Nextstellis (drospirenone/estetrol)

Nextstellis generic

Nextstellis is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics typically cost less than brand-name drugs.

Nextstellis uses

The Food and Drug Administration (FDA) approves prescription drugs such as Nextstellis for certain uses.

Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Nextstellis for birth control

Nextstellis is approved to help prevent pregnancy in females who can become pregnant. Females may be able to become pregnant after their first period. This often happens around 12 years of age.

Nextstellis may not be as effective in females with a body mass index (BMI) of 30 or more. (BMI is a measure of body size based on height and weight.) If your BMI is 30 or higher, talk with your doctor. They can recommend other birth control options that may be more effective in helping to prevent pregnancy.

Nextstellis and children

Nextstellis is approved to help prevent pregnancyin females of any age who can become pregnant. Females may be able to become pregnant after their first period. This often happens around 12 years of age.

Doctors may prescribe Nextstellis to help prevent pregnancy in adolescents.

Nextstellis side effects

Nextstellis can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Nextstellis. These lists do not include all possible side effects.

For more information about the possible side effects of Nextstellis, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Nextstellis, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Nextstellis. To learn about other mild side effects, talk with your doctor or pharmacist or view the Nextstellis prescribing information.

Mild side effects of Nextstellis can include:

• acne
• breast-related side effects, including breast pain, swelling, or discomfort
• headache
• irregular vaginal bleeding, including stopped periods and spotting between periods
• low libido
• mood changes, such as feeling more agitated, anxious, or nervous
• pain during your period, including pelvic pain and menstrual cramps
• weight gain
• mild allergic reaction*

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Nextstellis, see “Allergic reaction” below.

Serious side effects

Serious side effects from Nextstellis aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• High blood pressure, which typically doesn’t cause symptoms unless it’s severely high. Symptoms of severely high blood pressure can include:
  • chest pain
  • headache
  • nosebleeds
• Migraine episodes. Symptoms can include:
  • nausea
  • sensitivity to light
  • headache
• High blood potassium level. Symptoms can include:
  • nausea and vomiting
  • shortness of breath
  • heart palpitations
• Depression. Symptoms can include:
  • loss of interest in hobbies or activities
  • changes in weight or appetite
  • fatigue
• High levels of liver enzymes, which may be a sign of liver damage. Symptoms can include:
  • nausea and vomiting
  • upper-right abdominal pain
  • jaundice
• Risk of serious cardiovascular events with cigarette smoking.*
• Severe allergic reaction.†

* Nextstellis has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Nextstellis precautions” section below.
† For details about allergic reaction and Nextstellis, see “Allergic reaction” below.

ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after taking Nextstellis. This side effect wasn’t reported in clinical trials of this drug but can still occur.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Nextstellis, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Common questions about Nextstellis

Here are answers to some frequently asked questions about Nextstellis.

Can Nextstellis be prescribed for endometriosis or acne?

Possibly, but these uses for Nextstellis aren’t approved by the Food and Drug Administration (FDA).

Instead, doctors may prescribe Nextstellis off-label for endometriosis or acne. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

If you’re interested in taking Nextstellis for endometriosis or acne, talk with your doctor. They’ll explain treatment options for these conditions and recommend the right one for you.

Does Nextstellis cause weight loss?

No, it isn’t likely. Weight loss wasn’t reported as a side effect in clinical trials of Nextstellis. However, weight gain was reported in the drug’s trials.

If you have concerns about unintentional weight loss while taking Nextstellis, talk with your doctor or pharmacist.

How does Nextstellis work?

Nextstellis works by helping to prevent ovulation, which is the release of an egg from an ovary. When ovulation doesn’t occur, there is no egg available for sperm to fertilize. In this way, Nextstellis helps prevent pregnancy.

If you have other questions about how Nextstellis works, talk with your doctor or pharmacist.

Similar drugs

Other drugs are available that can help prevent pregnancy. Some may be a better fit for you than others. If you’re interested in finding an alternative to Nextstellis, talk with your doctor. They can tell you about other medications that may work well for you.

The following drugs are similar to Nextstellis:

• drospirenone/ethinyl estradiol (Yaz, Yasmin, others)
• norethindrone acetate/ethinyl estradiol/ferrous fumarate (Lo Loestrin Fe, Junel Fe, others)
• norgestimate/ethinyl estradiol (Previfem, Sprintec, others)

Nextstellis cost

As with all medications, the cost of Nextstellis can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons. You can visit Optum Perks* for price estimates of Nextstellis. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance. If you need financial support to pay for Nextstellis, or if you need help understanding your insurance coverage, help is available.

A savings card is available for Nextstellis. For more information and to find out whether you’re eligible for support, visit the manufacturer’s website.

To learn more about saving money on prescriptions, check out this article.

Generic version. Nextstellis is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

* Optum Perks is a sister site of Medical News Today.

Things to consider when taking Nextstellis

If you can become pregnant, consider the following information about pregnancy and breastfeeding.

