Lessina Levonorgestrel and Ethinyl Estradiol Kit, 3 pouches — NDC 00555-9014-67 package photo

Lessina Levonorgestrel and Ethinyl Estradiol Kit, 3 pouches

by Teva Pharmaceuticals USA, Inc. · 3 POUCH in 1 CARTON (0555-9014-67) / 1 BLISTER PACK in 1 POUCH (0555-9014-79) / 1 KIT in 1 BLISTER PACK
NDC 00555-9014-67
🏷️ FDA NDC (as labeled) 0555-9014-67 billing pads the labeler segment with a zero
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 0555-9014-67
Product NDC 0555-9014
11-digit billing NDC 00555901467
NCPDP billing unit EA — each (per item)
Application # ANDA075803
SPL Set ID a5fd1b3a-019c-4871-95b3-a45bbbd46f82
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2002-04-22
Dosage form KIT
GPI-14 25990002400305
GPI class Lessina
GCN Seq No 030986
GCN 11534
HICL code 001460
Ingredient (HICL) Levonorgestrel/Ethin.estradiol
HIC1 code G
Therapeutic class — broad (HIC1) Female Genital System
HIC2 code G8
Therapeutic class — intermediate (HIC2) Systemic Antifertility Agents
HIC3 code G8A
Therapeutic class — specific (HIC3) Contraceptives,Oral
AHFS code 68:12.00.00
AHFS class Contraceptives
FDB label name LESSINA-28 TABLET
FDB brand name Lessina
Legend status F — Federal legend — prescription drug or device
Why two NDCs? The FDA registers this code as 0555-9014-67 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00555-9014-67. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Estrogen class.

Pharmacologic class Estrogen
Drug family (ATC) Progestogens and estrogens, sequential preparations, Natural and semisynthetic estrogens, plain, Estrogens
How it works Estrogen Receptor Agonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerTeva Pharmaceuticals USA, Inc.
Application holderBARR LABORATORIES INC
FDA applicationANDA075803 (ANDA)
Labeler code00555
First marketedApr 2002
Product typeHuman Prescription Drug
Portfolio504 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name LESSINA-28 TABLET Ingredient Levonorgestrel/Ethin.estradiol
📖 What it is MedlinePlus · NLM

Oral contraceptives (birth-control pills) containing ethinyl estradiol (an estrogen) and levonorgestrel (a progestin) are used to prevent pregnancy. Estrogen and progestin are two female sex hormones. Combinations of estrogen and progestin work by preventing ovulation (the release of eggs from the ovaries). Oral contraceptives are an effective method of birth control, but they do not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • It prevents pregnancy mainly by stopping your ovaries from releasing an egg. It also thickens the cervical mucus so sperm can't easily get through, and changes the uterine lining a...
  • What exactly does this medication do, and how well does it work?
  • The most common ones in the first few months are headaches, nausea, irregular bleeding or spotting, breast tenderness, and mood changes. Most of these tend to settle down after you...
  • Are there any side effects I should expect when I first start?
📖 Read our full Ethinyl Estradiol / Levonorgestrel guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color pink / white
ShapeRound
Imprintb;208
Size6 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

