Gynecology Book

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Mini-Pill

Aka: Mini-Pill, Progesterone only OCP, Progestogen only oral contraceptive, Micronor, Nor QD, Nor-QD, Ovrette, Noriday, Nora-BE, Jolivette, Camila, Errin, Femulen, Norgeston, Microlut, Cerazette, Jencycla, Slynd
  1. See Also
    1. Oral Contraceptive
    2. Norethindrone
    3. Drospirenone
  2. Mechanism
    1. No Estrogen
    2. Progesterone only (typically L/L/L for Norethindrone 350 mcg)
      1. Low Progestational Activity
      2. Low Androgenic Activity
      3. Low Endometrial Activity
  3. Indications: Contraception
    1. Lactation
    2. Estrogen contraindicated
      1. See Oral Contraceptives
      2. Age over 35 years old and Tobacco use
      3. Migraine with Aura (risk of CVA)
      4. Venous Thromboembolism Risk
  4. Efficacy
    1. High failure rate compared with combination pills
      1. Consider more effective Progesterone-only options (Mirena IUD, Nexplanon Contraceptive Implant)
    2. Better efficacy then barrier methods
    3. Failure rates
      1. Perfect use: 0.5% failure rate
      2. Typical use: 5% failure rate
  5. Precautions
    1. Must be taken at the same time everyday (within 2 hours)
    2. Delay of 3 hours or more requires backup contraceptive use for 2 days
  6. Adverse Effects
    1. Ectopic Pregnancy increased Incidence
    2. Breakthrough Menstrual Bleeding
      1. Consider switching to combination Oral Contraceptive
  7. Preparations
    1. Norethindrone 350 mcg
      1. Micronor, Nor-QD, Nora-BE, Jolivette, Camila or Errin
      2. Noriday (UK)
    2. Norethindrone 750 mcg
      1. Ovrette
    3. Drospirenone 4 mg (Slynd)
      1. Released in 2019 in U.S. at $200/month
      2. Marketed as having more maintained efficacy after a missed pill than Norethindrone
        1. Does not require back-up Contraception if missed pill is taken within 24 hours
      3. Risk of Hyperkalemia (anti-mineralcorticoid effect)
      4. (2019) Presc Lett 26(10): 58
    4. Ethynodiol Diacetate 500 mcg
      1. Femulen (UK)
    5. Levonorgestrel 30 mcg
      1. Norgeston (UK)
      2. Microlut (Australia)
    6. Desogestrel 75 mcg
      1. Cerazette (UK)
    7. References
      1. Wikipedia
        1. http://en.wikipedia.org/wiki/Oral_contraceptive_formulations
Medication Costs
Jencycla (on 6/18/2017 at Walmart.com)
Jencycla #28 tablets for $9.00 $0.32 each
nora-be (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
NORA-BE TABLET Generic $0.38 each
jolivette (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
JOLIVETTE TABLET Generic $0.38 each
camila (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
CAMILA 0.35 MG TABLET Generic $0.38 each
errin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
ERRIN 0.35 MG TABLET Generic $0.38 each
jencycla (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
JENCYCLA 0.35 MG TABLET Generic $0.38 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Progestogen only oral contraceptive (C0420857)

Concepts Finding (T033)
SnomedCT 146703002, 169467008
English Progestogen only oral contracp, Mini-pill: oral contraceptive, Progestogen only oral contraceptive, Progestogen only pill, Progestogen only oral contraceptive (finding)
Spanish anticonceptivo oral solamente con progestágeno (hallazgo), anticonceptivo oral solamente con progestágeno
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Micronor (C0699160)

Concepts Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110)
MSH D009640
English ortho micronor, micronor, Ortho Micronor, Micronor
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Nor-QD (C0699165)

Concepts Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110)
MSH D009640
English Nor QD, nor-qd, norqd, nor q d, nor qd, NorQD, Nor-Q.D., Nor-QD
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Ovrette (C0699169)

Concepts Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110)
MSH D009644
English Norgestrel Wyeth Brand, Wyeth Brand of Norgestrel, Ovrette
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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