See FDA-approved patient labeling (Patient Information and Instructions for Use).
Counsel patients about the following information:
- •
- 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].
- •
- Increased risk of VTE compared to non-users of COCs is greatest after initially starting a COC or restarting (following a 4-week or greater pill-free interval) the same or a different COC [see WARNINGS AND PRECAUTIONS (5.1)].
- •
- Estarylla does not protect against HIV infection (AIDS) and other sexually transmitted infections.
- •
- Estarylla is not to be used during pregnancy; if pregnancy occurs during use of Estarylla instruct the patient to stop further use [see WARNINGS AND PRECAUTIONS (5.9)].
- •
- Take one tablet daily by mouth at the same time every day. Instruct patients what to do in the event tablets are missed [see DOSAGE AND ADMINISTRATION (2.2)].
- •
- Use a back-up or alternative method of contraception when enzyme inducers are used with Estarylla [see DRUG INTERACTIONS (7.1)].
- •
- COCs may reduce breast milk production; this is less likely to occur if breastfeeding is well established [see USE IN SPECIFIC POPULATIONS (8.3)].
- •
- Women who start COCs postpartum, and who have not yet had a period, should use an additional method of contraception until they have taken an active tablet for 7 consecutive days [see DOSAGE AND ADMINISTRATION (2.2)].
- •
- Amenorrhea may occur. Consider pregnancy in the event of amenorrhea at the time of the first missed period. Rule out pregnancy in the event of amenorrhea in two or more consecutive cycles [see WARNINGS AND PRECAUTIONS (5.8)].
ESTARYLLA is a registered trademark of Xiromed Pharma España, S.L.
Manufactured by Laboratorios Leon Farma S.A., Spain
for Xiromed, LLC., Florham Park, NJ 07932
Product of Spain
PI-119-02
Rev. 02/2023
Patient Information
Estarylla®(norgestimate and ethinyl estradiol tablets, USP)
(nor-JES-ti-mate, ETH-i-nil es-tra-DYE-ol)
What is the most important information I should know about Estarylla?
Do not use Estaryllaif you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects from hormonal birth control pills, including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke.
What is Estarylla?
Estarylla is a birth control pill (oral contraceptive) used by women to prevent pregnancy.
How does Estaryllawork for contraception?
Your chance of getting pregnant depends on how well you follow the directions for taking your birth control pills. The better you follow the directions, the less chance you have of getting pregnant.
Based on the results of clinical studies, about 1 out of 100 women may get pregnant during the first year they use Estarylla.
The following chart shows the chance of getting pregnant for women who use different methods of birth control. Each box on the chart contains a list of birth control methods that are similar in effectiveness. The most effective methods are at the top of the chart. The box on the bottom of the chart shows the chance of getting pregnant for women who do not use birth control and are trying to get pregnant.
Who should not take Estarylla?
Do not take Estaryllaif you:
- smoke and are over 35 years of age
- had blood clots in your arms, legs, lungs, or eyes
- had a problem with your blood that makes it clot more than normal
- have certain heart valve problems or irregular heart beat that increases your risk of having blood clots
- had a stroke
- had a heart attack
- have high blood pressure that cannot be controlled by medicine
- have diabetes with kidney, eye, nerve, or blood vessel damage
- have certain kinds of severe migraine headaches with aura, numbness, weakness or changes in vision, or any migraine headaches if you are over 35 years of age
- have liver problems, including liver tumors
- take any Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. This may increase levels of the liver enzyme “alanine aminotransferase” (ALT) in the blood.
- have any unexplained vaginal bleeding
- are pregnant
- had breast cancer or any cancer that is sensitive to female hormone
If any of these conditions happen while you are taking Estarylla, stop taking Estaryllaright away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Estarylla.
What should I tell my healthcare provider before taking Estarylla?
Tell your healthcare provider if you:
- •
- are pregnant or think you may be pregnant
- •
- are depressed now or have been depressed in the past had yellowing of your skin or eyes (jaundice) caused by pregnancy (Cholestasis of pregnancy)
- •
- are breastfeeding or plan to breastfeed. Estarylla may decrease the amount of breast milk you make. A small amount of the hormones in Estaryllamaypassintoyourbreast milk. Talktoyourhealthcareprovider aboutthebestbirthcontrol methodforyouwhilebreastfeeding.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
Estarylla may affect the way other medicines work, and other medicines may affect how well Estarylla works.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take Estarylla?
Read the Instructions for Use at the end of this Patient Information.
What are the possible serious side effects of Estarylla?
