Q: What is Lybrel?
A: Lybrel is a daily, low-dose combination birth control pill. Lybrel is the first FDA-approved birth control pill that prevents monthly menstrual periods when taken regularly. Other benefits of using Lybrel may include:
- Reduced risk of anemia due to iron deficiency, since the blood loss that normally accompanies menstrual periods is greatly reduced.
- Because Lybrel is the only birth control pill that eliminates a woman’s menstrual period, many women who take it experience few or no symptoms of PMS and no menstrual cramps.
- Reduced risk of ectopic pregnancies.
- Reduced risk of ovarian cysts.
- Non-cancerous lumps or cysts in the breast may occur less often.
- Risk for ovarian and uterine cancer may be reduced.
- Decreased risk for acute pelvic inflammatory disease.
Q: What are the active ingredients of Lybrel birth control pills?
A: Lybrel contains low doses of two types of hormones – a progestin called levonorgestrel (90 mg) and an estrogen called ethinyl estradiol (20 mg).
Q: How does Lybrel work?
A: The hormones in Lybrel prevent pregnancy by suppressing ovulation (egg release) and by changing the womb and cervical mucus to make it difficult for an egg to become fertilized or attached to the uterine wall.
Q: How is Lybrel different from other birth control pills?
A: Traditional birth control pills deliver hormones for 21 days and a placebo (or no pill at all) for 7 days. The hormones minimize the build up of the uterine lining. A woman who takes this type of birth control pill will experience withdrawal bleeding or a ‘pill period’ during the 7 days when she does not receive hormones.
Women who take Lybrel birth control pills do not have regular menstrual periods. This is because Lybrel delivers the same low dose of hormones every day (there are no placebo pills), which prevents the uterine lining from undergoing the changes required for menstruation.
Q: How can I tell if Lybrel is the right birth control pill for me?
A: You can talk to your doctor or gynecologist before deciding to use Lybrel. Lybrel may be the right birth control pill for you, if:
- You are looking for a reliable birth control pill.
- You are not considering pregnancy in the near future.
- You find it easy to take medication on a regular basis.
- You would like to reduce or eliminate symptoms of PMS.
- You are comfortable not having a monthly menstrual period.
- You are willing to accept the possibility of irregular spotting or bleeding.
If you feel uncomfortable about not having monthly menstrual periods, talk to your doctor about other birth control pills or contraceptive methods.
Q: Are there any medical conditions that I should discuss with my doctor before starting on Lybrel?
A: As with any other birth control pill, certain medical conditions may interact with Lybrel. Make sure to discuss your complete medical history with your gynecologist before deciding to use Lybrel, especially if any of the following apply to you:
- You are pregnant, planning to become pregnant, or breastfeeding.
- You have a history of irregular menstrual periods, endometriosis, or growths in the uterus.
- You or a family member has had breast cancer.
- You have a history of fibrocystic breast disease, lumps in the breast, or abnormal mammogram.
- You have a history of: diabetes or high blood sugar; high blood pressure; high blood cholesterol or lipid levels; high blood calcium levels; or heart problems.
- You suffer from migraines or severe or persistent headaches; mood swings or depression; or seizures.
- You have a history of kidney, liver, gall bladder, or liver problems; yellowing of the eyes or skin; blood or bleeding problems; or blood in the urine.
- You have chorea, lupus, porphyria, or varicose veins.
- You are taking any prescription or over-the-counter medication, including herbal preparations and dietary supplements.
- You are allergic to any food or medicine.
- You are overweight or you have swelling problems.
- You have not had your first menstrual period yet.
Q: How should I take Lybrel?
A: Before you start taking Lybrel birth control pills, read the patient information that comes with the medicine. However, patient information provided by the manufacturer is not a substitute for the advice of a licensed physician or pharmacist.
- Take Lybrel only under the guidance of a doctor.
- Take Lybrel orally with or without food. Do not remove the tablet from the dispenser until you are ready to take Lybrel.
- To start using Lybrel, take the first pill within the first 24 hours of your menstrual period. Since you are starting the birth control pill at the beginning of your period, you do not require back-up contraception.
- Lybrel works best if taken at the same time every day. Decide on a convenient time.
- Do not stop taking the pills if you are spotting, bleeding, or feeling nauseous.
- Lybrel works only as long as you take the pill every day. A single skipped pill increases the risk of pregnancy.
Q: How do I switch from other birth control measures to Lybrel?
A: If you are switching from other types of birth control – such as a POP (progestin-only pill), an injection, or an implant – follow your doctor’s instructions before switching to Lybrel. If you are switching from a combination birth control pill:
- From a 21-pill pack. Start Lybrel on the first day of your period (pill period or withdrawal bleed). Make sure that no more than seven days pass between your 21-pill pack and Lybrel.
- From a 28-pill pack. Start Lybrel on the first day of your period. Make sure that no more than seven days pass between the last active pill and Lybrel.
Q: What are the possible side effects of Lybrel?
