Aurovela Fe 1/20 Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate Kit, 3 pouches — NDC 65862-0940-88 package photo

Aurovela Fe 1/20 Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate Kit, 3 pouches

by Aurobindo Pharma Limited · 3 POUCH in 1 CARTON (65862-940-88) / 1 BLISTER PACK in 1 POUCH (65862-940-87) / 1 KIT in 1 BLISTER PACK
NDC 65862-0940-88
🏷️ FDA NDC (as labeled) 65862-940-88 billing pads the product segment with a zero
This package
Contains3 pouches Cost per ea$0.1309 NADAC Per package$0.39 / 3 kit Pack sizes2 compare ↓
Also priced by: Medicaid pays $0.2582/unit — full pricing hub ↓
Also comes in: 5 pouches 65862-0940-58
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) 65862-940-88
Product NDC 65862-940
11-digit billing NDC 65862094088
NCPDP billing unit EA — each (per item)
Application # ANDA207505
SPL Set ID 83513d13-5352-4d86-9dfd-fd1e456087c0
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2017-06-16
Dosage form KIT
GPI-14 25990003610310
GPI class Aurovela FE 1/20
GCN Seq No 003301
GCN 68102
HICL code 001454
Ingredient (HICL) Norethindrone-E.estradiol-Iron
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 AUROVELA FE 1-20 TABLET
FDB brand name Aurovela Fe
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 65862-940-88 — a 5-3-2 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 product segment → 65862-0940-88. 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 Iron bivalent, oral preparations class.

Drug family (ATC) Iron bivalent, oral preparations
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

LabelerAurobindo Pharma Limited
Application holderAUROBINDO PHARMA LTD
FDA applicationANDA207505 (ANDA)
Labeler code65862
First marketedJun 2017
Product typeHuman Prescription Drug
Portfolio1,449 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 AUROVELA FE 1-20 TABLET Ingredient Norethindrone-E.estradiol-Iron
📖 What it is MedlinePlus · NLM

Oral contraceptives (birth-control pills) containing ethinyl estradiol (an estrogen) and norethindrone (a progestin) are used to prevent pregnancy. Estrogen and progestin are two female sex hormones. Combinations of estrogen and progestin work mainly 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 ↗
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 Yellow / Brown
ShapeRound
ImprintS;57
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 $0.131 $0.39 / 3 kit
Medicaid paysCMS SDUD · 12 mo $0.2582 $0.77 / 3 kit
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
NADAC price history (per ea) — tap or hover for the price & month
Dec 2021 Jul 2022 Dec 2025 Aug 2026 $0.242 $0.128
▼ Down 46% 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
Tarina Fe 1/20 EQ 50102-0228-23 Afaxys 3 pouches $0.131 AB Availability likely
Aurovela Fe 1/20this 65862-0940-88 Aurobindo 3 pouches $0.131 AB Availability likely
HAILEY Fe 1/20 68462-0419-29 Glenmark 1 kit $0.131 AB Availability likely
Junel Fe 28 Day 00555-9026-58 Teva 6 pouches $0.131 AB Availability likely
Hailey Fe 1.5/30 68462-0503-29 Glenmark 3 pouches $0.138 AB Availability likely +6%
Junel Fe 28 Day 00555-9028-58 Teva 6 pouches $0.138 AB Availability likely +6%
Junel Fe 24 00093-5328-62 Teva 3 pouches $0.186 AB Availability likely +42%
Tarina 24 Fe 50102-0224-23 Afaxys 3 pouches $0.186 AB Availability likely +42%
Finzala 00093-8210-62 Teva 12 tablets $0.220 AB Availability likely +68%
Charlotte 24Fe 68462-0852-29 Glenmark 1 kit $0.220 AB Availability likely +68%
norethindrone acetate and ethinyl estradiol and ferrous fumarate 68462-0376-29 Glenmark 1 kit $0.422 AB FDA listed +223%
Melodetta 24 Fe 69238-1031-07 Amneal 1 kit $0.422 FDA listed +223%
Norethindrone Acetate And Ethinyl Estradiol And Ferrous Fumarate 00378-7303-53 Mylan 21 tablets $0.788 AB Availability likely +502%
Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate 68462-0849-29 Glenmark 24 capsules $0.864 AB Availability likely +560%
Loestrin Fe 28 Day 51285-0125-70 Teva 5 pouches $8.232 AB Availability likely +6190%
Junel Fe 28 Day 50090-3237-00 A-S 1 kit AB FDA listed
Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate 60219-1031-07 Amneal 1 kit FDA listed
Aurovela 24 Fe 65862-0934-58 Aurobindo 5 pouches AB FDA listed
AUROVELA Fe 65862-0941-58 Aurobindo 5 pouches AB FDA listed
Junel Fe 28 Day 50090-3122-00 A-S 6 pouches AB FDA listed
Junel Fe 28 Day 63629-5628-01 Bryant 6 pouches AB FDA listed
Oshih 59651-0504-88 Aurobindo 3 pouches FDA listed
Loestrin Fe 28 Day 51285-0128-70 Teva 5 pouches AB FDA listed
Junel Fe 28 Day 72789-0450-79 PD-Rx 1 pouch AB 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

