desogestrel / ethinyl estradiol
Volnea is a combined oral contraceptive (COC) that's taken by mouth every day to prevent pregnancy. It contains 2 medications: desogestrel (a progestin) and ethinyl estradiol (an estrogen). Each 28-day pack of Volnea contains 26 active (hormone) pills and 2 placebo pills. It's a biphasic birth control, meaning the hormone level in the active pills changes partly through the pack. Some potential side effects of Volnea include nausea, cramps, and changes in body weight.
Volnea is a generic of the discontinued brand name Mircette. Other generics that are like Volnea include Azurette, Pimtrea, Kariva, and Viorele.
What is Volnea?
What is Volnea used for?
- To prevent pregnancy
How Volnea works
Volnea is a combined contraceptive that contains two hormones: ethinyl estradiol (an estrogen) and desogestrel (a progestin). These two hormones work together to help prevent pregnancy by:
- Stopping ovulation (release of an egg from the ovary)
- Changing cervical mucus to block sperm movement
- Creating an unfriendly environment for the fertilized egg by changing the lining in the uterus (womb)
Drug facts
Side effects of Volnea
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Vomiting
- Stomach cramps
- Bloating
- Spotting
- Breast tenderness
- Weight changes (up or down)
- Headache
- Raised blood pressure
- Depression
Less Common Side Effects
- Yeast infection
- Spotty darkening of skin
- Change in sex drive
- Acne
- Change in appetite
Volnea serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
- Serious liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
The following Volnea 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
- Nausea
- Weight gain
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Pros and cons of Volnea
Pros
- Taken by mouth once daily
- Less likely to cause changes in menstrual bleeding that monophasic birth controls
- Available as many branded generics
Cons
- Must be taken in the exact order in your pill pack
- Can cause unpleasant side effects, like nausea, vomiting, and headaches
- Might worsen certain medical conditions, such as chloasma and hereditary angioedema
Pharmacist tips for Volnea
- Set an alarm to help you remember to take Volnea at the same time every day. Forgetting to take your pill raises the chance of getting pregnant. If you miss a dose, refer to the label or call your HCP for further instructions.
- It's normal to have spotting (light bleeding outside of your period) or feel sick to your stomach for the first few packs of Volnea. This should get better over time, but if it doesn't contact your prescriber.
- If you have vomiting or diarrhea, or take certain medications, Volnea might not work as well for you. Always use a non-hormonal birth control as back-up until you're able to check with your HCP.
- If you wear contact lenses and notice vision changes or dry eyes while taking Volnea, see your optometrist to get an exam. Though not common, taking birth controls can lead to eye-related side effects.
- Hormonal contraceptives like Volnea don't protect against sexually transmitted infections (STIs), such as human immunodeficiency virus (HIV) and chlamydia. Using a latex or polyurethane condom during sex can help lower your risk of an STI.
- Volnea can lower the amount of breast milk you're able to produce and isn't recommended during breastfeeding. If you're breastfeeding, ask your HCP about alternative birth control options.
- There might be a delay in getting pregnant after taking Volnea. It's recommended to wait until you have regular menstrual cycles again after stopping Volnea before you try to get pregnant. Talk with your HCP if you have questions about getting pregnant after stopping Volnea.
Common questions about Volnea
Studies show that with perfect use, 1 in 100 females might get pregnant during the first year of taking a COC, like Volnea. This means that Volnea is about 99% effective at preventing pregnancy if you take it daily around the same time each day. But your chance of getting pregnant will be higher if you miss some doses. If you're having trouble remembering to take your pill and want to consider other birth control options, talk to your healthcare professional (HCP).
Low-dose birth control is a COC that contains 20 mcg of ethinyl estradiol (estrogen) or less. Volnea is a low-dose birth control because the active pills contain either 10 mcg or 20 mcg of ethinyl estradiol, depending on where you are in the cycle.
Yes. Volnea is a combined oral contraceptive, which means it contains a combination of two hormones (desogestrel and ethinyl estradiol). However, not all pills in the pack have both hormones. Some of them only have ethinyl estradiol, and others don't have any hormones at all. Follow the instructions inside of the package carefully, since the tablets must be taken in a certain order.
The green pills in each pack of Volnea are placebo pills. This means they don't contain any hormones. Unlike some other birth control pills, the placebo pills are taken closer to the middle of the pack instead of the very end. Make sure to take the pills in the exact order in your pack so your birth control works the best for you.
