Femexin Uses

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What is Femexin?

Levonorgestrel (Femexin) and ethinyl estradiol combination is used to prevent pregnancy in women who can get pregnant with a BMI less than 30 kilograms (kg) per square meter (m2). It works by stopping a woman's egg from fully developing each month. The egg can no longer accept a sperm and fertilization (pregnancy) is prevented.

No contraceptive method is 100 percent effective. Birth control methods such as having surgery to become sterile or not having sex are more effective than birth control patches. Discuss your options for birth control with your doctor.

Levonorgestrel (Femexin) and ethinyl estradiol will not prevent HIV infection or other sexually transmitted diseases. It will not help as emergency contraception, such as after unprotected sexual contact.

Levonorgestrel (Femexin) and ethinyl estradiol is available only with your doctor's prescription.

Femexin indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Levonorgestrel (Femexin) and Ethinyl Estradiol tablets USP is indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception.

Oral contraceptives are highly effective for pregnancy prevention. Table 2 lists the typical unintended pregnancy rates for users of combination oral contraceptives and other methods of contraception. The efficacy of these contraceptive methods, except sterilization, the IUD, and implants, depend upon the reliability with which they are used. Correct and consistent use of methods can result in lower failure rates.

Table 2: Percentage of Women Experiencing an Unintended Pregnancy During The First Year of Typical Use and The First Year of Perfect Use of Contraception and The Percentage Continuing Use at The End of the First Year. United States.

% of Women Experiencing an Unintended Pregnancy within the First Year of Use

% of Women

Continuing Use at One Year3

Method (1)

Typical Use1 (2)

Perfect Use2 (3)

(4)

Chance4

85

85

Spermicides5

26

6

40

Periodic abstinence

25

63

Calendar

9

Ovulation Method

3

Sympto-Thermal6

2

Post-Ovulation

1

Cap7

Parous Women

40

26

42

Nulliparous Women

20

9

56

Sponge

Parous Women

40

20

42

Nulliparous Women

20

9

56

Diaphragm7

20

6

56

Withdrawal

19

4

Condom8

Female (RealityTM)

21

5

56

Male

14

3

61

Pill

5

71

Progestin only

0.5

Combined

0.1

IUD

Progesterone T

2.0

1.5

81

Copper T380A

0.8

0.6

78

LNg 20

0.1

0.1

81

Depo-Provera®

0.3

0.3

70

Levonorgestrel (Femexin)

Implants (Norplant®)

0.05

0.05

88

Female Sterilization

0.5

0.5

100

Male Sterilization

0.15

0.10

100

Emergency Contraceptive Pills: The FDA has concluded that certain combined oral contraceptives containing ethinyl estradiol and norgestrel or Levonorgestrel (Femexin) are safe and effective for use as postcoital emergency contraception. Treatment initiated within 72 hours after unprotected intercourse reduces the risk of pregnancy by at least 75%.9

Lactation Amenorrhea Method: LAM is a highly effective, temporary method of contraception.10

Source: Trussell J. Contraceptive efficacy. In: Hatcher RA, Trussell J, Stewart F, Cates W, Stewart GK, Kowel D, Guest F. Contraceptive Technology: Seventeenth Revised Edition. New York NY: Irvington Publishers; 1998.

1.
Among typical couples who initiate use of a method (not necessarily for the first time), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason.
2.
Among couples who initiate use of a method (not necessarily for the first time) and who use it perfectly (both consistently and correctly), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason.
3.
Among couples attempting to avoid pregnancy, the percentage who continue to use a method for one year.
4.
The percents becoming pregnant in columns (2) and (3) are based on data from populations where contraception is not used and from women who cease using contraception in order to become pregnant. Among such populations, about 89% become pregnant within one year. This estimate was lowered slightly (to 85%) to represent the percent who would become pregnant within one year among women now relying on reversible methods of contraception if they abandoned contraception altogether.
5.
Foams, creams, gels, vaginal suppositories, and vaginal film.
6.
Cervical mucus (ovulation) method supplemented by calendar in the pre-ovulatory and basal body temperature in the post-ovulatory phases.
7.
With spermicidal cream or jelly.
8.
Without spermicides.
9.
The treatment schedule is one dose within 72 hours after unprotected intercourse and a second dose 12 hours after the first dose. The FDA has declared the following dosage regimens of oral contraceptives to be safe and effective for emergency contraception: for tablets containing 0.05 mg of ethinyl estradiol and 0.50 mg of norgestrel 1 dose is 2 tablets; for tablets containing 0.02 mg of ethinyl estradiol and 0.1 mg of Levonorgestrel (Femexin) 1 dose is 5 tablets; for tablets containing 0.03 mg of ethinyl estradiol and 0.15 mg of Levonorgestrel (Femexin) 1 dose is 4 tablets.
10.
However, to maintain effective protection against pregnancy, another method of contraception must be used as soon as menstruation resumes, the frequency or duration of breastfeeds is reduced, bottle feeds are introduced, or the baby reaches 6 months of age.

