levonorgestrel / ethinyl estradiol
Camrese is a type of combined oral contraceptive (COC), or birth control. It's an extended-cycle birth control, which means you'll most likely only get a period every 3 months. It's also a biphasic birth control because it contains two doses of estrogen in each cycle. This medication works well to prevent pregnancy if it's taken at the same time every day.
What is Camrese?
What is Camrese used for?
To prevent pregnancy
How Camrese works
Camrese is a combination of two hormones, levonorgestrel (a progestin) and ethinyl estradiol (an estrogen). These two hormones work together to help prevent pregnancy by:
Stopping ovulation (release of an egg from the ovary) by blocking luteinizing hormone (LH) and follicle stimulating hormone (FSH)
Thickening cervical mucus (fluid from the cervix), which makes it hard for sperm to move and fertilize an egg
Thinning the lining of the uterus (womb) so a fertilized egg can't live
Drug Facts
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What are the side effects of Camrese?
Common Side Effects
- Irregular and/or heavy vaginal bleeding (17%)
- Weight gain (5%)
- Acne (5%)
Other Side Effects
- Mood changes
- Nausea
- Feeling tired
- Muscle spasms
- Bloating
- Swelling in the hands and feet
- Brownish patch on the face
- Problems tolerating contact lenses
Serious Side Effects
- Heart attack: chest pain, belly 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 or gallbladder problems: yellowing of the skin or the whites of the eyes, tiredness, pain in the right upper stomach, dark urine
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 these 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
- Nausea
- Weight gain
Pros and cons of Camrese
Pros
Available as a lower-cost generic medication
Period only once every 3 months
Once-daily dosing
Works well to prevent pregnancy
Cons
Possible higher risk of blood clots compared with 28-day birth control pills
Must take it at the same time every day for the medication to work well
Can cause unpleasant side effects, like nausea, breast tenderness, and weight gain
Can't be used by females over 35 who smoke because of risk of blood clots
Pharmacist tips for Camrese
Camrese can prevent pregnancy, but it can't protect you from human immunodeficiency virus (HIV), hepatitis, or other sexually transmitted diseases (STDs). Using a condom along with Camrese can help lower your risk of an STD.
Camrese isn't an emergency contraception (morning-after pill) and shouldn't be used after unprotected sex to prevent pregnancy. Talk to your provider or pharmacist if you had unprotected sex and need an emergency contraception, such as levonorgestrel (Plan B One-Step) or Ella (ulipristal).
Try to take Camrese around the same time every day. Consider setting an alarm to remind yourself to take your doses at the scheduled time.
If you missed one tablet, take your missed dose as soon as possible and take your next scheduled dose at the regular time. You might need to take two tablets in one day. If you've missed more than one tablet in a blister pack, refer to the instructions that came with your pack or call your provider or pharmacist for further instructions.
It's normal to have irregular bleeding (a small amount of vaginal bleeding) while using Camrese. This doesn't mean that your medication isn't working. Continue to take Camrese every day as directed by your provider. Speak with your provider if your bleeding doesn't stop or if you missed your period.
Tell your provider if you notice any swelling or sudden weight gain while taking Camrese. Talk with a provider about your medical history before taking this medication.
Let your provider know if you experience symptoms of depression or worsening mood while taking Camrese. In cases of serious depression, your provider might ask you to stop taking this medication.
If you wear contact lens, let your provider or an eye specialist know if you have changes in vision or discomfort with your lenses after starting Camrese.
Camrese can interact with many medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Camrese. Talk with your provider or pharmacist if you have any questions about interactions with this medication.
If you've had a skin condition that causes brownish patches on your skin, these patches can reappear or darken while taking Camrese. Avoid exposing your skin to the sun or ultraviolet radiation (e.g., tanning booths, sun lamps) while you're taking this medication.
Frequently asked questions about Camrese
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What are the risks and warnings for Camrese?
Camrese 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
Smoking cigarettes while taking COCs, like Camrese, can significantly raise the risk of serious heart problems, including heart attack and stroke. The risk is greater if you're over 35 years old. If you smoke, talk with your provider about safer birth control alternatives.
Risk of blood clot
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 COCs less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen | First year of using COCs | Restarting COCs after a month
Camrese can cause serious blood clots because it contains ethinyl estradiol (an estrogen). More estrogen can lead to more blood proteins that stimulate clot formation. These blood clots can be life-threatening and can happen anywhere in your body. Get medical attention right away if you have any signs or symptoms of a blood clot:
Brain (e.g., stroke): weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurry vision, dizziness, loss of balance, trouble walking, or confusion
Eyes (e.g., retinal thrombosis): trouble seeing, bulging eye, double vision
Heart (e.g., heart attack): chest pain, sweating, nausea, or dizziness
Lungs (e.g., pulmonary embolism or PE): trouble breathing, chest pain, or cough
Legs (e.g., deep vein thrombosis or DVT): cramps, swelling, pain, or muscle tightness
Your risk of getting a blood clot is higher if you're older, smoke cigarettes, or have certain medical conditions. Your risk is also higher if you're on bedrest after surgery or if you've just given birth. Typically your provider will temporarily stop Camrese for 3-4 weeks before surgery, then restart it 2 weeks after. If you recently delivered a baby, you shouldn't start this medication until 4 weeks after delivery and if you're not breastfeeding. Talk with your provider if you have any questions regarding your risk of blood clots.
