From the Guidelines
To write a 90-day supply for birth control, prescribe three packs or cycles of the chosen contraceptive with refills as appropriate, such as "Ortho-Cyclen 28-day pack, Dispense: 3 packs, Refills: 3" on the prescription, as recommended by the CDC 1. When writing the prescription, include clear instructions such as "Take one tablet by mouth daily" and specify if the medication should be taken at the same time each day. For non-oral methods like patches or rings, adjust the quantity accordingly (e.g., 9 patches for Xulane or 3 rings for NuvaRing) 1. A 90-day supply is beneficial as it reduces pharmacy visits, improves adherence, and minimizes the risk of missed pills, ultimately reducing morbidity and mortality related to unplanned pregnancies and improving quality of life for patients. Many insurance plans now cover 90-day supplies of contraceptives, though it's advisable to verify coverage beforehand 1. For new users, consider starting with a 1-month supply to assess tolerability before prescribing a 90-day supply, taking into account the patient's medical history and potential contraindications for certain contraceptive methods 1. Some key points to consider when prescribing contraceptives include:
- Medical history, including menstrual history and any chronic diseases
- Contraindications for certain methods, such as smoking or a history of blood clots
- Potential drug interactions that may affect the efficacy of the contraceptive method
- The importance of backup methods, such as condoms, in case of missed pills or other failures
- The availability of emergency contraception in case of unprotected intercourse.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Writing a 90-Day Supply for Birth Control
To write a 90-day supply for birth control, the following points should be considered:
- The type of birth control: combined oral contraceptives (COCs) are a common form of birth control that contain both estrogen and progestin 2, 3, 4.
- The dosage and regimen: different COCs have varying dosages and regimens, such as 24/4,84/7, or continuous cycles 5.
- The active ingredients: common active ingredients in COCs include ethinyl estradiol, drospirenone, and levonorgestrel 2, 3, 5, 6.
- The patient's medical history and needs: certain COCs may be more suitable for patients with specific medical conditions or concerns, such as high cholesterol or breast tenderness 4.
Key Considerations
Some key considerations when writing a 90-day supply for birth control include:
- Efficacy: COCs are highly effective in preventing pregnancy when taken correctly 2, 3, 5.
- Safety: COCs are generally well-tolerated, but may have side effects such as nausea, intermenstrual bleeding, and breast pain 3, 6.
- Patient satisfaction: COCs can improve patient satisfaction by reducing symptoms such as premenstrual dysphoric disorder (PMDD) and improving cycle control 3, 4.
- Regimen: the regimen of the COC, including the number of active pills and placebo pills, can affect the patient's experience and adherence to the medication 5.