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Generic name: ethinyl estradiol and levonorgestrelETH-in-ill-ess-tra-DYE-ol-and-LEE-vo-nor-JESS-trel ]
Brand names: Alesse, Altavera, Amethyst, Aviane, Enpresse, ... show all 18 brands
Drug class: Contraceptives

Medically reviewed by Last updated on Sep 7, 2023.

What is Lybrel?

Lybrel contains a combination of female hormones that prevent ovulation (the release of female hormones that prevent ovulation (the release of an egg from an ovary). Lybrel also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Lybrel is used as contraception to prevent pregnancy.

Lybrel may also be used for purposes not listed in this medication guide.


Do not use Lybrel if you are pregnant or if you have recently had a baby. You should not take Lybrel if you have any of the following conditions: uncontrolled high blood pressure, heart disease, a blood-clotting disorder, circulation problems, diabetic problems with your eyes or kidneys, unusual vaginal bleeding, liver disease or liver cancer, severe migraine headaches, if you smoke and are over 35, or if you have ever had breast or uterine cancer, jaundice caused by birth control pills, a heart attack, a stroke, or a blood clot.

You may need to use back up birth control, such as condoms or a spermicide, when you first start using Lybrel or if you miss a dose. Follow your doctor's instructions.

Missing a pill increases your risk of becoming pregnant. Carefully follow the "missed dose" instructions if you forget to take a Lybrel pill.

Some drugs can make Lybrel less effective in preventing pregnancy, including antibiotics, hepatitis C medications, HIV/AIDS medications, seizure medications, or barbiturate sedatives. Tell your doctor about all other medications you use.

Before taking this medicine

Lybrel can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before taking Lybrel. You should not take Lybrel if you have:

To make sure you can safely take Lybrel, tell your doctor if you have any of these other conditions:

The hormones in Lybrel (ethinyl estradiol and levonorgestrel) can pass into breast milk and may harm a nursing baby. Lybrel may also slow breast milk production. Do not Lybrel use if you are breast feeding a baby.

How should I take Lybrel?

Take Lybrel exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your pill pack contains 28 pills with active medication.

You will take your first Lybrel pill on the first day of your period. If your doctor directs you to start this medication on any other day, use an additional form of non-hormonal birth control (such as condoms, spermicide) for the first 7 days to prevent pregnancy until this medication has enough time to work. If you start on the first day of your period, you do not need to use back-up birth control the first week. Follow your doctor's instructions.

Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. There is no break between packs, and there are no reminder tablets. You may get pregnant if you do not take one pill daily. Get your prescription refilled before you run out of pills completely.

You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.

Use a back-up birth control if you are sick with severe vomiting or diarrhea.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using Lybrel for a short time. Any doctor or surgeon who treats you should know that you are using Lybrel.

While taking Lybrel, you will need to visit your doctor regularly.

Store Lybrel at room temperature away from moisture and heat.

What happens if I miss a dose?

Follow the patient instructions provided in your Lybrel packet. Ask your doctor or pharmacist if you do not understand these instructions. Missing a pill increases your risk of becoming pregnant.

If you miss one Lybrel pill:

If you miss two Lybrel pills and remembered on the day of the second missed pill:

If you miss two Lybrel pills and remembered on the day after the second pill is missed:

If you miss three or more Lybrel pills:

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

What should I avoid?

Smoking can increase your risk of blood clots, stroke, or heart attack caused by Lybrel, especially if you are older than 35.

Lybrel will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Lybrel side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Lybrel: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Lybrel and call your doctor at once if you have a serious side effect such as:

Less serious Lybrel side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Lybrel?

Some drugs can make Lybrel less effective, which may result in pregnancy. Before using Lybrel, tell your doctor if you are using any of the following drugs:

Tell your doctor about all other medicines you use, especially:

This list is not complete and other drugs may interact with Lybrel. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lybrel only for the indication prescribed.

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