Previfem Dosage

How to Start Previfem®

Previfem® (norgestimate and ethinyl estradiol tablets), are dispensed in a blister pack [see HOW SUPPLIED/STORAGE AND HANDLING (16)]. Previfem® 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 Previfem®

Table 1: Instructions for Administration of Previfem®

Complete instructions to facilitate patient counseling on proper tablet usage are located in the FDA-Approved Patient Labeling.
Starting COCs 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: Previfem® active tablets are blue (Day 1 to Day 21). Previfem® has green inactive tablets (Day 22 to Day 28)	Day 1 Start: Take first active tablet without regard to meals on the first day of menses. Take subsequent active tablets once daily at the same time each day for a total of 21 days. Take one green inactive tablet daily for 7 days and at the same time of day that active tablets were taken. Begin each subsequent blister pack on the same day of Previfem® the week as the first cycle blister pack (i.e., on the day after taking the last inactive tablet)
	Sunday Start: Take first active tablet without regard to meals 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 blister pack of Previfem®. Take subsequent active tablets once daily at the same time each day for a total of 21 days. Take one green inactive tablet daily for the following 7 days and at the same time of day that active tablets were taken. Begin each subsequent blister pack on the same day of the week as the first cycle blister pack (i.e., on the Sunday after taking the last inactive tablet) and additional non-hormonal contraceptive is not needed.
Switching to Previfem® from another oral contraceptive	Start on the same day that a new blister pack of the previous oral contraceptive would have started.
Switching from another contraceptive method to Previfem®	Start Previfem®:
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 blister pack.
Implant	On the day of removal

Starting Previfem® after Abortion or Miscarriage

First-trimester

• After a first-trimester abortion or miscarriage, Previfem® may be started immediately. An additional method of contraception is not needed if Previfem® is started immediately.
• If Previfem® 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 blister pack of Previfem®.

Second-trimester

• Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to the increased risk of thromboembolic disease. Start Previfem®, 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 blister pack of Previfem®.

Starting Previfem® after Childbirth

• Do not start until 4 weeks after delivery, due to the increased risk of thromboembolic disease. Start contraceptive therapy with Previfem® following the instructions in Table 1 for women not currently using hormonal contraception.
• Previfem® is not recommended for use in lactating women.
• If the woman has not yet had a period postpartum, consider the possibility of ovulation and conception occurring prior to use of Previfem®..

BEFORE YOU START TAKING YOUR PILLS

1. DECIDE WHAT TIME OF DAY YOU WANT TO TAKE YOUR PILL.

It is important to take it at about the same time every day.

2. LOOK AT YOUR PILL PACK

The pill blister pack has 21 active pills (with hormones) to take for 3 weeks. This is followed by 1 week of reminder green pills (without hormones).

There are 21 blue active pills, and 7 green reminder pills.

3. ALSO FIND:

1. where on the blister pack to start taking pills,

2. in what order to take the pills (follow the arrows)

3. The week numbers as shown in the diagram below.

4. BE SURE YOU HAVE READY AT ALL TIMES:

Another kind of birth control (such as a condom or spermicide) to use as a back-up method in case you miss pills.

An extra, full pill blister pack.

Missed Tablets

Table 2: Instructions for Missed Previfem® Tablets

If one 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 blister pack is finished.
If two 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 blister 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 active tablets are missed in the third week or three or more active tablets are missed in a row in Weeks 1, 2, or 3	Day 1 start: Throw out the rest of the blister 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 blister pack and start a new blister 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.