Twirla (Levonogestrel and Ethinyl Estradiol)

Description

Twirla contains a progestin, levonorgestrel, and an estrogen, ethinyl estradiol, to prevent pregnancy in women who have a body mass index (BMI) that is less than 30 kg/m2.

Directions

Twirla comes as a transdermal patch for application to the skin only. Apply the patch per the instructions that come with your prescription. Talk to your doctor or pharmacist about any questions or concerns you may have.

One patch should be applied to clean, dry, and intact skin of the abdomen, buttock, or upper torso every week for three consecutive weeks. 

Avoid applying the patch to the breasts. Avoid cutting the patch. You should not wear a patch during the fourth week.

120 mcg/day of levonorgestrel and 30 mcg/day of ethinyl estradiol are provided in each patch.

Ingredients

Levonorgestrel and Ethinyl Estradiol are the active ingredients in Twirla.

Contraindications

• Avoid the use of Twirla if you currently have or have a history of blood clots, a heart attack, or a stroke, uncontrolled high blood pressure, certain heart valve problems, a condition that makes your blood clot more than normal, or if you smoke and are older than 35 years old.
• Avoid the use of Twirla if your BMI is 30 kg/m2 or more.
• Avoid the use of Twirla if you currently have or have a history of breast cancer or other hormonally-sensitive cancer.
• Avoid the use of Twirla if you have liver tumors, acute viral hepatitis, or decompensated liver cirrhosis. 
• Avoid the use of Twirla if you have migraines with aura, if you are older than 35 years old and have migraines with or without aura, or if you have headaches with focal neurological symptoms.
• Avoid the use of Twirla if you have undiagnosed irregular vaginal bleeding.
• Avoid the use of Twirla if you are pregnant.
• Avoid the use of Twirla if you are allergic to levonorgestrel, ethinyl estradiol, or any of the other ingredients contained in the patch.
• Avoid the use of Twirla if you take hepatitis C drugs that contain ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

Cautions

• Before you start using Twirla transdermal system, talk to your doctor:
• About all the prescription and nonprescription medications you take, as well as vitamins and herbal supplements
• About any allergies you may have
• About your medical problems
• About any scheduled or planned surgeries 
• About your pregnancy status. Tell your doctor if you are pregnant or plan to become pregnant.
• About your breastfeeding status. Tell your doctor if you are planning to breastfeed.
• Your risk for blood clots, a heart attack, or a stroke may be increased with the use of Twirla. Cardiovascular risk factors should be evaluated before starting Twirla.
• Liver problems may occur with the use of Twirla. 
• High blood pressure may occur with the use of Twirla. Monitor your blood pressure periodically while using Twirla.
• Gallbladder disease may worsen or occur with the use of Twirla.
• Glucose intolerance may decrease in women who are prediabetic or diabetic and are using Twirla.
• Triglyceride levels may increase with the use of Twirla. Increased triglyceride levels can lead to pancreatitis.
• Severe or persistent headaches may occur with the use of Twirla.
• Irregular vaginal bleeding or no menstruation may occur with the use of Twirla.

Side Effects

Twirla can cause side effects such as application site reactions, nausea, headache, abnormal vaginal bleeding, and weight gain.

Immediately tell your doctor if you experience side effects that bother you or continue.

Reference:

Twirla. Grand Rapids, MI: Corium International, Inc.; 2020.

About Dr. Savannah Muncy (Page Author)

Dr. Muncy (PharmD) studied science and education as an undergraduate before attending the Appalachian College of Pharmacy where she completed her PharmD in three years. She is currently using her pharmacy and healthcare expertise to write medical content for clients all around the world. She is focused on delivering the most current, accurate, and engaging information to healthcare professionals and patients. Read More....