🏛️
2017
On the market since
Jun 2017
📍
2026
Currently FDA-listed
9 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 65862-0940-88, 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
103.1K
Units reimbursed last 4 qtrs
6.2M
Gross reimbursed last 4 qtrs
$1.6M
Avg / prescription
$15.48
Avg / unit
$0.2582
Latest quarter Q4 2025
35.7KRx
Medicaid pays / ea
$0.2582
gross reimbursed
vs
NADAC / ea
$0.1309
acquisition cost
=
Spread
+$0.1273
+97% 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
32% FFS 68% MCO
Fee-for-service · 32,602 Rx Managed care · 70,545 Rx
State Medicaid map
Alaska: no data reported AK Maine: 6,888 units · 494 per 100k residents ME Washington: 24,164 units · 309 per 100k residents WA Idaho: 5,824 units · 297 per 100k residents ID Montana: 1,764 units · 156 per 100k residents MT North Dakota: no data reported ND Minnesota: 56,728 units · 989 per 100k residents MN Wisconsin: 109,256 units · 1,849 per 100k residents WI Michigan: 328,104 units · 3,269 per 100k residents MI New York: 1,217,324 units · 6,220 per 100k residents NY Vermont: 6,272 units · 969 per 100k residents VT New Hampshire: 2,912 units · 208 per 100k residents NH Oregon: 32,144 units · 759 per 100k residents OR Nevada: 27,272 units · 854 per 100k residents NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: 25,088 units · 782 per 100k residents IA Illinois: 288,764 units · 2,301 per 100k residents IL Indiana: 249,398 units · 3,634 per 100k residents IN Ohio: 495,880 units · 4,208 per 100k residents OH Pennsylvania: 828,856 units · 6,395 per 100k residents PA New Jersey: 612,752 units · 6,596 per 100k residents NJ Massachusetts: 66,808 units · 954 per 100k residents MA California: 187,613 units · 481 per 100k residents CA Utah: 11,872 units · 347 per 100k residents UT Colorado: 55,692 units · 947 per 100k residents CO Nebraska: 18,900 units · 956 per 100k residents NE Missouri: 100,828 units · 1,627 per 100k residents MO Kentucky: 96,404 units · 2,130 per 100k residents KY West Virginia: no data reported WV Virginia: 115,584 units · 1,326 per 100k residents VA Maryland: 352,100 units · 5,697 per 100k residents MD Connecticut: 78,148 units · 2,161 per 100k residents CT Rhode Island: 12,740 units · 1,163 per 100k residents RI Arizona: 55,300 units · 744 per 100k residents AZ New Mexico: 33,152 units · 1,568 per 100k residents NM Kansas: 14,476 units · 492 per 100k residents KS Arkansas: 14,756 units · 481 per 100k residents AR Tennessee: 94,332 units · 1,324 per 100k residents TN North Carolina: 209,048 units · 1,929 per 100k residents NC South Carolina: 18,788 units · 350 per 100k residents SC Delaware: 45,024 units · 4,367 per 100k residents DE Oklahoma: 50,904 units · 1,256 per 100k residents OK Louisiana: 89,432 units · 1,955 per 100k residents LA Mississippi: 26,068 units · 887 per 100k residents MS Alabama: 14,504 units · 284 per 100k residents AL Georgia: 4,340 units · 39.4 per 100k residents GA D.C.: no data reported DC Hawaii: 1,736 units · 121 per 100k residents HI Texas: 55,412 units · 182 per 100k residents TX Florida: 41,608 units · 184 per 100k residents FL
Units reimbursed · per 100k residents
39.46,596
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 New Jersey 6,596 /100k
2 Pennsylvania 6,395 /100k
3 New York 6,220 /100k
4 Maryland 5,697 /100k
5 Delaware 4,367 /100k
6 Ohio 4,208 /100k
7 Indiana 3,634 /100k
8 Michigan 3,269 /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.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
3 pouches this page65862-0940-88 103,147 Rx · $1,596,823
5 pouches65862-0940-58 No Medicaid data
Drug total (last 4 qtrs): 103,147 Rx · 6,184,959 units · $1,596,823 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

🔬 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 Aurovela Fe 1/20 (this brand).