A current SPL was checked, but it does not contain a structured or narrative inactive-ingredient list for this product. This does not mean the product has no inactive ingredients.
Where does this data come from?
Source: official FDA Structured Product Labeling (SPL) via DailyMed and the openFDA label index. Structured IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eaPer package
Retail pharmacies payNADAC · weekly $0.151 $0.45 / 3 kit
Medicaid paysCMS SDUD · 12 mo $0.2937 $0.88 / 3 kit
Medicare drug plans payPart D · Q2 2026 $0.2870 $0.86 / 3 kit
NADAC price history (per ea) — tap or hover for the price & month
Dec 2021 Jul 2022 Dec 2025 Aug 2026 $0.248 $0.151
▼ Down 25% over the last 24 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Altavera 70700-0116-85 Xiromed, 1 kit $0.113 AB Availability likely save 25%
Ayuna 65862-0848-88 Aurobindo 3 pouches $0.113 AB Availability likely save 25%
Levonorgestrel And Ethinyl Estradiol 00378-6550-53 Mylan 3 pouches $0.113 AB Discontinued save 25%
Chateal EQ 50102-0230-23 Afaxys 3 pouches $0.113 AB Availability likely save 25%
Marlissa 68462-0388-29 Glenmark 1 kit $0.113 AB Availability likely save 25%
Kurvelo 68180-0844-73 Lupin 63 tablets $0.113 AB Availability likely save 25%
Portia 00555-9020-58 Teva 6 pouches $0.113 Availability likely save 25%
Daysee 68180-0846-13 Lupin 2 pouches $0.125 AB Availability likely save 17%
Levora 51862-0097-06 Mayne 1 kit $0.145 AB Discontinued save 4%
Lessinathis 00555-9014-67 Teva 3 pouches $0.151 Availability likely
Aubra EQ 50102-0220-23 Afaxys 3 pouches $0.151 AB1 Availability likely
Levonorgestrel and Ethinyl Estradiol 68180-0854-73 Lupin 1 kit $0.151 AB1 Availability likely
Levonorgestrel And Ethinyl Estradiol 00378-7287-53 Mylan 3 pouches $0.151 AB1 Availability likely
Aviane 00555-9045-58 Teva 6 pouches $0.151 Availability likely
Vienva 70700-0118-85 Xiromed, 1 kit $0.151 AB1 Availability likely
Falmina 16714-0359-01 Northstar 1 packet $0.151 AB1 Availability likely
Lutera 51862-0028-06 Mayne 1 kit $0.152 AB1 Discontinued +1%
Sronyx 51862-0545-06 Mayne 1 kit $0.174 AB2 Discontinued +15%
Introvale 70700-0117-87 Xiromed, 1 kit $0.184 AB FDA listed +22%
Setlakin 16714-0366-03 Northstar 3 pouches $0.221 AB Availability likely +46%
Levonorgestrel and Ethinyl Estradiol 68180-0843-13 Lupin 1 kit $0.221 AB Availability likely +46%
levonorgestrel and ethinyl estradiol 68462-0672-95 Glenmark 3 pouches $0.221 AB Availability likely +46%
Afirmelle 65862-0849-88 Aurobindo 3 pouches $0.225 AB1 FDA listed +49%
Iclevia 65862-0865-83 Aurobindo 3 pouches $0.227 AB FDA listed +50%
Levonorgestrel and Ethinyl Estradiol and Ethinyl Estradiol 68180-0848-13 Lupin 2 pouches $0.239 AB Availability likely +59%
Levonest 16714-0340-01 Northstar 1 packet $0.339 AB Availability likely +125%
Levonorgestrel and Ethinyl Estradiol 68180-0857-73 Lupin 1 kit $0.339 AB Availability likely +125%
Tyblume 00642-7471-01 Exeltis 1 kit $0.828 Availability likely +448%
levonorgestrel and ethinyl estradiol 42192-0623-03 Acella 1 kit $3.442 AB3 Availability likely +2181%
Levonest 50090-2505-00 A-S 1 kit AB FDA listed
Kurvelo 50090-6374-00 A-S 21 tablets AB FDA listed
Altavera 63629-2343-01 Bryant 1 kit AB FDA listed
Lutera 55741-0005-06 Dr. 1 kit AB1 FDA listed
Balcoltra 75854-0602-02 Avion 1 kit AB3 FDA listed
Vienva Tm 50090-5580-00 A-S 1 kit AB1 FDA listed
Levonorgestrel and Ethinyl Estradiol 79929-0003-07 Naari 1 kit AB FDA listed
Levonorgestrel and Ethinyl Estradiol 60505-4898-08 Apotex 1 kit AB1 FDA listed
Levonorgestrel and Ethinyl Estradiol 60505-4899-08 Apotex 1 kit AB FDA listed
Vienva TM 63629-2344-01 Bryant 1 kit AB1 FDA listed
Levonorgestrel and Ethinyl Estradiol 79929-0004-07 Naari 1 kit AB1 FDA listed
Aviane 63187-0889-28 Proficient 1 pouch FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2002
On the market since
Apr 2002
📍
2026
Currently FDA-listed
