Comparative Pharmacology
Head-to-head clinical analysis: LESSINA 21 versus NORTREL 7 7 7.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LESSINA 21 versus NORTREL 7 7 7.
LESSINA-21 vs NORTREL 7/7/7
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 estrogen-progestin oral contraceptive. Suppresses gonadotropin release, inhibiting ovulation. Increases cervical mucus viscosity and alters endometrial receptivity.
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.
One tablet orally once daily, taken at the same time each day. Each tablet contains norethindrone 0.5 mg/ethinyl estradiol 35 mcg for days 1-7, norethindrone 0.75 mg/ethinyl estradiol 35 mcg for days 8-14, and norethindrone 1 mg/ethinyl estradiol 35 mcg for days 15-21, followed by 7 placebo tablets.
None Documented
None Documented
17-21 hours (terminal elimination half-life; clinical significance: allows once-daily dosing, but missed doses increase risk of ovulation)
Norelgestromin terminal half-life is approximately 28 hours; ethinyl estradiol terminal half-life is approximately 17 hours. The extended half-life supports once-weekly dosing.
Renal (70% as unchanged drug and metabolites), fecal (30% as metabolites)
Renal excretion of metabolites (primarily ethinyl estradiol and norelgestromin conjugates) accounts for approximately 50% of elimination; fecal/biliary excretion accounts for the remainder (about 35-40% fecal, 10-15% biliary).
Category C
Category C
Oral Contraceptive
Oral Contraceptive