Clinical Studies

The efficacy and safety of Levonorgestrel (Femexin) and Ethinyl Estradiol were studied in 2 one-year clinical trials of subjects age 18-49. There were no exclusions for body mass index (BMI), weight, or bleeding history.

The primary efficacy and safety study (313-NA) was a one-year open-label clinical trial that treated 2,134 subjects in North America. Of these subjects 1,213 (56.8%) discontinued prematurely, including 102 (4.8%) discontinued by the Sponsor for early study closure. The mean weight of subjects in this study was 70.38 kg. The efficacy of Levonorgestrel (Femexin) and Ethinyl Estradiol was assessed by the number of pregnancies that occurred after the onset of treatment and within 14 days of the last dose. Among subjects 35 years or less, there were 23 pregnancies (4 of these occurred during the interval 1 to 14 days after the last day of pill use) during 12,572 28-day pill packs of use. The resulting total Pearl Index was 2.38 (95% CI: 1.51, 3.57) and the one-year life table pregnancy rate was 2.39 (95% CI: 1.57, 3.62). Pill pack cycles during which subjects used back-up contraception or were not sexually active were not included in these calculations. Among women 35 years or less who took the pills completely as directed, there were 15 pregnancies (method failures) resulting in a Pearl Index of 1.55 (95% CI: 0.87, 2.56) and the one-year life table pregnancy rate was 1.59 (95% CI: 0.95-2.67).

In a second supportive study conducted in Europe (315-EU), 641 subjects were randomized to Levonorgestrel (Femexin) and Ethinyl Estradiol (n=323) or the cyclic comparator of 0.1 mg Levonorgestrel (Femexin) and 0.02 mg ethinyl estradiol (n=318). The mean weight of subjects in this study was 63.86 kg. The efficacy analysis among women 35 years or less included 2,756 Levonorgestrel (Femexin) and Ethinyl Estradiol pill packs and 2,886 cyclic comparator pill packs. There was one pregnancy in the Levonorgestrel (Femexin) and Ethinyl Estradiol group that occurred within 14 days following the last dose. There were three pregnancies in the cyclic comparator group.

Inhibition of Menses (Bleeding Profile)

The bleeding profile for subjects in Study 313-NA also was assessed. Women with a history of unscheduled bleeding and/or spotting were not excluded from the study.

In those subjects who provided complete bleeding data, the percentage of patients who were amenorrheic in a given cycle and remained amenorrheic through cycle 13 (cumulative amenorrhea rate) was determined (Figure 2).

Figure 2: Percentage of Subjects with Cumulative Amenorrhea for Each Pill Pack through Pill Pack 13

When prescribing Levonorgestrel (Femexin) and Ethinyl Estradiol, the convenience of having no scheduled menstrual bleeding should be weighed against the inconvenience of unscheduled bleeding and spotting.

Femexin description

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Each tablet contains Levonorgestrel (Femexin) 100 mcg and Ethinylestradiol (Femexin) 20 mcg.

Femexin is a combined oral contraceptive (COC) tablet containing the synthetic progestin, Levonorgestrel (Femexin) and the synthetic estrogen, Ethinylestradiol (Femexin).

Levonorgestrel (Femexin) is (-)-13-ethyl-17-hydroxy-18,19-dinor-17α-pregn-4-en-20-yn-3-one. Its chemical formula is C21H28O2. It has a molecular weight of 312.45 and a melting point of 232-239°C.

