Nextstellis (drospirenone/estetrol) is a brand-name drug that’s prescribed for the prevention of pregnancy. Nextstellis comes as an oral tablet that’s typically taken once per day.

Nextstellis belongs to a drug class called combination hormonal contraceptives. Nextstellis is not available in a generic version. 

Keep reading for specific information about the dosage of Nextstellis, including its strength and how to take the medication. For a comprehensive look at Nextstellis, see this article.

Note: This article describes typical dosages for Nextstellis provided by the drug’s manufacturer. When taking Nextstellis, always follow the dosage prescribed by your doctor.

Nextstellis dosage

Below is information about Nextstellis’s form, strength, and dosage.

Nextstellis form

Nextstellis comes as an oral tablet.

Nextstellis strength

Each pack of Nextstellis contains:

  • 24 active tablets containing 3 milligrams (mg) of drospirenone and 14.2 mg of estetrol
  • 4 inactive tablets (tablets that do not contain any medication)

Typical dosages

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

Dosage for prevention of pregnancy

Doctors may prescribe Nextstellis to prevent pregnancy. If your doctor prescribes Nextstellis for you, you’ll take a tablet daily. You’ll typically take 1 active tablet on the first day of your menstrual period. You’ll continue taking 1 active tablet on days 2-24 and then take 1 inactive tablet on days 25-28. Then, you’ll start a new Nextstellis pack the next day.

If your doctor recommends starting Nextstellis on a different day of your menstrual cycle, you’ll need to use a backup method (condoms or spermicide) to prevent pregnancy during the first 7 days that you take Nexstellis.

Ask your doctor about when to start taking Nextstellis if you are:

  • switching to Nextstellis from another method of birth control
  • starting Nextstellis after having a baby
  • starting Nextellis after an abortion or a miscarriage

For more information about your specific dosage, talk with your doctor.

Children’s dosage

Nextstellis is approved to prevent pregnancy in those of any age who may become pregnant. Pregnancy can happen any time after having the first menstrual period. See “Dosage for prevention of pregnancy” above.

Talk with your child’s doctor if you have questions about their dosage.

Long-term treatment

Nextstellis may be taken long-term to prevent pregnancy. If you and your doctor determine that Nextstellis is safe and effective for you, you can take it long term.

Before you start taking Nextstellis, your doctor will discuss your treatment plan with you.

How to take Nextstellis

Nextstellis comes as an oral tablet that you swallow whole. You may take your dose with or without food. If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

It may be helpful to take Nextstellis around the same time of day. This helps maintain a steady level of the drug in your body so Nextstellis can work effectively.

If you have questions about how to take Nextstellis, talk with your doctor or pharmacist. There are also detailed instructions on the manufacturer’s website.

ACCESSIBLE DRUG LABELS

Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

Missed dose

What to do if you miss a dose of Nexstellis depends on certain factors, such as whether you missed an active or inactive pill. It can also depend on how many tablets you missed.

If you miss one active tablet, take the missed dose as soon as you remember. Then, take your next scheduled dose at the regular time. This may mean you’ll take two tablets on the same day.

Weeks 1 or 2

If you miss two or more active tablets during weeks 1 or 2 of your menstrual cycle, take one missed tablet as soon as you remember. Take that day’s tablet on the same day. Throw out any remaining missed tablets and continue taking one tablet per day until you finish the pack. Use backup, nonhormonal birth control until you’ve taken the active tablets at the regular time for 7 days in a row.

Week 3

If you miss two active tablets during week 3 of your menstrual cycle, take one missed tablet as soon as you remember. Then, take that day’s tablet on the same day. Throw out any remaining missed tablets and continue taking one tablet per day. When you finish taking all the active tablets, throw the inactive tablets out and start a new pack of Nextstellis. Use backup nonhormonal birth control until you’ve taken the active tablets at the regular time for 7 days in a row.

Other missed doses

If you vomit or have diarrhea 3–4 hours after taking an active tablet, take the next scheduled active tablet (the next day’s dose) as soon as possible (within 12 hours).

If you miss any of the inactive tablets at any time, skip the missed tablets and continue taking one tablet per day
until the pack is finished.

If you’re not sure what to do about a missed dose, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

Nextstellis and overdose

It’s important that you do not take more Nextstellis than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.

Effects of an overdose

Overdose effects of Nextstellis can include:

  • severe headache
  • nausea and vomiting
  • blood clots
  • vaginal bleeding
  • feeling irritable or drowsy

If you take more than the recommended amount of Nextstellis

Call your doctor right away if you believe you’ve taken too much Nextstellis. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Frequently asked questions

Below are some frequently asked questions about Nextstellis.

Is the dosage of Nextstellis similar to the dosage of Yaz?

Yes, the forms of each drug and how often you take them are similar. Nextstellis and Yaz (drospirenone/ethinyl estradiol) are both oral tablets taken once daily to prevent pregnancy.

The dose in milligrams for each drug differs because they have different active ingredients. Your doctor will prescribe the drug and the dosage that’s right for you.

To learn more about how these drugs compare, talk with your doctor.

How long does it take for Nextstellis to start working?

Nextstellis starts to work after your first dose when you start taking it on the first day of your menstrual cycle. If you start Nextstellis on a different day of your cycle, it may take 7 days for Nextstellis to work. To prevent pregnancy, be sure to take one tablet each day. Because of how the drug works, you may not feel the drug working in your body.

Talk with your doctor if you have questions about what to expect with Nextstellis treatment.

Takeaways and helpful resources

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Nextstellis for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Nextstellis without your doctor’s recommendation. If you have questions about the dosage of Nextstellis that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Nextstellis. These additional articles might be helpful:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.