also see Warnings Discontinue if these adverse reactions occurs Arterial thrombotic event or venous thromboembolic event occurs Unexplained loss of vision, proptosis, diplopia, papilledema, or retinal vascular lesions occurs Jaundice develops Hepatic impairment Pharmacokinetics of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate have not been studied in women with hepatic impairment Steroid hormones may be poorly metabolized in patients with hepatic impairment See Contraindications and Warnings Dosing Considerations Switching to levonorgestrel oral/ethinylestradiol/ferrous bisglycinate from another contraceptive method Transdermal patch: Start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate on the next scheduled application Vaginal ring: Start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate on the day when next insertion would have been scheduled Injection: Start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate on the day when next injection would have been scheduled Intrauterine contraceptive (IUD): Start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate on the day of removal; if IUD is not removed on first day of the patient’s menstrual cycle, additional nonhormonal contraceptive (eg, condoms, spermicide) is needed for the first 7 days of the first cycle pack Implant: Start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate on the day of removal After abortion or miscarriage during first trimester After a first-trimester abortion or miscarriage, start levonorgestrel oral/ethinylestradiol/ferrous bisglycinate immediately Initiating within 5 days after pregnancy termination: No additional method of contraception is needed Initiating >5 days after termination of pregnancy: Additional nonhormonal contraception (eg, condoms, spermicide) required for the first 7 days of first cycle pack Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to increased risk of thromboembolic disease; start therapy following instructions for Day 1 or Sunday start, as desired; if using Sunday start, use additional non-hormonal contraception (such as condoms or spermicide) for first seven days of patient’s first cycle pack of contraceptive therapy After childbirth Do not start until 4 weeks after delivery owing to increased risk of thromboembolic disease Start contraceptive therapy following instructions for women not currently using hormonal contraception If woman has not yet had a period postpartum, consider possibility of ovulation and conception occurring prior to use of contraceptive therapy CDC guidelines recommend waiting 3 weeks after delivery in postpartum women with no venous thromboembolism (VTE) risks and 3-6 weeks in postpartum women with additional VTE risks (Morbidity and Mortality Weekly; July 29, 2016) <18 years: Safety and efficacy not establishedInteraction CheckerEnter a drug name and levonorgestrel oral/ethinylestradiol/ferrous bisglycinateNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)levonorgestrel oral/ethinylestradiol/ferrous bisglycinate, ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC). unknown mechanism. Contraindicated. ALT elevations >5x ULN (including some >20x ULN) observed in clinical trials when ethinyl estradiol was coadministered with ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. Discontinue ethinyl estradiol-containing medications before initiating ombitasvir/paritaprevir/ritonavir, and/or dasabuvir. Restart ethinyl estradiol containing medication ~2 weeks after hepatitis C combination drug regimen completed.Serious - Use Alternative (20)abametapirabametapir will increase the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.atazanaviratazanavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.belzutifanbelzutifan will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Advise females of reproductive potential to use effective nonhormonal contraception. Based on animal studies, belzutifan can cause fetal harm.calaspargase pegolcalaspargase pegol, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. unknown mechanism. Avoid or Use Alternate Drug. Due to the potential for an indirect interaction between calaspargase pegol and oral contraceptives, concomitant use of these drugs is not recommended. Use another non-oral contraceptive method for females of childbearing potential.darunavirdarunavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.elagolixlevonorgestrel oral/ethinylestradiol/ferrous bisglycinate decreases effects of elagolix by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Based on the mechanism of action of elagolix, estrogen-containing contraceptives are expected to reduce elagolix efficacy. Effects of progestin-only contraceptives on the efficacy of elagolix is unknown. Advise women to use nonhormonal contraceptives during treatment with elagolix and for 1 week after discontinuing elagolix.encorafenibencorafenib will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of encorafenib with hormonal contraceptives (CYP3A4 substrates) can result in decreased concentrations and loss of hormonal contraceptive efficacy. Encorafenib can cause fetal harm. Advise women of childbearing potential to use a highly effective nonhormonal contraceptive during treatment and for 2 weeks after final encorafenib dose.indinavirindinavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.isavuconazonium sulfateisavuconazonium sulfate