Levonorgestrel (Femexin) is a white, odorless crystalline powder. It is practically insoluble in water, slightly soluble in alcohol, acetone, ether and soluble in chloroform.

Ethinylestradiol (Femexin) is 19-nor-17α-pregna-1,3,5(10)-trien-20-yne-3,17-diol. Its chemical formula is C20H24O2. It has a molecular weight of 296.41 and a melting point of 181-185°C.

Ethinylestradiol (Femexin) is a white to creamy white, odorless crystalline powder. It is insoluble in water and soluble in alcohol, chloroform, ether, vegetable oils and aqueous solutions of alkali hydroxides.

Femexin dosage

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The recommended dose for the prevention of pregnancy and the treatment of acne is the same.

To achieve maximum contraceptive effectiveness, Femexin must be administered as directed and at the same time everyday, preferably after the evening meal or at bedtime.

How to Take Femexin: Tablets 1-21 contain active ingredients (active tablets).

Tablets must be taken in the order directed on the package every day at about the same time. One tablet is to be taken daily for 21 consecutive days, followed by a 7-day tablet-free interval. Each subsequent pack is started on the day after the tablet-free interval. A withdrawal bleed usually starts on days 2-3 after the last active tablet and may not have finished before the next pack is started.

How to Start Femexin: No Hormonal Contraceptive Use Within the Preceding Month: Tablet-taking should start on day 1 of the woman's natural menstrual cycle (ie, the first day of menstrual bleeding). Starting on days 2-7 of the menstrual cycle (eg, Sunday start) is allowed; however, a nonhormonal back-up method of birth control (eg, condoms, spermicide) is recommended during the first 7 days of Femexin use.

Switching from Another Combined

Oral Contraceptive (COC):

Preferably, Femexin use should begin the day after the last active tablet of the previous COC pack has been taken but no later than the day following the usual tablet-free or inactive tablet interval of the previous COC.

Switching from a Progestin-Only Method of Birth Control [Pill, Implant, Intrauterine Device (IUD), injection]: The user may discontinue use of a progestin-only pill on any day and should start use of Femexin the following day. Femexin use should begin on the same day that a progestin-only implant or a progestin-only IUD is removed or on the day that the next progestin-only injection is scheduled.

In each of these situations, the user should be advised to use a nonhormonal back-up method of birth control during the first 7 days of Femexin use.

Following First-Trimester Abortion: Start Femexin immediately. Additional contraceptive measures are not needed.

Postpartum: Since the immediate postpartum period is associated with an increased risk of thromboembolism, Femexin use should begin no sooner than the 28th postpartum day following either delivery in a nonlactating woman or second-trimester abortion. The woman should be advised to use a nonhormonal back-up method of birth control during the first 7 days of Femexin use. However, if intercourse has already occurred, pregnancy must be ruled out before Femexin use is begun; otherwise, the woman must wait until her first menstrual period before beginning Femexin use.

How to Delay a Period: To delay a menstrual period, the user should skip the tablet-free interval and immediately begin a new pack of Femexin. The delay may be continued for as long as desired up until all tablets in the new pack are taken. During the delay, the user may experience breakthrough bleeding or spotting. Regular intake of Femexin should be resumed after the usual 7-day tablet-free interval.

Management of Missed Tablets: Contraceptive protection may be reduced if active tablets are missed, particularly if the missing of tablets extends the tablet-free interval.

If one active tablet is missed but is remembered within 12 hours of the usual dose, it should be taken as soon as it is remembered. Subsequent tablets should be taken at the usual time.

If one active tablet is missed and is remembered more than 12 hours after the usual dose or if two or more active tablets are missed, contraceptive protection may be reduced. The last missed tablet should be taken as soon as it is remembered, which may result in the user taking two tablets on the same day. Subsequent tablets should be taken at the usual time. A nonhormonal back-up method of birth control must be used for the next 7 days.

