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Ethinyl estradiol / levonorgestrel Pregnancy and Breastfeeding Warnings

Ethinyl estradiol / levonorgestrel is also known as: Alesse, Alesse-28, Altavera, Amethia, Aubra, Aviane, Camrese, Enpresse, Falmina, Jolessa, Levora, LoSeasonique, Lutera, Lybrel, Myzilra, Nordette, Orsythia, Portia, Quasense, Seasonale, Seasonique, Sronyx, Tri-Levlen, Triphasil, Trivora

Ethinyl estradiol / levonorgestrel Pregnancy Warnings

Oral contraceptive combinations have been assigned to pregnancy category X. Although some reports have suggested that oral contraceptive hormones may cause a variety of congenital malformations, recent studies (including a meta-analysis of prospective studies) have suggested that an association between oral contraceptive use and congenital malformations does not exist. Some progestins may cause masculinization of female infants. There is no indication for the use of oral contraceptive combinations during pregnancy. Oral contraceptive combinations are contraindicated for use during pregnancy.

One case report has suggested that oral contraceptive hormones may cause choreoathetosis in infants exposed in utero. A recent case control study has suggested a weak association between use of older high dose contraceptives (particularly those containing 1.0 mg of ethynodiol diacetate) and the occurrence of congenital limb defects. However, the authors concluded that "this weak causal relationship was probable in the past when relatively high doses of contraceptive pills were used. This risk is apparently minimized by the use of new type (e.g., D-norgestrel) and lower dose of contraceptive pills".

Ethinyl estradiol / levonorgestrel Breastfeeding Warnings

Some studies have examined the effect of progestin-only contraceptives on breast-feeding. The extent to which such studies have bearing on oral contraceptive combinations is uncertain. Use of such formulations have not been associated with deleterious effects on breast-fed infants.

Both the estrogens and progestins occurring in commercially available oral contraceptive formulations are excreted into human milk in very small amounts. The American Academy of Pediatrics considers use of oral contraceptive combinations to be compatible with breast-feeding despite rare reports of breast enlargement in the nursing infant and the possibility of a decrease in milk production and protein content.

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