Generic Name and Formulations:
Levonorgestrel 0.15mg, ethinyl estradiol 30micrograms (84 tabs); inert (7 tabs).
Indications for INTROVALE:
1 tab daily for 91 days; repeat. Use Sunday start for first cycle.
Pre-menarchal: not recommended.
Thrombophlebitis or thromboembolic disorders. Cerebrovascular or coronary artery disease. Valvular heart disease with thrombogenic complications. Uncontrolled hypertension. Diabetes with vascular involvement. Headaches with focal neurological symptoms. Major surgery with prolonged immobilization. Cholestatic jaundice of pregnancy or jaundice with prior pill use. Breast or other estrogen or progestin-sensitive neoplasms. Hepatic disease or tumors. Undiagnosed abnormal uterine bleeding. Pregnancy (Cat.X).
Discontinue if thrombotic event, unexplained visual changes, or jaundice occurs, and at least 4 weeks before through 2 weeks after surgery associated with increased risk of thromboembolism. Gallbladder disease. Diabetes. Prediabetes. Uncontrolled dyslipidemias. Hypertriglyceridemia. Pregnancy-related cholestasis. Depression. Evaluate significant changes in headaches, irregular uterine bleeding, amenorrhea. Monitor blood pressure. Do regular complete physical exams. Nursing mothers: not recommended.
Progestin + estrogen.
May be antagonized by CYP3A4 or other enzyme inducers (eg, barbiturates, bosentan, carbamazepine, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John’s wort, topiramate); use backup contraception. May be affected by protease inhibitors, NNRTIs, atorvastatin, acetaminophen, ascorbic acid, itraconazole, ketoconazole. May antagonize lamotrigine. May affect laboratory tests (eg, coagulation factors, lipids, glucose tolerance, binding proteins). May need dose adjustment of thyroid hormones.
Headache, nausea, vomiting, bleeding irregularities, dysmenorrhea, weight change, mastodynia, acne, abdominal pain, anxiety, depression; angioedema, chloasma, others (see literature).
Clinical Pain Advisor Articles
- Abuse-Deterrent Opioid Formulations: Barriers to Broader Use
- Women Frequently Prescribed High Doses of Opioids After Vaginal Delivery
- Notifications by PDMPs May Not Effectively Reduce Opioid Misuse
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Electroacupuncture May Help Reduce Opioid Use in Chronic Musculoskeletal Pain
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- Opioid Use Disorder Prevalence at Delivery on the Rise in the US, According to CDC
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Pharmacologically Induced Headache Accompanied by Dilated Cephalic Vessels
- IV Lidocaine May Be Safe, Efficacious for Pediatric Status Migraine
- Gray Matter Changes in Migraine Associated With Clinical Characteristics