MICROGESTIN Fe 1/20

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Overview

What is MICROGESTIN Fe 1/20?

MICROGESTIN and MICROGESTIN Fe are progestogen-estrogen combinations.

MICROGESTIN Fe 1/20 and 1.5/30: Each provides a continuous dosage regimen consisting of 21 oral contraceptive tablets and seven ferrous fumarate tablets. The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen, are non-hormonal, and do not serve any therapeutic purpose.

Each white tablet contains norethindrone acetate (17 alpha-ethinyl-19-nortestosterone acetate), 1 mg; ethinyl estradiol (17 alpha-ethinyl-1,3,5(10)-estratriene-3, 17 beta-diol), 20 mcg. Also contains acacia, NF; lactose, NF; magnesium stearate, NF; starch, NF; confectioner’s sugar, NF; talc, USP.

Each green tablet contains norethindrone acetate (17 alpha-ethinyl-19-nortestosterone acetate), 1.5 mg; ethinyl estradiol (17 alpha-ethinyl-1,3,5(10)-estratriene-3, 17 beta-diol), 30 mcg. Also contains acacia, NF; lactose, NF; magnesium stearate, NF; starch, NF; confectioner’s sugar, NF; talc, USP; D&C yellow No. 10; FD&C yellow No. 6; FD&C blue No. 1.

The structural formulas are as follows:

Each brown tablet contains ferrous fumarate, USP; mannitol, USP; povidone, USP; microcrystalline cellulose, NF; sodium starch glycolate, NF; magnesium stearate, NF; sucralose, NF; spearmint flavor.

What does MICROGESTIN Fe 1/20 look like?

What are the available doses of MICROGESTIN Fe 1/20?

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What should I talk to my health care provider before I take MICROGESTIN Fe 1/20?

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How should I use MICROGESTIN Fe 1/20?

MICROGESTIN and MICROGESTIN Fe are indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception.

Oral contraceptives are highly effective. Table I lists the typical accidental pregnancy rates for users of combination oral contraceptives and other methods of contraception. The efficacy of these contraceptive methods, except sterilization, depends upon the reliability with which they are used. Correct and consistent use of methods can result in lower failure rates.

The tablet dispenser has been designed to make oral contraceptive dosing as easy and as convenient as possible. The tablets are arranged in either three or four rows of seven tablets each, with the days of the week appearing on the tablet dispenser above the first row of tablets.

Note:

Important:

The possibility of ovulation and conception prior to initiation of use should be considered.

Dosage and Administration for 21-Day Dosage Regimen

A. Sunday-Start Regimen:

B. Day-1 Regimen:

Tablets should be taken regularly with a meal or at bedtime. It should be stressed that efficacy of medication depends on strict adherence to the dosage schedule.

Special Notes on Administration

If the patient forgets to take one or more tablets, the following is suggested:

One

Two

Two

Day-1 Start Regimen:

Three

Sunday-Start Regimen:

Day-1 Start Regimen:

The possibility of ovulation occurring increases with each successive day that scheduled tablets are missed. While there is little likelihood of ovulation occurring if only one tablet is missed, the possibility of spotting or bleeding is increased. This is particularly likely to occur if two or more consecutive tablets are missed.

In the rare case of bleeding which resembles menstruation, the patient should be advised to discontinue medication and then begin taking tablets from a new tablet dispenser on the next Sunday or the first day (Day 1), depending on her regimen. Persistent bleeding which is not controlled by this method indicates the need for reexamination of the patient, at which time nonfunctional causes should be considered.

Dosage and Administration for 28-Day Dosage Regimen

MICROGESTIN Fe provides a continuous administration regimen consisting of 21 light-colored (white or green) tablets of MICROGESTIN and 7 brown non-hormone containing tablets of ferrous fumarate. The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen and do not serve any therapeutic purpose. There is no need for the patient to count days between cycles because there are no “off-tablet days.’’

A. Sunday-Start Regimen:

B. Day-1 Start Regimen:

Tablets should be taken regularly with a meal or at bedtime. It should be stressed that efficacy of medication depends on strict adherence to the dosage schedule.

