TRUST PILL 28 Tabs - SET of 2 PACKS - Ethinylestradiol / Levonorgestrel / Ferrous Fumarate 30mcg / 125mcg / 75mg
Indications/Uses
Dosage/Direction for Use
Take one pill daily, beginning on the first day of menstrual bleeding. Patient can also start any day as long as patient is not pregnant and use a back-up method such as condom for the next seven days as a precaution to avoid pregnancy. Start with the pill marked number "1". Follow the arrows indicated on the pack.
The interval between two pills should be 24 hours. Incorporate it to patient's daily routine - after eating meals or before going to sleep so patient can easily remember to take it. A pack is good for 28 days.
Start a new pack the next day after taking the last brown pill regardless whether the patient's menstrual bleeding has stopped or not. Patient's menstrual period will return to normal two days after finishing the ochreous pills and while taking the brown pills.
Patient may continue taking the pill as long as the patient wants to avoid pregnancy. Do not skip taking the pill even if there is a brief pause from sexual activity.
Patient should only stop taking the pill after finishing a pack; otherwise, bleeding may start.
Vomiting and persistent severe diarrhea can interfere with the absorption of the pill. If vomiting occurs within two hours after taking a pill, another pill should be taken as soon as possible. If persistent vomiting and diarrhea last more that 24 hours, follow the instructions on Missed Pills.
Missed Pills: The key to effective contraception is following the recommended dosage consistently.
If the patient missed one ochreous pill, take it as soon as remembered. Take the pill due for the day at the regular time even if it means taking two pills in one day. Keep taking one pill each day at the usual time. Patient will not need a back-up contraceptive method if only one pill is missed.
Missing two or more ochreous pills consecutively increases the probability of getting pregnant. Take the most recently missed ochreous pill as soon as remembered and discard all remaining previously missed pills. Resume taking the next scheduled pill and either abstain from sex or use condoms for the next seven days. Count the ochreous pills left in the pack.
If one to six ochreous pills are left in the pack, finish the remaining ochreous pills and discard all brown pills. Start a new pack immediately and use condoms for the next seven days. Bleeding may not come at the regular time.
If there are seven or more ochreous pills left in the pack, continue taking the contents of the pack including the brown pills. Start with a new pack.
If patient continually forgets to take the pills, ask the healthcare provider for ways to become compliant, or for another method of contraception which will suit better. (See figure.)
Overdosage
Administration
Contraindications
Ethinyl Estradiol + Levonorgestrel + Ferrous Fumarate (TRUST PILL) is not recommended for pregnant women.
Breastfeeding mothers should not use Ethinyl Estradiol + Levonorgestrel + Ferrous Fumarate (TRUST PILL). This may reduce the volume of the breast milk. Breastfeeding mothers can use progestin-only pills.
Special Precautions
Adverse Reactions
Drug Interactions
Taking contraceptive pills and anti-infective drugs (such as clarithromycin, erythromycin, itraconazole, ketoconazole, ritonavir) or grapefruit juice may inhibit cytochrome P-450 isoenzyme 3A4. Adverse effects may be seen upon taking these drugs.
Taking oral contraceptive pills and drugs that induce hepatic enzyme such as anti-epileptic drugs (carbamazepine, oxcarbazepine, felbamate, topiramate, phenytoin), anti-fungal (griseofulvin), anti-diabetic (troglitazone), musculoskeletal (phenylbutazone), and anti-tuberculosis (rifampicin) drugs can considerably reduce the contraceptive's efficacy.
Taking contraceptives and troleandomycin may increase the risk of cholestatic jaundice.
Storage
Action
Pharmacokinetics: Ethinyl Estradiol is absorbed well and rapidly by the gastrointestinal tract. The presence of an Ethinyl group at the 17-position greatly reduces hepatic first-pass metabolism compared with Estradiol, enabling the compound to be much more active if taken orally. There is some initial conjugation at the gut wall, and the systemic bioavailability is only 40%. Ethinyl Estradiol is highly protein bound, unlike naturally occurring estrogens, which are mainly bound to sex hormone-binding globulin; it is principally bound to albumin. It is metabolized in the liver, and excreted in the urine and feces. Metabolites undergo enterohepatic recycling.
Levonorgestrel is rapidly and almost completely absorbed after being taken orally and undergoes little first-pass hepatic metabolism. It is highly bound to plasma proteins; 42% to 68% to sex hormone-binding globulin and 30% to 56% to albumin. The proportion bound to sex hormone-binding globulin is higher when it is given with an estrogen. Levonorgestrel is metabolized in the liver to sulfate and glucuronide conjugates, which are excreted in the urine and to a lesser extent in the feces.
MedsGo Class
Features
- Ethinylestradiol
- Iron
- Levonorgestrel