Quartette is a combined oral contraceptive (COC), or birth control. It's quadriphasic, meaning that it contains four different strengths of hormones. It's also an extended cycle birth control, so you only get your period once every 3 months.
To prevent pregnancy
Quartette is a combination medication that contains 2 hormones: levonorgestrel (a progestin) and ethinyl estradiol (an estrogen). These 2 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
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):
Taken once daily
Only experience 4 periods per year
Available as a lower-cost generic medication
Might have a higher risk of breakthrough bleeding and spotting
You might not be aware of pregnancy since periods don't happen monthly
Different color pills might be confusing
Quartette can prevent pregnancy, but it can't protect against human immunodeficiency virus (HIV) infections or other sexually transmitted diseases (STDs).
Let your provider or pharmacist know all of your current medications. Certain medications can interact with Quartette and make it work less well to prevent pregnancy. Some medications can raise the risk of bleeding.
Let your provider know if you are taking any medications for your thyroid. Quartette can affect how well some thyroid medications work, so your provider might need to raise your dose.
If you are getting any blood tests, let your provider know that you are taking Quartette because this medication can affect the results of certain tests.
Make sure to get yearly check ups with your provider so they can check your blood work, blood pressure, and for other health conditions that might be affected by your birth control.
If you're taking Quartette after having a baby and haven't had a period yet, use another form of birth control (if you're having sex) for the first 7 days of starting this medication. Make sure it's been at least 4 weeks after delivering your baby before you can start your birth control.
Speak to your provider before starting Quartette if you are breastfeeding your child. Quartette can lessen the amount of milk you produce so your provider might recommend another kind of birth control for you.
Talk to your provider if you experience symptoms of depression or worsening depression while taking Quartette. Your provider might take you off this medication if you have serious depression.
If you have a rare, swelling condition called hereditary angioedema, medications with estrogens, such as Quartette, might cause or worsen the symptoms of swelling in your body.
Females who have a history of a skin condition that causes the skin pigmentation to darken (chloasma gravidarum) can experience spots of darkened skin while taking COCs. If you're more prone to getting hyperpigmentation, avoid exposing your skin to the sun or ultraviolet radiation (e.g. tanning booths, sun lamps) while you're taking Quartette. Use sunscreen when going outside.
Quartette 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 Quartette, 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 Quartette less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Quartette 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 Quartette. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots. If you recently delivered a baby, you shouldn't start Quartette until 4 weeks after delivery if you're not breastfeeding your child.
People who take Quartette 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 missed your periods, make sure you get a pregnancy test to make sure you're not pregnant.
Risk factors: Older age | Using COCs for a long time | High blood pressure | Kidney problems
Quartette can raise your blood pressure, so make sure you check your blood pressure while you're taking this medication. The risk is higher in females who are older and have been taking birth control for a long period of time. Quartette can't be taken by females who have high blood pressure that's not under control. Speak to your provider if this medication raises your blood pressure and they can help you pick a different method of birth control that's safer for you.
Risk factors: Prediabetes or diabetes | High triglycerides
Quartette can raise your blood sugar and cholesterol levels. Females who have high triglycerides (a type of cholesterol) might have a higher risk of experiencing pancreatitis (inflammation of the pancreas) when taking COCs. Speak with your provider before starting Quartette if you have diabetes, prediabetes, or high cholesterol. If you choose to take Quartette with those health conditions, your provider will monitor you regularly.
Let your provider know if you experience new or worsening migraines or headaches while taking Quartette. You will have to stop your medication if your migraine or headache doesn't go away or becomes severe.
Risk factors: History of breast cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Quartette and other COCs can raise your risk for breast and cervical cancer.
Don't take Quartette if you currently have or have had breast cancer because some breast cancers grow faster in the presence of estrogen, a hormone in this medication. You can examine your breasts regularly at home or get yearly breast exams with your healthcare provider to help with early breast cancer detection. Let your provider know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your provider to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Risk factors: Liver problems or infection in the liver | Taking COCs with 50 mcg of estrogen or higher
Though rare, Quartette 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 Quartette since it at most only contains 30 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.
Certain medications can make Quartette get broken down faster in your body, making it less effective (not work as well) and can lead to pregnancy. Some examples include carbamazepine (Tegretol) and phenytoin (Dilantin). You'll likely need to use a back-up method or other form of birth control for several weeks after stopping any of these medications. Other medications can raise the amount of Quartette 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 Quartette.
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 Quartette before starting Viekira Pak because taking them together can cause liver problems. You can start Quartette again 2 weeks after you stop Viekira Pak.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
91 tablets | 1 package | $66.56 | $66.56 |
Quartette (and its branded generics) comes in a 91-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 91 active tablets and they contain different dosages of levonorgestrel and ethinyl estradiol. In general:
Day 1 through 42: 0.15 mg levonorgestrel and 20 mcg ethinyl estradiol
Day 43 through 63: 0.15 mg levonorgestrel and 25 mcg ethinyl estradiol
Day 64 through 84: 0.15 mg levonorgestrel and 30 mcg ethinyl estradiol
Day 85 through 91: 10 mcg ethinyl estradiol only
The typical dose is 1 tablet by mouth at the same time every day for 91 days, following the order instructed on the package.
Females over 35 years old who smoke
Current or history of blood clots
A history of heart attack or stroke
Heart valve problems or irregular heart beat that raises the risk of having blood clots
Health condition that makes it more likely for your blood to clot
High blood pressure that's not under control
Diabetes with kidney, eye, nerve, or blood vessel problems
Certain kinds of severe migraine headaches with aura, numbness, weakness, or vision changes
Any migraine headaches for women over 35 years old
Liver problems, including liver tumors or cancer
Unexplained vaginal bleeding that hasn't been diagnosed
Pregnancy
Current or history of breast cancer
Taking hepatitis C medication with ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir
To prevent pregnancy
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