{"ok":true,"entry":{"slug":"combined-oral-contraceptive","kind":"medication","name":"combined oral contraceptive","aliases":["ethinylestradiol + levonorgestrel","Yasmin","Yaz","Diane-35","Microgynon","Mercilon"],"brands_sg":["Yasmin","Yaz","Microgynon 30","Mercilon","Diane-35"],"class":"oestrogen + progestin","tags":["hormonal"],"use_for":"preventing pregnancy — nhs: >99% effective used correctly","use_after":"one tablet at the same time daily · 21-day or everyday packs","use_duration":null,"take_with":"us label: without regard to meals, same time each day","pros":["nhs: >99% effective used correctly, 91% in practice","nhs: periods often lighter, more regular, less painful","nhs: may ease pms, endometriosis and severe acne"],"cons":["us label: boxed — not for smokers over 35","nhs: blood clot in up to 1 in 1,000 users","nhs: breakthrough bleeding common in early months"],"dose_note":"the us levonorgestrel/ethinyl estradiol label (kurvelo 0.15 mg/30 mcg, lupin, spl v12, eff. 20 may 2026 — the same strength and 21+7 pack as microgynon 30 on the sg register) states 'counsel patients to take one tablet daily by mouth at the same time every day'; one tablet a day is the label maximum, and the lupin extended-cycle label repeats it as 'take one tablet daily by mouth at the same time every day for 91 days'. nhs describes 21-day and everyday (ED) packs. in singapore a doctor or pharmacist decides which pill and regimen.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["over 35 and smoking — us label: contraindicated","migraine with aura, past blood clots or stroke (nhs)","high blood pressure, heart disease or breast cancer (nhs)","breastfeeding — nhs: 6 weeks after giving birth before starting"],"clashes":[{"src":["nhs_coc_inter"],"note":"nhs: can stop the pill working — another method may be needed","with":"medicines for tb, epilepsy or hiv"},{"src":["nhs_coc_inter"],"note":"nhs: named among medicines that affect how the pill works","with":"griseofulvin"},{"src":["nhs_coc_inter"],"note":"nhs: named among medicines to ask about first","with":"lamotrigine (mood stabiliser)"},{"src":["nhs_coc_inter"],"note":"nhs: herbal remedy that can stop the pill working properly","with":"st john's wort"},{"src":["fda_lng_ee_gi"],"note":"us label: may reduce hormone absorption · nhs has separate sickness advice","with":"diarrhoea and vomiting"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg open dataset, 5,511 rows, full CSV pulled once via the datastore_search API and filtered locally)","quote":"Forensicclassification = 'Prescription Only' for every combined oral contraceptive row: SIN12334P YASMIN, SIN13584P YAZ, SIN04834P MICROGYNON 30, SIN06136P MERCILON, SIN04784P DIANE-35, SIN12117P ESTELLE-35, SIN14855P DROSPERA, SIN14996P GVEZA, SIN14995P JASTINDA, SIN14894P LIZA","accessed":"2026-08-27"},{"id":"nhs_coc_what","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/what-is-it/","label":"NHS — Combined pill: what is it (page dateModified 15 Apr 2025)","quote":"The combined contraceptive pill (also called the pill) is a type of hormonal contraception. It stops your ovaries releasing an egg each month.","accessed":"2026-08-27"},{"id":"nhs_coc_how","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/how-to-take-it/","label":"NHS — Combined pill: how to take it","quote":"There are 2 main ways to take the combined pill … You take the everyday (ED) pill every day … You take the 21-day pill for 21 days, then have a break (not taking a pill) for 7 days.","accessed":"2026-08-27"},{"id":"nhs_coc_eff","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/how-to-take-it/","label":"NHS — Combined pill: effectiveness","quote":"You need to take the combined pill at the same time every day for it to work properly. When used correctly all the time, the pill is more than 99% effective. If not used correctly, it's 91% effective","accessed":"2026-08-27"},{"id":"nhs_coc_who","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/who-can-take-it/","label":"NHS — Combined pill: who can take it","quote":"You may not be able to take it if you're living with obesity, or you're aged 35 or over and you smoke … blood clots … narrowed or blocked arteries, or a stroke … migraines with warning signs called aura","accessed":"2026-08-27"},{"id":"nhs_coc_benefit","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/who-can-take-it/","label":"NHS — Combined pill: