Indications  

Seasonique is a combination oral contraceptive (COC) indicated for use by women to prevent pregnancy.  

Seasonique is comprised of two female hormones, progestin (levonorgestrel) and estrogen (ethinyl estradiol). These hormones function by inhibiting ovulation, altering the uterine lining to prevent pregnancy development, and modifying cervical mucus to block sperm entry. 

Seasonique is a highly effective method of birth control; however, it does not provide protection against the transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), including acquired immunodeficiency syndrome (AIDS). 

Uses and Dosage 

Before taking Seasonique and every time you get a refill, carefully review its medication guide and patient information leaflet. Should you have any queries, seek advice from your doctor or pharmacist. 

Seasonique comes in extended-cycle tablet dispensers, each containing a 13-week supply of tablets: 84 active pills (estrogen/progestin) and 7 reminder pills (estrogen-only) 

This medication should be taken once daily as prescribed by the doctor at around the same time every day for 91 days.  

Start taking Seasonique on the first Sunday after your menstrual period starts. If your period begins on a Sunday, start taking this medication on that day. 

To maintain a regular cycle, the pills must be taken in a specific order. Trays 1 and 2 contain 28 pills each, while tray 3 has 35 pills, including the 7 reminder pills. Anticipate your period during the intake of reminder pills. 

After taking the last estrogen-only pill, begin a new pack the following day, regardless of whether you have your period. If you do not experience your period, consult your doctor. 

For first-time users of Seasonique, an additional non-hormonal form of birth control (like condoms or spermicide) is recommended for the initial 7 days to ensure pregnancy prevention until the medication becomes effective. However, if you begin taking the medication on the first day of your period, there is no need for backup birth control during the first week. 

For optimal contraceptive efficacy, take Seasonique exactly as directed without exceeding a 24-hour interval between doses. 

Do not skip any doses of this medication. Missing pills, starting a new pack late, or taking the pill at a different time than usual increases the likelihood of pregnancy. 

For guidance on managing missed doses, refer to the product information leaflet. It may also be necessary to use supplementary contraceptive methods, such as condoms or spermicide, to prevent pregnancy. 

Continue taking Seasonique daily, even if you experience spotting, bleeding, or stomach upset, and even if you believe pregnancy is unlikely. Do not discontinue intake without consulting your doctor. 

Side Effects 

Listed below are the potential adverse effects of Seasonique. Notify your doctor right away if any of them last or worsen. 

Common Side Effects 

• Nausea 
• Vomiting 
• Headache 
• Bloating 
• Breast tenderness 
• Swelling of the ankles or feet (fluid retention) 
• Weight change 
• Vaginal bleeding between periods (spotting), particularly in the initial months of medication use 

Serious Side Effects 

• Breast lumps 
• Mental/mood changes (e.g., new/worsening depression) 
• Severe stomach/abdominal pain 
• Unusual changes in vaginal bleeding (e.g., continuous spotting, sudden heavy bleeding, missed periods) 
• Dark urine 
• Yellowing of eyes/skin 

Inform your doctor right away if you encounter any of the serious side effects mentioned above. 

Rare but serious side effects of Seasonique may include blood clot-related issues (e.g., deep vein thrombosis, heart attack, pulmonary embolism, stroke). Seek immediate medical assistance if any of the following occur: 

• Chest, jaw, or left arm pain 
• Confusion 
• Sudden dizziness or fainting 
• Pain, swelling, or warmth in the groin/calf 
• Trouble speaking 
• Sudden shortness of breath or rapid breathing 
• Unusual headaches (including headaches with vision changes, lack of coordination, worsening of migraines, and sudden/very severe headaches) 
• Unusual sweating 
• Weakness on one side of the body 
• Vision problems/changes (such as double vision, partial/complete blindness) 

Allergic Reactions 

Although rare, a severe allergic reaction to Seasonique may occur. Seek immediate medical assistance if you encounter any signs of an allergic response, such as: 

• Rash 
• Itching or swelling (especially of the face/tongue/throat) 
• Severe dizziness 
• Trouble breathing  

Not all side effects of Seasonique are included in this list. Tell your doctor if any unlisted effects arise. 

