ethinyl estradiol-norgestimate
PrintTrade Name(s): Estarylla; Femynor; Mili; Mono-Linya; Mononessa; Nymyo; Ortho Tri-Cyclen; Previfem; Sprintec; Tri-Estarylla; Tri-Femynor; Tri-Linyah; Tri-Lo-Estarylla; Tri-Lo-Marzia; Tri-Lo-Mili; Tri-Lo-Sprintec; Tri-Mili; Trinessa; Tri-Sprintec; Tri-Vylibra; Vylibra | |
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>
- Harmful if swallowed.
- May cause cancer.
- Very toxic to aquatic life with long lasting effects.
Reference: SDS Cayman Chemical - ethinyl estradiol
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
Estradiol: Estrogen mediates its effects across the body through potent agonism of the Estrogen Receptor (ER), which is located in various tissues including in the breasts, uterus, ovaries, skin, prostate, bone, fat, and brain. Estradiol binds to both subtypes of the Estrogen Receptor: Estrogen Receptor Alpha (ERα) and Estrogen Receptor Beta (ERβ). Estradiol also acts as a potent agonist of G Protein-coupled Estrogen Receptor (GPER), which has recently been recognized as a major mediator of estradiol's rapid cellular effects 9.
When the estrogen receptor has bound its ligand it can enter the nucleus of the target cell, and regulate gene transcription which leads to formation of messenger RNA. The mRNA interacts with ribosomes to produce specific proteins that express the effect of estradiol upon the target cell. 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.
Reference: Drug Bank
Norgestimate:
Norgestimate binds to androgen and progestogen receptors. Target cells include the female reproductive tract, the mammary gland, the hypothalamus, and the pituitary. Once bound to the receptor, progestins like Norgestimate 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