WARNING TO WOMEN WHO SMOKE
Tell your healthcare provider about all medicines and herbal products that you take. Some medicines and herbal products may make birth control pills less effective, including:
- barbiturates
- bosentan
- carbamazepine
- felbamate
- griseofulvin
- oxcarbazepine
- phenytoin
- rifampin
- St. John’s wort
- topiramate
Use a back-up or alternative birth control method when you take medicines that may make birth control pills less effective.
- Birth control pills may interact with lamotrigine, an anticonvulsant used for epilepsy. This may increase the risk of seizures, so your healthcare provider may need to adjust the dose of lamotrigine.
- Women on thyroid hormone replacement therapy may need increased doses of thyroid hormone.
Do not take birth control pills if you:
- Legs (deep vein thrombosis)
- Lungs (pulmonary embolus)
- Eyes (loss of eyesight)
- Heart (heart attack)
- Brain (stroke)
Women who take birth control pills may get:
- High blood pressure
- Gallbladder problems
- Rare cancerous or noncancerous liver tumors
All of these events are uncommon in healthy women.
- Persistent leg pain
- Sudden shortness of breath
- Sudden blindness, partial or complete
- Severe pain or pressure in your chest
- Sudden, severe headache unlike your usual headaches
- Weakness or numbness in an arm or leg, or trouble speaking
- Yellowing of the skin or eyeballs
Quartette is a prescription birth control medication used to prevent pregnancy.
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
The most common side effects of birth control pills are:
- Spotting or bleeding between menstrual periods
- Nausea
- Breast tenderness
- Headache
These side effects are usually mild and usually disappear with time.
Less common side effects are:
- Acne
- Less sexual desire
- Bloating or fluid retention
- Blotchy darkening of the skin, especially on the face
- High blood sugar, especially in women who already have diabetes
- High fat (cholesterol, triglyceride) levels in the blood
- Depression, especially if you have had depression in the past. Call your healthcare provider immediately if you have any thoughts of harming yourself.
- Problems tolerating contact lenses
- Weight gain
This is not a complete list of possible side effects. Talk to your healthcare provider if you develop any side effects that concern you. You may report side effects to the FDA at 1-800-FDA-1088.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Quartette there are no specific foods that you must exclude from your diet when receiving Quartette.
Before receiving Quartette, tell your healthcare provider if you have:
- Ever had breast cancer or any cancer that is sensitive to female hormones
- Liver disease, including liver tumors
- Ever had blood clots in your arms, legs, eyes, or lungs
- Ever had a stroke
- Ever had a heart attack
- Certain heart valve problems or heart rhythm abnormalities that can cause blood clots to form in the heart
- An inherited problem with your blood that makes it clot more than normal
- High blood pressure that medicine can’t control
- Diabetes with kidney, eye, nerve or blood vessel damage
- Ever had certain kinds of severe migraine headaches with aura, numbness, weakness or changes in vision, or have any migraine headaches if you are over age 35
While you are taking Quartette, if you have a major surgery scheduled:
- you should stop Quartette at least four weeks before you have major surgery
- and not restart it for at least two weeks after the surgery, due to an increased risk of blood clots.
Quartette (generic: levonorgestrel/ethinyl estradiol and ethinyl estradiol) is a prescription birth control medication used to prevent pregnancy.
Quartette represents the next generation of extended regimen oral contraceptives, and was designed to minimize breakthrough bleeding (BTB) between scheduled periods. Quartette contains two hormones, levonorgestrel and ethinyl estradiol, which belong to a group of drugs called hormonal contraceptives. These hormones prevent pregnancy by stopping ovulation and by altering cervical mucus and the lining of the uterus. Quartette is unique in that the dose of estrogen increases at three distinct points over the first 84 days and the amount of progestin (levonorgestrel) remains consistent; this is followed by seven days of 10 mcg of ethinyl estradiol.
This medication comes in tablet form in an extended-cycle (91-day) tablet dispenser. Quartette is taken once daily, with or without food.
Common side effects of Quartette include nausea, breast tenderness, and vaginal bleeding between menstrual periods.
