Enpresse-28 Dosage

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Dosage of Enpresse-28 in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Enpresse-28 Dosage

Generic name: Levonorgestrel (Enpresse-28) and Ethinyl estradiol (Enpresse-28)

Dosage form: Tablets

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

To achieve maximum contraceptive effectiveness, Enpresse-28®-21 Tablets (Levonorgestrel (Enpresse-28) and Ethinyl estradiol (Enpresse-28) tablets—triphasic regimen) must be taken exactly as directed and at intervals not exceeding 24 hours.

Enpresse-28-21 Tablets are a three-phase preparation. The dosage of Enpresse-28-21 Tablets is one tablet daily for 21 consecutive days per menstrual cycle in the following order: 6 brown tablets (phase 1), followed by 5 white tablets (phase 2), and then followed by the last 10 light-yellow tablets (phase 3), according to the prescribed schedule. Tablets are then discontinued for 7 days (three weeks on, one week off). It is recommended that Enpresse-28-21 Tablets be taken at the same time each day, preferably after the evening meal or at bedtime. During the first cycle of medication, the patient should be instructed to take one Enpresse-28-21 Tablet daily in the order of 6 brown, 5 white and, finally, 10 light-yellow tablets, for twenty-one (21) consecutive days, beginning on day one (1) of her menstrual cycle. (The first day of menstruation is day one.) The tablets are then discontinued for one week (7 days). Withdrawal bleeding usually occurs within 3 days following discontinuation of Enpresse-28-21 Tablets and may not have finished before the next pack is started. (If Enpresse-28-21 Tablets are first taken later than the first day of the first menstrual cycle of medication or postpartum, contraceptive reliance should not be placed on Enpresse-28-21 Tablets until after the first 7 consecutive days of administration and a nonhormonal back-up method of birth control should be used during those 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.)

When switching from another oral contraceptive, Enpresse-28-21 Tablets should be started on the first day of bleeding following the last active tablet taken of the previous oral contraceptive. The patient may switch any day from a progestin-only pill and should begin Enpresse-28-21 the next day. If switching from an implant or injection, the patient should start Enpresse-28-21 on the day of implant removal or, if using an injection, the day the next injection would be due. In switching from a progestin-only pill, injection, or implant, the patient should be advised to use a nonhormonal back-up method of birth control for the first 7 days of tablet-taking.

The patient begins her next and all subsequent 21-day courses of Enpresse-28-21 Tablets on the same day of the week that she began her first course, following the same schedule: 21 days on — 7 days off. She begins taking her brown tablets on the 8th day after discontinuance, regardless of whether or not a menstrual period has occurred or is still in progress. Any time a subsequent cycle of Enpresse-28-21 Tablets is started later than the 8th day, the patient should be protected by another means of contraception until she has taken a tablet daily for seven consecutive days.

If spotting or breakthrough bleeding occurs, the patient is instructed to continue on the same regimen. This type of bleeding is usually transient and without significance; however, if the bleeding is persistent or prolonged, the patient is advised to consult her physician. Although the occurrence of pregnancy is highly unlikely if Enpresse-28®-21 Tablets are taken according to directions, if withdrawal bleeding does not occur, the possibility of pregnancy must be considered. If the patient has not adhered to the prescribed schedule (missed one or more tablets or started taking them on a day later than she should have), the probability of pregnancy should be considered at the time of the first missed period and appropriate diagnostic measures taken before the medication is resumed. If the patient has adhered to the prescribed regimen and misses two consecutive periods, pregnancy should be ruled out before continuing the contraceptive regimen.

The risk of pregnancy increases with each tablet missed. For additional patient instructions regarding missed pills, see the “WHAT TO DO IF YOU MISS PILLS” section in the DETAILED PATIENT LABELING below. If breakthrough bleeding occurs following missed tablets, it will usually be transient and of no consequence.

Enpresse-28-21 may be initiated no earlier than day 28 postpartum in the non-lactating mother or after a second trimester abortion due to the increased risk for thromboembolism. The patient should be advised to use a nonhormonal back-up method for the first 7 days of tablet-taking. However, if intercourse has already occurred, pregnancy should be excluded before the start of combined oral contraceptive use or the patient must wait for her first menstrual period. In the case of first-trimester abortion, if the patient starts Enpresse-28-21 immediately, additional contraceptive measures are not needed. It is to be noted that early resumption of ovulation may occur if Parlodel® (bromocriptine mesylate) has been used for the prevention of lactation.

