Ethinyl Estradiol Norgestrel

Ethinyl Estradiol Norgestrel Brand Names

Cryselle | ELINEST | Lo/Ovral | Low-Ogestrel | Ogestrel 0.5/50 | Ovral

What is Ethinyl Estradiol Norgestrel

Ethinyl estradiol and norgestrel are used together as a combined oral contraceptive (COC).

Ethinyl estradiol is a potent, synthetic estrogen.

Norgestrel is a progestin that is a racemic mixture of both an inactive and active isomer; levonorgestrel is the active isomer. Norgestrel is a second-generation progestin with moderate to high androgenic activity and minimal estrogenic activity.

Combined hormonal contraceptives can be used in female patients from menarche to over the age of 40 years up until the time of menopause with proper selection of products.

The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.

All combined oral contraceptives (COCs) have risks related to venous and arterial thromboembolism, particularly in women who smoke; all combined hormonal contraceptive labels contain a boxed warning about tobacco smoking.

The Centers for Disease Control’s U.S. Medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.

Norgestrel containing combination products can be used as a postcoital ’emergency’ contraceptive in the U.S., but none have an FDA-approved indication.

However, the FDA has explicitly declared these products to be safe and effective for this use, using the ‘Yutzpe method’; however, other methods are more effective and have a lower risk for side effects (e.g., vomiting).

Ethinyl estradiol/norgestrel containing oral contraceptive products were first approved by the FDA in the early 1970’s.

Indications

1. acne vulgaris
2. amenorrhea
3. contraception
4. dysfunctional uterine bleeding
5. endometriosis
6. hirsutism
7. polycystic ovary syndrome
8. postcoital contraception

Side Effects

1. abdominal pain
2. acne vulgaris
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. angioedema
7. anorexia
8. anxiety
9. appetite stimulation
10. arthralgia
11. asthenia
12. back pain
13. bowel ischemia
14. breakthrough bleeding
15. breast discharge
16. breast enlargement
17. candidiasis
18. cataracts
19. cervical dysplasia
20. cholecystitis
21. cholelithiasis
22. cholestasis
23. colitis
24. cystitis
25. depression
26. diarrhea
27. diplopia
28. dysmenorrhea
29. dyspepsia
30. edema
31. elevated hepatic enzymes
32. emotional lability
33. erythema multiforme
34. erythema nodosum
35. fatigue
36. fluid retention
37. galactorrhea
38. gingivitis
39. headache
40. hepatitis
41. hepatoma
42. hirsutism
43. hyperlipidemia
44. hypertension
45. hypertriglyceridemia
46. intracranial bleeding
47. irritability
48. jaundice
49. lactation suppression
50. leukorrhea
51. libido decrease
52. libido increase
53. lupus-like symptoms
54. maculopapular rash
55. mastalgia
56. melasma
57. menorrhagia
58. menstrual irregularity
59. migraine
60. musculoskeletal pain
61. myalgia
62. myocardial infarction
63. nausea
64. new primary malignancy
65. optic neuritis
66. pancreatitis
67. papilledema
68. peliosis hepatis
69. pelvic pain
70. photosensitivity
71. porphyria
72. pruritus
73. pulmonary embolism
74. rash
75. retinal thrombosis
76. rhinitis
77. sinusitis
78. stroke
79. thromboembolism
80. thrombosis
81. urticaria
82. vaginal discharge
83. vaginal irritation
84. vaginitis
85. visual impairment
86. vomiting
87. weight gain
88. weight loss

Monitoring Parameters

• pap smear
• pelvic exam
• pregnancy testing

Contraindications

• acquired immunodeficiency syndrome (AIDS)
• atrial fibrillation
• breast cancer
• breast-feeding
• cerebrovascular disease
• cervical cancer
• children
• chloasma
• cholestasis
• contact lenses
• coronary artery disease
• coronary thrombosis
• depression
• diabetes mellitus
• endocarditis
• endometrial cancer
• gallbladder disease
• glaucoma
• headache
• hepatic disease
• hepatitis
• hepatocellular cancer
• hereditary angioedema
• history of angioedema
• human immunodeficiency virus (HIV) infection
• hypercalcemia
• hypercholesterolemia
• hyperlipidemia
• hypertension
• hypertriglyceridemia
• hypothyroidism
• jaundice
• migraine
• myocardial infarction
• obesity
• obstetric delivery
• ovarian cancer
• porphyria
• pregnancy
• protein C deficiency
• protein S deficiency
• renal disease
• stroke
• surgery
• systemic lupus erythematosus (SLE)
• thromboembolic disease
• thromboembolism
• thrombophlebitis
• thyroid disease
• tobacco smoking
• uterine cancer
• vaginal bleeding
• vaginal cancer
• valvular heart disease
• visual disturbance

