Ethinylestradiol/levonorgestrel

{{Short description|Pharmaceutical combination}}

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{{Use dmy dates|date=February 2024}}

{{Drugbox

| type = combo

| component1 = Ethinylestradiol

| class1 = Estrogen

| component2 = Levonorgestrel

| class2 = Progestogen

| tradename = Altavera, Alysena, Amethyst, others

| Drugs.com = {{drugs.com|monograph|estrogen-progestin-combinations}}

| MedlinePlus = a601050

| DailyMedID =

| pregnancy_AU =

| pregnancy_category=

| routes_of_administration = By mouth

| ATC_prefix = G03

| ATC_suffix = AA07

| ATC_supplemental =

| legal_AU =

| legal_CA = Rx-only

| legal_CA_comment = {{cite web | title=Product monograph brand safety updates | website=Health Canada | date=February 2024 | url=https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/label-safety-assessment-update/product-monograph-brand-safety-updates.html | access-date=24 March 2024}}

| legal_UK =

| legal_US = Rx-only

| legal_status =

| CAS_number = 39366-37-5

| PubChem =

| IUPHAR_ligand =

| DrugBank =

| ChemSpiderID =

| KEGG = D04482

| ChEBI =

| ChEMBL =

| synonyms = EE/LNG

}}

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Ethinylestradiol/levonorgestrel (EE/LNG) is a combined birth control pill made up of ethinylestradiol (an estrogen) and levonorgestrel (a progestin).{{cite book | title = WHO Model Formulary 2008 | year = 2009 | isbn = 9789241547659 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization | hdl-access=free |pages=363–5 }} It is used for birth control, symptoms of menstruation, endometriosis, and as emergency contraception.{{cite web|title=Ethinyl estradiol and levonorgestrel medical facts from Drugs.com|url=https://www.drugs.com/mtm/ethinyl-estradiol-and-levonorgestrel.html|website=www.drugs.com|access-date=1 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170101232357/https://www.drugs.com/mtm/ethinyl-estradiol-and-levonorgestrel.html|archive-date=1 January 2017}} It is taken by mouth. Some preparations of EE/LNG additionally contain an iron supplement in the form of ferrous bisglycinate or ferrous fumarate.{{cite book|editor=Hamilton, RJ |title=Tarascon Pocket Pharmacopoeia 2020 Deluxe Lab-Coat Edition|url=https://books.google.com/books?id=--PcDwAAQBAJ&pg=PA347|date=April 2020|publisher=Jones & Bartlett Learning|isbn=978-1-284-40304-6|pages=347–}}

Side effects can include nausea, headache, blood clots, breast pain, depression, and liver problems. Use is not recommended during pregnancy, the initial three weeks after childbirth, and in those at high risk of blood clots. However, it may be started immediately after a miscarriage or abortion.{{cite web|title=Erlibelle 30micrograms/150micrograms film-coated tablets - Summary of Product Characteristics (SPC) - (eMC)|url=https://www.medicines.org.uk/emc/medicine/28986|website=www.medicines.org.uk|access-date=1 January 2017|url-status=dead|archive-url=https://web.archive.org/web/20170102081205/https://www.medicines.org.uk/emc/medicine/28986|archive-date=2 January 2017}} Smoking while using combined birth control pills is not recommended. It works by stopping ovulation, making the mucus at the opening to the cervix thick, and making the uterus not suitable for implantation.

Ethinylestradiol/levonorgestrel has been approved for medical use in the United States since 1982. It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }} It is available as a generic medication.{{cite book|editor=Hamilton, RJ |title=Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition|date=2015|publisher=Jones & Bartlett Learning|isbn=9781284057560|page=349}} It is marketed under many brand names. In 2022, it was the 128th most commonly prescribed medication in the United States, with more than 4{{nbsp}}million prescriptions.{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}{{cite web | title = Ethinyl Estradiol; Levonorgestrel Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/EthinylEstradiolLevonorgestrel | access-date = 30 August 2024 }}