Drug Uses

Alesse is one of the most effective methods for birth control (99% effective when taken as directed). Alesse contains natural hormones that stop the ovary from releasing an egg and prevent a man's sperm from entering the uterus. So with Alesse you can put your mind at ease and enjoy intimate moments with your partner.

How Taken

Take the first pill in a package on the first Sunday after your period begins (unless otherwise directed by your doctor). Take one pill every day, no more than 24 hours after your last dose. Try to take the pills at a time that you will remember every day--for example just before bed, with a meal, or first thing in the morning. Taking your pill at night may help to reduce any nausea or headache that you may experience because of the hormones. If you are on a 28-day cycle, take one pill every day. When the pack runs out, throw it away. Begin a new pack the following day. The 28-day cycle contains seven pills that are either placebos (with no active ingredients) or iron supplements. These are "reminder" pills to keep you on your regular cycle. They are taken while you are menstruating. If you are on a 21-day cycle, take one pill every day for 21 days, then do not take any pills for 7 days. You should have your period during the 7 days with no pills. Resume your pills on the 8th day with a new package. Follow your doctor's instructions about using a second form of birth control when you first start taking birth control pills, when you are taking antibiotics, or if you miss a pill. If you are unsure what to do in any of these cases, talk to your pharmacist, nurse, or doctor about how to ensure that you will not become pregnant.

Warnings/Precautions

Before taking this medication, tell your doctor if you have high blood pressure, angina, or heart disease; have had a stroke; have a bleeding or blood-clotting disorder; have breast, uterine, or another hormone-related cancer; have liver disease or a history of jaundice (yellowing of the skin and eyes) caused by use of birth control in the past; have undiagnosed, abnormal vaginal bleeding; have migraines; have asthma; or have seizures or epilepsy. You may not be able to take birth control pills, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above. Birth control pills are in the FDA pregnancy category X. This means that birth control pills will cause birth defects in an unborn baby. Hormonal changes during pregnancy can have very serious negative effects on a developing baby. Do not take birth control pills if you are pregnant or if you think you might be pregnant. The hormones in birth control pills pass into breast milk and may decrease milk production. Do not take birth control pills without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

If you miss pills you could get pregnant. This includes starting the pack late. The more pills you miss, the more likely you are to get pregnant in the 7 days after you miss pills. The pill may not be as effective if you miss pink active pills, and particularly if you miss the first few or the last few pink active pills in a pack. MISSING PILLS CAN ALSO CAUSE SPOTTING OR LIGHT BLEEDING, even when you make up these missed pills. On the days you take 2 pills to make up for missed pills, you could also feel a little sick to your stomach.

Possible Side Effects

- Vaginal bleeding
- Fluid retention
- Melasma.
Other side effects may include nausea, breast tenderness, change in appetite, headache, nervousness, depression, dizziness, loss of scalp hair, rash, vaginal infections, inflammation of the pancreas, and allergic reactions. If any of these side effects bother you, call your health-care provider.

Storage

Store at controlled room temperature 20° to 25°C (68° to 77°F). Keep this medication in the container it came in, and out of reach of children.

Overdose

Symptoms of oral contraceptive over dosage in adults and children may include nausea, vomiting, and drowsiness/fatigue; withdrawal bleeding may occur in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.

