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Combination of
Trade namesAltavera, Alysena, Amethyst, others[1]
Clinical data
Main usesBirth control[2]
Routes of
By mouth
Defined daily dosenot established[3]
External links
Legal status

Ethinylestradiol/levonorgestrel (also ethinyl estradiol/levonorgestrel) is a combined birth control pill made up of ethinylestradiol, an estrogen and levonorgestrel a progestin.[4] It is used for birth control, symptoms of menstruation, endometriosis, and as emergency contraception.[1][4] It is taken by mouth.[1]

Side effects can include nausea, headache, blood clots, breast pain, depression, and liver problems.[4] Use is not recommended during pregnancy, the initial three weeks after childbirth, and in those at high risk of blood clots.[4] However, it may be started immediately after a miscarriage or abortion.[5] Smoking while using combined birth control pills is not recommended.[1] It works by stopping ovulation, making the mucus at the opening to the cervix thick, and making the uterus not suitable for implantation.[1]

Ethinylestradiol/levonorgestrel has been approved for medical use in the United States at least since 1982.[1] It is on the World Health Organization's List of Essential Medicines.[6] It is available as a generic medication.[7] In the United Kingdom three months of medication costs the NHS about 1.80 pounds.[8] In the United States it costs about $25–50 per month.[7] It is marketed under a large number of brand names.[1] In 2017, it was the 136th most commonly prescribed medication in the United States, with more than four million prescriptions.[9][10]

Medical uses

It is used as a form of birth control.[2]


The defined daily dose is not established.[3] It is taken as 21 active pills of 30 micrograms ethinylestradiol / 150 micrograms levonorgestrel and 7 inactive pills.[2]

Side effects

Pregnancy and breastfeeding

It should not be used in the initial 6 weeks following delivery and is not recommended between 6 weeks and 6 months unless their is no other suitable option.[2]

See also


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 "Ethinyl estradiol and levonorgestrel medical facts from". Archived from the original on 1 January 2017. Retrieved 1 January 2017.
  2. 2.0 2.1 2.2 2.3 "ETHINYLESTRADIOL/LEVONORGESTREL oral - Essential drugs". Retrieved 30 August 2020.
  3. 3.0 3.1 "WHOCC - ATC/DDD Index". Retrieved 15 September 2020.
  4. 4.0 4.1 4.2 4.3 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. pp. 363–5. hdl:10665/44053. ISBN 9789241547659.
  5. "Erlibelle 30micrograms/150micrograms film-coated tablets - Summary of Product Characteristics (SPC) - (eMC)". Archived from the original on 2 January 2017. Retrieved 1 January 2017.
  6. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  7. 7.0 7.1 Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 349. ISBN 9781284057560.
  8. British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 552. ISBN 9780857111562.
  9. "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.
  10. "Ethinyl Estradiol; Levonorgestrel - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.

External links