Leena
Leena is a type of birth control called a combined oral contraceptive (COC). Leena is taken by mouth every day to prevent pregnancy. This medication is a triphasic birth control, which means it contains different hormone levels throughout the first three weeks to mimic your body's natural hormone levels closely.
What is Leena?
What is Leena used for?
To prevent pregnancy
How Leena works
Leena is a combination medication that contains two hormones, norethindrone (a progestin) and ethinyl estradiol (an estrogen). Norethindrone and ethinyl estradiol work together to prevent pregnancy by:
Preventing your ovaries from releasing eggs
Changing the mucus in your cervix to make it difficult for the sperm to enter the uterus
Changing the lining of the uterus to lower the chance of a fertilized egg from implanting into the uterus.
Drug Facts
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What are the side effects of Leena?
Common Side Effects
- Nausea
- Vomiting
- Stomach cramps and bloating
- Bleeding between periods
- Spotting
- Change in the flow of period
- Missing periods
Other Side Effects
- Swelling
- Skin condition that causes brown spots or patches
- Breast changes
- Weight changes
- Migraine
- Allergic rash
- Mood changes
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
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 Leena
Pros
Chance of becoming pregnant is less than 1% if taken as instructed
Can make your periods more regular
Lower the chance of painful periods
Blood flow during period might be lighter, which can prevent low iron levels
Might lower the risk of cancer of the ovaries and cancer of the lining of the uterus
Cons
Not recommended for females who smoke cigarettes
Risk of heart attacks and stroke
Risk of blood clots in the arms, legs, lungs, brain, or eyes
Can experience spotting or bleeding
Can affect mood and behavior
Pharmacist tips for Leena
Leena can be taken to prevent pregnancy, but it can't protect against human immunodeficiency virus (HIV) infections or other sexually transmitted diseases (STDs). Using a latex or polyurethane condom during sex can help lower your risk of an STD.
Let your provider know all of your current medications. Certain medications, such as rifampin (Rifadin), can interact with Leena and cause it to work less well to prevent pregnancy. Some medications can also raise your risk of breakthrough bleeding (bleeding outside of your period).
Before taking Leena, let your provider know all of your health conditions to see if this medication is safe for you. If you have conditions such as high cholesterol levels, your provider might check your labs regularly while you're taking Leena because this medication can make your cholesterol levels more difficult to control.
Take Leena at the same time every day. If you miss your pills, there is a chance that you can get pregnant.
If you don't start Leena on the first day of your period, use another method of birth control, such as condoms foam, or sponge, in the first 7 days to prevent pregnancy.
Make sure to get yearly check ups with your provider so they can check your blood work, blood pressure, breasts, stomach, and genitals.
Let your provider know if you have any abnormal vaginal bleeding. Continue taking Leena if spotting or light bleeding occurs in between your periods. Let your provider know if the spotting or bleeding won't go away.
Leena can cause swelling in some people, including swelling in the fingers or ankles. Talk to your provider if you experience swelling or have health problems that can also cause swelling.
Talk to your provider if you experience symptoms of depression or worsening depression while taking Leena. Your provider might take you off this medication if you have serious depression.
If you are getting any blood tests, let your provider know that you are taking Leena because this medication can affect the results of certain tests.
Frequently asked questions about Leena
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What are the risks and warnings for Leena?
Leena 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.
Heart problems and strokes
Risk factors: Females over 35 years old who smoke | Heavy smoking | High blood pressure | High cholesterol | Obese | Diabetes
Smoking cigarettes while taking Leena can raise the risk of serious heart problems. The risk is higher in females over 35 years old and females who smoke 15 or more cigarettes per day. Females who are taking oral contraceptives, such as Leena, shouldn't smoke because of this risk.
Leena can worsen certain health problems and raise the risk of heart attacks and strokes. These serious problems can lead to death or temporary or permanent disability. Speak to your provider before starting Leena if you have heart problems or any of the risk factors listed above that would put you at a risk for heart problems or strokes. Your provider can help you determine if this medication is safe for you. Let your provider know right away if you experience crushing chest pain, heaviness in the chest, sudden severe headache, vomiting, dizziness, fainting, changes in vision or speech, or weakness or numbness in the arms or legs.
