Amethyst is a combined hormonal birth control pill that's taken by mouth every day. It's known as a continuous cycle birth control because it doesn't contain any hormone-free pills. It can be a good option for you if you want to skip your periods. Amethyst is available as a lower-cost generic.
To prevent pregnancy
Amethyst is a combined oral contraceptive (COC) that contains two hormones: ethinyl estradiol (an estrogen) and levonorgestrel (a progestin). Both hormones work together to prevent pregnancy by suppressing ovulation (release of an egg from the ovary), changing cervical mucus to block sperm movement, and creating an unfriendly environment for the fertilized egg by changing the lining in the uterus (womb).
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Once-daily dosing
Can have fewer periods or no period at all
Works well to prevent pregnancy (98% successful at preventing pregnancy with perfect use)
Available as a lower-cost generic
Comes as an easy-to-follow blister pack
Not a good option for females over 35 who smoke
Can cause unpleasant side effects like nausea, vomiting, and headaches
Doesn't protect against sexually transmitted diseases (STDs)
Need to take it at the same time every day for it to work well
Not recommended during breastfeeding
Set an alarm to help you remember to take Amethyst at the same time every day. Forgetting to take your pill raises your chance of getting pregnant. If you miss a dose or start your pack late, use a back-up method of birth control any time you have sex until you can refer to the instructions that came with your prescription or call your provider.
It's normal to have spotting (light bleeding) or feel sick to your stomach for the first few packs of Amethyst. This should get better over time. If you experience continuous bleeding or spotting for more than 7 days in a row, contact your provider.
If you have vomiting or diarrhea, or take certain medications, Amethyst might not work as well for you. Always use a back-up birth control method until you're able to check with your healthcare provider.
Any time you vomit within 4 hours of taking Amethyst, it's considered a missed dose and you should check the instructions in your pack or call your provider to discuss what to do.
Don't skip pills even if you have spotting, bleeding, feel sick to your stomach, or don't have sex often. Doing so will make Amethyst work less well and can lead to pregnancy. If you have bothersome side effects or wish to change to a different birth control method, speak with your provider.
Make an appointment with your eye provider for an exam if you wear contact lenses and notice vision changes when wearing them or when wearing your glasses while taking Amethyst.
Once you finish a pack of Amethyst, continue directly to a new pack on the next day. Don't skip any days in between packs since they're meant to be taken continuously every day.
Since you're likely to skip periods while taking Amethyst, it can be harder to tell if you're pregnant. If you feel like you might be pregnant, call your provider. Studies haven't shown a risk of birth defects in females who've used birth control pills before pregnancy or during early pregnancy, but it's no longer necessary to take them once you're pregnant.
Hormonal birth control pills like Amethyst can lower the quality and amount of breast milk you're able to produce and aren't recommended during breastfeeding. If you're breastfeeding, ask your provider about alternative birth control options.
Amethyst has been prescribed specifically for you, so don't share it with anyone who wants to take birth control. Their provider should evaluate them to make sure they get a safe option.
Amethyst can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Female over 35 years old who smoke cigarettes
If you smoke cigarettes, using combined oral contraceptives (COCs), like Amethyst, raises your risk for serious health problems, such as strokes, heart attacks, and blood clots. Females age 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your provider about safer birth control alternatives.
Risk factors: Females over 35 years old who smoke | Females over 40 years old who don't smoke | Recent surgery with a long period of bed rest | Starting Amethyst less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Amethyst raises your risk of blood clots. These clots can occur anywhere in your body, including your lungs (pulmonary embolism or PE), legs (deep vein thrombosis or DVT), brain (stroke), and heart (heart attack). Get emergency help right away if you have any signs of a blood clot:
Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, or confusion
Eyes: trouble seeing, bulging eye, double vision
Heart: chest pain, sweating, nausea, or dizziness
Lungs: trouble breathing, chest pain, or cough
Legs: cramps, swelling, pain, or muscle tightness
If you need to have surgery, tell your provider you're taking Amethyst. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots.
Risk factors: History of breast cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Amethyst and other COCs can raise your risk for breast and cervical cancer.
