TriNessa

Generic name: norgestimate and ethinyl estradiol

Drug class: Combination oral contraceptive (estrogen and progestin)

Dosage form: Oral tablets

Route of administration: Oral

Dose: TriNessa is typically administered as follows:

• 21 active tablets: 0.180 mg norgestimate and 0.035 mg ethinyl estradiol per tablet
• 7 inactive (placebo) tablets

The regimen involves taking one active tablet daily for 21 days, followed by one inactive tablet daily for 7 days, maintaining a consistent daily schedule. Starting options include a Day 1 start (beginning on the first day of menstruation) or a Sunday start (beginning on the first Sunday after menstruation starts). If starting on a Sunday, additional non-hormonal contraception is recommended for the first seven days.

Mechanism of action: TriNessa prevents pregnancy primarily by inhibiting ovulation (the release of an egg from the ovary). It also thickens cervical mucus to impede sperm penetration and alters the endometrial lining to prevent implantation of a fertilized egg.

Drug usage cases:

• Contraception to prevent pregnancy
• Treatment of moderate acne vulgaris in females at least 15 years old who desire contraception

Drug contraindications:

• Known or suspected pregnancy
• History of thromboembolic disorders (e.g., deep vein thrombosis, pulmonary embolism) or stroke
• Active or history of liver disease or liver tumors
• Undiagnosed abnormal uterine bleeding
• Known or suspected breast cancer or other estrogen- or progestin-sensitive cancers
• Hypersensitivity to norgestimate, ethinyl estradiol, or any component of the formulation
• Concurrent use with hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
• Women over 35 years old who smoke

Side effects:

• Common: Nausea, vomiting, breakthrough bleeding, weight gain, breast tenderness, headache, difficulty wearing contact lenses
• Serious: Blood clots, high blood pressure, gallbladder disease, liver tumors (rare; may or may not be cancerous)
• Other: Fluid retention, melasma (skin darkening), mood changes, abdominal discomfort, dizziness, skin rash, vaginal infections, urinary tract infections, vertigo, pancreatitis, allergic reactions

Warnings:

• Smoking increases the risk of serious cardiovascular events, especially in women over 35 years old. TriNessa is contraindicated in this population.
• Monitor blood pressure regularly; discontinue if significant increases occur.
• Assess for signs of thromboembolic events; discontinue if such events occur.
• Evaluate for liver dysfunction; discontinue if jaundice develops.
• Monitor for signs of depression; discontinue if significant mood changes occur.
• Be aware of potential interactions with other medications that may reduce contraceptive efficacy or increase side effects.

Use during pregnancy or breastfeeding: TriNessa is contraindicated during pregnancy. If pregnancy occurs during use, discontinue immediately. During breastfeeding, the drug may pass into breast milk and affect milk production and quality. It is recommended to avoid using TriNessa while breastfeeding. Alternative contraceptive methods should be considered during this period.