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Uses
Tri-Estarylla™ (norgestimate and ethinyl estradiol tablets, USP) is indicated for use by females of reproductive potential to prevent pregnancy [see CLINICAL STUDIES (14)].
Tri-Estarylla™ is indicated for the treatment of moderate acne vulgaris in females at least 15 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. Tri-Estarylla™ should be used for the treatment of acne only if the patient desires an oral contraceptive for birth control [see CLINICAL STUDIES (14)].
History
There is currently no drug history available for this drug.
Other Information
Each of the following products is a combination oral contraceptive containing the progestational compound norgestimate and the estrogenic compound ethinyl estradiol. Norgestimate is designated as (18,19-Dinor-17-pregn-4-en-20-yn-3-one,17-(acetyloxy)-13-ethyl-, oxime,(17α)-(+)-) and ethinyl estradiol is designated as (19-nor-17α-pregna,1,3,5(10)-trien-20-yne-3,17-diol).
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- Each active white tablet contains 0.18 mg norgestimate and 0.035 mg of ethinyl estradiol. Inactive ingredients include crospovidone, lactose anhydrous, magnesium stearate, and pregelatinized starch.
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- Each active light blue tablet contains 0.215 mg norgestimate and 0.035 mg of ethinyl estradiol. Inactive ingredients include crospovidone, FD & C Blue No.2 lake, lactose anhydrous, magnesium stearate, and pregelatinized starch
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- Each active blue tablet contains 0.25 mg norgestimate and 0.035 mg of ethinyl estradiol. Inactive ingredients include crospovidone, FD & C Blue No.2 lake, lactose anhydrous, magnesium stearate, and pregelatinized starch
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- Each green tablet contains only inert ingredients, as follows: crospovidone, D &C Yellow No.10 aluminum Lake, FD & C Blue No.2 lake, lactose anhydrous, magnesium stearate, and pregelatinized starch
Sources
Tri-estarylla Manufacturers
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Sandoz Inc
Tri-estarylla | Sandoz Inc
2.1 How to Start Tri-Estarylla™Tri-Estarylla™ (norgestimate and ethinyl estradiol tablets, USP), is dispensed in a blister pack [see HOW SUPPLIED/STORAGE AND HANDLING (16)]. Tri-Estarylla™ may be started using either a Day 1 start or a Sunday start (see Table 1). For the first cycle of a Sunday Start regimen, an additional method of contraception should be used until after the first 7 consecutive days of administration.
2.2 How to Take Tri-Estarylla™Table 1: Instructions for Administration of Tri-Estarylla™
Complete instructions to facilitate patient counseling on proper tablet usage are located in the FDA-Approved Patient Labeling.Starting COCs in women not currently using hormonal contraception (Day 1 Start or Sunday Start)
Important:
Consider the possibility of ovulation and conception prior to initiation of this product.
Tablet Color:Day 1 Start:
• Take first active tablet without regard to meals on the first day of menses. • Take subsequent active tablets once daily at the same time each day for a total of 21 days. • Take one green inactive tablet daily for 7 days and at the same time of day that active tablets were taken. • Begin each subsequent blister pack on the same day of Tri-Estarylla™ the week as the first cycle blister pack (i.e., on the day after taking the last inactive tablet)Sunday Start:
• Take first active tablet without regard to meals on the first Sunday after the onset of menses. Due to the potential risk of becoming pregnant, use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of the patient's first cycle pack of Tri-Estarylla™. • Take subsequent active tablets once daily at the same time each day for a total of 21 days. • Take one green inactive tablet daily for the following 7 days and at the same time of day that active tablets were taken. • Begin each subsequent pack on the same day of the week as the first cycle pack (i.e., on the Sunday after taking the last inactive tablet) and additional non-hormonal contraceptive is not needed. • Switching to Tri-Estarylla™ from another oral contraceptiveStart on the same day that a new pack of the previous oral contraceptive would have started.
