Hormonal Contraception Drug Summary

Last updated: 04 December 2025
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Combination Contraceptive Vaginal Rings*

Content on this page:

Combination Contraceptive Vaginal Rings*

Combination Contraceptive Vaginal Rings*


Drug Available Strength Usage Remarks
Etonogestrel/ethinyl estradiol 0.12 mg/0.015 mg released per day from 11.7 mg/2.7 mg vaginal ring

Ring should be placed in the vagina during the first 5 days of the menstrual cycle and remains in place x 3 weeks followed by 1 week of vaginal ring-free period. After a 1-week ring-free interval, a new ring is inserted 

Adverse Reactions

  • Minor side effects occur during the first 3 cycles (nausea, breast tenderness, headache); Irregular menstrual bleeding (breakthrough bleeding or spotting most likely, amenorrhea in 2% to 3% of cycles); Other effects (acne, mood changes, increased weight and BP)
  • Patient should be made aware that side effects generally improve with time
  • Relative risk of VTE can increase with combination oral contraceptives (COCs) use but risk is still low and considerably lower than VTE risk associated with pregnancy
  • COC users with hypertension or those who smoke ≥15 cigarettes/day have an increased relative risk of MI and stroke
  • Considered to have less irregular bleeding when compared to COCs; vaginitis, vaginal discomfort, expulsion
Special Instructions
  • COCs should not be used in women with known contraindication to the component/s or where the risks usually outweigh the benefits
  • Dual protection with condoms to reduce risk of STIs should be discussed with patient
  • Follow-up visit should be scheduled to monitor the BP and review the user’s experience, satisfaction, and compliance; pelvic exam can also be performed
Segesterone acetate/ethinyl estradiol 0.15 mg/0.013 mg released per day from 103 mg/ 17.4 mg vaginal ring

Ring should be placed in the vagina between days 2 and 5 of the menstrual cycle and remains in place x 3 weeks followed by 1 week of vaginal ring-free period. After a 1-week ring-free interval, the same ring is washed and inserted. One ring provides contraception for 1 year (28-day cycles x 13) 

Adverse Reactions

  • GI effects (nausea/vomiting, abdominal pain, diarrhea); GU effects (UTI, genital pruritus, vulvovaginal mycotic infection/candidiasis, vag discharge); Other effects (headache, breast tenderness, dysmenorrhea, bleeding irregularities including metrorrhagia)
Special Instructions
  • COCs should not be used in women with known contraindication to the component/s or where the risks usually outweigh the benefits
  • Dual protection with condoms to reduce risk of STIs should be discussed with patient
  • Follow-up visit should be scheduled to monitor the BP and review the user’s experience, satisfaction, and compliance; pelvic exam can also be performed
  • Contraindicated in women with estrogen- or progestin-sensitive cancer, undiagnosed abnormal uterine bleeding, or concomitant use of hepatitis C drug combinations containing Ombitasvir/Paritaprevir/Ritonavir, with or without Dasabuvir
*When changing from a different type of contraceptive, please see the latest MIMS for specific prescribing information prior to use.

Combination Injectable Contraceptive



Drug Available Strength Dosage Remarks
Medroxyprogesterone/estradiol cypionate 25 mg/5 mg per 0.5 mL injection
50 mg/10 mg per 0.5 mL injection 		 Initial dose of 0.5 mL IM should be given within the first 5 days of menstrual cycle followed by 0.5 mL IM every 28-30 days 
Do not exceed >33 days between injections 		 Adverse Reactions
  • Minor side effects occur during the first 3 cycles (nausea, breast tenderness, headache); Irregular menstrual bleeding (breakthrough bleeding or spotting most likely, amenorrhea in 2% to 3% of cycles); Other effects (acne, mood changes, increased weight and BP)
  • Patient should be made aware that side effects generally improve with time
  • Relative risk of VTE can increase with combination oral contraceptives (COCs) use but risk is still low and considerably lower than VTE risk associated with pregnancy
  • COC users with hypertension or those who smoke ≥15 cigarettes/day have an increased relative risk of MI and stroke
Special Instructions
  • COCs should not be used in women with known contraindication to the component/s or where the risks usually outweigh the benefits
  • Dual protection with condoms to reduce risk of STIs should be discussed with patient
  • Follow-up visit should be scheduled to monitor the BP and review the user’s experience, satisfaction, and compliance; pelvic exam can also be performed
65 mg/7.5 mg per 1 mL injection   Initial dose: 1 mL IM 
Followed by 1 mL IM after 2 months 
120 mg/10 mg per 1 mL injection  Initial dose: 1 mL IM 
Followed by 1 mL IM after 3 months

