balziva
Balziva is a type of combined oral contraceptive (COC), or birth control. It contains both estrogen and progesterone hormones. It's monophasic, meaning all active tablets contain the same amount of hormones. This medication is available as a 28-tablet pack, with some branded generics available as a chewable tablet (e.g., Wymzya Fe, Nexesta Fe) that also contain iron tablets.
What is Balziva?
What is Balziva used for?
To prevent pregnancy
How Balziva works
Balziva is a combination medication that contains two hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen). These two hormones work together to prevent pregnancy by:
Preventing your ovaries from releasing eggs
Changing the mucus in your cervix to make it harder for the sperm to enter the uterus (womb)
Changing the lining of the uterus so it's more difficult for a fertilized egg to implant
Some branded generic versions contain placebo (hormone-free or inactive) tablets with ferrous fumarate. This is an iron supplement added to lower your risk for low iron levels or anemia when you have bleeding during the days when you're taking the placebo tablets.
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What are the side effects of Balziva?
Common Side Effects
- Nausea
- Vomiting
- Stomach cramps and bloating
- Bleeding between periods
- Spotting
- Change in the flow of period
- Missing periods
- Swelling
- Breast tenderness or getting bigger
Other Side Effects
- Weight going up or down
- Depression
- Vaginal yeast infection
- Migraine
- Allergic rash
Serious Side Effects
- Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening migraines or headaches
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual vaginal discharge, itching, or odor
- Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Breast pain or tenderness
- Dark patches of skin on the face or other sun-exposed areas
- Irregular menstrual cycles or spotting
Pros and cons of Balziva
Pros
Once-daily dosing
Some brands available as a chewable tablet, which is helpful for people who have trouble swallowing pills
Works better to prevent pregnancy compared to some other birth control methods
Can make periods more regular
Pills are in an easy-to-follow blister pack
Cons
Doesn't protect against sexually transmitted diseases (STDs)
Need to take your pill at the same time every day for it to work well
Not a good option for females age 35 years and older who smoke because of higher risk for blood clots
Can cause unpleasant side effects like nausea, vomiting, and headaches
Pharmacist tips for Balziva
Before starting Balziva, discuss your full medical history with your provider. This medication can worsen certain conditions, such as high blood pressure or headaches.
Set an alarm to help you remember to take Balziva at the same time every day. Take it with a meal or at bedtime to help with side effects like stomach upset and nausea.
Chewable tablets can be chewed and swallowed or swallowed whole. If chewed, make sure to drink a full glass ofwater afterwards to make sure you get your full dose.
It's normal to have spotting (light bleeding outside of your period) or have stomach problems during the first few cycles of Balziva. This should get better over time, but if it doesn't contact your provider.
If you have vomiting or diarrhea, or take certain medications, Balziva 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.
Contact your eye provider right away if you wear contact lenses and notice vision changes when wearing them or when wearing your glasses while taking Balziva.
If you've been taking Balziva as instructed and have missed two periods in a row or feel like you might be pregnant, call your provider. Studies haven't confirmed 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.
Oral contraceptives like Balziva can lower the 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.
If you want to stop taking this medication and become pregnant, speak to your provider. There might be a delay in getting pregnant after taking Balziva. It might help to wait until you have regular menstrual cycles again after stopping Balziva before you try to get pregnant.
Balziva 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.
Frequently asked questions about Balziva
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What are the risks and warnings for Balziva?
Balziva 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.
Cigarette smoking and serious heart problems
Risk factors: Females over 35 years old who smoke cigarettes
If you smoke cigarettes, using combined oral contraceptives (COCs), like Balziva, raises your risk for serious health problems, such as strokes, heart attacks, and blood clots. Females over age 35 years old who smoke are at even higher risk for these problems. If you smoke, talk with your provider about safer birth control alternatives.
Blood clots and strokes
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 Balziva less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Balziva 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 Balziva. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots.
Risk of breast and cervical cancer
Risk factors: History of breast cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Balziva and other COCs can raise your risk for breast and cervical cancer.
Don't use Balziva 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.
Liver problems
Risk factors: Liver problems or infection in the liver | Taking COCs with 50 mcg of estrogen or higher
Though rare, Balziva 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 Balziva since it only contains 35 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.
High blood pressure
Risk factors: High blood pressure | Older age | Using COCs for a long time | Kidney problems
Balziva 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, Balziva might not be the best option for you.
High blood sugar and lipids (fats)
Risk factors: Prediabetes or diabetes | Personal or family history of high triglycerides
COCs like Balziva might raise your blood sugar and triglyceride (fat) levels. In addition, some progesterones could raise LDL levels ("bad" cholesterol). If you have diabetes, let your provider know if you experience any changes in your blood sugar. Make sure to go to all of your check-ups so your provider can monitor any changes.
Headache
Headaches are a common side effect of COCs like Balziva. 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.
Irregular bleeding
Breakthrough bleeding and spotting are common side effects of Balziva. 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.
Depression
Risk factors: History of depression
Let your provider know if you experience symptoms of depression or worsening depression while taking Balziva. In cases of serious depression, your provider might have you stop taking it.
Interactions with other medications
Certain medications can make Balziva get broken down faster in your body, making it less effective and lead to pregnancy. Some examples include rifampin (Rifadin) and phenytoin (Dilantin). Other medications can raise the amount of Balziva in your body, which can lead to more side effects. Make sure to tell your provider or pharmacist about all of your medications so they can make sure they don't interact with Balziva.
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 Balziva before starting Viekira Pak because taking them together can cause liver problems. You can start Balziva again 2 weeks after you stop Viekira Pak.
Balziva dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 0.4mg/0.035mg | 1 package | $16.40 | $16.40 |
Typical dosing for Balziva
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:
Balziva (and its branded generics) come in a 28-day pack. There are 21 tablets that contain 0.4 mg norethindrone and 35 mcg ethinyl estradiol. There are 7 placebo tablets, and they don't contain any active medications.
The typical dose is to take 1 active tablet by mouth daily for 21 days, followed by 1 placebo tablet daily for the remaining 7 days.
Zenchent Fe (and its branded generics) come in a 28-day pack of chewable tablets. There are 21 tablets that contain 0.4 mg norethindrone and 35 mcg ethinyl estradiol. There are 7 tablets that contain 75 mg of ferrous fumarate.
The typical dose is to chew and swallow 1 active tablet by mouth daily for 21 days, followed by 1 iron tablet daily for the remaining 7 days. Drink 8 oz of water right after swallowing.
How much does Balziva cost?
Balziva contraindications
Currently have or history of DVT, PE, or other blood clotting problems
Coronary artery disease
Cerebrovascular disease (problems with blood flow in the brain)
Currently have or have a history of breast cancer
Undiagnosed abnormal vaginal bleeding
Jaundice (yellowing of the skin and whites of the eyes) with previous pregnancy or pill use
Liver tumors
Pregnancy
Taking hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir
What are alternatives to Balziva?
Balziva images
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