Alesse is a trusted combination oral contraceptive pill designed to prevent pregnancy with a low-dose hormonal formulation. It contains a precise blend of ethinyl estradiol and levonorgestrel, working synergistically to inhibit ovulation, thicken cervical mucus, and alter the endometrial lining. This comprehensive approach offers reliable contraception while minimizing hormonal exposure. Approved for use by healthcare providers, Alesse is a well-established option for individuals seeking a reversible and convenient birth control method. Its balanced formulation has been widely studied and prescribed, making it a cornerstone in hormonal contraceptive management.

Features

• Contains 0.10 mg levonorgestrel and 0.02 mg ethinyl estradiol per active tablet
• 21-day active pill regimen followed by a 7-day placebo interval
• Monophasic formulation providing consistent hormone levels throughout the cycle
• Small, easy-to-swallow tablets with clear packaging for adherence
• Manufactured under strict pharmaceutical quality standards

Benefits

• Highly effective pregnancy prevention when taken as directed
• Lower estrogen content reduces the risk of estrogen-related side effects
• May result in lighter, less painful, and more regular menstrual cycles
• Non-contraceptive benefits such as potential improvement in acne
• Reversible fertility upon discontinuation, allowing future family planning
• Convenient monthly pack design supports consistent daily use

Common use

Alesse is primarily prescribed for the prevention of pregnancy in individuals of reproductive age. It may also be used off-label for the management of moderate acne in females at least 14 years old who have achieved menarche, desire contraception, have no contraindications to oral contraceptive therapy, and have failed topical acne treatments. Some healthcare providers may recommend it for menstrual cycle regulation in cases of dysfunctional uterine bleeding or dysmenorrhea, though these uses are secondary to its contraceptive indication.

Dosage and direction

Take one tablet daily by mouth at approximately the same time each day, with or without food. Begin the first pack on either the first day of menstruation (Day 1 start) or on the first Sunday after menstruation begins (Sunday start). For the 21-tablet pack, take active tablets for 21 consecutive days, followed by 7 tablet-free days, during which withdrawal bleeding typically occurs. For the 28-tablet pack, take active tablets for 21 days followed by 7 days of placebo tablets. Begin a new pack the day after finishing the previous pack, regardless of bleeding pattern. If vomiting or severe diarrhea occurs within 3-4 hours of taking a tablet, consider it a missed dose and follow the missed dose guidelines.

Precautions

Alesse does not protect against HIV infection or other sexually transmitted diseases. Smoking while using combination oral contraceptives significantly increases the risk of serious cardiovascular side effects, especially in women over 35 years old. The risk of cardiovascular events is increased in persons with hypertension, diabetes, hyperlipidemia, or obesity. Monitor blood pressure at routine examinations. May cause glucose intolerance—monitor glucose levels in diabetic patients. Carefully monitor patients with depression; discontinue if depression recurs or worsens. May cause retinal vascular thrombosis; discontinue if unexplained vision loss, proptosis, or diplopia occurs. Use with caution in patients with impaired liver function, as steroids may be poorly metabolized. May increase risk of gallbladder disease. May increase risk of benign hepatic adenomas and hepatocellular carcinoma. May lead to fluid retention; use with caution in patients with conditions that might be aggravated by fluid retention. Use with caution in patients with a history of cholestasis. Alesse may reduce milk production in breastfeeding persons; generally not recommended until breastfeeding is well-established.

Contraindications

• Thrombophlebitis or thromboembolic disorders
• History of deep vein thrombosis or pulmonary embolism
• Cerebrovascular or coronary artery disease
• Known or suspected carcinoma of the breast or other estrogen-dependent neoplasia
• Undiagnosed abnormal genital bleeding
• Known or suspected pregnancy
• Cholestatic jaundice of pregnancy or jaundice with prior pill use
• Hepatic adenomas or carcinomas, active liver disease
• Hypersensitivity to any component of Alesse
• Major surgery with prolonged immobilization
• Diabetes with vascular involvement
• Headaches with focal neurological symptoms
• Uncontrolled hypertension
• Valvular heart disease with complications
• Current or history of ischemic heart disease

Possible side effects

Common side effects (may affect up to 1 in 10 users):

