Generic Ovral-L

Alesse (OVRAL - L)

Active ingredients: Levonorgestrel .15 mg + Ethinyl Estradiol .03 mg

Alesse (Ovral-L) is a popular birth control medication (oral contraceptive) produced by the pharmaceutical company Wyeth Pharmaceuticals, Inc. Allesse (Ovral-L) is available under the following brand name: Aviane, Lutera, Orsythia. 

Pharmacological action

Alesse (Ovral-L) is a combined monophasic oral birth control drug. Contraceptive effect is associated with the suppression of pituitary secretion of gonadotropin-releasing hormone.

The progestogen component (progestin) Levorgestrel acts at the receptor level without prior metabolic transformation. The estrogen component is ethinyl estradiol. Levorgestrel contributes to the blockade of LH and FSH release from the hypothalamus, inhibition of pituitary gonadotropin-releasing hormone secretion and ovulation development. The contraceptive effect is enhanced by Ethinyl Estradiol. Ethynil estradio maintains high viscosity of cervical mucus making the sperm penetration in the uterus more difficult. Another birth control mechanism consists in changing the lining of the uterus making it less receptive to an embryo.

Indication

Ovral-l (Alesse) is an oral contraceptive used to prevent undesirable pregnancy. In addition to contracetpive effect, Ovral-L has the following beneficial effects on the women health:

• Less menstrual periods
• Decreased risk of endometrial cancer and
• Lighter menstraul bleedings

Ovral-L mode of administration

You should begin taking Ovral-L (Alesse) in the first day of mentraul cycle taking the pill  marked with the correct day of the week. Try to take the medication until the whole pack is finished (21 days) at the same time each day to maintain the constant level of the medication in the blood. The following a 7-days interruption during which a vaginal hemorrhages can occur.

Contraindications:

• Severe liver disease
• Congenital hyperbilirubinemia (Gilbert's syndrome, Dubin-Johnson syndrome, Rotor syndrome)
• Cholecystitis
• History of severe cardiovascular and cerebrovascular disease;
• Thromboembolic conditions and a predisposition to them
• Malignant tumors (especially breast cancer or endometrial cancer)
• Tumors of the liver;
• Family forms of hyperlipidemia;
• Severe arterial hypertension;
• Endocrine disorders (including severe forms of diabetes);
• Sickle cell anemia;
• Chronic hemolytic anemia;
• Vaginal bleeding of unknown etiology;
• Hydatidiform mole;
• Migraine;
• Otosclerosis;
• Idiopathic jaundice in pregnancy or a history of jaundice
• Severe pruritus during pregnancy;
• Herpes during pregnancy;
• Age over 40 years;
• Pregnancy
• Lactation (breastfeeding);
• Hypersensitivity to any of the medication ingredients

Ovral-L (Alesse) should be used with caution in patients with liver and gall bladder diseases, depression, ulcerative colitis, uterine cancer, mastitis, tuberculosis, kidney disease, diabetes, diseases of the cardiovascular system, renal dysfunction, varicose veins diseases, otosclerosis, epilepsy, porphyria, epilepsy, bronchial asthma.

Ovral-L (Alesse) should be discontinued in the following cases:

• The appearance of migraine attack for the first time
• The appearance of early signs of phlebitis or phlebothrombosis (unusual pain or swelling of veins);
• In case of jaundice or hepatitis without jaundice;
• In cerebrovascular disorders;
• Pain of unknown etiology when breathing or coughing, pain and feelings of tightness in the chest;
• An acute deterioration of visual acuity;
• In suspected thrombosis or heart attack;
• Significant increase in blood pressure;
• Generalized pruritus;
• Seizures;
• 3 months before the planned pregnancy;
• Approximately 6 weeks before planned surgery;
• Prolonged immobilization;
• Pregnancy

Side effects

Ovral-L is generally well tolerated.

Possible side effects include: nausea, vomiting, headache, breast engorgement, and weight change in libido, mood changes, acyclic bleeding and in some cases - swelling of the eyelids, conjunctivitis, blurred vision, discomfort when wearing contact lenses

In very rary cases Alesse may cause chloasma, hearing loss, generalized pruritus, jaundice, leg cramps, increased frequency of epileptic seizures.

In very rare cases Alesse may cause hypertriglyceridemia, hyperglycemia, impaired glucose tolerance, increased blood pressure, thrombosis and venous thromboembolism, jaundice, skin rashes, changes in the nature of vaginal secretions, candidiasis, fatigue, and diarrhea.

Drug interaction

Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives can enhance the metabolism of Alesse

Reduced contraceptive efficacy can be observed while the appointment of some antimicrobial agents (including with ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines) that is associated with changes in intestinal microflora.

Ovral-L changes the blood levels of anticoagulants

Ovral-L (Alesse) increases the  bioavailability and toxicity of tricyclic antidepressants, maprotiline, beta-blockers.

Alesse may change the blood levels of hypoglycemic agents and insulin.