Mini-Pill

Aka: Mini-Pill, Progesterone Only OCP, Progestogen Only Oral Contraceptive, Progestin Only Pill, Progestin-Only Pill, Micronor, Nor QD, Nor-QD, Ovrette, Noriday, Nora-BE, Jolivette, Camila, Errin, Femulen, Norgeston, Microlut, Cerazette, Jencycla, Slynd

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II. 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

III. 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

IV. 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

V. 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

VI. Adverse Effects

  1. Ectopic Pregnancy increased Incidence
  2. Breakthrough Menstrual Bleeding
    1. Consider switching to combination Oral Contraceptive

VII. 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

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Related Studies

Cost: Medications

nora-be (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
NORA-BE TABLET Generic $0.15 each
camila (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CAMILA 0.35 MG TABLET Generic $0.15 each
errin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ERRIN 0.35 MG TABLET Generic $0.15 each
jencycla (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
JENCYCLA 0.35 MG TABLET Generic $0.15 each
slynd (on 8/17/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SLYND 4 MG TABLET $6.63 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. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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