• Nausea, vomiting, or abdominal cramping
• Breast tenderness or enlargement
• Breakthrough bleeding or spotting
• Changes in menstrual flow
• Headache or migraine
• Weight or appetite changes
• Mood changes, including depression
• Acne or skin changes
• Decreased libido
• Contact lens intolerance

Less common but serious side effects (seek immediate medical attention if experienced):

• Sharp chest pain, coughing blood, or sudden shortness of breath (possible pulmonary embolism)
• Pain in the calf or thigh (possible deep vein thrombosis)
• Crushing chest pain or heaviness (possible myocardial infarction)
• Sudden severe headache, vomiting, dizziness, or fainting (possible cerebrovascular events)
• Sudden partial or complete vision loss (possible retinal vascular thrombosis)
• Severe abdominal pain or tenderness (possible liver tumor or ectopic pregnancy)
• Jaundice (yellowing of skin or eyes) accompanied by fever, fatigue, or dark urine
• Severe depressive mood changes
• Breast lumps
• Severe allergic reactions characterized by rash, itching, or swelling

Drug interaction

Alesse may interact with various medications, potentially reducing contraceptive effectiveness or increasing side effects:

• Antibiotics (particularly rifampin, griseofulvin)
• Anticonvulsants (carbamazepine, phenytoin, phenobarbital, topiramate)
• Antifungals (griseofulvin)
• HIV medications (protease inhibitors, non-nucleoside reverse transcriptase inhibitors)
• St. John’s Wort
• Sevelamer
• Thyroid hormone replacements (may require dose adjustment)
• Cyclosporine, theophylline, corticosteroids (may increase their plasma concentrations)
• Angiotensin-converting enzyme inhibitors
• Potassium-sparing diuretics
• Nonsteroidal anti-inflammatory drugs
• Vitamin C (may increase ethinyl estradiol levels)
• Alcohol (may increase estrogen levels)

Consult healthcare provider about all medications, including over-the-counter drugs and herbal supplements, before starting Alesse.

Missed dose

If one active tablet is missed (24-48 hours late): Take the missed tablet as soon as remembered, and take the next tablet at the regular time. This may mean taking two tablets in one day. Continue the remaining tablets at the usual time. No additional contraceptive protection is needed.

If two active tablets are missed in weeks 1 or 2: Take two tablets on the day remembered and two tablets the next day. Then resume one tablet daily. Use backup contraception (such as condoms) for 7 days.

If two active tablets are missed in week 3, OR three or more active tablets are missed at any time: Discard the current pack and start a new pack the same day. Use backup contraception for 7 days. If missed tablets occurred in the third week and no withdrawal bleed occurs, consider the possibility of pregnancy.

For the 28-day pack: If placebo tablets are missed, discard them and continue taking one placebo daily until the pack is finished. No additional protection is needed.

Overdose

Serious ill effects have not been reported following acute overdose of oral contraceptives. Overdosage may cause nausea, vomiting, and withdrawal bleeding in females. In case of overdose, contact a poison control center or seek medical attention. Treatment should be symptomatic and supportive. There is no specific antidote.

Storage

Store at room temperature (20-25°C or 68-77°F), with excursions permitted between 15-30°C (59-86°F). Protect from light and moisture. Keep in the original container. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused medication after expiration or treatment completion.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The content provided here is not exhaustive and may not include all possible information about this medication. Individual responses to medication may vary. Only a healthcare provider can determine if this medication is appropriate for your specific medical situation. Never disregard professional medical advice or delay seeking it because of something you have read here.

Reviews

Clinical studies and patient reports indicate generally positive experiences with Alesse when prescribed appropriately. Many users report satisfactory contraceptive efficacy with manageable side effects. The low-dose formulation is often appreciated for causing fewer estrogen-related side effects compared to higher-dose alternatives. Some users report improvement in menstrual-related symptoms including reduced dysmenorrhea and more predictable cycles. A minority of users report side effects such as mood changes, breakthrough bleeding (especially during the first few cycles), or decreased libido. Overall satisfaction often correlates with proper patient selection, thorough education about potential side effects, and appropriate management of expectations. Individual experiences vary significantly, emphasizing the importance of personalized medical guidance.