24 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 00555-9014-67, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
40.4K
Units reimbursed last 4 qtrs
2.3M
Gross reimbursed last 4 qtrs
$672K
Avg / prescription
$16.65
Avg / unit
$0.2937
Latest quarter Q4 2025
13.1KRx
Medicaid pays / ea
$0.2937
gross reimbursed
vs
NADAC / ea
$0.1509
acquisition cost
=
Spread
+$0.1428
+95% vs cost
What Medicaid paid per ea (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
38% FFS 62% MCO
Fee-for-service · 15,369 Rx Managed care · 24,995 Rx
State Medicaid map
Alaska: 11,144 units · 1,520 per 100k residents AK Maine: 32,844 units · 2,354 per 100k residents ME Washington: 101,388 units · 1,298 per 100k residents WA Idaho: 11,340 units · 577 per 100k residents ID Montana: 13,300 units · 1,175 per 100k residents MT North Dakota: 3,388 units · 433 per 100k residents ND Minnesota: 50,540 units · 881 per 100k residents MN Wisconsin: 47,012 units · 795 per 100k residents WI Michigan: 96,749 units · 964 per 100k residents MI New York: 103,712 units · 530 per 100k residents NY Vermont: 9,464 units · 1,463 per 100k residents VT New Hampshire: 4,060 units · 290 per 100k residents NH Oregon: 122,304 units · 2,889 per 100k residents OR Nevada: 22,120 units · 693 per 100k residents NV Wyoming: 1,232 units · 211 per 100k residents WY South Dakota: 2,215 units · 241 per 100k residents SD Iowa: 35,056 units · 1,093 per 100k residents IA Illinois: 55,720 units · 444 per 100k residents IL Indiana: 43,260 units · 630 per 100k residents IN Ohio: 142,716 units · 1,211 per 100k residents OH Pennsylvania: 53,452 units · 412 per 100k residents PA New Jersey: 21,644 units · 233 per 100k residents NJ Massachusetts: 60,265 units · 861 per 100k residents MA California: 420,775 units · 1,080 per 100k residents CA Utah: 7,616 units · 223 per 100k residents UT Colorado: 101,500 units · 1,727 per 100k residents CO Nebraska: 10,080 units · 510 per 100k residents NE Missouri: 15,120 units · 244 per 100k residents MO Kentucky: 47,152 units · 1,042 per 100k residents KY West Virginia: 9,184 units · 519 per 100k residents WV Virginia: 20,776 units · 238 per 100k residents VA Maryland: 33,544 units · 543 per 100k residents MD Connecticut: 25,956 units · 718 per 100k residents CT Rhode Island: 18,480 units · 1,688 per 100k residents RI Arizona: 54,432 units · 732 per 100k residents AZ New Mexico: 51,102 units · 2,417 per 100k residents NM Kansas: 7,280 units · 248 per 100k residents KS Arkansas: 8,092 units · 264 per 100k residents AR Tennessee: 51,913 units · 729 per 100k residents TN North Carolina: 69,132 units · 638 per 100k residents NC South Carolina: 21,280 units · 396 per 100k residents SC Delaware: 2,128 units · 206 per 100k residents DE Oklahoma: 21,644 units · 534 per 100k residents OK Louisiana: 22,624 units · 495 per 100k residents LA Mississippi: 9,044 units · 308 per 100k residents MS Alabama: 13,748 units · 269 per 100k residents AL Georgia: 23,604 units · 214 per 100k residents GA D.C.: no data reported DC Hawaii: 20,160 units · 1,405 per 100k residents HI Texas: 46,648 units · 153 per 100k residents TX Florida: 110,132 units · 487 per 100k residents FL
Units reimbursed · per 100k residents
1532,889
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Oregon 2,889 /100k
2 New Mexico 2,417 /100k
3 Maine 2,354 /100k
4 Colorado 1,727 /100k
5 Rhode Island 1,688 /100k
6 Alaska 1,520 /100k
7 Vermont 1,463 /100k
8 Hawaii 1,405 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Lessina — the program that covers self-administered drugs. 1 manufacturer.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Lessina. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$20.3K
Claims incl. refills
917
Beneficiaries
565
Spend / beneficiary
$36.01
Spend / claim
$22.19
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Lessina (this brand).

