Pharm

Mini-Pill

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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

  • See Also
  • Mechanism
  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
  • 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
  • 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
  • Adverse Effects
  1. Ectopic Pregnancy increased Incidence
  2. Breakthrough Menstrual Bleeding
    1. Consider switching to combination Oral Contraceptive
  • 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