Top reported reactions

Headache9
Nausea8
Rash8
Dermatitis Atopic7
Fatigue5
Pruritus5
Vomiting4

Age at onset

Child1
Adolescent3
Adult30

Reporter sex

72 reports
Female · 100%

Serious outcomes

Hospitalization8
Reports over time (by year) — tap or hover for the count & year
2020 2022 2024 2026 21 3
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 Per unit Per pack Marketing startStatus
65862-0940-58 5 POUCH in 1 CARTON (65862-940-58) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK 2017-06-16 Active
65862-0940-88 You're viewing this 3 POUCH in 1 CARTON (65862-940-88) / 1 BLISTER PACK in 1 POUCH (65862-940-87) / 1 KIT in 1 BLISTER PACK $0.1309 / ea $0.39 2017-06-16 Active

In Medicaid, this is the most-dispensed pack of this product — about 100% of fills over the last four reported quarters. See all packs ↓

Pack size FAQ

What quantity is in NDC 65862-0940-88?
NDC 65862-0940-88 contains 3 pouches — 3 pouch in 1 carton / 1 blister pack in 1 pouch / 1 kit in 1 blister pack.
What is the difference between NDC 65862-0940-88 and NDC 65862-0940-58?
Both are Aurovela Fe 1/20 Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate Kit — the drug itself is identical. NDC 65862-0940-88 is the 3 pouches package, while NDC 65862-0940-58 is the 5 pouches package.
What NDC number is used to bill for this package of Aurovela Fe 1/20 Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate Kit?
Bill NDC 65862-0940-88 — the 11-digit billing format is 65862094088. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

🧭 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 ✓ Available
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 65862-940-88, 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: 65862-0940-88, written without dashes as 65862094088. 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 65862-0940-88, the first segment (65862) is the labeler code FDA assigned to Aurobindo Pharma Limited; the middle segment (0940) identifies this specific product — its ingredient, strength, and dosage form; and the last segment (88) 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 Aurobindo Pharma Limited. Listing status can change — the directory data on this page refreshes weekly.
Does this product come in other package sizes?
Yes — the FDA directory lists 1 other package presentation of this same product, including 5 pouches (65862-0940-58). Each has its own NDC and its own page — see the package list near the top of this page.
Who lists this product with the FDA?
Aurobindo Pharma Limited 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.
🎯 Indications and Usage ~1 min read

INDICATIONS AND USAGE Aurovela Fe 1/20 is indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. Oral contraceptives are highly effective. Table I 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 1 LOWEST EXPECTED AND TYPICAL FAILURE RATES DURING THE FIRST YEAR OF CONTINUOUS USE OF A METHOD % of Women Experiencing an Unintended Pregnancy in the First Year of Continuous Use Method Lowest Expected* Typical** (No contraception) (85) (85) Oral contraceptives 3 combined

0.1 N/A*** progestin only

0.5N/A*** Diaphragm with spermicidal cream or jelly 6 20 Spermicides alone (foam, creams, gels, vaginal suppositories, and vaginal film) 6 26 Vaginal Sponge nulliparous 9 20 parous 20 40 Implant 0.05

0.05Injection: depot medroxyprogesterone acetate 0.3

0.3IUD progesterone T 1.5 2 copper T 380A 0.6

0.8LNg 20 0.1

0.1Condom without spermicides female 5 21 male 3 14 Cervical Cap with spermicidal cream or jelly nulliparous 9 20 parous 26 40 Periodic abstinence (all methods) 1 to 9 25 Withdrawal 4 19 Female sterilization 0.5

0.5Male sterilization 0.1

0.15Adapted from RA Hatcher et al, Reference 7. * The authors’ best guess of the percentage of women expected to experience an accidental pregnancy among couples who initiate a method (not necessarily for the first time) and who use it consistently and correctly during the first year if they do not stop for any other reason. ** This term represents “typical” couples who initiate use of a method (not necessarily for the first time), who experience an accidental pregnancy during the first year if they do not stop use for any other reason. *** N/A--Data not available.

