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WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS
Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, CHCs, including TYBLUME® (levonorgestrel and ethinyl estradiol) tablets, are contraindicated in women who are over 35 years of age and smoke years of age and smoke.
INDICATION
TYBLUME is indicated for use by females of reproductive potential to prevent pregnancy.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
TYBLUME is contraindicated in females who are known to have or develop the following conditions:
WARNINGS and PRECAUTIONS
Thromboembolic Disorders and Other Vascular Problems
TYBLUME is contraindicated in females with a high risk of arterial or venous thrombotic/thromboembolic diseases. Consider cardiovascular risk factors before initiating in all females, particularly those over 35 years.
Liver Disease
TYBLUME is contraindicated in females with acute viral hepatitis or severe (decompensated) cirrhosis of the liver. TYBLUME may cause elevated liver enzymes. Discontinue TYBLUME if jaundice develops. Acute liver test abnormalities may necessitate the discontinuation of CHC use until liver tests return to normal and CHC causation has been excluded.
Hypertension
TYBLUME is contraindicated in females with uncontrolled hypertension or hypertension with vascular disease. For all females, including those with well-controlled hypertension, monitor blood pressure at routine visits and stop TYBLUME if blood pressure rises significantly.
Gallbladder Disease
Studies suggest an increased risk of developing or worsening gallbladder disease among CHC users. Females with a history of pregnancy-related cholestasis may be at an increased risk of CHC-related cholestasis.
Adverse Carbohydrate and Lipid Metabolic Effects
TYBLUME is contraindicated in diabetic women over 35 or females who have diabetes with hypertension, nephropathy, retinopathy, neuropathy, or other vascular diseases, or diabetes for >20 years. TYBLUME may decrease glucose tolerance. Carefully monitor prediabetic and diabetic females who are using TYBLUME.
Consider alternative contraception for females with uncontrolled dyslipidemia.
Headache
TYBLUME is contraindicated in females who have headaches with focal neurological symptoms, migraine headaches with aura, or women over 35 years who have migraine headaches. Evaluate significant change in headaches and discontinue TYBLUME if indicated.
Bleeding Irregularities and Amenorrhea
TYBLUME may cause irregular bleeding or amenorrhea. Evaluate for other causes if symptoms persist.
Additional warnings include depression, malignant neoplasms, increased serum concentrations of binding globulins, hereditary angioedema, chloasma (females who tend to develop chloasma should avoid exposure to the sun or UV radiation while using TYBLUME), and risk of liver enzyme elevations with concomitant Hepatitis C treatment.
ADVERSE REACTIONS
Common adverse reactions are headache, abdominal pain, nausea, metrorrhagia, vaginal moniliasis and pain, acne, and vaginitis.
Counsel patients that TYBLUME does not protect against HIV-infection (AIDS) and other sexually transmitted infections.
This is not a complete list of risks.
Please see full Prescribing Information including BOXED WARNING for detailed information [here].
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