Hailey 24 Fe
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL, AND FERROUS FUMARATE
Indications and usage 1 INDICATIONS AND USAGE Hailey 24 Fe is indicated for use by women to prevent pregnancy [see Clinical Studies ( 14 )].
The efficacy of Hailey 24 Fe in women with a body mass index (BMI) of > 35 kg/m 2 has not been evaluated.
Structured Monograph
Clinical summary
Indications and usage 1 INDICATIONS AND USAGE Hailey 24 Fe is indicated for use by women to prevent pregnancy [see Clinical Studies ( 14 )]. The efficacy of Hailey 24 Fe in women with a body mass index (BMI) of > 35 kg/m 2 has not been evaluated. Hailey 24 Fe is a combination of norethindrone acetate, a progestin, and ethinyl estradiol, an estrogen, indicated for use by women to prevent pregnancy. ( 1 ) The efficacy of Hailey 24 Fe in women with a body mass index (BMI) of >35 kg/m 2 has not been evaluated. ( 1 , 8.8 ) Dosage and administration 2 DOSAGE AND ADMINISTRATION • Take one tablet by mouth at the same time every day for 28 days ( 2.1 ) • Take tablets in the order directed on the blister pack ( 2.1 ) • Hailey 24 Fe may be administered without regard to meals ( 12.3 ) 2.1 How to Start Hailey 24 Fe Hailey 24 Fe is dispensed in a blister [see How Supplied/Storage and Handling ( 16 )]. Hailey 24 Fe may be started using either a Day 1 start or a Sunday start (see Table 1). For the first cycle of a Sunday Start regimen, an additional method of contraception must be used until after the first 7 consecutive days of administration. 2.2 How to Take Hailey 24 Fe Table 1: Instructions for Administration of Hailey 24 Fe Starting COCs in women not currently using hormonal contraception (Day 1 Start or Sunday Start) Important: Consider the possibility of ovulation and conception prior to initiation of this product. Tablet Color: • Hailey 24 Fe active tablets are white to off-white (Day 1 to Day 24). • Hailey 24 Fe inactive tablets are brown to dark brown (Day 25 to Day 28). Day 1 Start: • Take first white to off-white active tablet without regard to meals on the first day of menses. • Take subsequent active tablets once daily at the same time each day for a total of 24 days. • Take one brown to dark brown inactive tablet daily for 4 days and at the same time of day that active tablets were taken. • Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the day after taking the last inactive tablet). Sunday Start: For each 28-day course, take in the following order: • Take the white to off-white active tablet without regard to meals on the first Sunday after the onset of menses. Due to the potential risk of becoming pregnant, use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of the patient’s first cycle pack of Hailey 24 Fe. • Take subsequent active tablets once daily at the same time each day for a total of 24 days. • Take one brown to dark brown tablet (ferrous fumarate) daily for the following 4 days and at the same time of day that active tablets were taken. A scheduled period should occur during the 4 days that the brown to dark brown tablets are taken. • Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the Sunday after taking the last inactive tablet) and additional non-hormonal contraceptive is not needed. Switching to Hailey 24 Fe from another oral contraceptive Start on the same day that a new pack of the previous oral contraceptive would have started. Switching from another contraceptive method to Hailey 24 Fe Start Hailey 24 Fe: • Transdermal patch • On the day when next application would have been scheduled. • Vaginal ring • On the day when next insertion would have been scheduled • Injection • On the day when next injection would have been scheduled • Intrauterine contraceptive • On the day of removal • If the IUD is not removed on first day of the patient’s menstrual cycle, additional non-hormonal contraceptive (such as condoms and spermicide) is needed for the first seven days of the first cycle pack. • Implant • On the day of removal Starting Hailey 24 Fe after Abortion or Miscarriage First-trimester • After a first-trimester abortion or miscarriage, Hailey 24 Fe may be started immediately. An additional method of contraception is not needed if Hailey 24 Fe is started immediately. • If Hailey 24 Fe is not started within 5 days after termination of the pregnancy, the patient must use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of her first 28-day course of Hailey 24 Fe. Second-trimester • Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to the increased risk of thromboembolic disease. Start Hailey 24 Fe following the instructions in Table 1 for Sunday start. Use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of the patient’s first 28-day course of Hailey 24 Fe [see Contraindications ( 4 ) and Warnings and Precautions ( 5.1 )]. Starting Hailey 24 Fe after Childbirth • Do not start until 4 weeks after delivery, due to the increased risk of thromboembolic disease. Start contraceptive therapy with Hailey 24 Fe following the instructions in Table 1 for women not currently using hormonal contraception. • If the woman has not yet had a period postpartum, consider the
Boxed Warning
WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (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. • Hailey 24 Fe is contraindicated in women over 35 years old who smoke. ( 4 ) • Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. ( 4 )
Monitoring
- • 5 WARNINGS AND PRECAUTIONS • Thrombotic Disorders and Other Vascular Problems: Stop Hailey 24 Fe if a thrombotic event occurs.
- • Stop at least 4 weeks before through 2 weeks after major surgery.
- • Start no earlier than 4 weeks after delivery, in women who are not breastfeeding.
- • ( 5.1 ) • Liver disease: Discontinue Hailey 24 Fe if jaundice occurs.
Interaction Notes
- • 7 DRUG INTERACTIONS Consult the labeling of concurrently used drugs to obtain further information about interactions with oral 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 method 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 decreasing the plasma concentrations of COCs and potentially diminishing the efficacy of COCs: Drugs or herbal products that induce certain enzymes, including cytochrome P450 3A4 (CYP3A4), may decrease the plasma concentrations of COCs and potentially diminish the effectiveness of COCs or increase breakthrough bleeding.