Top reported reactions

Nausea67
Headache49
Fatigue42
Vomiting39
Anxiety38
Dizziness35
Diarrhoea34

Age at onset

Adolescent5
Adult76
Elderly1

Reporter sex

738 reports
Male · 1%
Female · 99%
Unknown · 0%

Serious outcomes

Hospitalization213
Life-threatening33
Disabling29
Death21
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 56 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
00555-9014-67 You're viewing this 3 POUCH in 1 CARTON (0555-9014-67) / 1 BLISTER PACK in 1 POUCH (0555-9014-79) / 1 KIT in 1 BLISTER PACK 2002-04-22 Active

🧭 About this NDC listing & data coverage

Finished prescription product Kit / multi-component package

Kit / multi-component package

This NDC identifies a kit — a package containing more than one component. Structured data (pricing, ingredients, equivalents) is often reported per component rather than for the kit NDC itself, which can make this page look thinner than the components' own pages.

What data is (and isn’t) available for this NDC — tap to expand
NDC identity (package / product / labeler codes) ✓ Available
Labeler ✓ Available
Product & package description ✓ Available
Marketing category & status ✓ Available
Active ingredient / dosage form / route ✓ Available
FDA label (SPL via DailyMed) ✓ Available
Package photos ✓ Available
Inactive ingredients (structured) — Not published for this NDC The labeler did not submit a structured excipient list, or no SPL is available.
NADAC pharmacy acquisition price (CMS) ✓ Available
Orange Book / therapeutic-equivalence data — Not published for this NDC Applies only to products approved under an NDA/ANDA; many listings are out of scope.
HCPCS J-code billing crosswalk — Not published for this NDC Most self-administered / retail products have no J-code — that is normal.
Medicaid utilization (CMS SDUD) ✓ Available
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.

Questions about this listing

Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The FDA registers it as 0555-9014-67, which is what is printed on the packaging and shown on DailyMed. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero: 00555-9014-67, written without dashes as 00555901467. The Identity section at the top of this page lists every form of this code.
What do the three segments of this NDC mean?
In 00555-9014-67, the first segment (00555) is the labeler code FDA assigned to Teva Pharmaceuticals USA, Inc.; the middle segment (9014) identifies this specific product — its ingredient, strength, and dosage form; and the last segment (67) identifies this exact package size and type. Together they name one specific package of one specific product.
Is this package still being marketed?
Yes, per the latest FDA NDC Directory data on this page: this package is listed as actively marketed, with no marketing end date reported by Teva Pharmaceuticals USA, Inc.. Listing status can change — the directory data on this page refreshes weekly.
Who lists this product with the FDA?
Teva Pharmaceuticals USA, Inc. is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🚨 Boxed Warning 158 words

Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke.

Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should not smoke.

Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should not smoke.

🎯 Indications and Usage ~2 min read

INDICATIONS AND USAGE Oral contraceptives are indicated for the prevention of pregnancy in women who elect to use this product as a method of contraception. Oral contraceptives are highly effective. Table III lists the typical accidental pregnancy rates for users of combination oral contraceptives and other methods of contraception.

The efficacy of these contraceptive methods, except sterilization, depends upon the reliability with which they are used. Correct and consistent use of methods can result in lower failure rates. TABLE III.