Combination Oral Contraceptives (COCs)


Drug1  Progestin (mcg)
 Estrogen (mcg) Remarks
Monophasic Adverse Reactions
  • Minor side effects occur during the first 3 cycles (nausea, breast tenderness, headache); Irregular menstrual bleeding (breakthrough bleeding or spotting most likely, amenorrhea in 2% to 3% of cycles); Other effects (acne, mood changes, increased weight and BP)
  • Patient should be made aware that side effects generally improve with time
  • Relative risk of VTE can increase with COC use but risk is still low and considerably lower than VTE risk associated with pregnancy
  • COC users with hypertension or those who smoke ≥15 cigarettes/day have an increased relative risk of MI and stroke
Special Instructions
  • COCs should not be used in women with known contraindication to the component/s or where the risks usually outweigh the benefits
  • Dual protection with condoms to reduce risk of STIs should be discussed with patient 
  • Follow-up visit should be scheduled to monitor the BP and review the user’s experience, satisfaction, and compliance; pelvic exam can also be performed
  • Emergency contraception regimens are administered for 2 doses 12 hours apart not later than 5 days after unprotected sexual intercourse or contraceptive failure (Yuzpe method) 
Chlormadinone acetate/ethinyl estradiol 

 2,000  30   
Cyproterone acetate/ethinyl estradiol2  2,000
  35
 Desogestrel/ethinyl estradiol 150 
 20
 150  30
Dienogest/ethinyl estradiol   2,000 30
Drospirenone/estetrol   3,000
 14,200
Drospirenone/ethinyl estradiol
 3,000
 20
3,000
 30 
Gestodene/ethinyl estradiol


 60  15
75 20
75 30
Levonorgestrel/ethinyl estradiol3  100   20
125  30
150 30
250 50
Nomegestrol/estradiol hemihydrate  2,500  1,500 
Norethisterone/estradiol valerate  50,000   5,000  
Norethisterone/ethinyl estradiol3  1,000
 20 
400  35 
Norethisterone/mestranol  1,000   50
Norgestimate/ethinyl estradiol   250   35 
Norgestrel/ethinyl estradiol3   150  30 
300  30 
500  50 
Biphasic 
Desogestrel/ethinyl estradiol
 (7 tabs) 25
followed by
(15 tabs) 125 		 40

30
Triphasic 
Levonorgestrel/ethinyl estradiol 
 (6 tabs) 50
followed by
(5 tabs) 75
followed by
(10 tabs) 125 		 30

40

30 
Norgestimate/ethinyl estradiol   (7 tabs) 180
followed by
(7 tabs) 215
followed by
(7 tabs) 250 		 35

35

35
Quadriphasic
Dienogest/estradiol valerate   (2 tabs) 0
followed by
(5 tabs) 2,000
followed by
(17 tabs) 3,000 
followed by
(2 tabs) 0 		 3,000

2,000

2,000

1,000 
Emergency Contraception 
Levonorgestrel/ethinyl estradiol
 500  100 
Norethisterone/ethinyl estradio  2,000 100
Norgestrel/ethinyl estradiol   1,000 100
1Dosage instructions may vary by formulation. Please see the latest MIMS for specific prescribing information.
2Cyproterone/ethinyl estradiol is used mainly for androgen-related symptoms and may be used as an oral contraceptive for women with these diseases. This drug should be taken as recommended for approved indication.
3Combination with Ferrous fumarate is available. Please see the latest MIMS for specific prescribing information.

