ethinyl estradiol-levonorgestrel
PrintTrade Name(s): Afirmelle; Altavera; Amethia; Amethyst; Ashlyna; Aubra; Aviane; Ayuna; Balcoltra; Camrese; Chateal; Daysee; Delyla; Dolishale; Enpresse; Falessa; Falmina; Fayosim; Iclevia; Introvale; Jaimess; Jolessa; Kurvelo; Larissa; Lessina; Levonest; Levora; Lillow; LoSeasonique; Lo Simpesse; Lutera; Marlissa; Minivlar; Myzilra; Orsythia; Portia; Seasonale; Seasonique; Setlakin; Spronyx; Trivora; Tyblume; Vienva | |
Group 2: Non-Antineoplastic Hazardous | AHFS Class: Contraceptives |
Activity | Gloves | Gown | Eye/Face | Notes/Instructions |
Dispensing prepackaged formulations |
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Counting/Repackaging tablets and capsules | Recommended if pregnant, breast feeding or trying to conceive |
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Formulation | Gloves | Gown | Eye/Face | Notes/Instructions |
Tablets and capsules | (If patient requires assistance) | (If patient requires assistance) |
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Topicals, creams, vaginal rings | (If patient requires assistance) | (If patient requires assistance) |
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Type of Instance | Gloves | Gown | Mask | Eye/Face | Notes/Instructions |
Receiving undamaged HD shipping container |
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Receiving damaged HD shipping container | If container must be opened | If container must be opened | If container must be opened |
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Spill Cleanup | Large volume | Large volume |
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Reference: USP <800>
Hazardous Pharmaceutical | Trace Chemo | Biohazardous and Sharps |
1. Non-returnable hazardous, chemo and EPA regulated drugs. (Patient specific prescriptions, partially used blister packs, containers with more than 3% medication remaining) 2. Empty bottles or packaging of P-Listed drugs. (Warfarin, nicotine, epinephrine, nitroglycerin, physostigmine) 3. PPE with visible contamination from hazardous drug. | 1. Waste contaminated through contact with chemotherapeutic agents. (Empty vials, IV bags, syringes and tubing) 2. PPE worn while handling hazardous drugs with NO visible contamination. (Gowns, gloves and masks) 3. Used CSTD devices. | 1. All sharps capable of cutting or piercing the skin. (Needles/syringes, broken ampules, lancets) 2. Items contaminated with blood or other potentially infectious materials. (Tubing, bags or dressings containing blood, contaminated waste from isolation patients) |
Dosage Form | Ship to Institution or Pharmacy | Ship to Locations Outside of ODOC |
Tablets and Capsules |
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Liquid, Topical, and Transdermal |
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PPE | Standards |
Shoe Covers |
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Gowns |
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Gloves |
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Face Shields |
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Goggles |
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N95 Masks |
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Removal and Disposal |
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Reference: USP <800>
- Suspected of causing cancer.
- May damage fertility. May damage the unborn child.
- May cause harm to breast-fed children.
Reference: SDS - Pfizer Inc
Estradiol: Black Box warning for malignant neoplasms;Increased risk of endometrial cancer, breast cancer,and ovarian cancer; in laboratory studies, increased frequency of carcinomas of the breast, uterus, cervix,vagina, testis, and liver; Present in breast milk
Ethinyl estradiol: Estrogens diffuse into their target cells and interact with a protein receptor. Target cells include the female reproductive tract, the mammary gland, the hypothalamus, and the pituitary. Estrogens increase the hepatic synthesis of sex hormone binding globulin (SHBG), thyroid-binding globulin (TBG), and other serum proteins and suppress follicle-stimulating hormone (FSH) from the anterior pituitary. This cascade is initiated by initially binding to the estrogen receptors. The combination of an estrogen with a progestin suppresses the hypothalamic-pituitary system, decreasing the secretion of gonadotropin-releasing hormone (GnRH).
Reference: Drug Bank
Levonorgestrel: Binds to the progesterone and estrogen receptors. Target cells include the female reproductive tract, the mammary gland, the hypothalamus, and the pituitary. Once bound to the receptor, progestins like levonorgestrel will slow the frequency of release of gonadotropin releasing hormone (GnRH) from the hypothalamus and blunt the pre-ovulatory LH (luteinizing hormone) surge.
Reference: Drug Bank