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Orsythia
Orsythia is a combination oral contraceptive pill containing ethinyl estradiol (an estrogen) and levonorgestrel (a progestin). It is used primarily for preventing pregnancy in women by preventing ovulation, thickening cervical mucus, and altering the uterine lining to prevent implantation. Orsythia is also sometimes prescribed to help regulate menstrual cycles, reduce menstrual cramps, and treat acne.
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Frequently Asked Questions
How long does it take for Orsythia to become effective?
If you start Orsythia on the first day of your period, it becomes effective immediately. If you start at another time, use a backup method of contraception (e.g., condoms) for the first 7 days.
What should I do if I miss a pill?
If you miss one active pill, take it as soon as you remember, then take the next pill at your regular time (this may mean taking two pills in one day). If you miss two or more pills, follow the instructions on the package insert and use a backup method of contraception for the next 7 days.
Can Orsythia help with acne?
Yes, Orsythia may help reduce acne in women who desire contraception, as it helps regulate hormone levels that contribute to acne.
Does Orsythia cause weight gain?
Some women may experience weight gain or bloating while taking Orsythia, although this is not common and is usually temporary.
Can I skip the placebo pills to avoid my period?
Yes, some women choose to skip the placebo pills and start a new pack of active pills right away to avoid having a period. Consult your healthcare provider before doing this to ensure it's safe for you.
Comprehensive Drug Guide
How Does Orsythia Work?
- Prevent ovulation: By suppressing the hormones that trigger the release of an egg from the ovaries.
- Thicken cervical mucus: Making it harder for sperm to enter the uterus.
- Alter the uterine lining: To make it less suitable for implantation in case fertilization does occur.
These actions together effectively prevent pregnancy.
Common Dosages
- Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg in each active tablet (21 active tablets per pack, 7 placebo tablets).
Typical Dosing
- Orsythia is typically taken one tablet daily at the same time each day, starting either on the first day of the menstrual cycle (Day 1 start) or on the first Sunday after the start of menstruation (Sunday start).
- After completing the 21 active tablets, 7 placebo tablets are taken to allow for a withdrawal bleed (similar to a menstrual period).
Typical Dosing
FDA Approved Indications
- Prevention of pregnancy.
It may also be prescribed off-label for:
- Regulation of menstrual cycles.
- Reduction of menstrual cramps.
- Treatment of acne in women who desire contraception.
Who Shouldn't Take Orsythia?
- A history of blood clots, stroke, or heart attack.
- Liver disease or liver tumors.
- Known or suspected breast cancer or other hormone-sensitive cancers.
- Uncontrolled high blood pressure.
- Migraine headaches with aura.
- Women over 35 who smoke, as smoking increases the risk of serious cardiovascular events with combined hormonal contraceptives.
Advice From The Pharmacist
- Take Orsythia at the same time every day, even during the 7 days of placebo pills. This ensures consistent hormone levels and prevents missed doses.
- If you miss a dose, take it as soon as you remember. If you miss more than one dose, follow the package instructions and use a backup method of contraception (such as condoms) until you've taken the active pills consistently for 7 days.
- Use additional contraception (e.g., condoms) if you are starting Orsythia for the first time or after a break, as it may take up to 7 days for full contraceptive protection.
- Avoid smoking while taking Orsythia, especially if you are over 35, as this significantly increases the risk of cardiovascular events, including heart attack and stroke.
Side Effects of Orsythia
Common Side Effects
- Nausea
- Breast tenderness
- Headache
- Weight gain or bloating
- Mood changes
- Spotting or breakthrough bleeding between periods, especially during the first few months
Uncommon/Severe Side Effects
- Blood clots: Signs include sudden leg pain, shortness of breath, or chest pain.
- High blood pressure: Symptoms may include severe headache, blurred vision, or dizziness.
- Liver problems: Signs include yellowing of the skin or eyes (jaundice), dark urine, or severe abdominal pain.
Risks and Warnings of Orsythia
- Increased risk of blood clots: Like other combined hormonal contraceptives, Orsythia increases the risk of blood clots, which can lead to serious complications such as deep vein thrombosis (DVT), pulmonary embolism (PE), heart attack, or stroke. This risk is higher in smokers, especially women over 35.
- Cancer risk: There may be a slight increase in the risk of breast cancer and cervical cancer with long-term use of combined hormonal contraceptives, although the overall risk remains low.
- Liver problems: Rare but serious liver problems, including benign liver tumors, may occur with long-term use of combined hormonal contraceptives.
Interactions with Orsythia
Common Drug Interactions
- Antibiotics: Some antibiotics, like rifampin, can reduce the effectiveness of Orsythia, increasing the risk of unintended pregnancy. Use a backup method of contraception if taking antibiotics.
- Anticonvulsants: Drugs like phenytoin, carbamazepine, and phenobarbital can reduce the effectiveness of hormonal contraceptives.
- St. John’s Wort: This herbal supplement can reduce the effectiveness of Orsythia, increasing the risk of pregnancy.
Alternatives to Orsythia
- Lo Loestrin Fe: A low-dose combination contraceptive with a similar hormone combination but lower estrogen content.
- Yaz: Another combination birth control pill containing drospirenone and ethinyl estradiol, which may be helpful for acne and premenstrual dysphoric disorder (PMDD).
- Progestin-only pills (e.g., Micronor): Suitable for women who cannot take estrogen-containing pills due to health concerns such as blood clots or breastfeeding.