If the user takes the last active tablet before the 7-day interval during which use of a nonhormonal back-up method of birth control is required has ended, the user must begin a new pack immediately; there should be no tablet-free interval between packs. This prevents an extended break in the tablet-taking interval, thereby reducing the risk of escape ovulation. The user is unlikely to have a withdrawal bleed until all tablets in the new pack are taken, although spotting or breakthrough bleeding may be experienced on tablet-taking days. If the user does not have a withdrawal bleed after all tablets in the new pack are taken, pregnancy must be ruled out before tablet-taking is resumed.

Advice in Case of Vomiting and/or Diarrhea: If vomiting or diarrhea occurs within 4 hours after tablet-taking, tablet absorption may be incomplete. The user must take the needed active tablet(s) from a back-up pack.

Femexin interactions

See also:
What other drugs will affect Femexin?

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Always inform the prescriber which medicines or herbal products that the patient is using. Also tell any other doctor or dentist who prescribes another medicine (or the dispensing pharmacist) that the patient uses Femexin. The healthcare providers can tell if the patient needs to take additional contraceptive precautions (eg, condoms) and if so, for how long.

Some medicines can make Femexin less effective in preventing pregnancy or can cause unexpected bleeding.

These include medicines used for the treatment of epilepsy (eg, primidone, phenytoin, barbiturates, carbamazepine, oxcarbamazepine) and tuberculosis (eg, rifampicin) or HIV infections (ritonavir) or other infectious disease (eg, griseofulvin, ampicillin, tetracycline) to increase intestinal motility (eg, metoclopramide) and the herbal remedy St. John's wort.

If the patient wants to use herbal products containing St. John 's wort while she is already using Femexin, consult the doctor first.

Femexin may decrease efficacy of other medicines eg, medicines containing cyclosporine or the antiepileptic lamotrigine (this could lead to an increased frequency of seizures).

Ask the doctor or pharmacist for advice before taking any medicine.

Laboratory Tests: If the patient needs blood test, inform the doctor or the laboratory staff that she is taking Femexin, because oral contraceptives can affect the results of some tests.

Femexin side effects

See also:
What are the possible side effects of Femexin?

An increased risk of the following serious adverse reactions has been associated with the use of oral contraceptives.

Thromboembolic disorders and other vascular problems (including thrombophlebitis, arterial thromboembolism, pulmonary embolism, myocardial infarction, cerebral hemorrhage, cerebral thrombosis), carcinoma of the reproductive organs, hepatic neoplasia (including hepatic adenomas or benign liver tumors), ocular lesions (including retinal vascular thrombosis), gallbladder disease, carbohydrate and lipid effects, elevated blood pressure, and headache.

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

Nausea.

Vomiting.

Gastrointestinal symptoms (such as abdominal pain, cramps and bloating).

Breakthrough bleeding.

Spotting.

Change in menstrual flow.

Amenorrhea.

Temporary infertility after discontinuation of treatment.

Edema/fluid retention.

Melasma/chloasma which may persist.

Breast changes: tenderness, pain, enlargement, secretion.

Change in weight or appetite (increase or decrease).

Change in cervical erosion and secretion.

Diminution in lactation when given immediately postpartum.

Cholestatic jaundice.

Rash (allergic).

Mood changes, including depression.

Vaginitis, including candidiasis.

Change in corneal curvature (steepening).

Intolerance to contact lenses.

Mesenteric thrombosis.

Decrease in serum folate levels.

Exacerbation of systemic lupus erythematosus.

Exacerbation of porphyria.

Exacerbation of chorea.

Aggravation of varicose veins.

Anaphylactic/anaphylactoid reactions, including urticaria, angioedema, and severe reactions with respiratory and circulatory symptoms.

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

Congenital anomalies.

Premenstrual syndrome.

Cataracts.

Optic neuritis, which may lead to partial or complete loss of vision.

Cystitis-like syndrome.

Nervousness.

Dizziness.

Hirsutism.

Loss of scalp hair.

Erythema multiforme.

Erythema nodosum.

Hemorrhagic eruption.

Impaired renal function.

Hemolytic uremic syndrome.

Budd-Chiari syndrome.

Acne.

Changes in libido.

Colitis.

Sickle-cell disease.

Cerebral-vascular disease with mitral valve prolapse.

Lupus-like syndromes.

Pancreatitis.

Dysmenorrhea.