Nextstellis and pregnancy

Nextstellis is prescribed for pregnancy prevention. The drug should not be taken during pregnancy.

If you think you’ve become pregnant while taking Nextstellis, talk with your doctor right away. They’ll likely order a pregnancy test. If the test shows you’re pregnant, your doctor can recommend whether it’s safe to continue the pregnancy.

Nextstellis and breastfeeding

In general, Nextstellis is considered safe to take while breastfeeding. However, the drug may reduce the amount of breast milk your body makes.

For this reason, it’s important to talk with your doctor before taking Nextstellis while breastfeeding. They can recommend other birth control options that are less likely to affect breastfeeding. Or, they can suggest other ways to feed your child while taking Nextstellis.

Nextstellis dosage

The following information describes dosages that are commonly prescribed or recommended. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Nextstellis comes as an oral tablet. It comes in a blister pack, with the following strengths in each pack:

• 24 pink tablets containing these active ingredients:
  • 3 milligrams (mg) of drospirenone (a type of progestin hormone)
  • 14.2 mg of estetrol (a type of estrogen hormone)
• 4 white tablets containing inactive ingredients*

* Tablets with inactive ingredients are taken so that you have a period. This helps confirm that the drug is working for pregnancy prevention. It also helps to keep you in the habit of taking doses.

Dosage for pregnancy prevention

The recommended dosage of Nextstellis is one tablet per day. You should take the tablet around the same time every day in the order provided on the blister pack labeling.

Children’s dosage

Nextstellis is approved to help prevent pregnancy in females* of any age who can become pregnant. Females may be able to become pregnant after their first period, which often happens around 12 years of age.

The recommended dosage of Nextstellis is one tablet per day. It should be taken at the same time every day in the order provided on the blister pack labeling.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

About taking Nextstellis

Below you’ll find information about key dosage issues.

When to take. You should take Nextstellis once per day, at any time of day. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Nextstellis work effectively.

When you’ll start taking Nextstellis depends on certain factors. These include whether you’ve recently:

• had an abortion or experienced pregnancy loss
• given birth
• started your period
• taken a different hormonal birth control

In general, you can start taking Nextstellis on or after the first day of your period. Your doctor will recommend the best time to start taking Nextstellis.

To learn more bout when to take Nextstellis, view the drug’s prescribing information. You can also visit the manufacturer’s website.

If you miss a dose. What you’ll do about a missed dose of Nextstellis depends on certain factors. These include whether you’ve missed a pink (active) tablet or a white (inactive) tablet and how many doses you’ve missed.

Below are instructions for missed doses of Nextstellis:

• If you miss one pink tablet at any time during treatment. Take your missed dose as soon as you remember, then take your next dose at the regular time. You may need to take two doses in one day. Continue taking one tablet per day until you finish the blister pack.
• If you miss two or more pink tablets during the first or second week of treatment. Take one missed dose as soon as you remember, then take another dose at the regular time. This could mean taking two doses in one day. Discard the other doses you’ve missed and continue taking one tablet per day until you finish the blister pack.*
• If you miss two pink tablets in the third week of treatment. Take one missed dose as soon as you remember, then take another dose at the regular time. This could mean taking two doses in one day. Discard the other doses you’ve missed and continue taking one tablet per day until you finish the blister pack. Then discard the white tablets from your current blister pack and start taking one pink tablet per day from a new blister pack.*
• If you miss one or more white tablets in the fourth week of treatment. Skip the missed dose and take one tablet per day until you finish the blister pack.

If you have questions about what to do if you miss a dose of Nextstellis, talk with your doctor or pharmacist.

* Be sure to use a hormone-free method of birth control (such as condoms) during sexual activity for at least 7 days after taking your missed tablets. Using another method will help prevent pregnancy during this time.

Taking Nextstellis with food. You can take Nextstellis with food or without it.

Crushing, splitting, or chewing Nextstellis. The manufacturer of Nextstellis hasn’t stated whether the tablets can be crushed, split, or chewed. If you have difficulty swallowing tablets, talk with your doctor or pharmacist. You can also read suggestions for swallowing tablets in this article.

Length of use. Nextstellis can be taken as a long-term option for pregnancy prevention. If you and your doctor determine that Nextstellis is safe and effective for you, you may take it long term.

Overdose

Taking more than the recommended dose of Nextstellis can lead to serious side effects. Do not take more Nextstellis than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

• nausea and vomiting
• severe headache
• irregular vaginal bleeding
• blood clots

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.

Nextstellis interactions

Nextstellis can interact with several other medications and certain supplements.

Before taking Nextstellis, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Interactions with medications, foods, and supplements

Below is a list of medications and supplements that can interact with Nextstellis. This list does not contain all drugs that may interact with Nextstellis. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Alcohol interaction

Alcohol is not known to interact with Nextstellis. It’s likely safe to consume alcohol while taking Nextstellis. If you have questions about how much alcohol is safe to drink while taking Nextstellis, talk with your doctor or pharmacist.