If you are breastfeeding, consider another birth control method until you are ready to stop breastfeeding. Birth control pills that contain estrogen, like Quartette, may decrease the amount of milk you make. A small amount of the pill’s hormones pass into breast milk.
Birth control pills should not be taken during pregnancy. However, birth control pills taken by accident during pregnancy are not known to cause birth defects.
How To Take Quartette
- Take one pill every day at the same time. Take pills in the order directed on the Extended-Cycle Tablet Dispenser. Do not skip pills or delay taking your pills. If you miss pills (including starting the pack late), you could get pregnant. The more pills you miss, the more likely you are to get pregnant.
- You may have spotting or light bleeding, or feel sick to your stomach during the first few months of taking Quartette. If you feel sick to your stomach, do not stop taking the pill. The problem will usually go away. If it doesn’t go away, check with your healthcare provider.
- Missing pills can also cause spotting or light bleeding, even when you take the missed pills later. On the days you take 2 pills to make up for missed pills, you could also feel a little sick to your stomach.
- If you have trouble remembering to take Quartette, talk to your healthcare provider about how to make pill-taking easier or about using another method of birth control.
Before you start taking Quartette
- Decide what time of day you want to take your pill. It is important to take it at about the same time every day.
- Look at your Extended-Cycle Tablet Dispenser. Your Extended-Cycle Tablet Dispenser consists of 3 trays with cards that hold 91 individually sealed pills (a 13-week or 91-day cycle). The 91 pills consist of 42 light pink tablets, each containing 0.15 mg of levonorgestrel and 0.02 mg ethinyl estradiol, 21 pink tablets containing 0.15 mg of levonorgestrel and 0.025 mg ethinyl estradiol, 21 purple tablets containing 0.15 mg of levonorgestrel and 0.03 mg ethinyl estradiol, and 7 yellow tablets containing 0.01 mg of ethinyl estradiol.
- Tray 1 contains 4 rows of 7 light pink pills.
- Tray 2 contains 2 rows of 7 light pink pills (a total of 14 light pink pills) followed by 2 rows of 7 pink pills (a total of 14 pink pills).
- Tray 3 contains 1 row of 7 pink pills, followed by three rows of 7 purple pills (a total of 21 purple pills), followed by the last row, which contains 7 yellow pills.
Also find:
- Where on the first tray in the pack to start taking pills (upper left corner at the start arrow) and
- In what order to take the pills (follow the weeks and arrow).
- Be sure you have another kind of birth control (such as condoms and spermicides) ready at all times, to use as a back-up in case you miss pills.
- Do not skip pills even if you are experiencing spotting or bleeding or feel sick to your stomach (nausea).
- Do not skip pills even if you do not have sex very often.
- Do not skip the yellow pills because they are not placebo pills (“sugar pills”). They contain ethinyl estradiol.
- After taking the last yellow pill, start taking the first light pink pill from a new Extended-Cycle Tablet Dispenser the very next day (this should be on a Sunday) regardless of when your period started.
- Take it as soon as you remember. Take the next pill at your regular time. This means you may take 2 pills in 1 day.
- You do not need to use a back-up birth control method if you have sex.
- Take 2 pills on the day you remember, and 2 pills the next day.
- Then take 1 pill a day until you finish the pack.
- You could become pregnant if you have sex in the 7 days after you miss two pills. You MUST use another birth control method (such as condoms and spermicide) as a back-up for the 7 days after you restart your pills.
- Do not take the missed pills. Keep taking 1 pill every day as indicated on the pack until you have completed all of the remaining pills in the pack. For example: If you resume taking the pill on Thursday, take the pill under “Thursday” and do not take the missed pills. You may experience bleeding during the week following the missed pills.
- You could become pregnant if you have sex during the days of missed pills or during the first 7 days after restarting your pills.
- You MUST use a non-hormonal birth control method (such as condoms and spermicide) as a back-up when you miss pills and for the first 7 days after you restart your pills. If you do not have your period when you are taking the yellow pills, call your healthcare provider because you may be pregnant.
- Take the next scheduled pill at the scheduled time.
- You do not need a back-up method of birth control.
- Use a back-up method anytime you have sex.
- Keep taking one pill each day until you contact your healthcare provider.
How Quartette May Affect Your Periods