Progestins For Contraceptive Use (Systemic)

Proper Use of This Medicine

To make the use of a progestin as safe and reliable as possible, you should understand how and when to take it and what effects may be expected. Progestins for contraception usually come with patient directions. Read them carefully before taking or using this medicine.

Progestins do not protect a woman from sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), or acquired immunodeficiency syndrome (AIDS). The use of latex (rubber) condoms or abstinence is recommended for protection from these diseases.

Take this medicine only as directed by your doctor. Do not take more of it and do not take it for a longer time than your doctor ordered . To do so may increase the chance of side effects. Try to take the medicine at the same time each day to reduce the possibility of side effects and to allow it to work better.

When using the levonorgestrel subdermal dosage form :

• For insertion:
  • Six implants are inserted under the skin of your upper arm by a health care professional. This usually takes about 15 minutes. No pain should be felt from the insertion process because you will receive a small injection from your doctor of a medicine that will numb your arm.
• For care of insertion site:
  • Keep the gauze wrap on for 24 hours after the insertion. Then, you should remove it. The sterile strips of tape should be left over the area for 3 days.
  • Be careful not to bump the site or get that area wet for at least 3 days after the procedure. Do not do any heavy lifting for 24 hours. Swelling and bruising are common for a few days.
• For contraceptive protection:
  • Full protection from pregnancy begins within 24 hours, if the insertion is done within 7 days of the beginning of your menstrual period. Otherwise, use another birth control method for the rest of your first cycle. Protection using implants lasts for 5 years or until removal, whichever comes first.
• For removal:
  • The implants need to be removed after 5 years. However, you may have them removed by a health care professional at any time before that.
  • If you want to continue using this form of birth control after 5 years, your health care professional may insert new implants in the same area where the old ones were or into the other arm.
  • After a local injection numbs the area on your arm, removal of the medication usually takes 20 minutes or longer. If the implants are hard to remove, your health care professional may want you to return another day to complete the removal process.
  • Keep a gauze wrap on for 24 hours after the removal. The sterile strips of tape underneath the gauze wrap should be left over the area for 3 days. Be careful not to bump the site or get that area wet until the area is healed.

When using levonorgestrel tablet dosage form for emergency contraception :

• The tablets may be taken at any time during the menstrual cycle.

When using medroxyprogesterone injection dosage form for contraception :

• Your injection is given by a health care professional every 3 months (13 weeks).
• To stop using medroxyprogesterone injection for contraception, simply do not have another injection.
• Full protection from pregnancy begins immediately if you receive the first injection within the first 5 days of your menstrual period or within 5 days after delivering a baby if you will not be breast-feeding. If you are going to breast-feed, you may have to wait for 6 weeks from your delivery date before receiving your first injection. If you follow this schedule, you do not need to use another form of birth control. Protection from that one injection ends at 3 months (13 weeks). You will need another injection every 3 months (13 weeks) to have full protection from becoming pregnant. However, if the injection is given later than 5 days from the first day of your last menstrual period, you will need to use another method of birth control as directed by your doctor.

When using an oral progestin dosage form :

• Take a tablet every 24 hours each day of the year. Taking the medicine at the same time each day helps to reduce the possibility of side effects and makes it work as expected. Taking your tablet 3 hours late is the same as missing a dose and can cause the medicine to not work properly.
• Keep the tablets in the container in which you received them to help you to keep track of your dosage schedule.
• When switching from estrogen and progestin oral contraceptives, you should take the first dose of the progestin-only contraceptive the next day after the last active pill of the estrogen and progestin oral contraceptive has been taken. This means you will not take the last 7 days (placebo or nonactive pills) of a 28-day cycle of the estrogen and progestin oral contraceptive pack. You will begin a new pack of progestin-only birth control pills on the 22nd day.
• Also, when switching, full protection from pregnancy begins after 48 hours if the first dose of the progestin-only contraceptive is taken on the first day of the menstrual period. If the birth control is begun on other days, full protection may begin 3 weeks after you begin taking the medicine for the first time. You should use a second method of birth control for at least the first 3 weeks to ensure full protection . You are not fully protected if you miss pills. The chances of your getting pregnant are greater with each pill that is missed.

Dosing - Follow your doctor's orders or the directions on the label . Also, follow your health care professional's orders to schedule the proper time to remove the implants or receive an injection of progestins for contraception. You and your health care professional may choose to replace the implants sooner or begin a new method of birth control. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

For levonorgestrel
• For subdermal dosage form (implants):
  • For preventing pregnancy:
    • Adults and teenagers - Six implants (a total dose of 216 milligrams [mg]) inserted under the skin of the upper arm in a fan-like pattern. From this total dose, about 30 mcg is released every day for 5 years.
• For oral dosage form (tablet):
  • For emergency contraception for preventing pregnancy:
    • Adults and teenagers - The first dose of 0.75 milligram (mg) should be taken as soon as possible within 72 hours of intercourse. The second dose must be taken 12 hours later.

For medroxyprogesterone
• For injection dosage form:
  • For preventing pregnancy:
    • Adults and teenagers - 150 milligrams injected into a muscle in the upper arm or in the buttocks every three months (13 weeks).

For norethindrone
• For oral dosage form (tablets):
  • For preventing pregnancy:
    • Adults and teenagers - 0.35 milligrams (mg) every 24 hours, beginning on the first day of your menstrual cycle whether menstrual bleeding begins or not. The first day of your menstrual cycle can be figured out by counting 28 days from the first day of your last menstrual cycle.

For norgestrel
• For oral dosage form (tablets):
  • For preventing pregnancy:
    • Adults and teenagers - 75 micrograms (mcg) every 24 hours, beginning on the first day of your menstrual cycle whether menstrual bleeding occurs or not. The first day of your menstrual cycle can be figured out by counting 28 days from the first day of your last menstrual cycle.

Missed dose -

• For oral dosage form (tablets): When you miss 1 day's dose of oral tablets or are 3 hours or more late in taking your dose, many doctors recommend that you take the missed dose immediately, continue your normal schedule, and use another method of contraception for 2 days. This is different from what is done after a person misses a dose of birth control tablets that contain more than one hormone.
• For injection dosage form: If you miss having your next injection and it has been longer than 13 weeks since your last injection, your doctor may want you to stop receiving the medicine. Use another method of birth control until your period begins or until your doctor determines that you are not pregnant.
• If your doctor has other directions, follow that advice. Any time you miss a menstrual period within 45 days after a missed or delayed dose you will need to be tested for a possible pregnancy .

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat. Light will fade some tablet colors but will not change the tablets" effect.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Keep the injectable form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.