A Framework for Fitness-for-Purpose and Reuse in Computational Phenotyping
November 17, 2025
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Brand Name :
Twirla
Synonyms :
ethinyl estradiol/levonorgestrel transdermal
Class :
Contraceptives, Transdermal
Brand Name :
Twirla
Synonyms :
ethinyl estradiol/levonorgestrel transdermal
Class :
Contraceptives, Transdermal
Dosage Forms & StrengthsÂ
Transdermal patchÂ
(30mcg/120mcg)/dayÂ
(ethinyl estradiol/levonorgestrel)/dayÂ
Cycle of 28 days:
Apply one new transdermal system (TDS) and worn for one week for three consecutive weeks
No new transdermal system is worn during week 4 when withdrawal bleeding is expected
Each new new transdermal system should be applied on the same day of the week
When week 4 ends then a new 28-day cycle is started by applying a new TDS
Under no situations should there be more than one week TDS-free interval between dosing cycles
If there are more than one week of TDS-free then women are not protected from nonhormonal back-up contraception and pregnancy, it must be used for one week
Dosing Considerations
Consider the drug’s decreased its effectiveness in women with a body mass index of ≥25 to <30 kg/m2
Dosage Forms & StrengthsÂ
Transdermal patchÂ
(30mcg/120mcg)/dayÂ
(ethinyl estradiol/levonorgestrel)/dayÂ
Cycle of 28 days:
Apply one new transdermal system (TDS) and worn for one week for three consecutive weeks
No new transdermal system is worn during week 4 when withdrawal bleeding is expected
Each new new transdermal system should be applied on the same day of the week
When week 4 ends then a new 28-day cycle is started by applying a new TDS
Under no situations should there be more than one week TDS-free interval between dosing cycles
If there are more than one week of TDS-free then women are not protected from nonhormonal back-up contraception and pregnancy, it must be used for one week
Dosing Considerations
Consider the drug’s decreased its effectiveness in women with a body mass index of ≥25 to <30 kg/m2
Refer to adult dosingÂ
Actions and SpectrumÂ
ethinyl estradiol/levonorgestrel transdermal work together to prevent pregnancy by primarily inhibiting ovulation, which is the release of eggs from the ovaries. They thicken the cervical mucus, making it more difficult for sperm to reach the egg.
Frequency defined Â
<1%Â
AppendicitisÂ
PneumoniaÂ
GastroenteritisÂ
Ectopic pregnancyÂ
CholelithiasisÂ
Suicidal ideationÂ
Major depressionÂ
CholecystitisÂ
1-10%Â
Dysmenorrhea (2.3%)Â
Increased weight (2%)Â
Nausea (4.1%)Â
Headache (3.6%)Â
Application site disorder (6.2%)Â
Black Box WarningÂ
Cigarette smoking will raise the threat of great cardiovascular occasions from blended hormonal contraceptive (CHC) use. Â
This threat will increase with age, in girls aged ≥35 year, and with the wide variety of cigarettes smoked.Â
Contraindication/Caution:Â
Contraindication:Â
Caution:Â
Pregnancy consideration:Â
Pregnancy category: N/AÂ
Lactation: Contraceptive hormones are present in human milkÂ
Pregnancy Categories:        Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.Â
Category N: There is no data available for the drug under this category.Â
Pharmacology Â
ethinyl estradiol/levonorgestrel transdermal changes cervical mucus consistency, making it thicker and less permeable to sperm, reducing their ability to reach and fertilize an egg. Â
PharmacodynamicsÂ
ethinyl estradiol/levonorgestrel transdermal inhibits the secretion of gonadotropins from the pituitary gland, which leads to the suppression of ovulation.Â
PharmacokineticsÂ
Absorption  Â
ethinyl estradiol/levonorgestrel transdermal both absorbed through the skin.Â
DistributionÂ
ethinyl estradiol/levonorgestrel transdermal distributes throughout body, reaching its target tissues.Â
MetabolismÂ
ethinyl estradiol/levonorgestrel transdermal undergo extensive hepatic metabolism.Â
Elimination and excretionÂ
ethinyl estradiol/levonorgestrel transdermal both are primarily excreted in the urine.
AdministrationÂ
ethinyl estradiol/levonorgestrel transdermal is available in combination hormonal contraceptive patch and is administered via skin.
Patient information leafletÂ
Generic Name: ethinyl estradiol/levonorgestrel transdermalÂ
Why do we use ethinyl estradiol/ levonorgestrel transdermal?Â
ethinyl estradiol/levonorgestrel transdermal may help alleviate symptoms associated with premenstrual syndrome (PMS), such as bloating and breast tenderness.  ethinyl estradiol/levonorgestrel transdermal drug is primarily used for contraception i.e., used to prevent pregnancy.
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