- •
- Like pregnancy, Estarylla may cause serious side effects, including blood clots in your lungs, heart attack, or a stroke that may lead to death. Some other examples of serious blood clots include blood clots in the legs or eyes.
Serious blood clots can happen especially if you smoke, are obese, or are older than 35 years of age. Serious blood clots are more likely to happen when you:
- •
- first start taking birth control pills
- •
- restart the same or different birth control pills after not using them for a month or more
Call your healthcare provider or go to a hospital emergency room right away if you have:
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Other serious side effects include:
- •
- liver problems, including:
- •
- rare liver tumors
- •
- jaundice (cholestasis), especially if you previously had cholestasis of pregnancy. Call your healthcare provider if you have yellowing of your skin or eyes.
- •
- high blood pressure. You should see your healthcare provider for a yearly check of your blood pressure.
- •
- gallbladder problems
- •
- changes in the sugar and fat (cholesterol and triglycerides) levels in your blood
- •
- new or worsening headaches including migraine headaches
- •
- irregular or unusual vaginal bleeding and spotting between your menstrual periods, especially during the first 3 months of taking Estarylla.
- •
- depression
- •
- possible cancer in your breast and cervix
- •
- swelling of your skin especially around your mouth, eyes, and in your throat (angioedema). Call your healthcare provider if you have a swollen face, lips, mouth tongue or throat, which may lead to difficulty swallowing or breathing. Your chance of having angioedema is higher if you have a history of angioedema.
- •
- dark patches of skin around your forehead, nose, cheeks and around your mouth, especially during pregnancy (chloasma). Women who tend to get chloasma should avoid spending a long time in sunlight, tanning booths, and under sun lamps while taking Estarylla. Use sunscreen if you have to be in the sunlight.
What are the most common side effects of Estarylla?
- •
- headache (migraine)
- •
- breast pain or tenderness, enlargement or discharge
- •
- stomach pain, discomfort, and gas
- •
- vaginal infections and discharge
- •
- mood changes, including depression
- •
- nervousness
- •
- changes in weight
- •
- skin rash
These are not all the possible side effects of Estarylla. For more information, ask your healthcare provider or pharmacist.
You may report side effects to Xiromed, LLC. at 1-844-XIROMED (844-947-6633) or FDA at 1-800-FDA-1088.
What else should I know about taking Estarylla?
- •
- If you are scheduled for any lab tests, tell your healthcare provider you are taking Estarylla. Certain blood tests may be affected by Estarylla.
- •
- Estarylla does not protect against HIV infection (AIDS) and other sexually transmitted infections.
How should I store Estarylla?
- •
- Store Estarylla at room temperature between 68°F to 77°F (20°C to 25°C).
- •
- Keep Estarylla and all medicines out of the reach of children.
- •
- Store away from light.
General information about the safe and effective use of Estarylla.
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Estarylla for a condition for which it was not prescribed. Do not give Estarylla to other people, even if they have the same symptoms that you have.
This Patient Information summarizes the most important information about Estarylla . You can ask your pharmacist or healthcare provider for information about Estarylla that is written for health professionals.
For more information, call Xiromed, LLC. at 1-844-XIROMED (844-947-6633).
Does hormonal birth control cause cancer?
It is not known if hormonal birth control pills causes breast cancer. Some studies, but not all, suggest that there could be a slight increase in the risk of breast cancer among current users with longer duration of use.
If you have breast cancer now, or have had it in the past, do not use hormonal birth control because some breast cancers are sensitive to hormones.
Women who use birth control pills may have a slightly higher chance of getting cervical cancer. However, this may be due to other reasons such as having more sexual partners.
What if I want to become pregnant?
You may stop taking the pill whenever you wish. Consider a visit with your healthcare provider for a pre-pregnancy checkup before you stop taking the pill.
What should I know about my period when taking Estarylla?
Your periods may be lighter and shorter than usual. Some women may miss a period. Irregular vaginal bleeding or spotting may happen while you are taking Estarylla, especially during the first few months of use. This usually is not a serious problem. It is important to continue taking your pills on a regular schedule to prevent a pregnancy.
What are the ingredients in Estarylla?
Active ingredients: Each blue pill contains norgestimate and ethinyl estradiol.
Inactive ingredients:
Blue pills: crospovidone, FD & C Blue No.2 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized starch.
Green pills: crospovidone, D & C Yellow No.10 Aluminum Lake, FD & C Blue No.2 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized starch.