A: Most women who take Lybrel birth control pills do not have serious side effects.
- Unscheduled spotting or bleeding is the most common side effect of using Lybrel. This tends to decrease over time.
- Other common side effects of Lybrel may include: nausea, vomiting, headache, stomach cramps, bloated stomach, dizziness, vaginal discomfort, increased vaginal fluids, or breast tenderness/enlargement.
- Women who wear contact lenses may notice a change in vision or difficulty in wearing the lenses while using Lybrel.
- Some women may experience edema and high blood pressure.
- In some women, dark spots may appear on the skin, particularly the face.
Q: What are the possible allergic reactions to Lybrel?
A: A serious allergic reaction to Lybrel is unlikely, but seek medical help if one occurs. Possible symptoms of an allergic reaction include:
- Difficulty in breathing
- Rash and itching
- Swelling
- Severe dizziness
Q: Are there any drugs that I should avoid while taking Lybrel?
A: Before you begin taking Lybrel, inform your doctor about all other prescription and over-the-counter medications you are taking, including herbal and dietary supplements. Some medications may interact with Lybrel birth control pills.
- Some medications decrease the effectiveness of Lybrel, resulting in pregnancy or bleeding. These include some antibiotics (e.g. cephalosporin, chloramphenicol, macrolides such as erythromycin, penicillin, sulfas), aprepitant, bexarotene, bosentan, dapsone, felbamate, griseofulvin, certain HIV protease inhibitors (e.g. amprenavir, nelfinavir, ritonavir), modafinil, nevirapine, phenylbutazone, rifamycins (e.g. rifampin), many seizure medications (e.g. barbiturates, carbamazepine, phenytoin, topiramate), and St. John’s wort.
- Azole antifungal drugs such as Diflucan and ketoconazole may decrease the effectiveness of Lybrel while increasing the risk of its side effects.
- Lybrel can speed up or slow down the removal of some drugs from the body including acetaminophen, aspirin, certain beta-blockers (e.g. metoprolol), clofibrate, cyclosporine, morphine, corticosteroids (e.g. prednisolone), certain benzodiazepines (e.g. lorazepam/temazepam), and theophylline. This may increase the risk of their side effects.
- Taking troleandomycin while using Lybrel may increase the risk of serious liver problems.
- Lybrel may decrease the effectiveness of lamotrigine.
Q: Are there any activities I should avoid while taking Lybrel birth control pills?
A: Be aware of the following while using Lybrel:
- Stop smoking cigarettes or using any form of tobacco. Lybrel increases the risk of heart problems and stroke among women who smoke cigarettes or consume tobacco. Visit eDrugstore.md for smoking cessation aids such as Zyban and Chantix.
- Use caution while engaging in activities that require alertness, such as driving or operating heavy machinery. Although uncommon, Lybrel may cause dizziness. Do not drive or perform other potentially dangerous tasks until you are sure of your reaction to Lybrel.
- Limit alcohol consumption while using Lybrel. The risk of dizziness increases with alcohol intake.
- Lybrel may cause dark spots on the face. Avoid excessive sun exposure, sun lamps, and tanning booths until you are sure of how you react to this birth control pill.
Before you receive any medical or dental care, emergency care, or surgery, inform your doctor that you take Lybrel. Some doctors suggest stopping Lybrel for at least four weeks before and two weeks after surgery, or any time a patient might be confined to a bed or chair for a long period of time (such as a long plane journey or bed rest).
Q: How soon after childbirth can I start using Lybrel birth control pills? Is it safe to take Lybrel when I’m breastfeeding?
A: Lybrel should not be used for the first four weeks after childbirth. If you continue breastfeeding, consult with your doctor regarding other methods of birth control until the baby is weaned. Lybrel passes into breast milk and may be harmful to a nursing baby.
Q: Will Lybrel affect my chances of getting pregnant in the future?
A: Lybrel prevents pregnancy as long as it is taken every day. A pregnancy can occur within days of stopping the pill. Many doctors advise women to postpone conception until their menstrual cycle regularizes after stopping birth control pills.
Q: What happens when I miss a dose or doses?
A: Lybrel relies on daily low doses to prevent pregnancy. A single skipped pill may result in pregnancy.
If you miss a pill, take it as soon as you remember. Take the next dose at the regular time. You may take two pills on one day.
If you vomit within four hours of taking a pill, or if you are suffering from diarrhea, follow the steps taken when you miss a dose and use a back-up birth control method.
For seven days after missing one or more doses, use non-hormonal methods of birth control, such as condoms plus spermicide.
Q: What should I do in case of an accidental overdose of Lybrel?
A: If you suspect an overdose of Lybrel, contact your local poison control center or emergency room immediately. Possible symptoms of overdose include severe dizziness, nausea, or vomiting; stomach pain; unusual drowsiness or tiredness; and unusual vaginal bleeding.
For more information about Lybrel and other birth control pills, visit the online knowledge base at eDrugstore.md.