Breast and cervical cancer
Risk factors: History of breast or cervical cancer | Taking COCs for a long time | Taken COCs in the last 6 months
It's not clear whether Camrese and other COCs can significantly raise your risk for breast and cervical cancer. Research shows that people who used COCs for more than 5 years seemed to be at a greater risk for cervical cancer than those who never used these medications. In addition, certain breast cancer cells grow faster in the presence of estrogen. Since there's a risk of serious harm, don't take Camrese if you currently have or have had breast cancer or cervical cancer. If you currently take this medication or have taken it in the last 6 months, make sure to get a yearly breast exam with your provider to check for early signs of breast cancer. Your provider can also make sure you get appropriate screenings for cervical cancer. Let your provider know if you notice any signs of breast cancer (e.g., new or abnormal lumps, pain, or swelling in your breasts) or cervical cancer (e.g., vaginal bleeding or discharge that's not normal).
Liver problems
Risk factors: Taking COCs for more than 8 years | Certain hepatitis C medications
Don't take Camrese if you have liver problems, such as liver infection caused by a virus (e.g., hepatitis) or liver tumors. Although rare, this medication can raise your risk of getting benign liver tumors. If you experience signs of liver problems, you should stop taking Camrese and ask your provider for an alternative birth control. Signs of liver problems can include jaundice (yellowing of the skin or whites of the eyes), fever, tiredness, loss of appetite, or dark colored urine.
Additionally, Camrese shouldn’t be taken together with Viekira Pak, a hepatitis C medication contains ombitasvir, paritaprevir, and ritonavir. Doing so can cause liver problems. You can restart Camrese two weeks after completing hepatitis C treatment.
Gallbladder problems
Some studies show that Camrese can raise the risk of gallbladder disease since more progestin and estrogen can lead to higher chance of gallstones. Although the risk is low, talk to your provider if you a history of gallbladder disease before starting Camrese.
High blood sugar and triglycerides
Risk factors: High blood sugar | High triglycerides
Camrese can raise your levels of blood sugar and triglycerides (a type of fat). Your risk is higher if you already have high blood sugar. This is because Camrese can prevent your body from breaking down sugar properly.
Additionally, this medication can raise your triglycerides levels and put you at risk for pancreatitis (pancreas inflammation). Speak with your provider before starting Camrese if you have a history of high blood sugar or triglycerides. Your provider might help you choose another birth control or monitor your blood works more closely if you take this medication.
High blood pressure
Risk factors: Older age | Using COCs for a long time | History of high blood pressure | Kidney problems
Camrese can raise your blood pressure, so make sure you check your blood pressure while you're taking this medication. The risk is higher if you're older and have been taking birth control for a long period of time. If you have a history of kidney problems or high blood pressure that's not controlled, don't use this medication. Talk with your provider so you can discuss the benefits and risks of taking Camrese.
Headache
Let your provider know if you experience new or worsening migraines or headaches while taking Camrese. You might need to stop your medication if your migraine or headache doesn't go away or becomes severe.
Irregular bleeding
Risk factor: First 3 months of COCs
People who take Camrese 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 is often temporary, so continue taking your medication as directed. If your bleeding doesn't stop, becomes heavier, or you miss a period after the initial bleeding, let your provider know. Your provider can perform blood tests to rule out other potential causes for bleeding.
Camrese dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 91 tablets | 1 package | $493.64 | $493.64 |
Typical dosing for Camrese
Camrese (and its branded generic) 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 84: 0.15 mg of levonorgestrel and 30 mcg of ethinyl estradiol
Day 85 through 91: 10 mcg of ethinyl estradiol
The typical dose is to take 1 tablet by mouth daily, following the order on the package, for 91 days.
Camrese contraindications
History of blood clots, stroke, or heart attack
Females over the age of 35 who smoke or have migraine headaches
Certain medical conditions like uncontrolled high blood pressure, diabetes, obesity, coronary artery disease (CAD), or atrial fibrillation (AFib)
Liver tumors or liver disease
Currently pregnant
Currently have or have had breast cancer
Abnormal vaginal bleeding that your provider doesn’t know about or you haven’t gone to them about
Take certain hepatitis C medications like Viekira Pak, containing ombitasvir, paritaprevir, and ritonavir; with or without dasabuvir
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