Combination Transdermal Contraceptives


Drug Available Strength Usage Remarks
Levonorgestrel/ethinyl estradiol 120 mcg/30 mcg patch releases 120 mcg/30 mcg per day

Apply 1 patch weekly x 3 weeks followed by 1 week of patch-free period starting on day 22 

Adverse Reactions

  • Minor side effects occur during the first 3 cycles (nausea, breast tenderness, headache); Irregular menstrual bleeding (breakthrough bleeding or spotting most likely, amenorrhea in 2% to 3% of cycles); Other effects (acne, mood changes, increased weight and BP)
  • Patient should be made aware that side effects generally improve with time
  • Relative risk of VTE can increase with combination oral contraceptives (COCs) use but risk is still low and considerably lower than VTE risk associated with pregnancy
  • COC users with hypertension or those who smoke ≥15 cigarettes/day have an increased relative risk of MI and stroke
  • Application site reaction
Special Instructions
  • COCs should not be used in women with known contraindication to the component/s or where the risks usually outweigh the benefits
  • Dual protection with condoms to reduce risk of STIs should be discussed with patient
  • Follow-up visit should be scheduled to monitor the BP and review the user’s experience, satisfaction, and compliance; pelvic exam can also be performed
Norelgestromin/ethinyl estradiol  150 mcg/35 mcg patch releases 150 mcg/35 mcg per day  Apply 1 patch weekly x 3 weeks followed by 1 week of patch-free period starting on day 22 
6,000 mcg/600 mcg patch releases 150 mcg/20 mcg per day  Apply 1 patch weekly x 3 weeks followed by 1 week of patch-free period starting on day 22  

Progestin-Only Contraceptive Implants


Drug Available Strength Usage Remarks
Etonogestrel1 68 mg/implant x 1 

Insert 1 implant subdermally within the first 5 days of the menstrual cycle
Effective x 3 years

Adverse Reactions

  • Irregular bleeding which tends to decrease with time; headache, bloating, acne and breast tenderness
  • Insertion and removal may cause bruising, irritation, pain and occasionally scarring
Special Instructions
  • Contraceptive doses of progestins do not appear to increase the risk of VTE, MI or stroke 
  • Do not leave any one system in place longer than its effectivity
Levonorgestrel 75 mg/implant x 2 Insert 2 implants subdermally within first 7 days of the menstrual cycle 
Effective x 3 years or 5 years2
1When changing from a different type of contraceptive, please see the latest MIMS for specific prescribing information prior to use.
2Duration of use varies depending on product labeling. Please see the latest MIMS for specific prescribing information prior to use.

Progestin-Only Contraceptive Intrauterine System


Drug Available Strength Usage Remarks
Levonorgestrel 52 mg/IUD delivers 
20 mcg/24 hr

Insert 52 mg IUD into the uterine cavity within the first 7 days of the menstrual cycle 
Effective x 5 years 

Adverse Reactions

  • CNS effects (mood changes, headache); GI effects (abdominal pain, nausea, weight gain); Dermatologic effect (acne); Other effects (edema, back pain, pelvic pain, dysmenorrhea, vaginal discharge, cervicitis, breast tenderness, expulsion)
Special Instructions
  • May insert immediately after first trimester abortion; postpartum insertion should be postponed until 6 weeks after delivery
  • Reexamine patient 4-12 weeks after insertion and once yearly thereafter
  • Do not leave any one system in place for >5 years

Progestin-Only Contraceptive Pills (POPs)