⏱️ Dosage and Administration ~3 min read

DOSAGE AND ADMINISTRATION The blister pack has been designed to make oral contraceptive dosing as easy and as convenient as possible. The tablets are arranged in four rows of seven tablets each, with the days of the week appearing on the blister pack above the first row of tablets. Note: Each blister pack has been preprinted with the days of the week, starting with Sunday, to facilitate a Sunday-Start regimen.

Six different day label stickers have been provided with the Detailed Patient & Brief Summary Patient Package Insert in order to accommodate a Day-1 Start regimen. If the patient is using the Day-1 Start regimen, she should place the self-adhesive day label sticker that corresponds to her starting day over the preprinted days. Important: The patient should be instructed to use an additional method of protection until after the first week of administration in the initial cycle when utilizing the Sunday-Start regimen.

The possibility of ovulation and conception prior to initiation of use should be considered. Dosage and Administration for 28-Day Dosage Regimen To achieve maximum contraceptive effectiveness, Aurovela Fe 1/20 should be taken exactly as directed and at intervals not exceeding 24 hours. Aurovela Fe 1/20 provides a continuous administration regimen consisting of 21 light yellow to yellow tablets of norethindrone acetate and ethinyl estradiol and 7 brown non-hormone containing tablets of ferrous fumarate.

The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen and do not serve any therapeutic purpose. There is no need for the patient to count days between cycles because there are no “off-tablet days.” A. Sunday-Start Regimen: The patient begins taking the first light yellow to yellow tablet from the top row of the blister pack (labeled Sunday) on the first Sunday after menstrual flow begins.

When the menstrual flow begins on Sunday, the first light yellow to yellow tablet is taken on the same day. The patient takes one light yellow to yellow tablet daily for 21 days. The last light yellow to yellow tablet in the blister pack will be taken on a Saturday.

Upon completion of all 21 light yellow to yellow tablets, and without interruption, the patient takes one brown tablet daily for 7 days. Upon completion of this first course of tablets, the patient begins a second course of 28-day tablets, without interruption, the next day (Sunday), starting with the Sunday light yellow to yellow tablet in the top row. Adhering to this regimen of one light yellow to yellow tablet daily for 21 days, followed without interruption by one brown tablet daily for seven days, the patient will start all subsequent cycles on a Sunday.

B. Day-1 Start Regimen: The first day of menstrual flow is Day 1. The patient places the self-adhesive day label sticker that corresponds to her starting day over the preprinted days on the blister pack.

She starts taking one light yellow to yellow tablet daily, beginning with the first light yellow to yellow tablet in the top row. After the last light yellow to yellow tablet (at the end of the third row) has been taken, the patient will then take the brown tablets for a week (7 days). For all subsequent cycles, the patient begins a new 28 tablet regimen on the eighth day after taking her last light yellow to yellow tablet, again starting with the first tablet in the top row after placing the appropriate day label sticker over the preprinted days on the blister pack.

Following this regimen of 21 light yellow to yellow tablets and 7 brown tablets, the patient will start all subsequent cycles on the same day of the week as the first course. Tablets should be taken regularly with a meal or at bedtime. It should be stressed that efficacy of medication depends on strict adherence to the dosage schedule.

Special Notes on Administration Menstruation usually begins two or three days, but may begin as late as the fourth or fifth day, after the brown tablets have been s…

Contraindications 108 words

CONTRAINDICATIONS Oral contraceptives are contraindicated in women who currently have 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 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 The use of oral contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease, 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 principally based 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, epidemiological 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 (adapted from References 8 and 9 with the author's permission). For further information, the reader is referred to a text on epidemiological 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 (10 to 16). 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 (17).

Mortality rates associated with circulatory disease have been shown to increase substantially in smokers over the age of 35 and non-smokers over the age of 40 (Table II) among women who use oral contraceptives. Oral contraceptives may compound the effects of well-known risk factors, such as hypertension, diabetes, hyperlipidemias, age and obesity (19). In particular, some progestogens are known to decrease HDL cholesterol and cause glucose intolerance, while estrogens may create a state of hyperinsulinism (20 to 24).