Don't use Amethyst if you have breast cancer because some types of breast cancer grow faster in the presence of estrogen, an ingredient in this birth control pill. To help with early breast cancer detection, you can do monthly breast self-checks at home and yearly breast exams with your healthcare provider. Call your healthcare provider if you notice any abnormal changes or feel lumps, pain, or swelling in your breasts.
Get medical help right away if you experience abnormal vaginal bleeding, discharge, or pain during sex, since these could be signs of cervical cancer.
Risk factors: Liver problems or infection in the liver | Taking COCs with 50 mcg of estrogen or higher
Though rare, Amethyst can cause liver problems, such as liver damage and liver tumors. These problems are linked more with earlier formulations of COCs that contained higher levels of estrogen (50 mcg or higher), and less so with Amethyst since it only contains 20 mcg of estrogen. Don't use this medication if you already have liver problems. Call your provider right away if you experience symptoms of liver problems, such as tiredness, stomach pain, or yellowing of the skin or whites of the eyes.
Risk factors: High blood sugar
Amethyst might raise your blood sugar and triglyceride (fat) levels. If you have diabetes, you might need to monitor your blood sugar more closely after you start Amethyst. Let your provider know if you experience any changes in your blood sugar.
Risk factors: High blood pressure | Older age | Using COCs for a long time | Kidney problems
Amethyst and other COCs can raise your blood pressure. Your provider might ask you to check your blood pressure regularly. If you notice your blood pressure is higher while you're taking this medication, contact your provider. If you have uncontrolled high blood pressure, Amethyst might not be the best option for you.
Headaches are a common side effect of COCs like Amethyst. But, if you experience a new migraine, a migraine that's worse than normal, or a new headache that keeps coming back or is severe, call your provider so you can be checked out.
Breakthrough bleeding and spotting are common side effects of Amethyst. This is more common at first, but should get better over time. Let your provider know if you experience any irregular vaginal bleeding so they can help you figure out why you're bleeding.
Research suggests that females who take that COCs are at a higher risk of pregnancy occuring outside of the womb (ectopic pregnancy) if the birth control pills don't work like they're supposed to. The chance of becoming pregnant is higher when you don't take Amethyst as instructed at the same time every day. Symptoms of an ectopic pregnancy include low back pain, abnormal vaginal bleeding, and cramping. If you experience any of these symptoms, contact your provider.
Risk factors: History of depression
Let your provider know if you experience symptoms of depression or changes in your mood while taking Amethyst. In cases of serious depression, your provider might have you stop taking it.
Certain medications can make Amethyst get broken down faster in your body, making it less effective and can lead to pregnancy. Some examples include carbamazepine (Tegretol) and phenytoin (Dilantin). Use a back-up method or other form of birth control for at least 28 days after stopping any of these medications. Other medications can raise the amount of Amethyst in your body, which can lead to more side effects. Make sure to tell your provider or pharmacist all of your medications so they can make sure they don't interact with Amethyst.
If you have hepatitis C and need to be treated with Viekira Pak (dasabuvir / ombitasvir / paritaprevir / ritonavir), let your provider know right away that you're taking a COC. You'll need to stop Amethyst before starting Viekira Pak because taking them together can cause liver problems. You can start Amethyst again 2 weeks after you stop Viekira Pak.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
28 tablets of 90mcg/20mcg | 1 package | $20.70 | $20.70 |
Your medication might look different and have slightly different directions depending on which branded generic your provider prescribes. Please take the medication as instructed by your provider. In general:
Amethyst (and its branded generics) comes in a 28-day pack. All 28 tablets are active tablets and they each contains 90 mcg levonorgestrel and 20 mcg ethinyl estradiol.
The typical dose is 1 tablet by mouth at the same time every day.
Smoking and smoking over the age of 35
History of heart attack or stroke
Currently have or history of DVT, PE, or blood clot in your eye(s)
History of blood clotting problems
Chest pain
Currently have or have a history of breast cancer
Endometrial cancer, cervical cancer, or certain estrogen-dependent cancers
Undiagnosed abnormal vaginal bleeding
Liver tumors
Liver disease
Taking hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir
Currently have or have a history of jaundice (yellowing of the skin and whites of the eyes)
Pregnancy
Major surgery where you aren't able to walk for a long time
Certain heart valve or heart rhythm problems
Diabetes with blood vessel problems
Certain types of headaches
Uncontrolled high blood pressure
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