Drug Dosage Remarks
Desogestrel  75 mcg PO 24 hourly at the same time each day without interruption starting from the first day of menstrual cycle  Adverse Reactions
  • Irregular bleeding which tends to decrease with time; headache, bloating, acne and breast tenderness
Special Instructions
  • Contraceptive doses of progestins do not appear to increase the risk of VTE, MI or stroke
  • Drospirenone: Use with caution in patients with hyperkalemia
  • Levonorgestrel: If vomiting occurs within 3 hours of drug intake, consider this dose missed. Repeat dose and administer 2nd dose 12-24 hours later, if 0.75 mg is used
  • Back-up contraceptive method is recommended for 48 hours if there is >3-hour delay in pill intake for traditional POPs and >12-hour delay in pill intake for Desogestrel
Drospirenone  4 mg PO 24 hourly at the same time for 24 days starting from the first day of menstrual cycle followed by 4-day hormone-free interval 
Etynodiol 
(Ethynodiol) 		 500 mcg PO 24 hourly at the same time each day without interruption starting from the first day of menstrual cycle  
Levonorgestrel  0.03 mg or 0.0375 mg PO 24 hourly 
Emergency contraception within 72 hours of unprotected sex or failure of other method: 0.75 mg PO within 72 hours following coitus and repeated 12 hours after first dose or 1.5 mg PO single dose within 72 hours following coitus  
Lynestrenol 500 mcg PO 24 hourly at the same time each day without interruption starting from the first day of menstrual cycle
Norethisterone   350 mcg PO 24 hourly at the same time each day without interruption starting from the first day of menstrual cycle  
Norgestrel
75 mcg PO 24 hourly at the same time each day without interruption starting from the first day of menstrual cycle

Progestin-Only Injectable Contraceptives


Drug Dosage Remarks
Medroxyprogesterone 150 mg IM every 3 months starting within the first 5-7 days of the menstrual cycle or within the first 5 days following childbirth (delay until 6 weeks after childbirth if breastfeeding) or 
104 mg SC every 3 months starting within the first 5 days of the menstrual cycle or within the first 5 days following childbirth (delay until 6 weeks after childbirth if breastfeeding) 		 Adverse Reactions
  • Menstrual cycle disturbance (irregular bleeding, amenorrhea); Unpredictable bleeding may be common during the first month of use and many patients become amenorrheic with continued use; headache, acne, decreased libido, breast tenderness, weight gain
  • Delay in the return of fertility may be encountered but no evidence of infertility
  • Reversible reduction in BMD has been reported
Special Instructions
  • Injectable progestins do not appear to increase the risk of VTE, CVD, stroke or MI
Norethisterone 200 mg IM starting within the first 5 days of the menstrual cycle or immediately after giving birth
Next 3 injections are given every 8 weeks after which the intervals should be extended to 200 mg IM every 12 weeks 

Other Oral Contraceptives


Drug Dosage Remarks
Antiprogestogens
Mifepristone Emergency contraception:
10 mg PO taken within 120 hours after unprotected sexual intercourse
Treatment is more effective if will be taken earlier		 Adverse Reactions
  • Gynecological effects (excessive vaginal bleeding, uterine hemorrhage, uterine infections); GI effects (diarrhea, nausea/vomiting, abdominal cramps); Other effects (UTI, fatigue, back pain, headache)
Special Instructions
  • Avoid use in patients with suspected or confirmed ectopic pregnancy, chronic adrenal failure, concurrent long-term corticosteroid therapy or anticoagulant therapy, hemorrhagic disorders, hepatic or renal impairment
  • Use with caution in patients with asthma, COPD, CVD, history of infective endocarditis, or in female smokers >35 years old, alcoholic drinkers
Ulipristal acetate Emergency contraception: 
30 mg PO taken not later than 120 hours (5 days) after unprotected intercourse or contraceptive failure
May be taken at any moment during the menstrual cycle
Another tab should be taken if vomiting occurs within 3 hours of intake 		 Adverse Reactions
  • CNS effects (headache, dizziness); GI effects (nausea/vomiting, abdominal pain/discomfort, upper abdominal pain); Gynecologic effects (dysmenorrhea, pelvic pain); Other effects (mood disorders, myalgia, back pain, fatigue, breast tenderness) 
Special Instructions
  • Avoid use in pregnant patients, in patients with galactose intolerance, glucose-galactose malabsorption
  • Use with caution in patients with hepatic impairment, asthma not sufficiently controlled by oral glucocorticoid, in women concomitantly taking Levonorgestrel-containing emergency contraceptive
    • Repeat administration within the same menstrual cycle is not advised

Disclaimer

All dosage recommendations are for non-elderly adults with normal renal and hepatic function unless otherwise stated.
Not all products are available or approved for above use in all countries.
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.

Related MIMS Drugs