Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
DEMULEN 1/35-28 vs LARIN 1.5/30
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Combination estrogen-progestin contraceptive; suppresses gonadotropin release, inhibiting ovulation; increases cervical mucus viscosity, impeding sperm penetration; alters endometrial receptivity.
Combination oral contraceptive: ethinyl estradiol suppresses FSH and LH, preventing ovulation; norethindrone induces endometrial changes and increases cervical mucus viscosity, impeding sperm penetration.
Prevention of pregnancy
Prevention of pregnancy
One tablet (contains 1 mg ethynodiol diacetate and 35 mcg ethinyl estradiol) orally once daily at the same time each day for 21 days, followed by 7 days of placebo or no tablets.
One tablet (norethindrone acetate 1.5 mg, ethinyl estradiol 30 mcg) orally once daily at the same time each day for 21 consecutive days, followed by 7 days of placebo tablets.
Ethinyl estradiol: 17.4 ± 5.6 h (terminal); norethindrone: 10.9 ± 1.6 h (terminal); clinically, steady-state achieved within 5-7 days.
Ethinyl estradiol: 13-19 hours; Norethindrone: 7-9 hours. Steady-state achieved in ~5-7 days.
Ethinylestradiol undergoes hepatic metabolism via CYP3A4; norethindrone undergoes reduction and conjugation in the liver.
Ethinyl estradiol: primarily CYP3A4; norethindrone: primarily CYP3A4, with some reduction to active metabolites.
Renal 50% (metabolites), fecal 50% (biliary elimination of conjugates).
Renal (40% as metabolites, <10% unchanged); fecal (50% as metabolites); biliary (minor).
Ethinyl estradiol: 97-98% bound to albumin; norethindrone: 93% bound to albumin and SHBG.
Ethinyl estradiol: 97-98% bound to albumin; Norethindrone: 93-99% bound to SHBG and albumin.
Ethinyl estradiol: 2.3-4.3 L/kg; norethindrone: 4.4 L/kg; indicates extensive tissue distribution.
Ethinyl estradiol: 2.5-5 L/kg; Norethindrone: 2-4 L/kg. Indicates extensive tissue distribution.
Ethinyl estradiol: 40-45% (oral; first-pass metabolism); norethindrone: 64-67% (oral).
Oral: Ethinyl estradiol ~40-50% (first-pass metabolism); Norethindrone ~50-60% (first-pass metabolism).
No dose adjustment required for mild to moderate renal impairment. Contraindicated in severe renal impairment or acute renal failure.
No dose adjustment required in mild to moderate renal impairment (Cr Cl >=30 m L/min). Use contraindicated in severe renal impairment (Cr Cl <30 m L/min) or renal failure due to potential for fluid retention and hyperkalemia.
Contraindicated in acute or chronic hepatic dysfunction, including Child-Pugh class A, B, or C. Avoid use if liver function tests are abnormal.
Contraindicated in Child-Pugh class B or C (moderate to severe hepatic impairment). For Child-Pugh class A, lowest possible effective dose should be used with close monitoring of liver function.
Not indicated for use before menarche. For postmenarchal adolescents, use same dosing as adults (one tablet orally once daily).
Post-menarche adolescents: same dosing as adults (one tablet daily for 21 days, then 7 days placebo). Safety and efficacy in pre-menarche girls have not been established.
Not indicated for use in postmenopausal women.
Not indicated for postmenopausal women. No specific geriatric dose adjustments; however, consider increased risk of thromboembolic events and cardiovascular disease in women aged >40 years who smoke or have other risk factors.
Cigarette smoking increases risk of serious cardiovascular events. Risk increases with age and smoking intensity. Women over 35 who smoke should not use this product.
Cigarette smoking increases risk of serious cardiovascular events. Risk increases with age and heavy smoking (≥15 cigarettes/day). Women over 35 who smoke should not use this product.
Increased risk of thromboembolic disorders,Cerebrovascular disease,Myocardial infarction,Hepatic neoplasia,Gallbladder disease,Hypertension,Carbohydrate/lipid effects,Headache,Uterine bleeding,Ocular lesions,Depression
Cardiovascular disease risk: smoking, hypertension, diabetes, hyperlipidemia,Thromboembolic events: increased risk in surgery, postpartum, or immobilization,Liver disease: discontinue if jaundice develops,Gallbladder disease: increased risk,Glucose intolerance: monitor in diabetics,Blood pressure elevation: monitor periodically,Depression: discontinue if severe
Known or suspected pregnancy,Current or past thrombosis,Cerebrovascular or coronary artery disease,Valvular heart disease with complications,Severe hypertension,Diabetes with vascular involvement,Headaches with focal neurological symptoms,Major surgery with prolonged immobilization,Known or suspected breast cancer,Endometrial cancer or other estrogen-dependent neoplasia,Undiagnosed abnormal genital bleeding,Cholestatic jaundice of pregnancy or jaundice with prior pill use,Hepatic adenomas or carcinomas,Active liver disease,Known hypersensitivity to any component
Current or history of venous thromboembolism,Cerebrovascular or coronary artery disease,Uncontrolled hypertension,Diabetes with vascular involvement,Known or suspected pregnancy,Liver tumors or active liver disease,Undiagnosed abnormal uterine bleeding,Hypersensitivity to any component,Cigarette smoking in women over 35
No significant food interactions. Grapefruit juice has minimal effect on ethinyl estradiol; no restriction needed. Avoid excessive alcohol, which may impair adherence or increase liver enzymes. St. John's wort reduces contraceptive efficacy and should be avoided.
