ELLA- ulipristal acetate tablet
RedPharm Drug, Inc
1 INDICATIONS AND USAGE
Ella is a progesterone agonist/antagonist emergency contraceptive indicated for prevention of pregnancy following unprotected intercourse or a known or suspected contraceptive failure [see Dosage and Administration (2.1)] . E lla is not intended for routine use as a contraceptive.
2 DOSAGE AND ADMINISTRATION
2.1 Recommended Dosage and Administration
- Take one tablet of ella orally as soon as possible within 120 hours (5 days) after unprotected intercourse or a known or suspected contraceptive failure.
- Take ella with or without food.
ella at any time during the menstrual cycle.
2.2 Recommendations Regarding Use with Hormonal Contraception
After ella use, initiate or resume hormonal contraception no sooner than 5 days after the intake of ella and use a reliable barrier method until the next menstrual period. For known or suspected failure of hormonal contraception refer to the hormonal contraceptive’s prescribing information for instructions on what to do [see Warnings and Precautions (5.5), Drug Interactions (7.1) and Clinical Pharmacology (12.2)] .
2.3 Recommendation in Case of Gastrointestinal Disturbances
If vomiting occurs within 3 hours of taking ella , consider repeating the dose.
3 DOSAGE FORMS AND STRENGTHS
The ella tablet is supplied as a white to off-white, round, curved tablet containing 30 mg of ulipristal acetate and is marked ” ella ” on both sides.
Ella is contraindicated for use in the case of known or suspected pregnancy [see Use in Specific Populations (8.1)].
5 WARNINGS AND PRECAUTIONS
5.1 Existing Pregnancy
Ella is not indicated for termination of an existing pregnancy.
5.2 Ectopic Pregnancy
A history of ectopic pregnancy is not a contraindication to use of this emergency contraceptive method. Healthcare providers, however, should consider the possibility of ectopic pregnancy in women who become pregnant or complain of lower abdominal pain after taking ella. A follow-up physical or pelvic examination is recommended if there is any doubt concerning the general health or pregnancy status of any woman after taking ella.
5.3 Repeated Use
Ella is for occasional use as an emergency contraceptive. It should not replace a regular method of contraception. Repeated use of ella within the same menstrual cycle is not recommended, as safety and efficacy of repeat use within the same cycle has not been evaluated.
5.4 CYP3A4 Inducers
A CYP3A4 inducer, rifampin, decreases the plasma concentration of ella significantly. Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3)] .
5.5 Fertility Following Use
A rapid return of fertility is likely following treatment with ella for emergency contraception.
After use of ella , a reliable barrier method of contraception should be used with subsequent acts of intercourse until the next menstrual period.
After using ella , if a woman wishes to initiate hormonal contraception as a regular method, she can do so, no sooner than 5 days after the intake of ella and she should use a reliable barrier method until the next menstrual period [ see Dosage and Administration (2.2), Drug Interactions (7.1 and 7.3) and Clinical Pharmacology (12.2)].
Progestin-containing contraceptives may impair the ability of ella to delay ovulation. Advise women to follow the instructions on the initiation or resumption of hormonal contraceptives after ella intake [see Dosage and Administration(2.2)].
5.6 Effect on Menstrual Cycle
After ella intake, menses sometimes occur earlier or later than expected by a few days. In clinical trials, cycle length was increased by a mean of 2.5 days but returned to normal in the subsequent cycle. Seven percent of subjects reported menses occurring more than 7 days earlier than expected, and 19% reported a delay of more than 7 days. If there is a delay in the onset of expected menses beyond 1 week, rule out pregnancy.
Nine percent of women studied reported intermenstrual bleeding after use of ella.
5.7 Sexually Transmitted Infections/HIV
Ella does not protect against HIV infection (the virus that causes AIDS) or other sexually transmitted infections (STIs).
6 ADVERSE REACTIONS
6.1 Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
Ella was studied in an open-label multicenter trial (Open-Label Study) and in a comparative, randomized, single-blind, multicenter trial (Single-Blind Comparative Study). In these studies, a total of 2,637 (1,533 + 1,104) women in the 30 mg ulipristal acetate groups were included in the safety analysis. The mean age of women who received ulipristal acetate was 24.5 years and the mean body mass index (BMI) was 25.3. The racial demographics of those enrolled were 67% Caucasian, 20% Black or African American, 2% Asian, and 12% other.
The most common adverse reactions (≥ 10%) in the clinical trials for women receiving ella were headache (18% overall), nausea (12% overall) and abdominal and upper abdominal pain (12% overall). Table 1 lists those adverse reactions that were reported in ≥ 5% of subjects in the clinical studies ( 14).
|Most Common Adverse Reactions||Open-Label Study|| |
Single-Blind Comparative Study
|N = 1,533||N = 1,104|
|Abdominal and upper abdominal pain||15||8|
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