Nextstellis (Estetrol Monohydrate And Drospirenone)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Nextstellis Used For?
Nextstellis is a combined oral contraceptive pill (often called ‘The Pill’) used by women to prevent pregnancy.
Primary Uses
Nextstellis is used by women to prevent pregnancy. It is a combined oral contraceptive pill containing both an estrogen and progestin.
How It Works
Nextstellis contains estetrol (E4) made from a plant source to match the naturally occurring estrogen in the body with selective activity, and drospirenone, a synthetic version of another naturally occurring female reproductive hormone.
Important: Nextstellis does not protect against HIV infections (AIDS) and other sexually transmitted infections.
How to Take Nextstellis
Take one tablet every day at the same time. Take the tablets in the order directed on the blister pack. Both the pink tablets and white tablets should be swallowed whole.
Dosage Instructions
Take one tablet daily at the same time. Follow the direction of the arrows on the blister pack until all tablets have been taken. Start the first tablet from the purple area on the blister pack corresponding to the day of the week. A period should begin 2-3 days after starting the white inactive tablets. Always start a new blister pack on the same day of the week as the previous pack.
What If You Miss a Dose?
If you miss one pink active tablet in Weeks 1, 2 or 3: Take it as soon as you remember and take the next tablet at your regular time (you may take two tablets in one day). Continue taking one tablet daily until you finish the pack. No backup contraception needed. If you miss two or more pink active tablets in week 1 or 2: Take the missed tablet as soon as possible and the current day’s tablet (two tablets in one day). Discard other missed tablets. Continue one tablet daily until pack is finished. Use non-hormonal backup contraception for the first seven days. If you miss two or more pink active tablets in week 3: Take one missed tablet as soon as possible and the current day’s tablet. Discard other missed tablets. Continue taking pink active tablets until all are used, then skip white inactive tablets and start a new pack.
Important: Do not skip your tablets, even if you do not have sex often. If you miss tablets (including starting the pack late) you could get pregnant. The more tablets you miss, the more likely you are to get pregnant.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Acne
- Headache
- Irregular vaginal bleeding (including absence of period)
- Pain and/or discomfort with your periods
- Weight gain
- Breast tenderness
- Decreased sex drive
- Nausea
- Mood changes
Seek immediate medical attention if you experience:
- Blood clots in the lungs, heart attack or stroke that may lead to death
- Blood clots in the legs or eyes
- Leg pain that will not go away
- Sudden severe shortness of breath
- Sudden change in vision or blindness
- Chest pain
- Sudden, severe headache unlike your usual headaches
- Weakness or numbness in your arm or leg
- Liver problems including rare liver tumours
- Jaundice (yellowing of your skin or eyes)
- High blood pressure
- Changes in blood sugar and fat levels
Important Warnings
There are several important conditions and situations where Nextstellis should not be used or requires careful medical supervision.
Who Should Not Take Nextstellis
Do not use if you: are allergic to E4, drospirenone or any ingredients; have or have had blood clots in arms, legs, lungs or eyes; have blood clotting problems; have certain heart valve problems or irregular heartbeat; had a stroke or heart attack; have uncontrolled high blood pressure; have diabetes with complications; have severe migraine headaches with aura; have liver problems including tumours; have adrenal gland problems; have unexplained vaginal bleeding; are pregnant; have or had breast cancer or hormone-sensitive cancers; have kidney disease or failure.
Medical Conditions to Discuss
Check with your doctor if you have: hereditary angioedema or other medical conditions; are scheduled for surgery (stop Nextstellis at least 4 weeks before major surgery); think you may be pregnant; are depressed or have been depressed; have yellowing of skin/eyes or itching related to bile flow problems; have gall bladder disease; have inflammatory bowel disease; multiple risk factors for blood clots including family history, age over 35, or smoking.
Pregnancy and Breastfeeding
Do not use if pregnant. Check with your doctor if you are pregnant or intend to become pregnant. Nextstellis may decrease the amount of breastmilk you make and a small amount of hormones may pass into breastmilk. Talk to your doctor about the best birth control method while breastfeeding.
Blood Clot Risk: You are more at risk of having a blood clot when you take the Pill, especially if you smoke or are obese. The risk increases if you smoke heavily (15+ cigarettes per day). You should stop smoking when taking the Pill.
Drug Interactions
Some medicines may interfere with Nextstellis and affect how it works. Nextstellis may also affect how other medicines work.
Grapefruit interaction: Grapefruit juice is listed as a CYP inhibitor that may interact with Nextstellis.
- CYP inducers (aprepitant, barbiturates, bosentan, carbamazepine, efavirenz, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, rifabutin, rufinamide, topiramate, St. John’s wort)
- Atorvastatin or rosuvastatin
- CYP inhibitors (azoles such as fluconazole, grapefruit juice)
- HIV/hepatitis C virus protease inhibitors and non-nucleoside reverse transcriptase inhibitors
- Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir or sofosbuvir/velpatasvir/voxilaprevir
- Lamotrigine
- ACE inhibitors
- Angiotensin-II receptor antagonists
- Potassium-sparing diuretics
- Potassium supplementation
- Heparin
- NSAIDs (ibuprofen, naproxen)
Alcohol & Driving
Nextstellis has specific guidelines regarding alcohol consumption and driving ability.
Alcohol
Drinking alcohol has no effect on Nextstellis.
Driving and Operating Machinery
Nextstellis has no influence on ability to drive or use machines.
Storage
Store below 30°C. Keep Nextstellis and all medicines out of the reach of children. If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Overdose Information
If you think you have used too much Nextstellis, you may need urgent medical attention. Immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
If you start taking Nextstellis on the first day of your period, it works immediately. If you start on any other day, use backup contraception (condoms) for the first 7 days until tablets have been taken for 7 days in a row.
The medication guide does not specify food requirements. Both pink and white tablets should be swallowed whole at the same time each day.
If you want to become pregnant, you may stop taking the Pill whenever you wish. Consider visiting your doctor for a pre-pregnancy check-up before stopping Nextstellis.
Yes, drinking alcohol has no effect on Nextstellis according to the medication information.
Weight gain is listed as one of the less serious side effects that may occur with Nextstellis.
If you have vomiting or diarrhea within 3-4 hours after taking your tablet, follow the instructions for missed doses. Diarrhea or certain medicines may make your tablets work less effectively.
Contact your doctor immediately if you experience symptoms of blood clots such as leg pain that won’t go away, sudden severe shortness of breath, sudden vision changes, chest pain, sudden severe headache, or weakness/numbness in arms or legs.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.