Similar Products to Lo Loestrin Fe
Lo Loestrin Fe (norethindrone acetate 1 mg/ethinyl estradiol 10 mcg) is an ultra-low-dose combined oral contraceptive, and the most comparable alternatives are other low-dose ethinyl estradiol formulations containing norethindrone acetate, particularly Loestrin Fe 1/20 (norethindrone acetate 1 mg/ethinyl estradiol 20 mcg) and Loestrin 24 Fe, which share the same progestin component but with slightly higher estrogen doses. 1
Direct Alternatives with Same Progestin Component
Loestrin Fe 1/20 (norethindrone acetate 1 mg/ethinyl estradiol 20 mcg)
- Contains the identical progestin (norethindrone acetate 1 mg) but double the estrogen dose (20 mcg vs 10 mcg) 2, 1
- Demonstrated excellent cycle control and tolerability in clinical trials 2
- May be preferred if breakthrough bleeding occurs with ultra-low-dose formulations 1
Loestrin 24 Fe (norethindrone acetate 1 mg/ethinyl estradiol 20 mcg)
- Extended 24-day active hormone regimen (vs traditional 21-day) with same hormone composition as Loestrin Fe 1/20 1
- Associated with significantly fewer intracyclic bleeding days (0.95 vs 1.63 days) and fewer withdrawal bleeding days (2.66 vs 3.88 days) compared to 21-day regimens 1
- Cumulative pregnancy risk of 0.9% over six cycles, demonstrating excellent efficacy 1
Alternative Low-Dose Formulations with Different Progestins
Ortho Tri-Cyclen LO (norgestimate 180/215/250 mcg/ethinyl estradiol 25 mcg)
- Triphasic formulation with 25 mcg ethinyl estradiol throughout the cycle 2
- Demonstrated superior cycle control compared to Loestrin Fe 1/20, with significantly lower proportion of cycles with breakthrough bleeding/spotting 2
- Higher satisfaction rates (86% vs 81.1% at cycle 6) compared to Loestrin Fe 1/20 2
- Well-tolerated when switching from higher-dose (30-35 mcg) formulations 2
Other Low-Dose Options (20 mcg ethinyl estradiol range)
- The American Academy of Dermatology notes that formulations containing 20 mcg ethinyl estradiol represent the lower end of the typical range for combined oral contraceptives 3
- Lower estrogen doses are associated with reduced venous thromboembolism risk, with an odds ratio of 1.19 per 10 mcg increase in ethinyl estradiol 3
Clinical Considerations for Selection
Estrogen Dose and Side Effect Profile
- Lo Loestrin Fe's 10 mcg ethinyl estradiol dose is among the lowest available, which minimizes estrogen-related side effects 3
- The absolute VTE risk with combined oral contraceptives is 3-9 per 10,000 person-years versus 1-5 in non-users 3
- Lower estrogen formulations may be preferred for patients with hypertension or concerns about estrogen-related side effects 3
Breakthrough Bleeding Management
- Ultra-low-dose formulations (10 mcg) may have higher rates of breakthrough bleeding compared to 20-25 mcg formulations 2, 1
- Extended-cycle regimens (24-day active pills) reduce intracyclic bleeding compared to traditional 21-day regimens 1
- If breakthrough bleeding is problematic with Lo Loestrin Fe, stepping up to Loestrin Fe 1/20 or Loestrin 24 Fe maintains the same progestin while providing better cycle control 2, 1
Contraindications Apply to All Combined Hormonal Contraceptives
- All combined oral contraceptives are contraindicated in women with history of venous thromboembolism, uncontrolled hypertension, or migraine with aura 3
- The absolute VTE risk with any combined oral contraceptive remains lower than pregnancy-associated risk (5-20 per 10,000 person-years) 3
Alternative Delivery Systems (Non-Oral)
Contraceptive Patch
- Contains comparable ethinyl estradiol exposure but delivers 1.6 times higher estrogen levels than low-dose oral contraceptives 4
- Associated with slightly higher VTE risk and may cause skin irritation 4
- Efficacy slightly lower in women weighing >198 pounds 4