More about Enpresse-28 (Ethinyl estradiol (Enpresse-28) / Levonorgestrel (Enpresse-28))

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What other drugs will affect Enpresse-28?

Many drugs can affect Enpresse-28 (Enpresse-28), and some drugs can make hormonal birth control less effective, which may result in pregnancy. Tell your doctor about all your other medicines, especially:

This list is not complete and many other drugs may affect Enpresse-28 (Enpresse-28). This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Enpresse-28 (Enpresse-28) drug interactions (more detail)

Enpresse-28 interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Enpresse-28, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Interactions between Ethinyl estradiol (Enpresse-28) (EE) and other substances may lead to decreased or increased serum EE concentrations, respectively.

Decreased EE serum concentrations may cause an increased incidence of breakthrough bleeding and menstrual irregularities and may possibly reduce efficacy of the COC.

During concomitant use of EE-containing products and substances that may lead to decreased EE serum concentrations, it is recommended that a nonhormonal back-up method of birth control (such as condoms and spermicide) be used in addition to the regular intake of Enpresse-28. In the case of prolonged use of such substances COCs should not be considered the primary contraceptive.

After discontinuation of substances that may lead to decreased EE serum concentrations, use of a nonhormonal back-up method is recommended for at least 7 days. Longer use of a back-up method is advisable after discontinuation of substances that have lead to induction of hepatic microsomal enzymes, resulting in decreased EE serum concentrations. It may sometimes take several weeks until enzyme induction has completely subsided, depending on dosage, duration of use and rate of elimination of the inducing substance.

Examples of Substances that May Decrease Serum EE Concentrations: Any substance that reduces gastrointestinal transit time and therefore, EE absorption; substances that induce hepatic microsomal enzymes such as rifampicin, rifabutin, barbiturates, primidone, phenylbutazone, phenytoin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil; Hypericum perforatum, also known as St. John's wort, and ritonavir* (possibly by induction of hepatic microsomal enzymes); certain antibiotics (e.g., ampicillin and other penicillin, tetracyclines), by a decrease of enterohepatic circulation of estrogens.

Examples of Substances that May Increase Serum EE Concentrations: Atorvastatin; competitive inhibitors for sulfation in the gastrointestinal wall such as ascorbic acid (vitamin C) and paracetamol (acetaminophen); substances that inhibit cytochrome P-450 3A4 isoenzymes eg, indinavir, fluconazole, and troleandomycin.

Troleandomycin may increase the risk of intrahepatic cholestasis during co-administration with COCs.

EE may interfere with the metabolism of other drugs by inhibiting hepatic microsomal enzymes, or by inducing hepatic drug conjugation, particularly glucuronidation.

Accordingly, plasma and tissue concentration may either be increased (e.g., cyclosporine, theophylline, corticosteroids) or decreased (e.g., lamotrigine).

In patients treated with flunarizine, use of oral contraceptives has been reported to increase the risk of galactorrhea.

The prescribing information of concomitant medications should be consulted to identify potential interactions.

*Although ritonavir is an inhibitor of cytochrome P450 3A4, treatment with ritonavir has been shown to decrease EE serum concentrations.

Laboratory Test Interactions: Estrogen-containing preparations affect the following blood components and endocrine and liver function tests: Increased prothrombin and factors VII, VIII, IX and X; decreased antithrombin 3, increased norepinephrine-induced platelet aggregability.

Increased thyroid-binding globulin (TBG) leading to increased circulating total thyroid hormone, as measured by protein-bound iodine (PBI), T4 by column, or T4 by radioimmunoassay. Free T3 resin uptake is decreased, reflecting the elevated TBG, free T4 concentrations unaltered.

Decreased pregnanediol excretion.

Reduced response to metyrapone test.

Increased sulfobromophthalein retention.

The results of these tests should not be regarded as reliable until oral contraceptive use has been discontinued for 1-2 months. Abnormal tests should then be repeated.

Oral contraceptives may produce false-positive results when neutrophil alkaline phosphatase activity is evaluated for the early diagnosis of pregnancy.


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References

  1. DailyMed. "ETHINYL ESTRADIOL; NORETHINDRONE ACETATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "ESTRADIOL; LEVONORGESTREL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. FDA/SPL Indexing Data. "5W7SIA7YZW: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).

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