Skip to main content
MedicHelpLine
Join Free
Verified Professional Network190+ CountriesHIPAA-Aware Platform
Back to Drug Index
General MedicationsOralBlack Box

Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium

DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE CALCIUM AND LEVOMEFOLATE CALCIUM

Standard Dose
2 DOSAGE AND ADMINISTRATION • Take one tablet daily by mouth at the same time every day. ( 2.1 ) • Tablets must be taken in the order directed on the blister pack. ( 2.1 ) 2.1 How to Take Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Take one tablet by mouth at the same time every day. The failure rate may increase when pills are missed or taken incorrectly. To achieve maximum contraceptive effectiveness, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium must be taken as directed, in the order directed on the blister pack. Single missed pills should be taken as soon as remembered. 2.2 How to Start Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Instruct the patient to begin taking Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium either on the first day of her menstrual period (Day 1 Start) or on the first Sunday after the onset of her menstrual period (Sunday Start). Day 1 Start During the first cycle of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium use, instruct the patient to take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily, beginning on Day 1 of her menstrual cycle. (The first day of menstruation is Day 1.) She should take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate calcium alone, daily on Days 22 through 28. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium can be taken without regard to meals. If Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is first taken later than the first day of the menstrual cycle, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered. Sunday Start During the first cycle of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium use, instruct the patient to take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily, beginning on the first Sunday after the onset of her menstrual period. She should take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate calcium alone, daily on Days 22 through 28. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium can be taken without regard to meals. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered. The patient should begin her next and all subsequent 28-day regimens of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her orange tablets on the next day after ingestion of the last light orange folate tablet, regardless of whether or not a menstrual period has occurred or is still in progress. Anytime a subsequent cycle of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is started later than the day following administration of the last light orange tablet, the patient should use another method of contraception until she has taken an orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium tablet daily for seven consecutive days. When switching from a different birth control pill When switching from another birth control pill, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be started on the same day that a new pack of the previous oral contraceptive would have been started. When switching from a method other than a birth control pill When switching from a transdermal patch or vaginal ring, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be started when the next application would have been due. When switching from an injection, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be started when the next dose would have been due. When switching from an intrauterine contraceptive or an implant, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be started on the day of removal. Withdrawal bleeding usually occurs within 3 days following the last orange tablet. If spotting or breakthrough bleeding occurs while taking Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium, instruct the patient to continue taking Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium by the regimen described above. Counsel her that this type of bleeding is usually transient and without significance; however, advise her that if the bleeding is persistent or prolonged, she should consult her healthcare provider. Although the occurrence of pregnancy is low if Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is taken according to directions, if withdrawal bleeding does not occur, consider the possibility of pregnancy. If the patient has not adhered to the prescribed dosing schedule (missed one or more active tablets or started taking them on a day later than she should have), consider the possibility of pregnancy at the time of the first missed period and take appropriate diagnostic measures. If the patient has adhered to the prescribed regimen and misses two consecutive periods, rule out pregnancy. Discontinue Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium if pregnancy is confirmed. The risk of pregnancy increases with each active orange tablet missed. If breakthrough bleeding occurs following missed tablets, it will usually be transient and of no consequence. If the patient misses one or more light orange tablets, she should still be protected against pregnancy provided she begins taking a new cycle of orange tablets on the proper day. For postpartum women who do not breastfeed or after a second trimester abortion, start Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium no earlier than 4 weeks postpartum due to the increased risk of thromboembolism. If the patient starts Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium postpartum and has not yet had a period, evaluate for possible pregnancy, and instruct her to use an additional method of contraception until she has taken Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium for 7 consecutive days. 2.3 Missed Doses Table 1: Instructions for Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Missed Doses If one orange active tablet is missed Take it as soon as possible. Take the next tablet at the regular time. This means two tablets may be taken in one day. A back-up birth control method is not required if the patient has sex. If two orange active tablets in a row are missed in Week 1 or Week 2 Take two tablets as soon as possible and two tablets the next day. Then take one tablet a day until the pack is finished. Additional nonhormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets. If two orange active tablets in a row are missed in Week 3 Day 1 Start: Throw out the rest of the pack and start a new pack that same day. Sunday Start: Keep taking one tablet every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that same day. Additional nonhormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets. The patient may not have their period this month but this is expected. However, if they miss their period two months in a row, they should call their healthcare provider because they might be pregnant. If three or more orange active tablets in a row are missed during any week Day 1 Start: Throw out the rest of the pack and start a new pack that same day. Sunday Start: Keep taking one tablet every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that same day. Additional nonhormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets. The patient may not have their period this month but this is expected. However, if they miss their period two months in a row, they should call their healthcare provider because they might be pregnant. If any of the seven light orange inactive tablets are missed in Week 4: Throw away the tablets that were missed. Keep taking one tablet each day until the pack is empty. They do not need a back-up method. Finally, if they are still not sure what to do about the tablets they have missed: Use nonhormonal contraception (such as condoms and spermicides) anytime they have sex. Contact their healthcare provider and continue taking one active orange tablet each day until otherwise directed. 2.4 Advice in Case of Gastrointestinal Disturbances In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures should be taken. If vomiting occurs within 3-4 hours after tablet-taking, this can be regarded as a missed tablet. 2.5 Folate Supplementation The U.S. Preventive Services Task Force recommends that women of childbearing age consume supplemental folic acid in a dose of at least 0.4 mg (400 mcg) daily. 1 Consider other folate supplementation that a woman may be taking before prescribing Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium. Ensure that folate supplementation is maintained if a woman discontinues Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium due to pregnancy.
Max Dose
See official label
Primary Use
1 INDICATIONS AND USAGE Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is a combination of drospirenone, a progestin and ethinyl estradiol, an estrogen containing a folate, indicated for use by females of reproductive potential to: • Prevent pregnancy.
Summary