Instructions For Use
Estarylla(norgestimate and ethinyl estradiol tablets, USP)
Important Information about taking Estarylla
- •
- Take 1 pill every day at the same time. Take the pills in the order directed on your blister pack.
- •
- Do not skip your pills, even if you do not have sex often. If you miss pills (including starting the pack late) you could get pregnant. The more pills you miss, the more likely you are to get pregnant.
- •
- If you have trouble remembering to take Estarylla, talk to your healthcare provider. When you first start taking Estarylla, spotting or light bleeding in between your periods may occur. Contact your healthcare provider if this does not go away after a few months.
- •
- You may feel sick to your stomach (nauseous), especially during the first few months of taking Estarylla. If you feel sick to your stomach, do not stop taking the pill. The problem will usually go away. If your nausea does not go away, call your healthcare provider.
- •
- Missing pills can also cause spotting or light bleeding, even when you take the missed pills later. On the days you take 2 pills to make up for missed pills (see What should I do if I miss any Estarylla pills? below), you could also feel a little sick to your stomach.
- •
- It is not uncommon to miss a period. However, if you miss a period and have not taken Estarylla according to directions, or miss 2 periods in a row, or feel like you may be pregnant, call your healthcare provider. If you have a positive pregnancy test, you should stop taking Estarylla.
- •
- If you have vomiting or diarrhea within 3 to 4 hours of taking your pill, take another pill of the same color from your extra pill blister pack. If you do not have an extra pill blister pack, take the next pill in your pill blister pack. Continue taking all your remaining pills in order. Start the first pill of your next pill blister pack the day after finishing your current pill blister pack. This will be 1 day earlier than originally scheduled. Continue on your new schedule.
- •
- If you have vomiting or diarrhea for more than 1 day, your birth control pills may not work as well. Use an additional birth control method, like condoms and a spermicide, until you check with your healthcare provider.
- •
- Stop taking Estarylla at least 4 weeks before you have major surgery and do not restart after the surgery without asking your healthcare provider. Be sure to use other forms of contraception (like condoms and spermicide) during this time period.
Before you start taking Estarylla:
- •
- Decide what time of day you want to take your pill. It is important to take it at the same time every day and in the order as directed on your blister pack.
- •
- Have backup contraception (condoms and spermicide) available and if possible, an extra full blister pack of pills as needed.
When should I start taking Estarylla?
If you start taking Estaryllaand you have not used a hormonal birth control method before:
- •
- There are 2 ways to start taking your birth control pills. You can either start on a Sunday (Sunday Start) or on the first day (Day 1) of your natural menstrual period (Day 1 Start). Your healthcare provider should tell you when to start taking your birth control pill.
- •
- If you use the Sunday Start, use non-hormonal back-up contraception such as condoms and spermicide for the first 7 days that you take Estarylla™. You do not need back-up contraception if you use the Day 1 Start.
If you start taking Estarylla and you are switching from another birth control pill:
- •
- Start your new Estarylla pack on the same day that you would start the next pack of your previous birth control method.
- •
- Do not continue taking the pills from your previous birth control pack.
If you start taking Estarylla and previously used a vaginal ring or transdermal patch:
- •
- Start using Estarylla on the day you would have reapplied the next ring or patch.
If you start taking Estarylla and you are switching from a progestin-only method such as an implant or injection:
- •
- Start taking Estarylla on the day of removal of your implant or on the day when you would have had your next injection.
If you start taking Estarylla and you are switching from an intrauterine device or system (IUD or IUS):
- •
- Start taking Estarylla on the day of removal of your IUD or IUS.
- •
- You do not need back-up contraception if your IUD or IUS is removed on the first day (Day 1) of your period. If your IUD or IUS is removed on any other day, use non-hormonal back-up contraception such as condoms and spermicide for the first 7 days that you take Estarylla.
Keep a calendar to track your period:
If this is the first time you are taking birth control pills, read, "When should I start taking Estarylla?" above. Follow these instructions for either a Sunday Start or a Day 1 Start.
Sunday Start:
You will use a Sunday Start if your healthcare provider told you to take your first pill on a Sunday.
- •
- Take pill 1 on the Sunday after your period starts.
- •
- If your period starts on a Sunday, take pill "1" that day and refer to Day 1 Start instructions below.
- •
- Take 1 pill every day in the order on the blister pack at the same time each day for 28 days.
- •
- After taking the last pill on Day 28 from the blister pack, start taking the first pill from a new blister pack, on the same day of the week as the first blister pack (Sunday). Take the first pill in the new blister pack whether or not you are having your period.