use for acne and heavy or painful periods","quote":"Taking the combined pill usually makes your periods regular, lighter and less painful. The pill may also help the symptoms of: premenstrual syndrome (PMS) · endometriosis … severe acne","accessed":"2026-08-27"},{"id":"nhs_coc_bf","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/who-can-take-it/","label":"NHS — Combined pill: after birth and while breastfeeding","quote":"If you're breastfeeding, you should wait 6 weeks after giving birth before you start taking the pill. You'll need to use a different method of contraception, such as condoms, until then","accessed":"2026-08-27"},{"id":"nhs_coc_side","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/","label":"NHS — Combined pill: side effects","quote":"Bleeding between periods (breakthrough bleeding) or changes to your periods are common in the first few months. Taking the pill can cause high blood pressure in a small number of people.","accessed":"2026-08-27"},{"id":"nhs_coc_risk","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/","label":"NHS — Combined pill: risks and complications","quote":"The risk of getting a blood clot is very small and affects up to 1 in 1,000 people using combined hormonal contraception like the pill … can slightly increase your risk of getting: breast cancer · cervical cancer","accessed":"2026-08-27"},{"id":"nhs_coc_inter","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/how-to-take-it/","label":"NHS — Combined pill: medicines and herbal remedies that affect it","quote":"Some medicines and herbal remedies can affect how the combined pill works … before taking the pill if you take medicine to treat TB, epilepsy or HIV … griseofulvin, lamotrigine (a mood stabiliser), or St John's wort","accessed":"2026-08-27"},{"id":"nhs_coc_get","url":"https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/where-to-get-it/","label":"NHS — Combined pill: where to get it (UK supply route, for contrast with Singapore)","quote":"You can get the combined pill free on the NHS from sexual health clinics, GP surgeries and young people's services … A pharmacist may be able to supply the combined pill for free without a prescription.","accessed":"2026-08-27"},{"id":"fda_lng_ee","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=752f525e-1838-4058-9ab7-2c2d91f86dfd","label":"FDA DailyMed — Kurvelo (levonorgestrel and ethinyl estradiol tablets USP, 0.15 mg/30 mcg), Lupin Pharmaceuticals, SPL v12, effective 20 May 2026","quote":"Kurvelo is indicated for use by females of reproductive potential to prevent pregnancy … Counsel patients to take one tablet daily by mouth at the same time every day.","accessed":"2026-08-27"},{"id":"fda_lng_ee_start","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=752f525e-1838-4058-9ab7-2c2d91f86dfd","label":"FDA DailyMed — Kurvelo: Dosage and Administration, Table 3","quote":"Take first tablet without regard to meals on the first day of menses · Take subsequent tablets once daily at the same time each day · Begin each subsequent pack on the same day of the week","accessed":"2026-08-27"},{"id":"fda_lng_ee_boxed","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=752f525e-1838-4058-9ab7-2c2d91f86dfd","label":"FDA DailyMed — Kurvelo prescribing information: boxed warning","quote":"WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS — Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use … COCs, including Kurvelo, are contraindicated in women who are over 35 years of age and smoke","accessed":"2026-08-27"},{"id":"fda_lng_ee_gi","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=752f525e-1838-4058-9ab7-2c2d91f86dfd","label":"FDA DailyMed — Kurvelo prescribing information: precautions on absorption","quote":"Diarrhea and/or vomiting may reduce hormone absorption (see DOSAGE AND ADMINISTRATION).","accessed":"2026-08-27"},{"id":"fda_lng_ee_extended","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58e85e02-93e7-42ba-b8f5-a36290c68423","label":"FDA DailyMed — Levonorgestrel and ethinyl estradiol tablets (extended-cycle, 91-day), Lupin Pharmaceuticals, SPL v19, effective 31 Aug 2026","quote":"Take one tablet daily by mouth at the same time every day for 91 days … Patients should take one tablet daily by mouth at the same time every day.","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:16.693643+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}