Standard Pack Size for Levonorgestrel-Ethinyl Estradiol Combination Pills
Standard pill packs contain 28 pills total, consisting of 21 to 24 hormone-containing tablets plus 4 to 7 placebo (hormone-free) pills. 1
Pack Configuration Details
The specific levonorgestrel 0.15mg/ethinyl estradiol 0.03mg formulation you're asking about is a monophasic combined oral contraceptive (COC) that follows the standard 28-day pack structure 1:
- 21 active hormone tablets containing levonorgestrel 0.15mg (150 micrograms) and ethinyl estradiol 0.03mg (30 micrograms) 1
- 7 placebo tablets for the hormone-free interval 1
Clinical Context
This monophasic formulation (where each active tablet contains the same hormone dose) is commonly recommended as a starting option for adolescents and women seeking contraception 1. The 30 microgram ethinyl estradiol dose with levonorgestrel is specifically mentioned as a preferred initial choice by many adolescent medicine providers 1.
Important Prescribing Considerations
- The 7-day hormone-free interval (placebo week) is when withdrawal bleeding typically occurs 1
- For patients with conditions like severe dysmenorrhea, endometriosis, or bleeding disorders, extended-cycle regimens that minimize or eliminate the placebo interval may be more appropriate 1
- Shorter placebo intervals optimize ovarian suppression and may improve contraceptive effectiveness, particularly in patients who frequently miss pills 1