• Switching from another contraceptive method to Tri-Estarylla™Start Tri-Estarylla™:
• Transdermal patch • On the day when next application would have been scheduled • Vaginal ring • On the day when next insertion would have been scheduled • Injection • On the day when next injection would have been scheduled • Intrauterine contraceptive • On the day of removal • If the IUD is not removed on first day of the patient's menstrual cycle, additional non-hormonal contraceptive (such as condoms and spermicide) is needed for the first seven days of the first cycle pack. • Implant • On the day of removalStarting Tri-Estarylla™ after Abortion or Miscarriage
First-trimester
• After a first-trimester abortion or miscarriage, Tri-Estarylla™ may be started immediately. An additional method of contraception is not needed if Tri-Estarylla™ is started immediately. • If Tri-Estarylla™ is not started within 5 days after termination of the pregnancy, the patient should use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of her first cycle blister pack of Tri-Estarylla™.Second-trimester
• Do not start until 4 weeks after a second-trimester abortion or miscarriage, due to the increased risk of thromboembolic disease. Start Tri-Estarylla™, following the instructions in Table 1 for Day 1 or Sunday start, as desired. If using Sunday start, use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of the patient's first cycle pack of Tri-Estarylla™. [See CONTRAINDICATIONS (4), WARNINGS AND PRECAUTIONS (5.1), and FDA-Approved Patient Labeling.]Starting Tri-Estarylla™ after Childbirth
• Do not start until 4 weeks after delivery, due to the increased risk of thromboembolic disease. Start contraceptive therapy with Tri-Estarylla™ following the instructions in Table 1 (above) for women not currently using hormonal contraception. • Tri-Estarylla™ is not recommended for use in lactating women [see USE IN SPECIFIC POPULATIONS (8.3)]. • If the woman has not yet had a period postpartum, consider the possibility of ovulation and conception occurring prior to use of Tri-Estarylla™. [See CONTRAINDICATIONS (4), WARNINGS AND PRECAUTIONS (5.1), USE IN SPECIFIC POPULATIONS (8.1 and 8.3), and FDA-Approved Patient Labeling].BEFORE YOU START TAKING YOUR PILLS
1. DECIDE WHAT TIME OF DAY YOU WANT TO TAKE YOUR PILL.
It is important to take it at about the same time every day. 2. LOOK AT YOUR PILL BLISTER PACKThe pill pack has 21 "active" pills (with hormones) to take for 3 weeks. This is followed by 1 week of "reminder" green pills (without hormones).
3.ALSO FIND:
1) where on the pack to start taking pills, 2) in what order to take the pills (follow the arrows) 3) The week numbers as shown in the diagram below4.BE SURE YOU HAVE READY AT ALL TIMES:
Another kind of birth control (such as a condom or spermicide) to use as a back-up method in case you miss pills. An extra, full pill blister pack. 2.3 Missed Tablets Table 2: Instructions for Missed Tri-Estarylla™ TabletsIf one active tablet is missed in Weeks 1, 2, or 3
Take the tablet as soon as possible. Continue taking one tablet a day until the pack is finished.
If two active tablets are missed in Week 1 or Week 2
Take the two missed tablets as soon as possible and the next two active tablets the next day. Continue taking one tablet a day until the pack is finished. Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.
If two active tablets are missed in the third week or three or more active tablets are missed in a row in Weeks 1, 2, or 3
Day 1 start: Throw out the rest of the pack and start a new pack that same day.
2.4 Advice in Case of Gastrointestinal Disturbances
Sunday start: Continue taking one tablet a day until Sunday, then throw out the rest of the pack and start a new pack that same day. Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures should be taken. If vomiting or diarrhea occurs within 3 to 4 hours after taking an active tablet, handle this as a missed tablet [see FDA-Approved Patient Labeling].
2.5 Tri-Estarylla™ Use for AcneThe timing of initiation of dosing with Tri-Estarylla™ for acne should follow the guidelines for use of Tri-Estarylla™ as an oral contraceptive. Consult the DOSAGE AND ADMINISTRATION section (2.1) for instructions
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