Grapefruit juice may increase ethinyl estradiol levels; avoid excessive consumption. No specific dietary restrictions; can be taken with or without food.
First trimester: Increased risk of neural tube defects, cardiovascular anomalies, and oral clefts (OR ~1.3-1.6). Second/third trimester: Androgenization of female fetus (clitoromegaly, labial fusion) due to progestin component; possible association with hypospadias in males with first-trimester exposure. Avoid use in pregnancy.
First trimester: No consistent evidence of major malformations, but a small increased risk of cardiovascular defects and oral clefts cannot be excluded. Second and third trimesters: Associated with adverse fetal outcomes including low birth weight, preterm delivery, and neonatal withdrawal symptoms. Avoid use during pregnancy due to known risks.
Excreted in breast milk; estimated infant dose <1% of maternal dose. M/P ratio not available for ethinyl estradiol/ethynodiol diacetate. May reduce milk production and quality. Use only if benefits outweigh risks; lowest effective dose recommended.
Small amounts of ethinyl estradiol and norethindrone transfer into breast milk, with a milk-to-plasma ratio approximately 0.2-0.3 for norethindrone and <0.1 for ethinyl estradiol. May reduce milk production and composition. Use caution and consider alternative contraception in nursing mothers.
Contraindicated in pregnancy; no dose adjustment applicable. If inadvertently used, discontinue immediately.
Contraindicated in pregnancy; no dose adjustment is applicable as the drug should be discontinued immediately upon confirmed pregnancy.
DEMULEN 1/35-28 (ethinyl estradiol 35 mcg + ethynodiol diacetate 1 mg) is a monophasic combined oral contraceptive. Its progestin has mild androgenic activity, which may be less favorable for acne-prone patients compared to third-generation pills. The 28-day pack includes 21 active pills and 7 inert pills. Counsel patients to take at the same time daily; missed pills increase breakthrough bleeding and pregnancy risk. It may be used off-label for cycle control in patients without contraindications.
Larin 1.5/30 is a monophasic combination oral contraceptive containing 1.5 mg norethindrone acetate and 30 mcg ethinyl estradiol. It is indicated for prevention of pregnancy and may also be used for management of acne and menstrual disorders. Advise patients to take at the same time daily to maintain consistent hormone levels. Counsel about breakthrough bleeding, especially during first cycles. Monitor for thrombotic events; use with caution in women with migraine with aura, hypertension, or smoking history over age 35. Effectiveness may be reduced with strong CYP3A4 inducers. Consider alternative contraception if patient is on chronic enzyme-inducing drugs. Use of NSAIDs can increase risk of breakthrough bleeding. Not recommended during breastfeeding or pregnancy.
Take one pill daily at the same time, preferably after dinner to reduce nausea.,If you miss one pill, take it as soon as remembered; if missed more than one, use backup contraception for 7 days.,Smoking increases risk of blood clots; especially dangerous if over 35 and smokes.,Some antibiotics (e.g., rifampin) and antiseizure medications may reduce effectiveness.,Report any signs of blood clot: sudden leg pain/swelling, chest pain, shortness of breath, or sudden severe headache.,Breakthrough bleeding is common in first 3 cycles; if persistent, contact your healthcare provider.,Do not use if pregnant; if pregnancy occurs, stop immediately.
Take one tablet at the same time each day, with or without food.,If you miss a dose, follow the instructions in the package insert; use backup contraception if needed.,Common side effects include nausea, breast tenderness, headache, and breakthrough bleeding, especially in the first few months.,Seek medical attention if you experience leg pain, chest pain, shortness of breath, severe headache, vision changes, or jaundice.,Do not smoke while taking this medication as it increases the risk of serious cardiovascular side effects.,Inform your healthcare provider of all medications you are taking, including over-the-counter drugs and supplements.,This medication does not protect against sexually transmitted infections; use condoms for STI prevention.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about DEMULEN 1/35-28 vs LARIN 1.5/30, answered by our medical review team.
DEMULEN 1/35-28 is a Combination Oral Contraceptive that works by Combination estrogen-progestin contraceptive; suppresses gonadotropin release, inhibiting ovulation; increases cervical mucus viscosity, impeding sperm penetration; alters endometrial receptivity.. LARIN 1.5/30 is a Combination Oral Contraceptive that works by Combination oral contraceptive: ethinyl estradiol suppresses FSH and LH, preventing ovulation; norethindrone induces endometrial changes and increases cervical mucus viscosity, impeding sperm penetration.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between DEMULEN 1/35-28 and LARIN 1.5/30 depend on the specific clinical indication. These are both Combination Oral Contraceptive agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of DEMULEN 1/35-28 is: One tablet (contains 1 mg ethynodiol diacetate and 35 mcg ethinyl estradiol) orally once daily at the same time each day for 21 days, followed by 7 days of placebo or no tablets.. The standard adult dose of LARIN 1.5/30 is: One tablet (norethindrone acetate 1.5 mg, ethinyl estradiol 30 mcg) orally once daily at the same time each day for 21 consecutive days, followed by 7 days of placebo tablets.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between DEMULEN 1/35-28 and LARIN 1.5/30 in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. DEMULEN 1/35-28 is classified as Category C. First trimester: Increased risk of neural tube defects, cardiovascular anomalies, and oral clefts (OR ~1.3-1.6). Second/third trimester: Androgenization of female fetus (clitoromeg. LARIN 1.5/30 is classified as Category C. First trimester: No consistent evidence of major malformations, but a small increased risk of cardiovascular defects and oral clefts cannot be excluded. Second and third trimesters. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.