Femexin contraindications

See also:
What is the most important information I should know about Femexin?

Hypersensitivity to any of the components of Femexin; current or history of deep vein thrombosis and thromboembolism; hepatic adenomas or carcinomas, active liver disease, as long as liver function has not returned to normal; known or suspected carcinoma of the breast or other known or suspected estrogen-dependent neoplasia; disorders of lipometabolism; thrombogenic rhythm disorders and thrombogenic valvulopathies; sickle-cell anemia; diabetes with vascular involvement; undiagnosed vaginal bleeding; known or suspected pregnancy; cerebrovascular or coronary artery disease; uncontrolled hypertension; hereditary or acquired thrombophilias; headache with focal neurological symptoms such as aura; pancreatitis associated with severe hypertriglyceridemia (current or history).

Reasons for the Immediate Discontinuation of Femexin: Occurrence for the first time of migrainous headaches or the more frequent occurrence of unusually severe headaches; acute disturbances of vision, hearing or speech; first symptoms of thrombophlebitis or thromboembolism (eg, unusual pain in or swelling of the legs, stabbing pain on breathing or coughing for no apparent reason); feeling of pain or tightness in the chest; six weeks before planned operations or during prolonged periods of immobilization; development of jaundice (cholestasis), hepatitis or generalized pruritus; increase in epileptic seizures; significant rise in blood pressure; onset of severe clinical depression; severe upper abdominal pain or liver enlargement.

Use in Pregnancy: If pregnancy occurs during treatment with combined oral contraceptives (COCs), further intake should be discontinued. There is no conclusive evidence that the estrogen and progestin contained in the COC will damage the developing child if conception accidentally occurs during COC use.

Use in Lactation: Small amounts of contraceptive steroids and/or metabolites have been identified in the milk of nursing mothers and a few adverse effects on the child have been reported, including jaundice and breast enlargement. Lactation may be affected by COCs, as COCs may reduce the quantity and change the composition of breast milk.

The use of COCs is generally not recommended until the nursing mother has completely weaned her child.



Active ingredient matches for Femexin:

Ethinylestradiol/Levonorgestrel in Argentina.


List of Femexin substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Dragee; Oral; Ethinyl Estradiol; Levonorgestrel (Wyeth)
Tablet; Oral; Ethinyl Estradiol 0.03 mg; Levonorgestrel 0.15 mg (Silesia)
Generic Alesse 0.03/0.15 mg - 21 Tablets$ 34.95
Generic Alesse 0.03/0.15 mg - 63 Tablets$ 69.95
Tablet, Sugar-Coated; Oral; Ethinyl Estradiol 0.05 mg; Levonorgestrel 0.125 mg (Jenapharm)
Tablet; Oral; Ethinyl Estradiol 0.03 mg; Levonorgestrel 0.15 mg (Laboratorios chile)
Lady 28's (DKT)$ 0.91
Lady tab 28's (DKT)$ 1.00

References

  1. 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).
  2. PubChem. "Levonorgestrel". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "Levonorgestrel". http://www.drugbank.ca/drugs/DB00367 (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Femexin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Femexin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

1 consumer reported useful

Was the Femexin drug useful in terms of decreasing the symptom or the disease?
According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
Users%
Useful1
100.0%


1 consumer reported price estimates

Was the price you paid to purchase the drug reasonable? Did you feel it was expensive?
The below mentioned numbers have been reported by ndrugs.com website users about whether the Femexin drug is expensive or inexpensive. There is a mixed opinion among users. The rating about the cost of the drug depends on factors like which brand drug the patient purchased, how effective it was for the price paid, the country or place the drug is marketed, and the economic condition of the patient. The users who feel the drug is expensive can look for an alternative brand drug or a generic drug to save the cost.
Users%
Not expensive1
100.0%


1 consumer reported time for results

To what extent do I have to use Femexin before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 5 days and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Femexin. To get the time effectiveness of using Femexin drug by other patients, please click here.
Users%
5 days1
100.0%


6 consumers reported age

Users%
30-454
66.7%
16-292
33.3%


Consumer reviews

Shamima25 May 2020 08:44
I have taken 33pills and have not menstruated.Why please??


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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