Percentage of women experiencing an unintended pregnancy during the first year of typical use and first year of perfect use of contraception and the percentage continuing use at the end of the first year. United States. % of Women Experiencing an Accidental Pregnancy within the First Year of Use % of Women Continuing Use at One Year 3 Method (1) Typical Use 1 (2) Perfect Use 2 (3) (4) Chance 4 85 85 Spermicides 5 26 6 40 Periodic abstinence 25 63 Calendar 9 Ovulation method 3 Sympto-thermal 6 2 Post ovulation 1 Withdrawal 19 4 Cap 7 Parous women 40 26 42 Nulliparous women 20 9 56 Sponge Parous women 40 20 42 Nulliparous women 20 9 56 Diaphragm 7 20 6 56 Condom 8 Female (Reality) 21 5 56 Male 14 3 61 Pill 5 71 Progestin only

0.5 Combined

0.1IUD Progesterone T 2 1.5 81 Copper T 380A 0.8 0.6 78 Lng 20 0.1 0.1 81 Depo Provera 0.3 0.3 70 Norplant and Norplant-2 0.05 0.05 88 Female sterilization 0.5 0.5 100 Male sterilization 0.15 0.1 100 Source: Trussell J, Contraceptive efficacy. In Hatcher RA, Trussell J, Stewart F, Cates W, Stewart GK, Kowal D, Guest F, Contraceptive Technology: Seventeenth Revised Edition. New York NY: Irvington Publishers, 1998, in press.

1. Among typical couples who initiate use of a method (not necessarily for the first time), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason. 2.

Among couples who initiate use of a method (not necessarily for the first time) and who use it perfectly (both consistently and correctly), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason. 3. Among couples attempting to avoid pregnancy, the percentage who continue to use a method for one year.

4. The percentages becoming pregnant in columns (2) and (3) are based on data from populations where contraception is not used and from women who cease using contraception in order to become pregnant. Among such populations, about 89% become pregnant within one year.

This estimate was lowered slightly (to 85%) to represent the percentage who would become pregnant within one year among women now relying on reversible methods of contraception if they abandoned contraception altogether. 5. Foams, creams, gels, vaginal suppositories, vaginal film.

6. Cervical mucus (ovulation) method supplemented by calendar in the pre-ovulatory and basal body temperature in the postovulatory phases. 7.

With spermicidal cream or jelly. 8. Without spermicides.

⏱️ Dosage and Administration ~3 min read

DOSAGE AND ADMINISTRATION To achieve maximum contraceptive effectiveness , Lessina ® (levonorgestrel and ethinyl estradiol tablets USP) must be taken exactly as directed at intervals not exceeding 24-hours. Lessina Tablets are a monophasic preparation plus 7 inert tablets. The dosage of Lessina Tablets is one tablet daily for 21 consecutive days per menstrual cycle plus 7 white inert tablets according to the prescribed schedule.

It is recommended that Lessina Tablets be taken at the same time each day, preferably after the evening meal or at bedtime. During the first cycle of medication, the patient should be instructed to take one pink Lessina Tablet daily and then 7 white inert tablets for twenty-eight (28) consecutive days, beginning on day one (1) of her menstrual cycle. (The first day of menstruation is day one.) Withdrawal bleeding usually occurs within 3 days following the last pink tablet.

(If Lessina Tablets are first taken later than the first day of the first menstrual cycle of medication or postpartum, contraceptive reliance should not be placed on Lessina Tablets until after the first 7 consecutive days of administration. The possibility of ovulation and conception prior to initiation of medication should be considered.) When switching from another oral contraceptive, Lessina Tablets should be started on the first day of bleeding following the last active tablet taken of the previous oral contraceptive.

The patient begins her next and all subsequent 28-day courses of Lessina Tablets on the same day of the week that she began her first course, following the same schedule. She begins taking her pink tablets on the next day after ingestion of the last white tablet, regardless of whether or not a menstrual period has occurred or is still in progress. Anytime a subsequent cycle of Lessina Tablets is started later than the next day, the patient should be protected by another means of contraception until she has taken a tablet daily for seven consecutive days.