Cautions 

Before taking Seasonique, inform your doctor if you have any known allergies, particularly to: 

• Ethinyl estradiol 
• Levonorgestrel 
• Other estrogens 
• Other progestins 
• Other medications 

Consult your pharmacist for more information about Seasonique, as it may contain inactive ingredients that may trigger allergic reactions or other complications. 

To ensure Seasonique is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Blood clots (in legs. Eyes, lungs) 
• Blood clotting disorders 
• High blood pressure 
• Abnormal breast exam 
• Cancer (endometrial or breast) 
• High cholesterol or triglyceride levels 
• Depression 
• Diabetes 
• Angioedema 
• Gallbladder problems 
• Severe headaches/migraines 
• Heart problems (valve disease, irregular heartbeat, previous heart attack) 
• Jaundice during pregnancy or while using hormonal birth control 
• Kidney disease 
• Liver disease (including tumors) 
• Stroke 
• Swelling (edema) 
• Thyroid problems 
• Unexplained vaginal bleeding 

Inform all your healthcare providers of any current or recently started or stopped medications, including prescription/nonprescription drugs, vitamins, and herbal supplements, to reduce the risk of drug interaction with Seasonique. 

Some of the products that may interact with Seasonique include: 

• Aromatase inhibitors like anastrozole and exemestane 
• Fezolinetant 
• Ospemifene 
• Tamoxifen 
• Tizanidine 
• Tranexamic acid 
• Certain combination products used to treat chronic hepatitis C (ombitasvir/paritaprevir/ritonavir with or without dasabuvir) 

The efficacy of Seasonique may be compromised by certain drugs that diminish the presence of birth control hormones in the body. This can heighten the likelihood of pregnancy. Examples of such medications include: 

• Griseofulvin 
• Modafinil 
• Rifamycins (such as rifampin and rifabutin)  
• Ritonavir  
• St. John’s wort  
• Antiepileptic drugs (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate) 
• HIV drugs (such as nelfinavir and nevirapine) 

Seasonique might affect specific lab tests, including blood clotting factors and thyroid function, leading to potential false test results. Inform lab personnel and all healthcare providers about your use of this medication. 

Vomiting or diarrhea may hinder the effectiveness of Seasonique. If these symptoms occur, consider using an additional contraceptive method, such as condoms or spermicide. 

Inform your doctor and pharmacist if you wear contact lenses. Should you experience any changes in vision or encounter difficulties wearing your lenses while using Seasonique, consult an eye doctor promptly. 

Notify your doctor about any recent surgical procedures, scheduled operations, and extended periods of immobilization (e.g., during long-haul flights). These conditions increase the risk of blood clot formation, particularly in conjunction with Seasonique. Temporary discontinuation of this medication or implementation of special measures may be required. 

Smoking significantly raises the likelihood of developing blood clots, stroke, or heart attack. Individuals who smoke and are 35 years old or older should refrain from using Seasonique. 

Patients with diabetes should monitor their blood sugar levels regularly while taking Seasonique and report any changes to their doctor. If symptoms of high blood sugar, such as increased thirst and urination, occur, immediate medical attention is advised. Adjustments to diabetes medication, exercise routine, or diet may be necessary. 

Seasonique can heighten the risk of blood clots, stroke, or heart attack, especially if you have high blood pressure, diabetes, high cholesterol, or are overweight. The highest risk occurs during the first year of taking Seasonique and when restarting it after a 4-week or longer break. 

Seasonique usage may lead to melasma, causing blotchy, dark areas on the face and skin. Sun exposure can exacerbate this condition. Minimize sun exposure, avoid tanning booths and sunlamps, and use sunscreen and protective clothing when outdoors. 

Notify your doctor if you experience any recent episodes of spotting or breakthrough bleeding, as these could indicate inadequate effectiveness of Seasonique. 

Pregnant individuals should refrain from using Seasonique. In the event of pregnancy or two consecutive missed menstrual periods, discontinue use and promptly inform your healthcare provider. Individuals who have recently given birth should wait at least 4 weeks before initiating Seasonique. 

Breastfeeding is not recommended during Seasonique intake, as the hormones present in it can be transferred to breast milk and potentially harm a nursing baby. This medication may also inhibit breast milk production.