will increase the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.lopinavirlopinavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.mavacamtenmavacamten will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Progestin and ethinyl estradiol are CYP3A4 substrates. Mavacamten may decrease systemic exposures of ethinyl estradiol and progestin, which may lead to contraceptive failure or an increase in breakthrough bleeding. Advise patients to use a contraceptive method that is not affected by CYP450 enzyme induction (eg, intrauterine system) or add nonhormonal contraception (eg, condoms) during coadministration and for 4 months after last mavacamten dose.mobocertinibmobocertinib will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of mobocertinib with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Advise females of reproductive potential to use effective non-hormonal contraception.nelfinavirnelfinavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.nevirapinenevirapine will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use an alternative method of contraception or a backup method when enzyme inducers are used with combined hormonal contraceptives (CHCs), and continue backup contraception for 28 days after discontinuing enzyme inducer to ensure contraceptive reliability.omaveloxoloneomaveloxolone will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Omaveloxolone may reduce efficacy of hormonal contraceptives (eg, pill, patch, ring), implants, and progestin-only pills owing to weak CYP3A4 induction.pexidartiniblevonorgestrel oral/ethinylestradiol/ferrous bisglycinate and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.pretomanidlevonorgestrel oral/ethinylestradiol/ferrous bisglycinate, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.ritonavirritonavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.saquinavirsaquinavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.tipranavirtipranavir, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.Monitor Closely (123)acetaminophenlevonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of acetaminophen by unknown mechanism. Use Caution/Monitor.acetaminophen increases levels of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by decreasing hepatic clearance. Use Caution/Monitor. Coadministration of ascorbic acid and certain combined hormonal contraceptives (CHCs) containing EE may increase plasma EE concentrations, possibly by inhibition of conjugation.acetaminophen IVlevonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of acetaminophen IV by unknown mechanism. Use Caution/Monitor.acetaminophen rectallevonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of acetaminophen rectal by unknown mechanism. Use Caution/Monitor.alprazolamlevonorgestrel oral/ethinylestradiol/ferrous bisglycinate will increase the level or effect of alprazolam by decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.amobarbitalamobarbital will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. The efficacy of hormonal contraceptives may be reduced. Use an alternative method of contraception or a backup method when enzyme inducers are used with combined hormonal contraceptives (CHCs), and continue backup contraception for 28 days after discontinuing enzyme inducer to ensure contraceptive reliability.amoxicillinamoxicillin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.ampicillinampicillin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.aprepitantaprepitant will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. The efficacy of hormonal contraceptives may be reduced. Use an alternative method of contraception or a backup method when enzyme inducers are used with combined hormonal contraceptives (CHCs), and continue backup contraception for 28 days after discontinuing enzyme inducer to ensure contraceptive reliability.ascorbic acidascorbic acid increases levels of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by decreasing hepatic clearance. Use Caution/Monitor. Coadministration of ascorbic acid and certain combined hormonal contraceptives (CHCs) containing EE may increase plasma EE concentrations, possibly by inhibition of conjugation.atorvastatinatorvastatin increases levels of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Coadministration of atorvastatin and certain combined hormonal contraceptives (CHCs) containing EE increase AUC values for EE by approximately 20-25%.bosentanbosentan will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. The efficacy of hormonal contraceptives may be reduced. Use an alternative method of contraception or a backup method when enzyme inducers are used with combined hormonal contraceptives (CHCs), and continue backup contraception for 28 days after discontinuing enzyme inducer to ensure contraceptive reliability.brigatinibbrigatinib will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Brigatinib induces CYP3A4 in vitro. Coadministration of hormonal contraceptives with brigatinib can result in decreased concentrations and loss of efficacy. Brigatinib can cause fetal harm. Women should use an effective nonhormonal method of contraception during treatment and for at least 4 months after the last brigatinib dose.butabarbitalbutabarbital will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. The efficacy of hormonal contraceptives may be reduced. Use an alternative method