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Generic name: ethinyl estradiol and levonorgestrel [ETH-in-ill-ess-tra-DYE-ol-and-LEE-vo-nor-JESS-trel]
Brand names: Afirmelle, Altavera, Amethyst, Aubra, Aubra EQ,… show all 28 brands
Drug class: contraceptives

What is Ayuna?

Ayuna can be used to stop pregnancy. Ayuna is available in many different brands and types. This leaflet does not list all Ayuna brands.Ayuna can be used in other ways not mentioned in the medication guide.

Side effects of Ayuna

If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: difficulty breathing, hives, swelling in your lips, face, throat, or tongue.

Some birth control pills can cause severe side effects. Call your doctor immediately if:

  • Signs of a Stroke: sudden numbness, weakness, or slurred words (especially one-sided), severe headache;
  • Signs of blood clots: sudden vision loss; chest pain that stabs; shortness of breath; blood in the cough; swelling of an arm or leg.
  • Heart attack symptoms: chest pain, pressure or pain in your shoulder or jaw, sweating.
  • If you have liver disease, look for symptoms such as fatigue, nausea, dark urine or stools with a clay color, fever, and jaundice.
  • Increased blood pressure: severe headaches, blurred or distorted vision, and pounding of the neck, ears, or head;
  • Gallbladder problem:chalky-colored stools, stomach pain after eating, nausea, heartburn, bloating, and severe upper stomach pain that may spread to your back;
  • You may experience swelling of your ankles, feet, hands, or fingers.
  • Changes in migraine headaches' pattern or severity;
  • A breast lump,
  • Symptoms of depression include sleep problems, fatigue, feeling weak, and changes in mood.

Ayuna can cause the following side effects:

  • You may experience nausea or vomiting, especially when taking the medicine for the first time.
  • Breast tenderness
  • Bleeding
  • Acne is a darkening or discoloration of the facial skin.
  • Weight gain or weight loss
  • Contact lenses are causing problems.

There may be other side effects. For medical advice on side effects, call your doctor. Report side effects by calling the FDA at 1-800-FDA-1088.


Avoid using birth control pills while pregnant or after having a recent baby.Birth control pills should be avoided if: you are suffering from uncontrolled hypertension, cardiovascular disease, circulatory problems, undiagnosed bleeding in the vaginal area, liver disease (especially when you suffer from diabetes), severe headaches or migraines, you take certain hepatitis C medications, you plan to have a major operation, you smoke, you're over 35 and you had a previous heart attack or stroke, a blood clot or jaundice due to pregnancy, birth control pills, or cancers of the uterus or cerevixPill birth control can raise your chances of a stroke or heart attack.If you are older than 35 and smoke, Ayuna should be avoided.

Before you take this drug

This medicine increases your risk of blood clots and stroke. If you suffer from high blood pressure, diabetes, high cholesterol, or are overweight, you're at even greater risk. The risk of a stroke or blood clot increases during the first year you take birth control pills. You are at high risk if you start taking this medication again after a break of 4 weeks.The older you get, the greater your chance of having a stroke or heart attack. This risk is increased by the amount you smoke. If you are older than 35 and smoke, it is not recommended that you take combination birth-control pills.Avoid using it if pregnant. Tell your doctor immediately if you are pregnant or have missed more than two periods. Wait at least four weeks after giving birth to take birth control pills.

If you are pregnant, or if:

  • Untreated high blood pressure or hypertension
  • Heart disease (chest discomfort, coronary artery diseases, history of stroke, or blood clots);
  • An increased risk for blood clots as a result of a blood disorder or heart disease;
  • Circulatory problems, especially if they are caused by diabetes
  • A history of cancers of the breast, uterus, or cervix, or of vaginal or ovarian origin;
  • Unusual vaginal bleeding not checked by your doctor
  • Liver disease, or cancer of the liver;
  • Severe migraine headaches, especially in older people over 35.
  • A history of jaundice due to pregnancy or birth-control pills
  • If you take any hepatitis C medication containing ombitasvir, paritaprevir, or ritonavir (Technivie).

If you've ever:

  • If you have heart disease, blood pressure problems, or are susceptible to blood clots, then this is the right product for you.
  • If you have high triglycerides or cholesterol or are overweight,
  • Depression;
  • A seizure or migraine headache;
  • Gallbladder Disease
  • Liver or kidney disease
  • Menstrual irregularities;
  • Fibrocystic Breast Disease lumps, nodules, or abnormal mammograms

Ayuna may slow down the production of breast milk. Breastfeeding is not recommended while taking this medication.

How to take Ayuna?

Read all the instructions or guides that come with your medication and follow all the directions. Be sure to follow all instructions listed on your prescription label.You can take your first tablet on the day you start your period or on the Sunday following the beginning of your cycle. When you start taking Ayuna, it may be necessary to have a backup birth control method, like a condom or spermicide. You should follow your doctor's advice.One pill per day is recommended, but no more than one every 24 hours. Start a fresh pack of pills the next day when the old ones run out. If you don't take a pill every day, it is possible to become pregnant. Refill your prescription before the pills run out.Some birth control packages contain seven reminder pills that help you maintain your cycle. Usually, your period begins while you're using the reminder pills.The chewable pill (tablet) should be chewed and swallowed with water. If you wish, you can swallow the tablet whole. It is best to take it with an empty stomach.If you have severe nausea or diarrhea, use backup birth control.You might experience bleeding during your first three months. If the bleeding persists or becomes very heavy, tell your doctor.You may have to temporarily stop taking this medication if you are going through major surgery or a long period of bedrest. You should let any doctor who treats you know that you use birth control pills.You will have to see your doctor frequently if you are taking birth-control pills.Keep away from heat, moisture, and light.

What happens if I miss the dose?

Please read the instructions that come with your medication. You are more likely to become pregnant if you miss a pill.Take two active pills the next day if you forget. Take one pill a day until the remainder of the package is used.Take two pills a day for the next two consecutive days if you missed two active pills back to back in Week 1. Take one pill a day until the end of your pack. After missing a pill, use a backup birth control method for 7 days.You can start fresh the next day if your Day 1 starter pack is empty. You can continue taking the pill until Sunday if you started on Sunday. Throw out the remaining pills on Sunday and begin a brand new package that same day.You can start over if you missed three pills consecutively in the first, second, or third week. You can continue to take a tablet every day up until Sunday if you started on Sunday. Throw out the remaining pills on Sunday and begin a brand new package that same day.You may miss your period if you don't take two active pills or more. Call your doctor if you have missed two periods in a month. You might be pregnant.You can throw away the missed pill and continue taking one pill per day until you finish your pack.

What happens if I overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. Symptoms of an overdose include nausea, vomiting, and drowsiness.

Avoid this

Don't smoke when taking birth-control pills, particularly if you are more than 35 years old.The birth control pill will not protect you from sexually transmitted diseases, including HIV or AIDS. The only way to prevent these diseases is by using a condom.

Interaction with other drug

Other medications, such as prescription drugs, over-the-counter products, herbal products, and vitamins, may also interact with birth-control pills. Birth control pills can be less effective if you take certain drugs. This may lead to pregnancy. Inform your doctor of all the medications you are taking and those that you stop or start using.