Balcoltra

Balcoltra is typically taken as follows:

• Standard Dosage: One active tablet (containing levonorgestrel 0.1 mg and ethinyl estradiol 0.02 mg) is taken once daily for 21 days, followed by one inactive tablet daily for 7 days. This 28-day cycle is repeated continuously, with menstruation typically occurring during the 7 days of inactive pills.

Balcoltra is contraindicated in patients with:

• History of thromboembolic disorders (e.g., deep vein thrombosis, pulmonary embolism).
• History of stroke or myocardial infarction.
• Known or suspected breast cancer or other estrogen- or progestin-sensitive cancers.
• Liver disease, including liver tumors or active hepatitis.
• Uncontrolled hypertension.
• Migraines with aura.
• Known hypersensitivity to levonorgestrel, ethinyl estradiol, or any component of the product.
• Pregnancy.

Patients using Balcoltra should be advised to:

• Take the pill at the same time every day to maintain its effectiveness and reduce the risk of missing doses.
• Be aware of potential side effects, such as nausea, breast tenderness, or mood changes, especially during the first few months of use.
• Use additional contraception (e.g., condoms) if they miss a dose or if they experience vomiting or severe diarrhea within a few hours of taking the pill, as these can reduce its effectiveness.
• Inform their healthcare provider if they experience any unusual symptoms, such as severe headaches, vision changes, or signs of a blood clot (e.g., sudden leg pain, chest pain, or difficulty breathing).
• Avoid smoking, especially if over the age of 35, as smoking increases the risk of serious cardiovascular side effects associated with hormonal contraceptives.
• Consult their healthcare provider before starting any new medications, including over-the-counter drugs and supplements, as some medications can reduce the effectiveness of oral contraceptives.

Common side effects of Balcoltra may include:

• Nausea or vomiting
• Breast tenderness or enlargement
• Headache
• Weight changes
• Mood changes or depression
• Spotting or breakthrough bleeding between periods
• Decreased libido

Serious side effects can include:

• Thromboembolic Events: Such as deep vein thrombosis, pulmonary embolism, stroke, or heart attack.
• Hypertension: Especially in patients with pre-existing high blood pressure.
• Liver Problems: Including liver tumors or jaundice.
• Severe Allergic Reactions: Such as rash, itching, swelling, or difficulty breathing.

Patients should seek immediate medical attention if they experience severe or persistent side effects, especially symptoms indicative of a blood clot or stroke.

• Increased Risk of Blood Clots: Balcoltra, like all combined oral contraceptives, increases the risk of venous thromboembolism (VTE), particularly in women who smoke, are over the age of 35, or have a history of clotting disorders. Patients should be informed of the signs of blood clots and advised to stop the medication and seek medical attention if they experience symptoms like leg pain, chest pain, or difficulty breathing.
• Cardiovascular Risks: The risk of cardiovascular events, such as heart attack or stroke, is higher in women who smoke and use combined oral contraceptives. Smoking cessation is strongly recommended for women using Balcoltra, particularly those over 35 years of age.
• Liver Disease: Combined oral contraceptives can exacerbate liver conditions or cause liver tumors. Regular monitoring of liver function may be necessary for some patients.

Balcoltra may interact with other medications, including:

• Antibiotics: Certain antibiotics, such as rifampin, can decrease the effectiveness of Balcoltra.
• Anticonvulsants: Medications like phenytoin and carbamazepine can reduce the contraceptive efficacy of Balcoltra.
• HIV Medications: Some antiretroviral drugs may interact with hormonal contraceptives.
• St. John’s Wort: An herbal supplement that can reduce the effectiveness of Balcoltra by increasing the metabolism of the hormones.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions and discuss the need for backup contraception if necessary.

Alternative contraceptive methods include:

• Other Combined Oral Contraceptives (COCs): Such as Yaz, Yasmin, or Loestrin, which contain different combinations or dosages of hormones.
• Progestin-Only Pills: An option for women who cannot take estrogen-containing contraceptives.
• Long-Acting Reversible Contraceptives (LARCs): Such as intrauterine devices (IUDs) or contraceptive implants, which provide long-term contraception without the need for daily pills.
• Barrier Methods: Such as condoms or diaphragms, which can be used in combination with hormonal contraceptives or alone.
• Non-Hormonal Methods: Such as copper IUDs or fertility awareness-based methods.

The choice of contraception depends on individual preferences, health status, and lifestyle considerations.