VA CFU Criteria Formulary Advisor Reference
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ETHINYL ESTRADIOL/ FERROUS FUMARATE/ NORETHINDRONE TAB

Generic Name
ETHINYL ESTRADIOL/ FERROUS FUMARATE/ NORETHINDRONE TAB
Brand Names
AUROVELA 24 FE, AUROVELA FE, BLISOVI 24 FE, BLISOVI FE, FEIRZA, HAILEY 24 FE, HAILEY FE, JUNEL FE 24, LARIN 24 FE, LARIN FE, LO LOESTRIN FE, LOESTRIN FE, MICROGESTIN FE, NORETHINDRONE-E.ESTRADIOL-IRON, TARINA 24 FE, TARINA FE, TARINA FE 1-20 EQ, TILIA FE, TRI-LEGEST FE, XARAH FE
Drug Class
CONTRACEPTIVES,SYSTEMIC
Formulary Status
N
Copay Tier
2
Last Updated
2017-02-27

Clinical Criteria Summary

Indication & Efficacy

  • Highly effective in preventing pregnancy when used as directed
  • Classified as a combination hormonal contraceptive agent

Regimen & Administration

  • Monophasic pills with 30 mcg EE and desogestrel 0.15 mg: 21 active pills; 7 inert pills

Clinical Considerations & Management

  • Nuisance side effects associated with combination hormonal contraceptives may be managed by adjusting the estrogen/progestin content or ratio
  • Progestin-only products may be considered in patients with contraindications or a desire to avoid estrogen (general class guidance)

Formulary & Substitution Criteria

  • Listed on the VA National Formulary as generic components to allow for substitution of the least expensive equivalent product
  • Product availability varies and the listed products are not comprehensive

Source Documents

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