Comparative Pharmacology
Head-to-head clinical analysis: LESSINA 21 versus NORTREL 0 5 35 21.
Head-to-head clinical analysis: LESSINA 21 versus NORTREL 0 5 35 21.
LESSINA-21 vs NORTREL 0.5/35-21
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Combination oral contraceptive containing ethinyl estradiol and levonorgestrel. Suppresses gonadotropin release (FSH, LH) from pituitary, inhibiting ovulation. Causes cervical mucus thickening and endometrial alterations, impeding sperm penetration and implantation.
Combination hormonal contraceptive containing norethindrone (a progestin) and ethinyl estradiol (an estrogen). Norethindrone inhibits ovulation by suppressing gonadotropin release (LH and FSH) and alters cervical mucus and endometrial receptivity. Ethinyl estradiol provides negative feedback on the hypothalamic-pituitary-ovarian axis, further suppressing ovulation.
One tablet (0.1 mg levonorgestrel, 0.02 mg ethinyl estradiol) orally once daily for 21 days, followed by 7 days placebo or no tablets.
1 tablet orally once daily for 21 days, followed by 7 days off. Each tablet contains 0.5 mg norethindrone and 35 mcg ethinyl estradiol.
None Documented
None Documented
17-21 hours (terminal elimination half-life; clinical significance: allows once-daily dosing, but missed doses increase risk of ovulation)
Norethindrone: terminal half-life approximately 7-8 hours. Ethinyl estradiol: terminal half-life approximately 13-27 hours, mean about 17 hours. Ethinyl estradiol exhibits a longer half-life due to enterohepatic recirculation and extensive tissue distribution.
Renal (70% as unchanged drug and metabolites), fecal (30% as metabolites)
Norethindrone is primarily excreted renally (approximately 60-80% as metabolites) and approximately 20-40% fecally. Ethinyl estradiol is excreted renally (about 40%) and fecally (about 60%) as glucuronide and sulfate conjugates.
Category C
Category C
Oral Contraceptive
Oral Contraceptive