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.
Drug facts
Side effects of Balziva
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 and bloating
- Bleeding between periods
- Spotting
- Change in the flow of period
- Missing periods
- Swelling
- Breast tenderness or getting bigger
Less Common Side Effects
- Weight going up or down
- Depression
- Vaginal yeast infection
- Migraine
- Allergic rash
Balziva 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
- Liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
The following Balziva 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
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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.
Common questions about Balziva
COCs, like Balziva, are more than 99% successful at preventing pregnancy if you take it at the same time every day consistently. But with typical use (when you miss some doses or take some doses late), there's about a 3% chance of getting pregnant. Your chance of getting pregnant while taking Balziva is higher if you don't take it as directed. If you're having trouble remembering to take your pill, talk to your provider for other options.
If you're not currently taking another form of hormonal birth control, the two most common ways to start taking Balziva are the Day 1 Start and the Sunday Start methods. For the Day 1 Start, you'd begin taking Balziva during the first 24 hours of your period. If you choose the Sunday Start method, you'd begin taking Balziva on the Sunday after your period starts (even if you're still bleeding). For this method, you need to use a non-hormonal method of birth control (e.g., condom or spermicide) for 7 days. If you're switching from another hormonal birth control, discuss the best way to start taking Balziva with your provider.
It's important for you to take Balziva every day for the medication to prevent pregnancy. But if you missed a dose, your next steps depend on when you missed it and how many pills you missed. If you only missed 1 pill, you can take the missed pill as soon as you remember and continue taking the next pill at your regular time. If you missed pills multiple days in a row, you might have to take 2 pills on the same day and next day to make up for it. Or you might have to throw away your current pack and start a new pack. Make sure to follow the instructions on the patient information sheet that was provided with your medication, or contact your provider or pharmacist. Also, ask them if you need to use another method of birth control to prevent pregnancy during this time.
There are two different colors of pills in your Balziva pack to show which pills have hormones and which are hormone-free. There are 21 active pills that are one color, and 7 placebo pills that contain no medication or iron (depending on the brand) that are another color. The colors will be different depending on which brand you're taking. If you aren't sure what a colored pill is, check the instructions that came with your pack or ask your pharmacist or provider for help.
If you vomit or have diarrhea within 3 or 4 hours after taking an active tablet, it's typically recommended to treat it as a missed dose (see FAQ above). If you're unsure, check with your provider or pharmacist on what you should do. In the meantime, use a backup method of birth control until you can speak with them since missing tablets can raise your chance of pregnancy.
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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
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 0.4mg/0.035mg | 1 package | $17.74 | $17.74 |
Typical dosage 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?
$16.65
Balziva 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 Balziva will not be safe for you to take.
- 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
