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
  1. Oral Contraceptive
  2. Norethindrone
  3. Drospirenone
  • 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
  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