Blood clots
Risk factors: Females over 35 years old | High blood pressure | Smoking | Surgery | Not moving | Within 4 weeks of childbirth
Leena can raise the risk of blood clots. You are at a higher risk for blood clots if you are going in for surgery, unable to move for a long period of time, or recently delivered a baby. Talk to your provider about stopping Leena at least 4 weeks before and for 2 weeks after your surgery or during bed rest. If you recently delivered a baby, you shouldn't start Leena until at least 4 weeks after delivery if you're not breastfeeding your child. Let your provider know right away if you experience sharp chest pain, coughing up blood, shortness of breath, or pain in your legs, as these could be a sign of a clot in the lung(s).
Although rare, Leena can raise the risk of getting a blood clot in the veins of your eye, which can lead to eye problems. Stop taking Leena and let your provider know right away if you experience any vision changes or vision loss. Get your eyes checked if you have vision changes while wearing contacts or if your eyes can no longer tolerate your contacts.
Irregular bleeding
People who take Leena can sometimes experience irregular bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can vary from slight staining to bleeding similar to a regular period. This problem might be temporary, so continue taking your medication as directed. Let your provider know if the bleeding is a problem for you and they can change your birth control. If you are missing your periods, make sure you get a pregnancy test to make sure you're not pregnant.
High blood pressure
Risk factors: Older age | Long-term use | High blood pressure | Kidney problems
Leena can raise your blood pressure, so make sure you monitor your blood pressure while you're taking this medication. Speak to your provider if you have high blood pressure or kidney problems, and they can help you pick a different method of birth control that's safer for you. Your blood pressure can return to normal after stopping your oral contraceptives.
High blood sugar and cholesterol
Risk factors: Prediabetes or diabetes | High triglycerides
Leena can raise your blood sugar levels and cholesterol levels. Speak with your provider before starting oral contraceptives if you have diabetes, prediabetes, or high cholesterol. Your provider will monitor you regularly if you have high blood sugar and high cholesterol while you're taking Leena.
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 Leena and other COCs can raise your risk for breast and cervical cancer.
Don't use Leena 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: Long-term use | Hepatitis C treatment
Don't take Leena if you have liver problems, such as sudden liver infection caused by a virus, severe (decompensated) scarring of the liver, or liver tumors. Although rare, Leena can raise your risk of benign liver tumors. If you experience signs of liver problems, you should stop taking Leena and ask your provider for a different type of birth control. Signs of liver problems can include jaundice (yellowing of the skin or eyes), along with fever, tiredness, loss of appetite, or dark colored urine. People with liver problems might have trouble breaking down hormones.
Talk to your provider before starting Leena if you are taking medications to treat Hepatitis C. Medications that contain ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, can raise the liver levels and cause liver problems. Stop taking Leena if you need to start your treatment for Hepatitis C. You can restart Leena 2 weeks after your treatment is completed.
Headache
Let your provider know if you experience new or worsening migraines or headaches while taking Leena. You will have to stop your medication if your migraine or headache doesn't go away or becomes severe.
Leena dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets | 3 packages | $35.64 | $11.88 |
Typical dosing for Leena
Leena (and its branded generics) comes in a 28-day pack. Your medication might look different depending on which branded generic your provider prescribes. Please take the medication as instructed by your provider or following the directions on the package.
There are 21 active tablets and they contain different dosages of norethindrone and ethinyl estradiol. In general:
Day 1 through 7: 0.5 mg norethindrone and 35 mcg ethinyl estradiol
Day 8 through 16: 1 mg norethindrone and 35 mcg ethinyl estradiol
Day 17 through 21: 0.5 mg norethindrone and 35 mcg ethinyl estradiol
Day 22 through 28: Placebo tablets (hormone-free)
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.
How much does Leena cost?
Leena contraindications
Current or history of blood clots in the legs, brain, lungs, or eyes
A history of heart attack or stroke
Current or history of breast cancer
Unexplained vaginal bleeding that hasn't been diagnosed
Yellowing of the whites of the eyes or skin (jaundice) during pregnancy or during previous use of the medication
Liver tumors
Pregnancy
Taking Hepatitis C medication with ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir
What are alternatives to Leena?
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