- •
- Use non-hormonal back-up contraception such as condoms and spermicide for the first 7 days of the first cycle that you take Estarylla.
Day 1 Start:
You will use a Day 1 Start if your doctor told you to take your first pill (Day 1) on the first day of your period.
- •
- Take 1 pill every day in the order of the blister pack, at the same time each day, for 28 days.
- •
- After taking the last pill on Day 28 from the blister pack, start taking the first pill from a new pack, on the same day of the week as the first pack. Take the first pill in the new pack whether or not you are having your period.
Estarylla comes in a blister pack. Read the instructions below for using your blister pack.
BEFORE YOU START TAKING YOUR PILLS:
1. BE SURE TO READ THESE DIRECTIONS:
Before you start taking your pills.
Anytime you are not sure what to do.
2. THE RIGHT WAY TO TAKE THE PILL IS TO TAKE ONE PILL EVERY DAY AT THE SAME TIME. If you miss pills you could get pregnant. This includes starting the pack late.
The more pills you miss, the more likely you are to get pregnant.
3. MANY WOMEN HAVE SPOTTING OR LIGHT BLEEDING, OR MAY FEEL SICK TO THEIR STOMACH DURING THE FIRST 1 to 3 PACKS OF PILLS. If you feel sick to your stomach or have spotting or light bleeding, do not stop taking the pill. The problem will usually go away. If it doesn't go away, check with your healthcare professional.
4. MISSING PILLS CAN ALSO CAUSE SPOTTING OR LIGHT BLEEDING, even when you make up these missedpills.
On the days you take 2 pills to make up for missed pills, you could also feel a little sick to your stomach.
5. IF YOU HAVE VOMITING OR DIARRHEA, OR IF YOU TAKE SOME MEDICINES, your pills may not work as well.
Use a back-up method (such as a condom or spermicide) until you check with your healthcare professional.
6. IF YOU HAVE TROUBLE REMEMBERING TO TAKE THE PILL, talk to your healthcare professional about how to make pill-taking easier or about using another method of birth control.
7. IF YOU HAVE ANY QUESTIONS OR ARE UNSURE ABOUT THE INFORMATION IN THIS LEAFLET, call your healthcare professional.
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 PACK
The 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).
There are 21 blue active pills, and 7 green reminder pills.
3. ALSO FIND:
1) where on the pack to start takingpills,
2) in what order to take the pills (follow thearrows)
3) the week numbers as shown in the diagrambelow.
4.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 PACK.
What should I do if I miss any Estarylla pills?
If you miss 1 pill in Weeks 1, 2, or 3, follow these steps:
- •
- Take it as soon as you remember. Take the next pill at your regular time. This means you may take 2 pills in 1 day.
- •
- Then continue taking 1 pill every day until you finish the pack.
- •
- You do not need to use a back-up birth control method if you have sex.
If you miss 2 pills in Week 1 or Week 2 of your pack, follow these steps:
- •
- Take the 2 missed pills as soon as possible and the next 2 pills the next day.
- •
- Then continue to take 1 pill every day until you finish the pack.
- •
- Use a non-hormonal birth control method (such as a condom and spermicide) as a back-up if you have sex during the first 7 days after missing your pills.
If you miss 2 pills in a row in Week 3, or you miss 3 or more pills in a row during Weeks 1, 2, or 3 of the pack, follow these steps:
- •
- If you are a Day 1 Starter:
- ∘
- Throw out the rest of the pill pack and start a new pack that same day.
- ∘
- You may not have your period this month but this is expected. However, if you miss your period 2 months in a row, call your healthcare provider because you might be pregnant.
- ∘
- You could become pregnant if you have sex during the first 7 days after you restart your pills. You MUST use a non-hormonal birth control method (such as a condom and spermicide) as a back-up if you have sex during the first 7 days after you restart your pills.
- •
- If you are a Sunday Starter:
- ∘
- Keep taking 1 pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack of pills that same day.
- ∘
- Use a non-hormonal birth control method (such as a condom and spermicide) as a back-up if you have sex during the first 7 days after you restart your pills.
If you have any questions or are unsure about the information in this leaflet, call your healthcare provider.
This Patient Information and Instructions for Use has been approved by the U.S. Food and Drug Administration.
The brands listed are trademarks of their respective owners and are not trademarks of Xiromed, LLC.
ESTARYLLA is a registered trademark of Xiromed Pharma España, S.L.
Manufactured by Laboratorios Leon Farma S.A., Spain
for Xiromed, LLC. Florham Park, NJ 07932
Product of Spain
PIL-119-02
Rev. 02/2023
