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Nexesta Fe Dosage

Generic name: NORETHINDRONE 0.4mg, ETHINYL ESTRADIOL 0.035mg;
Dosage form: tablets
Drug class: Contraceptives

Medically reviewed by Drugs.com. Last updated on Nov 24, 2023.

How to Start Nexesta Fe

Nexesta Fe is dispensed in a blister pack [see How Supplied/Storage and Handling (16)]. Nexesta Fe may be started using either a Day 1 start or a Sunday start (see Table 1). For the first cycle of a Sunday Start regimen, an additional method of contraception should be used until after the first 7 consecutive days of administration.

How to Take Nexesta Fe

Nexesta Fe (white to off-white active tablets and brown placebo tablets) may be swallowed whole or chewed and swallowed. If the tablet is chewed, the patient should drink a full glass (8 ounces) of liquid immediately after swallowing.


Table 1: Instructions for Administration of Nexesta Fe
Starting CHCs in women not currently using hormonal contraception (Day 1 Start or Sunday Start)

Important:
Consider the possibility of ovulation and conception prior to initiation of this product.

Tablet Color:
• Nexesta Fe active tablets are white to off-white (Day 1 to Day 21).
• Nexesta Fe placebo tablets are brown (Day 22 to Day 28).
 Day 1 Start:
• Take first white to off-white active tablet on the first day of menses.
• Take subsequent white to off-white active tablets once daily at the same time each day for a total of 21 days.
• Take one brown placebo tablet daily for 7 days and at the same time of day that active tablets were taken.
• Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the day after taking the last inactive tablet).
Sunday Start:
• Take first active tablet on the first Sunday after the onset of menses. Due to the potential risk of becoming pregnant, use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of the patient’s first cycle pack of Nexesta Fe.
• Take subsequent white to off-white active tablets once daily at the same time each day for a total of 21 days.
• Take one brown placebo tablet daily for the following 7 days and at the same time of day that active tablets were taken.
• Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the Sunday after taking the last inactive tablet) and additional non-hormonal contraceptive is not needed.
Switching to Nexesta Fe from another hormonal contraceptive
 Start on the same day that a new pack of the previous hormonal contraceptive would have started.
Switching from another contraceptive method to Nexesta Fe
 Start Nexesta Fe:
• Transdermal patch
 • On the day when next application would have been scheduled
• Vaginal ring
 • On the day when next insertion would have been scheduled
• Injection
 • On the day when next injection would have been scheduled
• Intrauterine contraceptive
 • On the day of removal
• If the IUD is not removed on first day of the patient’s menstrual cycle, additional non-hormonal contraceptive (such as condoms and spermicide) is needed for the first seven days of the first cycle pack.
• Implant
 • On the day of removal
Complete instructions to facilitate patient counseling on proper tablet usage are located in the FDA-Approved Patient Labeling.

Starting Nexesta Fe after Abortion or Miscarriage

First-trimester

  • After a first-trimester abortion or miscarriage, Nexesta Fe may be started immediately. An additional method of contraception is not needed if Nexesta Fe is started within 5 days after termination of the pregnancy.
  • If Nexesta Fe is not started within 5 days after termination of the pregnancy, the patient should use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of her first cycle pack of Nexesta Fe.

Second-trimester

  • Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to the increased risk of thromboembolic disease. Start Nexesta Fe, following the instructions in Table 1 for Day 1 or Sunday start, as desired. If using Sunday start, use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of the patient’s first cycle pack of Nexesta Fe. [See Contraindications (4), Warnings and Precautions (5.1), and FDA-Approved Patient Labeling.]

Starting Nexesta Fe after Childbirth

Missed Tablets

Table 2: Instructions for Missed Nexesta Fe Tablets
  • If one white to off-white active tablet is missed in Weeks 1, 2, or 3
 Take the tablet as soon as possible. Continue taking one tablet a day until the pack is finished.
  • If two white to off-white active tablets are missed in Week 1 or Week 2
 Take the two missed tablets as soon as possible and the next two active tablets the next day.
Continue taking one tablet a day until the pack is finished. Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.
  • If two white to off-white active tablets are missed in Week 3 or three or more white to off-white active tablets are missed in a row in Weeks 1, 2, or 3
 Day 1 start: Throw out the rest of the pack and start a new pack that same day.
Sunday start: Continue taking one tablet a day until Sunday, then throw out the rest of the pack and start a new pack that same day.
Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.

Advice in Case of Gastrointestinal Disturbances

In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures should be taken. If vomiting or diarrhea occurs within 3 to 4 hours after taking an active tablet, handle this as a missed tablet [see FDA-Approved Patient Labeling].

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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