Contraceptives
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Loestrin 24 FE Dosage

Drug Detail:Loestrin 24 fe (Ethinyl estradiol, norethindrone and ferrous fumarate tablets)

Generic Name: NORETHINDRONE ACETATE 1mg, ETHINYL ESTRADIOL 20ug;

Dosage Form: tablets

Drug Class: Contraceptives Sex hormone combinations

Contents
Uses Warnings Before Taking Dosage Side effects Interactions

2.1 How to Start LOESTRIN 24 Fe

LOESTRIN 24 Fe is dispensed in a blister card [see How Supplied/Storage and Handling (16)]. LOESTRIN 24 FE may be started using either a Day 1 start or a Sunday start (see Table 1). For the first cycle of a Sunday Start regimen, an additional method of contraception must be used until after the first 7 consecutive days of administration.

2.2 How to Take LOESTRIN 24 Fe

Table 1: Instructions for Administration of LOESTRIN 24 Fe
Starting COCs in women not currently using hormonal contraception (Day 1 Start or Sunday Start)

Important:
Consider the possibility of ovulation and conception prior to initiation of this product.

Tablet Color:
  • LOESTRIN 24 Fe active tablets are white (Day 1 to Day 24).
  • LOESTRIN 24 Fe inactive tablets are brown (Day 25 to Day 28).
 Day 1 Start:
  • Take first white active tablet without regard to meals on the first day of menses.
  • Take subsequent active tablets once daily at the same time each day for a total of 21 days.
  • Take one brown inactive tablet daily for 7 days and at the same time of day that active tablets were taken.
  • Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the day after taking the last inactive tablet).
__________________________________________
Sunday Start:
For each 28-day course, take in the following order:
  • Take the white active tablet without regard to meals on the first Sunday after the onset of menses. Due to the potential risk of becoming pregnant, use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of the patient’s first cycle pack of LOESTRIN 24 Fe.
  • Take subsequent active tablets once daily at the same time each day for a total of 24 days.
  • Take one brown tablet (ferrous fumarate) daily for the following 4 days and at the same time of day that active tablets were taken. A scheduled period should occur during the 4 days that the brown tablets are taken.
  • Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the Sunday after taking the last inactive tablet) and additional non-hormonal contraceptive is not needed.
Switching to LOESTRIN 24 Fe from another oral contraceptive Start on the same day that a new pack of the previous oral contraceptive would have started.
Switching from another contraceptive method to LOESTRIN 24 Fe Start LOESTRIN 24 Fe:
  • Transdermal patch
  • On the day when next application would have been scheduled.
  • Vaginal ring
  • On the day when next insertion would have been scheduled
  • Injection
  • On the day when next injection would have been scheduled
  • Intrauterine contraceptive
  • On the day of removal
  • If the IUD is not removed on first day of the patient’s menstrual cycle, additional non-hormonal contraceptive (such as condoms and spermicide) is needed for the first seven days of the first cycle pack.
  • Implant
  • On the day of removal
Complete instructions on proper tablet usage are located in the FDA-approved patient labeling.

Starting LOESTRIN 24 Fe after Abortion or Miscarriage

First-trimester

  • After a first-trimester abortion or miscarriage, LOESTRIN 24 Fe may be started immediately. An additional method of contraception is not needed if LOESTRIN 24 Fe is started immediately.
  • If LOESTRIN 24 Fe is not started within 5 days after termination of the pregnancy, the patient must use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of her first 28-day course of LOESTRIN 24 Fe.

Second-trimester

  • Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to the increased risk of thromboembolic disease. Start LOESTRIN 24 Fe following the instructions in Table 1 for Sunday start. Use additional non-hormonal contraception (such as condoms and spermicide) for the first 7 days of the patient’s first 28-day course of LOESTRIN 24 Fe [see Contraindications (4), Warnings and Precautions (5.1), and FDA-approved Patient Labeling].

Starting LOESTRIN 24 Fe after Childbirth

  • Do not start until 4 weeks after delivery, due to the increased risk of thromboembolic disease. Start contraceptive therapy with LOESTRIN 24 Fe following the instructions in Table 1 for women not currently using hormonal contraception.
  • If the woman has not yet had a period postpartum, consider the possibility of ovulation and conception occurring prior to use of LOESTRIN 24 Fe [see Contraindications (4), Warnings and Precautions (5.1), Use in Specific Populations (8.1 and 8.3)].

2.3 Missed Tablets

Table 2: Instructions for Missed LOESTRIN 24 Fe Tablets
  • If one active tablet is missed in Weeks 1, 2 or 3
 Take the tablet as soon as possible. Take the next pill at the regular time, and continue taking one tablet a day until the pack is finished. Back-up contraception is not needed
  • If two consecutive active tablets are missed in Week 1 or Week 2
 Take the two missed tablets as soon as possible and the next two active tablets the next day. Continue taking one tablet a day until the pack is finished. Additional non-hormonal contraception (such as condoms and spermicide) must be used as back-up if the patient has sex within 7 days after missing tablets.
  • If two consecutive active tablets are missed in Week 3 or Week 4 or three or more consecutive active tablets are missed at any time
 Day 1 Start: Throw out the rest of the pack and start a new pack that same day.
Sunday Start: Continue taking one tablet a day until Sunday, then throw out the rest of the pack and start a new pack that same day.
Additional non-hormonal contraception (such as condoms and spermicide) must be used as back-up if the patient has sex within 7 days after missing 3 tablets.

2.4 Advice in Case of Gastrointestinal Disturbances

In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures must be taken. If vomiting or diarrhea occurs within 3-4 hours after taking a white tablet, handle this as a missed tablet [see FDA-Approved Patient Labeling].

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