Indications and usage 1 INDICATIONS AND USAGE Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is a combination of drospirenone, a progestin and ethinyl estradiol, an estrogen containing a folate, indicated for use by females of reproductive potential to: • Prevent pregnancy. ( 1.1 ) • Raise folate levels in females of reproductive potential who choose to use an oral contraceptive for contraception. ( 1.2 ) 1.1 Oral Contraceptive Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated for use by females of reproductive potential to prevent pregnancy. 1.2 Folate Supplementation Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated in females of reproductive potential who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product.

Dosage and administration 2 DOSAGE AND ADMINISTRATION • Take one tablet daily by mouth at the same time every day. ( 2.1 ) • Tablets must be taken in the order directed on the blister pack. ( 2.1 ) 2.1 How to Take Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Take one tablet by mouth at the same time every day.

Structured Monograph

Clinical summary

Indications and usage 1 INDICATIONS AND USAGE Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is a combination of drospirenone, a progestin and ethinyl estradiol, an estrogen containing a folate, indicated for use by females of reproductive potential to: • Prevent pregnancy. ( 1.1 ) • Raise folate levels in females of reproductive potential who choose to use an oral contraceptive for contraception. ( 1.2 ) 1.1 Oral Contraceptive Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated for use by females of reproductive potential to prevent pregnancy. 1.2 Folate Supplementation Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated in females of reproductive potential who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product. Dosage and administration 2 DOSAGE AND ADMINISTRATION • Take one tablet daily by mouth at the same time every day. ( 2.1 ) • Tablets must be taken in the order directed on the blister pack. ( 2.1 ) 2.1 How to Take Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Take one tablet by mouth at the same time every day. The failure rate may increase when pills are missed or taken incorrectly. To achieve maximum contraceptive effectiveness, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium must be taken as directed, in the order directed on the blister pack. Single missed pills should be taken as soon as remembered. 2.2 How to Start Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium Instruct the patient to begin taking Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium either on the first day of her menstrual period (Day 1 Start) or on the first Sunday after the onset of her menstrual period (Sunday Start). Day 1 Start During the first cycle of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium use, instruct the patient to take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily, beginning on Day 1 of her menstrual cycle. (The first day of menstruation is Day 1.) She should take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate calcium alone, daily on Days 22 through 28. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium can be taken without regard to meals. If Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is first taken later than the first day of the menstrual cycle, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered. Sunday Start During the first cycle of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium use, instruct the patient to take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily, beginning on the first Sunday after the onset of her menstrual period. She should take one orange Drospirenone/Ethinyl Estradiol/Levomefolate Calcium Tablet daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate calcium alone, daily on Days 22 through 28. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium can be taken without regard to meals. Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered. The patient should begin her next and all subsequent 28-day regimens of Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her orange

Boxed Warning

WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs should not be used by women who are over 35 years of age and smoke [see Contraindications ( 4 )] . WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS See full prescribing information for complete boxed warning. • Women over 35 years old who smoke should not use Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium. ( 4 ) • Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use. ( 4 )

Monitoring

  • • 5 WARNINGS AND PRECAUTIONS • Vascular risks : Stop Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium if a thrombotic event occurs.
  • • Stop at least 4 weeks before and through 2 weeks after major surgery.
  • • Start no earlier than 4 weeks after delivery, in women who are not breastfeeding.
  • • ( 5.1 ) COCs containing DRSP may be associated with a higher risk of venous thromboembolism (VTE) than COCs containing levonorgestrel or some other progestins.

Interaction Notes

  • • 7 DRUG INTERACTIONS Consult the labeling of all concurrently-used drugs to obtain further information about interactions with hormonal contraceptives or the potential for enzyme alterations.
  • • Drugs or herbal products that induce certain enzymes (for example, CYP3A4) may decrease the effectiveness of COCs or increase breakthrough bleeding.
  • • Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs.
  • • ( 7.1 ) 7.1 Effects of Other Drugs on Combined Oral Contraceptives Substances diminishing the efficacy of COCs: Drugs or herbal products that induce certain enzymes, including cytochrome P450 3A4 (CYP3A4), may decrease the effectiveness of COCs or increase breakthrough bleeding.