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With bi- and tri-phasic pills, skipping the placebo week results in a sudden change in hormone levels, which may cause irregular spotting or flow. (Monophasic pills offer the same dose of estrogen and progestogen whereas multiphasic pills have varying doses from day to day; see formulations for details.) [citation needed]
It is available as a generic medication. [7] It is marketed under many brand names. [1] In 2022, it was the 128th most commonly prescribed medication in the United States, with more than 4 million prescriptions. [8] [9]
These differ in the amount of estrogen given, and whether they are monophasic (the same dose of estrogen and progestogen during each of the 21 days) or multiphasic (varying doses). The introduction of extended-cycle monophasic pills (i.e. Seasonale) has shown that the withdrawal bleeding intervals can be decreased.
At low doses, levonorgestrel is used in monophasic and triphasic formulations of combined oral contraceptive pills, with available monophasic doses ranging from 100 to 250 μg, and triphasic doses of 50 μg, 75 μg, and 125 μg. [23] It is combined with the estrogen ethinylestradiol in these formulations. [23]
A package insert from 1970, with Ovrette brand contraception pills A package insert is a document included in the package of a medication that provides information about that drug and its use. For prescription medications , the insert is technical , providing information for medical professionals about how to prescribe the drug.
CPA/EE-containing birth control pills were developed by 1975 [20] [21] and were first introduced for medical use in 1978. [22] They originally contained 50 μg EE (Diane); subsequently, the EE dosage was decreased to 35 μg in a new "low-dose" preparation in 1986 (Diane-35).