Alesse (Levonorgestrel / Ethinyl Estradiol)

Description

Alesse is a combination oral contraceptive pill (OCP) that contains two hormones, Levonorgestrel and Ethinyl Estradiol. These hormones prevent ovulation, which means they stop the ovaries from releasing an egg each month. Classified as a low-dose birth control pill, Alesse is typically prescribed to prevent pregnancy.

Directions

Alesse is usually started on the first Sunday after the onset of menstruation or on day 1 of the menstrual cycle. The standard Alesse dosage involves taking 1 pill every day for 28 days, following the sequence specified on the blister pack. Users take 21 active hormonal pills followed by 7 inert pills, during which they usually experience a withdrawal bleed. It's important to take the pill at the same time each day to maintain consistent hormone levels and ensure effectiveness. If a dose is missed, refer to the product leaflet for specific instructions, as the actions may vary depending on how many pills have been missed.

Ingredients

The active ingredients in Alesse are Levonorgestrel and Ethinyl Estradiol.

Contraindications

Avoid taking or using Alesse if any of the following apply:

• A history of blood clots or thrombotic disorders
• Known or suspected breast or uterine cancer
• Uncontrolled high blood pressure
• Diabetes with complications such as neuropathy or vascular disease
• Liver tumors or liver disease
• Unexplained vaginal bleeding
• Known or suspected pregnancy
• Hypersensitivity to any of the components of Alesse
• Migraine headaches with aura

Cautions

• Before taking Alesse, tell your healthcare provider about the following:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding
• Cigarette smoking while taking Alesse increases the risk of serious heart-related problems, especially for women over 35. Do not use Alesse if you are over 35 and smoke.
• Taking Alesse may increase the risk of blood clots, heart attacks, strokes, liver tumors, gallbladder disease, and high blood pressure. The risk is higher if you have certain conditions like diabetes, obesity, high cholesterol, or a family history of blood clots.
• Alesse is not recommended for women who have or have had breast cancer, as some breast cancers may be affected by hormones. Studies have not consistently shown an increased risk of breast cancer from Alesse use.
• Some studies suggest a link between oral contraceptive use and an increased risk of cervical cancer. This may be influenced by other factors like sexual activity.
• Alesse may cause liver problems, including benign liver tumors that, in rare cases, can rupture and cause internal bleeding. Long-term use may slightly increase the risk of liver cancer.
• Alesse may worsen or accelerate gallbladder disease. Women with a history of gallbladder problems should talk to their doctor before taking Alesse.
• Alesse may increase triglyceride levels, which can raise the risk of pancreatitis and other complications. Women with high cholesterol should be monitored closely.
• Alesse may increase blood pressure. Women with high blood pressure should not take Alesse. Blood pressure should be checked regularly while using this medication.
• Alesse should not be used by women who have migraines with aura, as it increases the risk of stroke. Women over 35 who have any type of migraines should not take Alesse.
• Irregular bleeding may occur, especially in the first few months of using Alesse. If bleeding continues or worsens, consult a doctor to rule out other causes.
• Alesse may cause skin discoloration (chloasma), especially in women with a history of pregnancy-related skin changes. Avoid excessive sun exposure and use sunscreen.
• Alesse does not protect against sexually transmitted infections, including HIV. Use condoms or other protection if needed.
• Women should have regular medical checkups while taking Alesse, including blood pressure monitoring and cancer screenings.
• Alesse may affect cholesterol levels. Women with high cholesterol should talk to their doctor before taking Alesse.
• Alesse should be stopped if jaundice (yellowing of the skin or eyes) develops, as this may indicate liver problems.
• Alesse can cause fluid retention, which may worsen conditions like heart or kidney disease.
• Alesse may contribute to depression. Women with a history of depression should be monitored and may need to stop taking Alesse if symptoms worsen.
• Contact lens users may experience vision changes or discomfort while taking Alesse. Consult an eye doctor if this occurs.
• Vomiting or diarrhea may reduce Alesse’s effectiveness. If you have severe vomiting or diarrhea for more than 48 hours, use backup contraception and consult a doctor.
• Some medications, including certain antibiotics, epilepsy drugs, and herbal supplements like St. John’s Wort, may make Alesse less effective. Backup contraception may be needed.
• Alesse should not be used in pregnancy. Stop taking Alesse immediately if you become pregnant.
• Alesse is not recommended for women over 65, as safety and effectiveness have not been established for this age group.
• Alesse may be less effective in women with a body mass index (BMI) over 35. Discuss alternative birth control options with a healthcare provider.

Side Effects

The most common side effects of Alesse include headaches, nausea, abdominal pain, and changes in menstrual flow. Some users may experience acne, breast tenderness, or mood changes. Vaginal infections, bloating, and fluid retention have also been reported. These side effects are typically mild and improve over time.

Alesse may increase the risk of blood clots, stroke, and heart attack, particularly in smokers and those with certain health conditions. Rare but serious cases of liver issues, high blood pressure, and vision changes related to contact lens intolerance have been reported. Some users may also experience jaundice, significant mood changes, or unusual vaginal bleeding. If you develop symptoms such as chest pain, severe headaches, or leg swelling, contact a healthcare provider immediately.

References

1. Alesse (Levonorgestrel / Ethinyl Estradiol) Product Monograph. Atlanta, GA: Cadence Health; 2024.
2. Alesse (Levonorgestrel / Ethinyl Estradiol) Drug Label Information. Morgantown, WV: Mylan Pharmaceuticals Inc.; 2024.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....