Interactions

• Acarbose
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetohexamide
• Acitretin
• Albiglutide
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Alprazolam
• Amikacin
• Aminoglycosides
• Amiodarone
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Amprenavir
• Anastrozole
• Apalutamide
• Aprepitant, Fosaprepitant
• Armodafinil
• Artemether; Lumefantrine
• Ascorbic Acid, Vitamin C
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Atazanavir
• Atazanavir; Cobicistat
• Atorvastatin
• Atorvastatin; Ezetimibe
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine; Fluticasone
• Azithromycin
• Aztreonam
• Bacitracin
• Barbiturates
• Beclomethasone
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bendamustine
• Benzhydrocodone; Acetaminophen
• Betamethasone
• Bexarotene
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Blinatumomab
• Boceprevir
• Bosentan
• Brigatinib
• Bromocriptine
• Budesonide
• Budesonide; Formoterol
• Butabarbital
• Cabozantinib
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• Caffeine; Ergotamine
• Calaspargase pegol
• Calcium
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• Canagliflozin
• Canagliflozin; Metformin
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• Cenobamate
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• Ceritinib
• Charcoal
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• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chlorpropamide
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• Cimetidine
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• Clevidipine
• Clindamycin
• Clobazam
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• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deferasirox
• Deflazacort
• Delafloxacin
• Delavirdine
• Demeclocycline
• Dexamethasone
• Diazepam
• Dicloxacillin
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Dirithromycin
• Doripenem
• Doxazosin
• Doxercalciferol
• Doxorubicin
• Doxycycline
• Dronabinol
• Dronedarone
• Dulaglutide
• Duloxetine
• Dutasteride; Tamsulosin
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Elvitegravir
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Felodipine
• Enasidenib
• Encorafenib
• Enzalutamide
• Eravacycline
• Ertapenem
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Eslicarbazepine
• Estazolam
• Exemestane
• Exenatide
• Felbamate
• Felodipine
• Fidaxomicin
• Flibanserin
• Fluconazole
• Fludrocortisone
• Flunisolide
• Flurazepam
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• food
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• Fosamprenavir
• Fostemsavir
• Frovatriptan
• Gemifloxacin
• Gentamicin
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• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycylcyclines
• grapefruit juice
• Green Tea
• Griseofulvin
• Hemin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrocortisone
• Icosapent ethyl
• Idelalisib
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• Imipenem; Cilastatin; Relebactam
• Incretin Mimetics
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• Insulins
• Isavuconazonium
• Isotretinoin
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• Itraconazole
• Ivosidenib
• Ixabepilone
• Kanamycin
• Ketoconazole
• Lamotrigine
• Lefamulin
• Leflunomide
• Lenalidomide
• Lesinurad
• Lesinurad; Allopurinol
• Letrozole
• Levofloxacin
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin
• Linagliptin; Metformin
• Lincomycin
• Lincosamides
• Linezolid
• Liothyronine
• Liraglutide
• Lixisenatide
• Lomitapide
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Lorlatinib
• Lumacaftor; Ivacaftor
• Mecamylamine
• Meglitinides
• Melatonin
• Mephobarbital
• Meropenem
• Meropenem; Vaborbactam
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methohexital
• Methylprednisolone
• Metreleptin
• Metronidazole
• Metyrapone
• Miconazole
• Miconazole; Petrolatum; Zinc Oxide
• Midazolam
• Mifepristone
• Miglitol
• Miltefosine
• Mineral Oil
• Minocycline
• Minoxidil
• Mitotane
• Mivacurium
• Modafinil
• Mometasone
• Morphine
• Morphine; Naltrexone
• Moxifloxacin
• Mycophenolate
• Nafcillin
• Naratriptan
• Nefazodone
• Nelfinavir
• Neomycin
• Nevirapine
• Nicardipine
• Nifedipine
• Nimodipine
• Nisoldipine
• Nitrofurantoin
• Nitroprusside
• Norfloxacin
• Ofloxacin
• Omadacycline
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Oritavancin
• Ospemifene
• Oxacillin
• Oxazepam
• Oxcarbazepine
• Paromomycin
• Pazopanib
• Pegaspargase
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Pentobarbital
• Perampanel
• Perindopril; Amlodipine
• Pexidartinib
• Phenobarbital
• Phenothiazines
• Phenoxybenzamine
• Phentermine; Topiramate
• Piperacillin
• Piperacillin; Tazobactam
• Pitolisant
• Plazomicin
• Polymyxin B
• Polymyxins
• Posaconazole
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prazosin
• Prednisolone
• Prednisone
• Primidone
• Propafenone
• Propoxyphene
• Pyrimethamine; Sulfadoxine
• Quazepam
• Raloxifene
• Ramelteon
• Ranolazine
• Rasagiline
• Reserpine
• Ribociclib
• Ribociclib; Letrozole
• Rifamycins
• Riluzole
• Ritonavir
• Rituximab; Hyaluronidase
• Rivaroxaban
• Roflumilast
• Romidepsin
• Ropinirole
• Rosuvastatin
• Rufinamide
• Ruxolitinib
• Sapropterin
• Saquinavir
• Sarilumab
• Saxagliptin
• Secobarbital
• Selegiline
• Semaglutide
• SGLT2 Inhibitors
• Siltuximab
• Simvastatin; Sitagliptin
• Sincalide
• Sitagliptin
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Somatropin, rh-GH
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Streptomycin
• Succinylcholine
• Sugammadex
• Sulfadiazine
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Sulfasalazine
• Sulfisoxazole
• Sulfonamides
• Sulfonylureas
• Tacrine
• Tacrolimus
• Tamsulosin
• Tazemetostat
• Tedizolid
• Telaprevir
• Telavancin
• Telithromycin
• Telotristat Ethyl
• Temazepam
• Temsirolimus
• Terazosin
• Terbinafine
• Teriflunomide
• Testolactone
• Tetracycline
• Thalidomide
• Theophylline, Aminophylline
• Thiazolidinediones
• Thiopental
• Thyroid hormones
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Tigecycline
• Tinidazole
• Tipranavir
• Tizanidine
• tobacco
• Tobramycin
• Tocilizumab
• Tolazamide
• Tolbutamide
• Tolvaptan
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Tranexamic Acid
• Trastuzumab; Hyaluronidase
• Triamcinolone
• Triazolam
• Tricyclic antidepressants
• Trimethoprim
• Tucatinib
• Ulipristal
• Ursodeoxycholic Acid, Ursodiol
• Valdecoxib
• Valproic Acid, Divalproex Sodium
• Vancomycin
• Verapamil
• Vincristine
• Vincristine Liposomal
• Vorapaxar
• Voriconazole
• Warfarin
• Zolmitriptan
• Zonisamide