Ethinyl estradiol / norethindrone Pregnancy and Breastfeeding Warnings
Ethinyl estradiol / norethindrone is also known as: Balziva, Blisovi Fe 1/20, Brevicon, Cyclafem 1/35, Estrostep Fe, Generess Fe, Gildess Fe 1/20, Jinteli, Junel Fe 1/20, Layolis Fe, Lo Loestrin Fe, Loestrin 1/20, Loestrin 21 1/20, Loestrin 24 Fe, Loestrin Fe 1/20, Lomedia 24 Fe, Microgestin 1.5/30, Microgestin 1/20, Microgestin Fe 1/20, Minastrin 24 Fe, Necon 1/35, Nortrel 1/35, Ortho-Novum 1/35, Zenchent, femhrt
Ethinyl estradiol / norethindrone Pregnancy Warnings
Ethinyl estradiol-norethindrone has been assigned to pregnancy category X by the FDA. Animal studies have failed to reveal evidence of teratogenicity. Ethinyl estradiol-norethindrone is considered contraindicated during pregnancy.
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. 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 / norethindrone 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 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. The manufacturer recommends that caution be used when administering ethinyl estradiol-norethindrone to nursing mothers.
References for pregnancy information
- Czeizel AE, Kodaj I "A changing pattern in the association of oral contraceptives and the different groups of congenital limb deficiencies." Contraception 51 (1995): 19-24
- Profumo R, Toce S, Kotagal S "Neonatal choreoathetosis following prenatal exposure to oral contraceptives." Pediatrics 86 (1990): 648-9
- Janerich DT, Piper JM, Glebatis DM "Hormones and limb-reduction deformities." Lancet 2 (1973): 96-7
- Bracken MB "Oral contraception and congenital malformations in offspring: a review and meta-analysis of the prospective studies." Obstet Gynecol 76 (1990): 552-7
References for breastfeeding information
- Canto TE, Vera L, Polanco LE, Colven CE "Mini-pill in lactating women." Contraception 39 (1989): 589-601
- Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
- McCann MF, Moggia AV, Higgins JE, Potts M, Becker C "The effects of a progestin-only oral contraceptive (levonorgestrel 0.03 mg) on breast-feeding." Contraception 40 (1989): 635-48
- Kacew S "Adverse effects of drugs and chemicals in breast milk on the nursing infant." J Clin Pharmacol 33 (1993): 213-21
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