If spotting or breakthrough bleeding occurs, the patient is instructed to continue on the same regimen. This type of bleeding is usually transient and without significance, however, if the bleeding is persistent or prolonged, the patient is advised to consult her physician. Although the occurrence of pregnancy is highly unlikely if Lessina Tablets are taken according to directions, if withdrawal bleeding does not occur, the possibility of pregnancy must be considered.

If the patient has not adhered to the prescribed schedule (missed one or more active tablets or started taking them on a day later than she should have), the probability of pregnancy should be considered at the time of the first missed period and appropriate diagnostic measures taken before the medication is resumed. If the patient has adhered to the prescribed regimen and misses two consecutive periods, pregnancy should be ruled out before continuing the contraceptive regimen. The risk of pregnancy increases with each active (pink) tablet missed.

For additional patient instructions regarding missed pills, see the “WHAT TO DO IF YOU MISS PILLS” section in the DETAILED PATIENT LABELING below. If breakthrough bleeding occurs following missed tablets, it will usually be transient and of no consequence. If the patient misses one or more white tablets, she is still protected against pregnancy provided she begins taking pink tablets again on the proper day.

In the nonlactating mother, Lessina Tablets may be initiated postpartum, for contraception. When the tablets are administered in the postpartum period, the increased risk of thromboembolic disease associated with the postpartum period must be considered. (See CONTRAINDICATIONS , WARNINGS , and PRECAUTIONS concerning thromboembolic disease.) It is to be noted that early resumption of ovulation may occur if bromocriptine mesylate has been used for the prevention of lactation.

Contraindications 111 words

CONTRAINDICATIONS Lessina is contraindicated in females who are known to have or develop the following conditions: Thrombophlebitis or thromboembolic disorders A past history of deep-vein thrombophlebitis or thromboembolic disorders Cerebral-vascular or coronary-artery disease Current diagnosis of, or history of, breast cancer, which may be hormone-sensitive Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia Undiagnosed abnormal genital bleeding Cholestatic jaundice of pregnancy or jaundice with prior pill use Hepatic adenomas or carcinomas Known or suspected pregnancy Are receiving Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to the potential for ALT elevations (see WARNINGS , Risk of Liver Enzyme Elevations with Concomitant Hepatitis C Treatment ).

⚠️ Warnings ~3 min read

WARNINGS Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke.

The use of oral contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, gallbladder disease, and hypertension, although the risk of serious morbidity or mortality is very small in healthy women without underlying risk factors. The risk of morbidity and mortality increases significantly in the presence of other underlying risk factors such as hypertension, hyperlipidemias, obesity and diabetes. Practitioners prescribing oral contraceptives should be familiar with the following information relating to these risks.

The information contained in this package insert is based principally on studies carried out in patients who used oral contraceptives with higher formulations of estrogens and progestogens than those in common use today. The effect of long-term use of the oral contraceptives with lower formulations of both estrogens and progestogens remains to be determined. Throughout this labeling, epidemiologic studies reported are of two types: retrospective or case control studies and prospective or cohort studies.

Case control studies provide a measure of the relative risk of a disease, namely, a ratio of the incidence of a disease among oral contraceptive users to that among nonusers. The relative risk does not provide information on the actual clinical occurrence of a disease. Cohort studies provide a measure of attributable risk, which is the difference in the incidence of disease between oral contraceptive users and nonusers.

The attributable risk does provide information about the actual occurrence of a disease in the population. For further information, the reader is referred to a text on epidemiologic methods. 1.

Thromboembolic disorders and other vascular problems a. Myocardial Infarction An increased risk of myocardial infarction has been attributed to oral contraceptive use. This risk is primarily in smokers or women with other underlying risk factors for coronary-artery disease such as hypertension, hypercholesterolemia, morbid obesity, and diabetes.

The relative risk of heart attack for current oral contraceptive users has been estimated to be two to six. The risk is very low under the age of 30. Smoking in combination with oral contraceptive use has been shown to contribute substantially to the incidence of myocardial infarctions in women in their mid-thirties or older with smoking accounting for the majority of excess cases.