People who take COC, including Volnea, have reported weight gain. But it's unclear if the change in body weight is caused by the birth control or by other factors. In general, people who take COC are more likely gain weight from water retention, rather than from an increase in body fat. But not everyone will experience weight gain; some people reported weight loss as well. If weight changes concern you, speak with your obstetrician-gynecologist (OB-GYN) or healthcare professional (HCP).
Volnea and Viorele can be thought of as generics of one another. They're combined oral contraceptives that contain the same doses of the same hormones (desogestrel and ethinyl estradiol). They're both branded generics of a brand-name birth control pill called Mircette that's no longer available. Branded generics work just as well as the brand name. The colors of the tablets might look different between branded generics like Volnea and Viorele.
Both Volnea and Kariva are considered generics of one another. They both contain the same hormones (desogestrel and ethinyl estradiol) at the same doses. Keep in mind that the colors of the tablets might look different between branded generics like Volnea and Kariva.
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Risks and warnings for Volnea
Volnea 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 Volnea, 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 prescriber 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 Volnea less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Volnea 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 prescriber you're taking Volnea. 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 Volnea and other COCs can raise your risk for breast and cervical cancer.
Don't use Volnea 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 professional. Call your HCP 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 a COC for 8 years or longer
Though rare, Volnea can cause liver problems, such as liver damage and liver tumors. These problems are linked more with earlier formulations of COCs that contained higher doses of estrogen (50 mcg or higher), and less so with Volnea since it only contains up to 20 mcg of estrogen. Don't use this medication if you already have liver problems. Call your HCP 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 sugar and triglycerides
- Risk factors: Prediabetes or diabetes | Personal or family history of high triglycerides | High dose
COCs like Volnea might raise your blood sugar and triglyceride (fat) levels. If you have diabetes, let your prescriber know if you experience any changes in your blood sugar. Make sure to go to all of your check-ups so your prescriber can monitor any changes.
High blood pressure
- Risk factors: High blood pressure | Older age | Using COCs for a long time | Kidney problems
Volnea and other COCs can raise your blood pressure. Your HCP 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 HCP. If you have uncontrolled high blood pressure, Volnea might not be the best option for you.
Headache
Headaches are a common side effect of COCs like Volnea. 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 prescriber so you can be checked out.
Irregular bleeding
Breakthrough bleeding and spotting are common side effects of hormonal birth control pills. This is more common during the first 3 months of using Volnea. Let your prescriber know if you experience any vaginal bleeding outside of your period, or if your period has stopped completely. There are other causes besides your birth control pills for irregular bleeding that your prescriber will evaluate.
Depression
- Risk factors: History of depression
Let your prescriber know if you experience symptoms of depression or worsening depression while taking Volnea. In cases of serious depression, your prescriber might have you stop taking it.
Gallbladder problems
Some studies suggest that Volnea 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 gynecologist if you a history of gallbladder disease before starting Volnea.
Interactions with other medications
Certain medications can make Volnea 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 Volnea in your body, which can lead to more side effects. Make sure to tell your prescriber or pharmacist all of your medications so they can make sure they don't interact with Volnea.
If you're taking medications to treat hepatitis C, immediately let your HCP know that you're taking a COC. Certain hepatitis C medications can affect the level of Volnea in your body, either making it work not as well in preventing pregnancy or raising your risk of side effects. Your healthcare team can give you instructions about what to do if you're taking a hepatitis C medication that can interact with Volnea.
Volnea dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 0.15mg/0.02mg/0.01mg | 3 packages | $26.78 | $8.93 |
Typical dosage for Volnea
Volnea comes in a 28-day pack. Please take the medication as instructed by your HCP or by following the directions on the package.
There are 26 active tablets and they contain different dosages of desogestrel and ethinyl estradiol. In general:
- Day 1 through 21: 0.15 mg desogestrel and 20 mcg ethinyl estradiol
- Day 22 through 23: Placebo tablets (hormone-free)
- Day 24 through 28: 10 mcg ethinyl estradiol only
The typical dose is 1 tablet by mouth at the same time every day. Tablets must be taken in the exact order of the blister pack.
How much does Volnea cost?
$13.24
Volnea contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Volnea will not be safe for you to take.
- History of DVT 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
- Endometrial cancer or other estrogen-dependent cancer growth
- Undiagnosed abnormal genital bleeding
- Currently have or have a history of jaundice (yellowing of the skin and whites of the eyes)
- Liver tumors
- Pregnancy
- Receiving hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir
What are alternatives to Volnea?
Volnea images
