Amethyst Dosage

Generic name: levonorgestrel and ethinyl estradiol
Dosage form: tablet

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

To achieve maximum contraceptive effectiveness, Amethyst must be taken exactly as directed and at intervals not exceeding 24 hours. The possibility of ovulation and conception prior to initiation of medication should be considered. Women who do not wish to become pregnant after discontinuation should be advised to immediately use another method of birth control. The dosage of Amethyst is one white tablet daily without any tablet-free interval.

It is recommended that Amethyst be taken at the same time each day.

Initiation of Therapy

Instructions for beginning Amethyst are provided in Table 4 below.

Table 4
 Current contraceptive therapy  Levonorgestrel and ethinyl estradiol tablets USP start day  Nonhormonal back-up method of birth control needed when correctly starting levonorgestrel and ethinyl estradiol tablets USP?
 None  Day 1 of patient’s menstrual cycle
(during the first 24 hours of her period)
 No
 21-day COC regimen OR 28-day COC regimen  Day 1 of patient’s withdrawal bleed, at the latest 7 days after her last active tablet  No
 Progestin-only pill  Day after taking a
progestin-only pill
 Yes, for the first 7 days of levonorgestrel and ethinyl estradiol tablets USP tablet-taking
 Implant  Day of implant removal  Yes, for the first 7 days of levonorgestrel and ethinyl estradiol tablets USP tablet-taking
 Injection  Day the next injection is due  Yes, for the first 7 days of levonorgestrel and ethinyl estradiol tablets USP tablet-taking

If spotting or unscheduled bleeding occurs, the patient is instructed to continue on the same regimen. This type of bleeding is usually transient and without significance; however, if the bleeding is persistent or prolonged, the patient is advised to consult her health care professional. The possibility of ovulation increases with each successive day that scheduled white tablets are missed. If the patient has not adhered to the prescribed schedule (missed one or more tablets or started taking them on a day later than she should have), the probability of pregnancy should be considered. Hormonal contraception must be discontinued if pregnancy is confirmed.

The risk of pregnancy increases with each tablet missed. For additional patient instructions regarding missed tablets, see the WHAT TO DO IF YOU MISS PILLS section in the DETAILED PATIENT LABELING below.

Levonorgestrel and ethinyl estradiol tablets USP may be initiated no earlier than day 28 postpartum in the nonlactating mother or after a second-trimester abortion due to the increased risk for thromboembolism (see CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS concerning thromboembolic disease). The patient should be advised to use a nonhormonal back-up method for the first 7 days of tablet-taking. However, if intercourse has already occurred, pregnancy should be excluded before the start of combined oral contraceptive use or the patient must wait for her first menstrual period.

In the case of first-trimester abortion, if the patient starts Amethyst immediately, additional contraceptive measures are not needed.

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