Progestin Only Pill Flashcards
Efficacy?
93%
Acne?
Weight Gain?
VTE risk?
Can Increase
No effect
No effect
Bleeding
Cycle control?
Withdrawal Bleeding/Spotting?
Amenorrhea?
No doesn’t provide cycle control, bleeding is disrupted
Average 5 days/month at year 1
MICRONOR 5.4 % at 1 year
Adverse Effects?
Rare, main reason for quitting is bleeding
Drug interactions
Decrease levels with CYP34A4 Inducers
Return to Fertility?
Most ovulate in 1 month, 99% in 3-6 months
Contraindications
Current breast cancer, unexplained vaginal bleeding, current VTE, liver disease, uncontrolled HTN, CVD
Additional Considerations
Norethindrone is continuous
Drospirenone has 4 HFI days - can increase potassium, watch with certain meds
Initiation and DOsing
Norethindrone - 0.35 mcg daily - Must take at the same time daily
Drospirenone 4mg daily for 24 days then 4 day HFI- more forgiving with timing, can miss a pill up to 24 hours and be ok
How long do you need to use back up contraception if not started within 5 days of menses?
2 days
Missed dose of norethindrone
if dose is more than 3 hours late - EC if unprotected sex within 5 days, use back up contraception for 2 days
Missed dose Drosperinone
take next dose asap ( can take 2 pills in one day)
use back up contraception for 7 days adn consier EC if unprotected sex within 5 days if you have missed **2 active pills **
When do you need to use EC with Drosperinone?
Only if you have missed more than 2 active pills
Im vomiting after I took my pill, what do I do?
If you have vomited within 3 hours of taking your pill you should take another one and continue as usual, consider a back up method until two days after symptoms have resolved or you have taken your pill consistently for 2 days
What kind I do to manage irregular bleeding?
NSAIDS for 5-7 days
COC for 1-3 months
or exogenous estrogen for 28 days