Mortality rates associated with circulatory disease have been shown to increase substantially in smokers over the age of 35 and nonsmokers over the age of 40 (Table IV) among women who use oral contraceptives. TABLE IV. (Adapted from P.M.

Layde and V. Beral, ref. #12.) CIRCULATORY DISEASE MORTALITY RATES PER 100,000 WOMAN-YEARS BY AGE, SMOKING STATUS, AND ORAL CONTRACEPTIVE USE AGE EVER-USERS NON- SMOKERS EVER-USERS SMOKERS CONTROLS NON- SMOKERS CONTROL SMOKERS 15 to 24 0 10.5 0 0 25 to 34 4.4 14.2 2.7 4.2 35 to 44 21.5 63.4 6.4 15.2 45+ 52.4 206.7 11.4

27.9Oral contraceptives may compound the effects of well-known risk factors, such as hypertension, diabetes, hyperlipidemias, age and obesity. In particular, some progestogens are known to decrease HDL cholesterol and cause glucose intolerance, while estrogens may create a state of hyperinsulinism. Oral contraceptives have been shown to increase blood pressure among users (see section 10 in WARNINGS ).

Similar effects on risk factors have been associated with an increased risk of heart disease. Oral contraceptives must be used with caution in women with cardiovascular disease risk factors. b. Thromboembolism An increased risk of…

🤒 Adverse Reactions ~2 min read

ADVERSE REACTIONS Post Marketing Experience Five studies that compared breast cancer risk between ever-users (current or past use) of COCs and never-users of COCs reported no association between ever use of COCs and breast cancer risk, with effect estimates ranging from 0.90 - 1.12 (Figure II). Three studies compared breast cancer risk between current or recent COC users (<6 months since last use) and never users of COCs (Figure II). One of these studies reported no association between breast cancer risk and COC use.

The other two studies found an increased relative risk of 1.19 - 1.33 with current or recent use. Both of these studies found an increased risk of breast cancer with current use of longer duration, with relative risks ranging from 1.03 with less than one year of COC use to approximately 1.4 with more than 8-10 years of COC use. Figure II Risk of Breast Cancer with Combined Oral Contraceptive Use RR = relative risk; OR = odds ratio; HR = hazard ratio. “ever COC” are females with current or past COC use; “never COC use” are females that never used COCs.

An increased risk of the following serious adverse reactions has been associated with the use of oral contraceptives (see WARNINGS section). Thrombophlebitis Arterial thromboembolism Pulmonary embolism Myocardial infarction Cerebral hemorrhage Cerebral thrombosis Hypertension Gallbladder disease Hepatic adenomas or benign liver tumors There is evidence of an association between the following conditions and the use of oral contraceptives, although additional confirmatory studies are needed: Mesenteric thrombosis Retinal thrombosis The following adverse reactions have been reported in patients receiving oral contraceptives and are believed to be drug related: Nausea Vomiting Gastrointestinal symptoms, (such as abdominal cramps and bloating) Breakthrough bleeding Spotting Change in menstrual flow Amenorrhea Temporary infertility after discontinuation of treatment Edema Melasma which may persist Breast changes: tenderness, enlargement, secretion Change in weight (increase or decrease) Change in cervical erosion and secretion Diminution in lactation when given immediately postpartum Cholestatic jaundice Migraine Rash (allergic) Mental depression Reduced tolerance to carbohydrates Vaginal candidiasis Change in corneal curvature (steepening) Intolerance to contact lenses The following adverse reactions have been reported in users of oral contraceptives and the association has been neither confirmed nor refuted: Pre-menstrual syndrome Cataracts Optic neuritis Changes in appetite Cystitis-like syndrome Headache Nervousness Dizziness Hirsutism Loss of scalp hair Erythema multiforme Erythema nodosum Hemorrhagic eruption Vaginitis Porphyria Impaired renal function Hemolytic uremic syndrome Budd-Chiari syndrome Acne Changes in libido Colitis 2

🔄 Drug Interactions 87 words

8. Drug interactions Reduced efficacy and increased incidence of breakthrough bleeding and menstrual irregularities have been associated with concomitant use of rifampin. A similar association, though less marked, has been suggested with barbiturates, phenylbutazone, phenytoin sodium, and possibly with griseofulvin, ampicillin and tetracyclines.

