Description
Twirla contains two drugs: levonorgestrel, a progestin, and ethinyl estradiol, and estrogen. Twirla (levonorgestrel and ethinyl estradiol) is used to prevent pregnancy in women who have a body mass index (BMI) that is less than 30 kg/m2.
Fact Table |
Formula |
C21H28O2, C20H24O2 |
License |
US DailyMed, US FDA, EU EMA |
Bioavailability |
38% - 48% |
Legal status |
Rx-Only |
Chemical Name |
Levonogestrel and Ethinyl Estradiol |
Elimination half-life |
7–36 hours |
Dosage (Strength) |
120mcg/30mcg |
Pregnancy |
- |
Brands |
Twirla |
Protein binding |
97–98% |
PubChem CID |
13109, 5991 |
MedlinePlus |
a610021, a604032 |
ChEBI |
6443, 4903 |
ATC code |
G03AC03, G03CA01 |
DrugBank |
DB00367 |
KEGG |
D00950, D00554 |
Routes of administration |
Patches |
Directions
Twirla is available as a transdermal patch for use on the skin only. Follow the instructions that come with your prescription. If you have any questions, talk to your doctor or pharmacist.
The dose is to apply one patch to clean, dry, and intact skin every week for three consecutive weeks.
Apply the patch to the abdomen, buttock, or upper torso. Do not apply the patch to the breasts. Do not cut the patch. Do not wear the patch during the fourth week.
Each patch delivers 120 mcg/day of levonorgestrel and 30 mcg/day of ethinyl estradiol.
Ingredients
The active ingredients in Twirla include levonorgestrel and ethinyl estradiol.
Contraindications
WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS and CONTRAINDICATED IN WOMEN WITH A BMI = 30 KG/M2 See full prescribing information for complete boxed warning.
- TWIRLA is contraindicated in women over 35 years old who smoke. Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use.
- TWIRLA is contraindicated in women with a BMI = 30 KG/m2. Compared to women with a lower BMI, women with a BMI = 30 KGg/m2 had reduced effectiveness and may have a higher risk for venous thromboembolic events.
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- Do not use Twirla if you have or have ever had blood clots, a heart attack, or a stroke, uncontrolled high blood pressure, certain heart valve problems, a condition that makes your blood clot more than normal, or if you smoke and are older than 35 years old.
- Do not use Twirla if your body mass index is 30 kg/m2 or more.
- Do not use Twirla if you have or have had breast cancer or other hormonally-sensitive cancer.
- Do not use Twirla if you have liver tumors, acute viral hepatitis, or decompensated liver cirrhosis.
- Do not use Twirla if you have migraines with aura, if you are older than 35 years old and have migraines with or without aura, or if you have headaches with focal neurological symptoms.
- Do not use Twirla if you have undiagnosed abnormal bleeding from the vagina.
- Do not use Twirla if you are pregnant.
- Do not use Twirla if you are allergic to levonorgestrel, ethinyl estradiol, or any of its other ingredients.
- Do not use Twirla if you take hepatitis C drugs that contain ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.
Cautions
- Prior to using Twirla transdermal system, tell your doctor:
- About all the medications you take, including prescription, over-the-counter, vitamins, and herbal supplements
- About your allergies
- About your health conditions
- About any planned surgeries
- If you are pregnant or have plans to become pregnant
- If you are breastfeeding or have plans to breastfeed
- Twirla can increase your risk for blood clots, a heart attack, or a stroke. Cardiovascular risk factors should be considered before starting Twirla.
- Twirla can cause liver problems.
- Twirla can cause high blood pressure. Your blood pressure should be checked periodically.
- Twirla can cause or worsen existing gallbladder disease.
- Twirla can decrease glucose intolerance in women who are prediabetic or diabetic.
- Twirla can increase triglyceride levels, which can lead to pancreatitis.
- Twirla can cause headaches that may become severe or persistent.
- Twirla can cause abnormal vaginal bleeding or no menstruation.
Side Effects
The most common side effects of Twirla include application site reactions, nausea, headache, abnormal vaginal bleeding, and weight gain.
These are not all the possible side effects that can be caused by Twirla. Call your doctor right away if you develop side effects that become bothersome or won't go away.
Reference:
Twirla. Grand Rapids, MI: Corium International, Inc.; 2020.
About Dr. Savannah Muncy (Page Author)
Dr. Muncy (PharmD) studied science and education as an undergraduate before attending the Appalachian College of Pharmacy where she completed her PharmD in three years. She is currently using her pharmacy and healthcare expertise to write medical content for clients all around the world. She is focused on delivering the most current, accurate, and engaging information to healthcare professionals and patients. Read More....
IMPORTANT NOTE:
The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Product Code : 13643