Oral contraceptives have been shown to increase blood pressure among users (see section 9 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 thromboembolic and thrombotic disease associated with the use of oral contraceptives is well established. Case control studies have found the relative risk of users compared to non-users to be 3 for the first episode of superficial venous thrombosis, 4 to 11 for deep vein thrombosis or pulmonary embolism, and 1.5 to 6 for women with predisposing conditions for venous thromboembolic disease (9,10, 25 to 30). Cohort studies have shown the relative risk to be somewhat lower, about 3 for new cases and about 4.5 for new cases requiring hospitalization (31).

The risk of thromboembol…

🤒 Adverse Reactions ~2 min read

ADVERSE REACTIONS 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 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 to 1.12 (Figure 1) (70 to 74).

Three studies compared breast cancer risk between current or recent COC users (<6 months since last use) and never users of COCs (Figure 1) (70,73,75). 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 to 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 to 10 years of COC use. FIGURE 1: RELEVANT STUDIES OF RISK OF BREAST CANCER WITH COMBINED ORAL CONTRACEPTIVES 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. 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) 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 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 FIGURE 1: RELEVANT STUDIES OF RISK OF BREAST CANCER WITH COMBINED ORAL CONTRACEPTIVES

🆘 Overdosage 143 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. NON-CONTRACEPTIVE HEALTH BENEFITS The following non-contraceptive health benefits related to the use of oral contraceptives are supported by epidemiological studies which largely utilized oral contraceptive formulations containing estrogen doses exceeding 0.035 mg of ethinyl estradiol or 0.05 mg of mestranol (76 to 81).

Effects on menses: Increased menstrual cycle regularity Decreased blood loss and decreased incidence of iron deficiency anemia Decreased incidence of dysmenorrhea Effects related to inhibition of ovulation: Decreased incidence of functional ovarian cysts Decreased incidence of ectopic pregnancies Effects from long-term use: Decreased incidence of fibroadenomas and fibrocystic disease of the breast Decreased incidence of acute pelvic inflammatory disease Decreased incidence of endometrial cancer Decreased incidence of ovarian cancer

🧬 Clinical Pharmacology ~2 min read

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). Pharmacokinetics The pharmacokinetics of Aurovela Fe 1/20 has not been characterized; however, the following pharmacokinetic information regarding norethindrone acetate and ethinyl estradiol is taken from the literature.

Absorption Norethindrone acetate appears to be completely and rapidly deacetylated to norethindrone after oral administration, since the disposition of norethindrone acetate is indistinguishable from that of orally administered norethindrone (1). Norethindrone acetate and ethinyl estradiol are subject to first-pass metabolism after oral dosing, resulting in an absolute bioavailability of approximately 64% for norethindrone and 43% for ethinyl estradiol (1 to 3). Distribution Volume of distribution of norethindrone and ethinyl estradiol ranges from 2 to 4 L/kg (1 to 3).

Plasma protein binding of both steroids is extensive (greater than 95%); norethindrone binds to both albumin and sex hormone binding globulin, whereas ethinyl estradiol binds only to albumin (4). Metabolism Norethindrone undergoes extensive biotransformation, primarily via reduction, followed by sulfate and glucuronide conjugation. The majority of metabolites in the circulation are sulfates, with glucuronides accounting for most of the urinary metabolites (5).

A small amount of norethindrone acetate is metabolically converted to ethinyl estradiol. Ethinyl estradiol is also extensively metabolized, both by oxidation and by conjugation with sulfate and glucuronide. Sulfates are the major circulating conjugates of ethinyl estradiol and glucuronides predominate in urine.

The primary oxidative metabolite is 2-hydroxy ethinyl estradiol, formed by the CYP3A4 isoform of cytochrome P450. Part of the first-pass metabolism of ethinyl estradiol is believed to occur in gastrointestinal mucosa. Ethinyl estradiol may undergo enterohepatic circulation (6).

Excretion Norethindrone and ethinyl estradiol are excreted in both urine and feces, primarily as metabolites (5, 6). Plasma clearance values for norethindrone and ethinyl estradiol are similar (approximately

0.4L/hr/kg) (1 to 3). Special Population Race The effect of race on the disposition of Aurovela Fe 1/20 has not been evaluated. Renal Insufficiency The effect of renal disease on the disposition of Aurovela Fe 1/20 has not been evaluated.