Concomitant Use with HCV Combination Therapy – Liver Enzyme Elevation Do not co-administer Lessina with HCV drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to potential for ALT elevations (see WARNINGS , Risk of Liver Enzyme Elevations with Concomitant Hepatitis C Treatment ).

🔄 Drug / Laboratory Test Interactions 140 words

9. Interactions with laboratory tests Certain endocrine- and liver-function tests and blood components may be affected by oral contraceptives: Increased prothrombin and factors VII, VIII, IX and X; decreased antithrombin 3; increased norepinephrine-induced platelet aggregability. Increased thyroid-binding globulin (TBG) leading to increased circulating total thyroid hormone, as measured by protein-bound iodine (PBI), T4 by column or by radioimmunoassay.

Free T3 resin uptake is decreased, reflecting the elevated TBG, free T4 concentration is unaltered. Other binding proteins may be elevated in serum. Sex-binding globulins are increased and result in elevated levels of total circulating sex steroids and corticoids; however, free or biologically active levels remain unchanged.

Triglycerides may be increased. Glucose tolerance may be decreased. Serum folate levels may be depressed by oral contraceptive therapy.

This may be of clinical significance if a woman becomes pregnant shortly after discontinuing oral contraceptives.

🤰 Pregnancy 12 words

11. Pregnancy Teratogenic Effects Pregnancy Category X See CONTRAINDICATIONS and WARNINGS sections.

🧒 Pediatric Use 53 words

13. Pediatric use Safety and efficacy of levonorgestrel and ethinyl estradiol tablets have been established in women of reproductive age. Safety and efficacy are expected to be the same for post-pubertal adolescents under the age of 16 and for users 16 years and older. Use of this product before menarche is not indicated.

🆘 Overdosage 31 words

OVERDOSAGE Serious ill effects have not been reported following acute ingestion of large doses of oral contraceptives by young children. Overdosage may cause nausea, and withdrawal bleeding may occur in females.

🧬 Clinical Pharmacology 48 words

CLINICAL PHARMACOLOGY Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation).

📦 How Supplied / Storage and Handling 82 words

HOW SUPPLIED Lessina ® (levonorgestrel and ethinyl estradiol tablets USP 0.1 mg/ 0.02 mg) are packaged in blister cards. Each card contains 21 pink, round, film-coated, biconvex, unscored tablets, debossed stylized b on one side and 965 on the other side, and 7 white, round, biconvex, unscored tablets, debossed stylized b on one side and 208 on the other side. Available in cartons of 3 blister cards (NDC: 0555-9014-67).

Store at 20º to 25ºC (68º to 77ºF) [See USP Controlled Room Temperature].

📋 Description 113 words

DESCRIPTION Each cycle of Lessina ® 28 (levonorgestrel and ethinyl estradiol tablets USP) consists of 21 pink active tablets each containing 0.1 mg levonorgestrel, USP and 0.02 mg ethinyl estradiol, USP; and seven white inert tablets. The inactive ingredients include anhydrous lactose, FD&C red no. 40 aluminum lake, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, corn starch, and titanium dioxide.

Each white tablet contains only inert ingredients as follows: anhydrous lactose, hypromellose, microcrystalline cellulose, and magnesium stearate. The structural formulas are as follows: Levonorgestrel, USP C 21 H 28 O 2 Molecular Weight: 312.4 Ethinyl Estradiol, USP C 20 H 24 O 2 Molecular Weight: 296.4 levonorgestrel structural formula ethinyl estradiol

💬 Information for Patients 9 words

INFORMATION FOR THE PATIENT See “Patient Labeling” printed below.

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.