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BNSSG Paediatric Joint Formulary

7.3 Contraception

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Last edited: 30-05-2024

First line drugs

Second line drugs

Specialist drugs

Secondary care drugs

7.3.1 Contraception, combined oestrogen and progesterone

For assessment of venous thromboembolism risk for under16’s follow best practice UK eligibility criteria can be found www.fsrh.org

FSRH guidelines on contraceptive choice for young people

Combined Oestrogen and Progesterone Oral Contraception

Dianette^® (co-cyprindiol) is not considered a contraceptive

Type of preparation	Oestrogen content	Progestogen content	Alternative brand (TLS Blue)	Recommended Formulary brand (TLS Green)
Monophasic low strength (21-day preparations)	Ethinylestradiol 20micrograms	Desogestrel 150micrograms Gestodene 75micrograms N.B. 3rd generation COCs have a higher VTE risk	Mercilon^® Millinette 20/75^®	Bimizza Gedarel^® 20/150
Monophasic standard strength (21-day preparations)	Ethinylestradiol 30micrograms	Desogestrel 150micrograms	Marvelon^®	Gedarel^® 30/150
	Ethinylestradiol 30micrograms	Levonorgestrel 150micrograms Drospirenone 3mg N.B. 3rd generation COCs have a higher VTE risk. Gestodene 75micrograms N.B. 3rd generation COCs have a higher VTE risk	Microgynon 30^® Ovranette^® Yacella^® Dretine^® Millinette 30/75^®	Rigevidon^® Levest^®
	Ethinylestradiol 35micrograms	Norgestimate 250micrograms	Cilique Lizinna	N/A
	Ethinylestradiol 35 micrograms	Norethisterone 500micrograms	N/A	Brevinor
	Ethinylestradiol 35 micrograms	Norethisterone 1000micrograms	N/A	Norimin
Monophasic everyday (28 day preparation) For use where the inactive tablets may add benefit to support compliance only	Ethinylestradiol 30 micrograms	Levonorgestrel 150 micrograms Gestodene 75micrograms N.B. 3rd generation COCs have a higher VTE risk	Microgynon ED Femodene ED	N/A

Combined Contraception – other formulations

Specific indication:

Ethinylestradiol / Norelgestromin patch (Evra^®) (TLS Blue)

For patients where compliance is a problem according to local guidelines

Qlaira^® (estradiol valerate / dienogest) (TLS Amber Specialist Recommended)

As an option for patients with premature ovarian insufficiency requiring contraception and HRT cover where standard oral contraceptives are not suitable and patients have completed puberty
Non formulary as standard contraception for other patients outside of this cohort

7.3.2 Contraception, oral progesterone-only

Progesterone Only Oral Contraception

Not usually needed in under 18’s but may be considered in cases where oestrogens must be avoided

Type of preparation

Progesterone content

Alternative brand

(TLS Blue)

Recommended Formulary brand

(TLS Green)

Progestogen-only contraceptives

Levonorgestrel 30micrograms

Desogestrel 75micrograms

Drospirenone 4mg

Norgeston^®

Cerazette^®

Cerelle^®

Slynd^®

Or prescribe generically

Zelleta

7.3.3 Emergency Contraception

Emergency Contraception

For advice see Clinical Guideline from the Faculty of Sexual and Reproductive Health

Levonorgestrel 1500 micrograms (Levonelle 1500^®) (TLS Green)

Intrauterine device (Copper) (TLS Green)

Specific indication:

Ulipristal (EllaOne^®) (TLS Blue)

For presenters 72-120 hours after unprotected sexual intercourse, or at the clinician’s discretion (around the time of ovulation)

7.3.4 Contraception, parenteral progestogen-only

Depo-Provera^® (Medroxyprogesterone 150mg vial) (TLS Blue)

In adolescents, Depo-Provera^® may be used, but only after other methods of contraception have been discussed with the patient and considered unsuitable or unacceptable.

Nexplanon^® (Etonogestrel 68mg per rod) (TLS Blue)

Intrauterine Progestogen-only Device

Mirena^® (Levonorgestrel intrauterine device) (TLS Blue)

7.3.5 Progesterone Receptor Modulators

Ulipristal acetate (Esmya^®) (TLS Red)

MHRA Alert – indication restricted due to risk of serious liver injury and liver failure.

For the intermittent treatment of moderate to severe symptoms of uterine fibroids, if not eligible for surgical treatment