More Information

Your health-care provider will take a medical and family history before prescribing oral contraceptives and will examine you. The physical examination may be delayed to another time if you request it and the health-care provider believes that it is appropriate to postpone it. You should be reexamined at least once a year. Be sure to inform your health-care provider if there is a family history of any of the conditions listed previously in this leaflet. Be sure to keep all appointments with your health-care provider, because this is a time to determine if there are early signs of side effects of oral-contraceptive use. Do not use the drug for any condition other than the one for which it was prescribed. This drug has been prescribed specifically for you; do not give it to others who may want birth-control pills. Avoid smoking. Smoking greatly increases your risk of a heart attack, stroke, or blood clot formation.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Birth Control for Women with Epilepsy Is there any way to be sure that I don't get pregnant? All available birth control methods can be used by persons with epilepsy. These include: * barriers: diaphragms, spermicidal vaginal creams, intrauterine devices (IUDs) and condoms; * timing: the "rhythm method" where intercourse is avoided during a woman's ovulation period or withdrawal by the man prior to ejaculation; * hormonal contraception: birth control pills, hormone implants, or hormone injections. Of these, hormonal contraception is the most reliable method for most women, but it is not 100% effective, especially in women with epilepsy. Keep in mind that even in the general population there is always a slight chance of an unwanted pregnancy despite appropriate use of contraceptives. If you have decided that you never want to have children, you can talk to your doctor about an operation called a tubal ligation. This procedure is the most secure way to ensure that you will never become pregnant. If you are in a monogamous relationship (only one male partner) he can have a similar operation, a vasectomy. This would not protect you from pregnancy with other male partners. These are serious decisions, and you need to think about them carefully before choosing either of these procedures. How do I know which method is best for me? You need to work with your gynecologist and your neurologist to choose the birth control method that is most appropriate for you. It is possible that your antiepileptic drug (AED) may make your hormonal birth control less reliable, resulting in an unwanted pregnancy. You and your physicians may consider different combinations of hormonal birth control and seizure medications to find the one that works best for you. How will my seizure medication affect my hormonal birth control? There are complex interactions between the hormones (estrogen and progesterone) contained in birth control pills or devices, and some of the medications used to control seizures. Some of these medications increase the breakdown of contraceptive hormones in the body, making them less effective in preventing pregnancy. The seizure medications that have this effect are often called "liver enzyme-inducing" drugs because the liver is the organ that breaks down these hormones. They are carbamazepine (Tegretol, Carbatrol), oxcarbazepine (Trileptal), phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline), and topiramate (Topamax). Valproate (Depakote) and felbamate (Felbatol) do not increase breakdown of hormones, and may even increase hormonal levels, which may require an adjustment in the dose of your birth control. Gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), and tiagabine (Gabitril) have no effect on this system and do not interfere with the effectiveness of hormonal birth control. Are there special concerns about "the pill" for women with epilepsy? Yes, there are. The popular low-dose combined oral contraceptive pill has a relatively small amount of estrogen (less than 35 micrograms). That's not enough to protect women with epilepsy who take enzyme-inducing AEDs from becoming pregnant. You may need contraceptive pills with higher doses of estrogen, and even then, there is a risk of unexpected pregnancy. It is a good idea to use barrier methods (a diaphragm, spermicidal cream or a condom) in addition to the contraceptive pill, if you are taking one of the seizure medications that speed up the breakdown of the hormones in birth control pills. Are there problems with other forms of hormonal birth control? Hormonal implants, like levonorgestrel (Norplant) which is placed under the skin, may not provide effective birth control protection if you are taking certain epilepsy drugs. The medications that cause the most problems with Norplant are the "liver enzyme-inducing" seizure medications such as carbamazepine (Tegretol, Carbatrol), oxcarbazepine (Trileptal), phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline), and topiramate (Topamax). These antiepileptic drugs increase the rate of breakdown of birth control hormones. Medroxyprogesterone (Depo-Provera) is a hormonal injection used for birth control and it may need to be given more frequently in women with epilepsy taking medications such as those mentioned earlier. If you are using one of these forms of birth control, and you take one of the liver enzyme-inducing medications, it is a good idea to use a second barrier method of contraception in addition, such as a diaphragm, a spermicidal cream, or have your partner use a condom. Are there any warning signals if my contraception is not working? Breakthrough bleeding while you're on hormonal contraception, for example during the middle of your cycle, could be a sign that you are ovulating and may become pregnant. If you are using birth control pills, bleeding at any other time than when you switch from the active to the inactive pills may indicate that the pills are not working. If bleeding occurs, ask your doctor to help you select an additional form of contraception such as a diaphragm, spermicidal vaginal cream, or condom. It is important for you to know that hormonal contraception can fail without signs of breakthrough bleeding. Does it matter that my periods aren't regular? Yes, because it may make hormonal birth control and timing methods more complicated. Usually, irregular menstrual cycles mean that hormones are out of balance in some way. It is important for your gynecologist and your neurologist to know if your periods are irregular so that they can help you choose the best method of contraception. It may be necessary to consult with an endocrinologist, a doctor who specializes in diagnosing and treating hormonal problems. Will my seizure pattern change if I use hormonal birth control? Current research does not indicate changes in seizure frequency when women with epilepsy use hormonal birth control, but individual reports suggest they may change. Some women have reported more seizures, some have reported less. If you notice a change in your seizure pattern when you use hormonal birth control, contact your physician.

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