Special Notes on Administration

If the patient forgets to take one or more tablets, the following is suggested:

One

Two

Two

Day-1 Start Regimen:

Three

Sunday-Start Regimen:

Day-1 Start Regimen:

The possibility of ovulation occurring increases with each successive day that scheduled light-colored tablets are missed. While there is little likelihood of ovulation occurring if only one light-colored tablet is missed, the possibility of spotting or bleeding is increased. This is particularly likely to occur if two or more consecutive light-colored tablets are missed.

If the patient forgets to take any of the seven brown tablets in week four, those brown tablets that were missed are discarded and one brown tablet is taken each day until the pack is empty. A back-up birth control method is not required during this time. A new pack of tablets should be started no later than the eighth day after the last light-colored tablet was taken.

In the rare case of bleeding which resembles menstruation, the patient should be advised to discontinue medication and then begin taking tablets from a new tablet dispenser on the next Sunday or the first day (Day-1), depending on her regimen. Persistent bleeding which is not controlled by this method indicates the need for reexamination of the patient, at which time nonfunctional causes should be considered.

Use of Oral Contraceptives in the Event of a Missed Menstrual Period

1. If the patient has not adhered to the prescribed dosage regimen, the possibility of pregnancy should be considered after the first missed period and oral contraceptives should be withheld until pregnancy has been ruled out.

2. If the patient has adhered to the prescribed regimen and misses two consecutive periods, pregnancy should be ruled out before continuing the contraceptive regimen.

After several months on treatment, bleeding may be reduced to a point of virtual absence. This reduced flow may occur as a result of medication, in which event it is not indicative of pregnancy.

What interacts with MICROGESTIN Fe 1/20?

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What are the warnings of MICROGESTIN Fe 1/20?

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What are the precautions of MICROGESTIN Fe 1/20?

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What are the side effects of MICROGESTIN Fe 1/20?

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What should I look out for while using MICROGESTIN Fe 1/20?

Oral contraceptives should not be used in women who currently have the following conditions:

The use of oral contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease, although the risk of serious morbidity or mortality is very small in healthy women without underlying risk factors. The risk of morbidity and mortality increases significantly in the presence of other underlying risk factors such as hypertension, hyperlipidemias, obesity, and diabetes.

Practitioners prescribing oral contraceptives should be familiar with the following information relating to these risks.

The information contained in this package insert is principally based on studies carried out in patients who used oral contraceptives with higher formulations of estrogens and progestogens than those in common use today. The effect of long-term use of the oral contraceptives with lower formulations of both estrogens and progestogens remains to be determined.

Throughout this labeling, epidemiological studies reported are of two types: retrospective or case control studies and prospective or cohort studies. Case control studies provide a measure of the relative risk of a disease, namely, a of the incidence of a disease among oral contraceptive users to that among nonusers. The relative risk does not provide information on the actual clinical occurrence of a disease. Cohort studies provide a measure of attributable risk, which is the in the incidence of disease between oral contraceptive users and nonusers. The attributable risk does provide information about the actual occurrence of a disease in the population (adapted from References 8 and 9 with the author’s permission). For further information, the reader is referred to a text on epidemiological methods.

What might happen if I take too much MICROGESTIN Fe 1/20?

Serious ill effects have not been reported following acute ingestion of large doses of oral contraceptives by young children. Overdosage may cause nausea, and withdrawal bleeding may occur in females.

How should I store and handle MICROGESTIN Fe 1/20?

MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F). MICROGESTIN 1/20 is available in dispensers each containing 21 white tablets. Each tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1/20 is available in dispensers each containing 21 white tablets and 7 brown tablets. Each white tablet contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol, with “P-D 915” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCMICROGESTIN 1.5/30 is available in dispensers each containing 21 green tablets. Each tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Available in packages of 6 dispensers.NDCMICROGESTIN Fe 1.5/30 is available in dispensers each containing 21 green tablets and 7 brown tablets. Each green tablet contains 1.5 mg of norethindrone acetate and 30 mcg of ethinyl estradiol, with “P-D 916” embossed only on one side. Each brown tablet contains 75 mg ferrous fumarate, with “624” embossed on one side and “WC” on the other side. Available in packages of 6 dispensers.NDCStore below 30˚ C (86˚ F).