In premenopausal women with chronic renal failure undergoing peritoneal dialysis who received multiple doses of an oral contraceptive containing ethinyl estradiol and norethindrone, plasma ethinyl estradiol concentrations were higher and norethindrone concentrations were unchanged compared to concentrations in premenopausal women with normal renal function. Hepatic Insufficiency The effect of hepatic disease on the disposition of Aurovela Fe 1/20 has not been evaluated. However, ethinyl estradiol and norethindrone may be poorly metabolized in patients with impaired liver function.

Drug-Drug Interactions Numerous drug-drug interactions have been reported for oral contraceptives. A summary of these is found under PRECAUTIONS , Drug Interactions .

📦 How Supplied / Storage and Handling 137 words

HOW SUPPLIED Aurovela ® Fe 1/20 (Norethindrone Acetate and Ethinyl Estradiol Tablets USP, 1 mg/20 mcg and Ferrous Fumarate Tablets, 75 mg) are light yellow to yellow, round, flat-faced, beveled-edge, uncoated tablets, debossed with ‘S’ on one side and ‘64’ on other side of the tablet. Each brown mottled, round, flat-faced beveled-edge tablet contains 75 mg ferrous fumarate and is debossed with ‘S’ on one side and ‘57’ on other side of the tablet. The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen, are non-hormonal, and do not serve any therapeutic purpose.

1 pouch of 28 tablets NDC 65862-940-87 Carton of 3 pouches NDC 65862-940-88 Carton of 5 pouches NDC 65862-940-58 Store at 20 o to 25 o C (68 o to 77 o F) [see USP Controlled Room Temperature].

📋 Description 155 words

DESCRIPTION Aurovela Fe 1/20 is progestogen-estrogen combination. Aurovela Fe 1/20: Each provides a continuous dosage regimen consisting of 21 oral contraceptive tablets and seven ferrous fumarate tablets. The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen, are non-hormonal, and do not serve any therapeutic purpose.

Each light yellow to yellow tablet contains norethindrone acetate USP (17 alpha-ethinyl-19-nortestosterone acetate), 1 mg; ethinyl estradiol USP (17 alpha-ethinyl-1,3,5(10)-estratriene-3, 17 beta-diol), 20 mcg. Each light yellow to yellow tablet contains the following inactive ingredients: compressible sugar, croscarmellose sodium, D&C yellow No.10 aluminum lake, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, and vitamin E. Each brown placebo tablet contains the following ingredients: croscarmellose sodium, ferrous fumarate, lactose monohydrate, magnesium stearate, microcrystalline cellulose, Nat spearmint FL, povidone and sucralose.

The ferrous fumarate tablets do not serve any therapeutic purpose. The structural formulas are as follows: Meets USP Dissolution Test 2 Chemical Structure Chemical Structure

💬 Information for Patients ~1 min read

PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling ( PATIENT PACKAGE INSERT BRIEF SUMMARY and DETAILED PATIENT PACKAGE INSERT ). Counsel patients that cigarette smoking increases the risk of serious cardiovascular events from COC use, and that women who are over 35 years old and smoke should not use COCs (see BOXED WARNING and CONTRAINDICATIONS ). Counsel patients that the increased risk of venous thromboembolism compared to non-users of CHCs is greatest after initially starting a CHC or restarting (following a 4-week or greater interruption in intake) the same or a different CHC (see WARNINGS ).

Counsel patients that this product does not protect against HIV-infection (AIDS) and other sexually transmitted infections. Counsel patients to take one tablet daily by mouth at the same time every day. Instruct patients what to do in the event pills are missed (see DOSAGE AND ADMINISTRATION ).

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs (see PRECAUTIONS ). Counsel patients who are breastfeeding or who desire to breastfeed that COCs may reduce breast milk production. This is less likely to occur if breastfeeding is well established (see PRECAUTIONS ).

Counsel any patient who starts Aurovela Fe 1/20 postpartum, and who has not yet had a period, to use an additional method of contraception until she has taken a light-orange tablet for 7 consecutive days (see DOSAGE AND ADMINISTRATION ). Counsel patients that amenorrhea may occur. Pregnancy should be considered in the event of amenorrhea, and should be ruled out if amenorrhea is associated with symptoms of pregnancy, such as morning sickness or unusual breast tenderness (see WARNINGS ).

Counsel patients with a history of depression that depression may reoccur. Women should contact their healthcare provider if depression occurs (see WARNINGS ).

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.