What is the difference between Jolessa (levonorgestrel and ethinyl estradiol) and Simpesse?

Comparison of Jolessa and Simpesse Oral Contraceptives

Jolessa and Simpesse are essentially the same medication - both are extended-cycle oral contraceptives containing levonorgestrel and ethinyl estradiol with identical formulations, efficacy, and safety profiles.

Composition and Formulation

Both Jolessa and Simpesse:

• Contain the same active ingredients: levonorgestrel (progestin) and ethinyl estradiol (estrogen)
• Use the same dosage: typically 30 μg ethinyl estradiol and 150 μg levonorgestrel
• Are extended-cycle oral contraceptives designed for continuous use with fewer hormone-free intervals
• Provide 84 active pills followed by 7 inactive pills in a 91-day cycle 1
• Result in only 4 menstrual periods per year instead of the traditional 13

Efficacy and Mechanism of Action

Both medications work through the same mechanisms:

• Primary action: inhibition of ovulation
• Secondary actions: thickening cervical mucus and thinning the endometrial lining
• Pearl Index (pregnancy rate): approximately 1-2% with perfect use 2, 3
• Typical use failure rates: 5-8% (comparable to other combined hormonal contraceptives) 1

Benefits Beyond Contraception

Both medications offer identical non-contraceptive benefits:

• Decreased menstrual bleeding and cramping
• Reduced frequency of menstrual periods (only 4 per year)
• Improvement in conditions exacerbated by menstruation such as:
  • Anemia
  • Severe dysmenorrhea
  • Endometriosis
  • Abnormal uterine bleeding
  • Bleeding disorders
  • Migraines without aura
  • Certain psychiatric symptoms 4

Side Effects and Risks

Both medications share the same potential side effects:

• Breakthrough bleeding (most common in first few cycles)
• Headache
• Nausea
• Breast tenderness
• Potential increased risk of venous thromboembolism (similar to other combined hormonal contraceptives)
• Contraindicated in women with history of VTE, stroke, coronary artery disease, migraine with aura, uncontrolled hypertension, or smokers ≥35 years 1

Practical Considerations

For both medications:

• Start on the first day of menstruation or use the "Quick Start" method with backup contraception for 7 days
• Take one pill daily at approximately the same time
• Missed pill instructions are identical:
  • <24 hours late: Take immediately and continue normal schedule
  • 24-48 hours late: Take most recent missed pill, continue normal schedule, use backup method for 7 days

  • 48 hours late: Take most recent missed pill, continue normal schedule, use backup method for 7 days, consider emergency contraception if unprotected intercourse occurred 4

Drug Interactions

Both medications have reduced efficacy when taken with:

• Certain anticonvulsants (phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine)
• Rifampin or rifabutin
• St. John's wort 4, 1

Clinical Implications

The choice between Jolessa and Simpesse should be based on:

• Insurance coverage and cost differences
• Pharmacy availability
• Patient preference regarding packaging or brand

Conclusion

From a clinical perspective, there are no meaningful differences between Jolessa and Simpesse in terms of efficacy, safety, side effects, or contraindications. They are essentially the same medication marketed under different brand names.