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Clinical Information

Chemical Structure

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Clinical Pharmacology

The pharmacokinetics of MICROGESTIN have not been characterized; however, the following pharmacokinetic information regarding norethindrone acetate and ethinyl estradiol is taken from the literature.

Non-Clinical Toxicology

Oral contraceptives should not be used in women who currently have the following conditions:

The use of oral contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease, although the risk of serious morbidity or mortality is very small in healthy women without underlying risk factors. The risk of morbidity and mortality increases significantly in the presence of other underlying risk factors such as hypertension, hyperlipidemias, obesity, and diabetes.

Practitioners prescribing oral contraceptives should be familiar with the following information relating to these risks.

The information contained in this package insert is principally based on studies carried out in patients who used oral contraceptives with higher formulations of estrogens and progestogens than those in common use today. The effect of long-term use of the oral contraceptives with lower formulations of both estrogens and progestogens remains to be determined.

Throughout this labeling, epidemiological studies reported are of two types: retrospective or case control studies and prospective or cohort studies. Case control studies provide a measure of the relative risk of a disease, namely, a of the incidence of a disease among oral contraceptive users to that among nonusers. The relative risk does not provide information on the actual clinical occurrence of a disease. Cohort studies provide a measure of attributable risk, which is the in the incidence of disease between oral contraceptive users and nonusers. The attributable risk does provide information about the actual occurrence of a disease in the population (adapted from References 8 and 9 with the author’s permission). For further information, the reader is referred to a text on epidemiological methods.

1. Patients should be counseled that this product does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

2. Physical Examination and Follow-Up

3. Lipid Disorders

4. Liver Function

5. Fluid Retention

6. Emotional Disorders

7. Contact Lenses

8. Drug Interactions

Effects of Other Drugs on Oral Contraceptives

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Rifampin:

Anticonvulsants:

Troglitazone:

Antibiotics:

Atorvastatin:

Other:

Effects of Oral Contraceptives on Other Drugs

Oral contraceptive combinations containing ethinyl estradiol may inhibit the metabolism of other compounds. Increased plasma concentrations of cyclosporine, prednisolone, and theophylline have been reported with concomitant administration of oral contraceptives. In addition, oral contraceptives may induce the conjugation of other compounds. Decreased plasma concentrations of acetaminophen and increased clearance of temazepam, salicylic acid, morphine, and clofibric acid have been noted when these drugs were administered with oral contraceptives.

9. Interactions With Laboratory Tests

a. Increased prothrombin and factors VII, VIII, IX, and X; decreased antithrombin 3; increased norepinephrine-induced platelet aggregability.

b. Increased thyroid binding globulin (TBG) leading to increased circulating total thyroid hormone, as measured by protein-bound iodine (PBI), T by column or by radioimmunoassay. Free T resin uptake is decreased, reflecting the elevated TBG; free T concentration is unaltered.

c. Other binding proteins may be elevated in serum.

d. Sex-binding globulins are increased and result in elevated levels of total circulating sex steroids and corticoids; however, free or biologically active levels remain unchanged.

e. Triglycerides may be increased.

f. Glucose tolerance may be decreased.

g. Serum folate levels may be depressed by oral contraceptive therapy. This may be of clinical significance if a woman becomes pregnant shortly after discontinuing oral contraceptives.

10. Carcinogenesis

11. Pregnancy

12. Nursing Mothers

13. Pediatric Use

An increased risk of the following serious adverse reactions has been associated with the use of oral contraceptives (see section):

There is evidence of an association between the following conditions and the use of oral contraceptives, although additional confirmatory studies are needed:

The following adverse reactions have been reported in patients receiving oral contraceptives and are believed to be drug-related:

The following adverse reactions have been reported in users of oral contraceptives and the association has been neither confirmed nor refuted:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72

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Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).

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