Twirla

Birth Control, Acne Vulgaris, Folate supplementation therapy + 5 more

Treatment

1 FDA approval

19 Active Studies for Twirla

What is Twirla

Ethinylestradiol

The Generic name of this drug

Treatment Summary

Ethinylestradiol, developed in 1938, is a form of the hormone estrogen that is able to be taken orally. Its approval by the FDA in 1943 allowed it to be used in contraceptive pills, replacing an earlier form of estrogen called mestranol. Ethinylestradiol is still widely used in contraception today.

LOESTRIN Fe 1.5/30

is the brand name

image of different drug pills on a surface

Twirla Overview & Background

Brand Name

Generic Name

First FDA Approval

How many FDA approvals?

LOESTRIN Fe 1.5/30

Ethinylestradiol

1973

679

Approved as Treatment by the FDA

Ethinylestradiol, also known as LOESTRIN Fe 1.5/30, is approved by the FDA for 1 uses including Birth Control .

Birth Control

Used to treat Contraception in combination with Levonorgestrel

Effectiveness

How Twirla Affects Patients

Ethinylestradiol is a synthetic form of the hormone estrogen. It prevents ovulation by decreasing luteinizing hormone and gonadotrophic hormone. It is usually taken once daily and is generally considered to be very safe, though patients should be aware of potential risks of thrombotic events.

How Twirla works in the body

Ethinylestradiol is a synthetic estrogen used in oral contraceptives. It works by stopping ovulation, blocking the travel of sperm, and preventing fertilized eggs from attaching to the uterus. It also reduces luteinizing hormone, decreasing the ability of the uterus to accept a fertilized egg. It also increases a protein in the body that binds to hormones, reducing their effect.

When to interrupt dosage

The proposed dosage of Twirla is based on the identified problem, including Acne Vulgaris, Hormonal Contraception and Folate supplementation therapy. The amount of dosage is contingent upon the method of delivery, as outlined in the table below.

Condition

Dosage

Administration

Birth Control

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Patient desires oral contraception for birth control

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Hormonal Contraception

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Menopause

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Acne Vulgaris

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Folate supplementation therapy

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Acne Vulgaris

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Osteoporosis

, 0.02 mg, 0.0025 mg, 0.03 mg, 0.0035 mg/hour, 0.005 mg, 2.7 mg, 0.035 mg, 0.6 mg, 2.6 mg, 0.05 mg, 0.5 mg, 0.75 mg, 0.025 mg, 0.0015 mg/hour, 0.04 mg, 0.01 mg, 1.0 mg, 0.075 mg, 0.105 mg, 0.07 mg, 0.1 mg, 0.75 mg/[USP'U], 0.0075 mg/hour, 17.4 mg, 0.085 mg, 2.3 mg

, Kit, Tablet - Oral, Oral, Tablet, Kit - Oral, Insert, extended release, Vaginal, Insert, extended release - Vaginal, Ring, Ring - Vaginal, Patch, extended release - Transdermal, Transdermal, Patch, extended release, Tablet, chewable, Tablet, chewable - Oral, Tablet, film coated, Tablet, film coated - Oral, Patch, Patch - Transdermal, Capsule, Capsule - Oral

Warnings

Twirla has twenty-six contraindications, so it should not be administered in concurrence with any of the ailments indicated in the following table.

Twirla Contraindications

Condition

Risk Level

Notes

Smoking

Do Not Combine

Metrorrhagia

Do Not Combine

estrogen-sensitive cancer

Do Not Combine

Thrombophlebitis

Do Not Combine

Venous Thrombosis

Do Not Combine

Venous Thrombosis

Do Not Combine

Pulse Frequency

Do Not Combine

Breast

Do Not Combine

Coronary Artery Disease

Do Not Combine

high risk of arterial thrombotic disease

Do Not Combine

Thromboembolism

Do Not Combine

Coronary Disease

Do Not Combine

Hypersensitivity

Do Not Combine

Pulse Frequency

Do Not Combine

Adrenal Insufficiency

Do Not Combine

major surgery with prolonged immobilization

Do Not Combine

Pulse Frequency

Do Not Combine

Hypertension

Do Not Combine

undiagnosed abnormal genital bleeding

Do Not Combine

Breast Cancer

Do Not Combine

Liver Neoplasms

Do Not Combine

Deep Vein Thrombosis

Do Not Combine

Fibrosis

Do Not Combine

Breast

Do Not Combine

Renal Insufficiency

Do Not Combine

Severe Hypersensitivity Reactions

Do Not Combine

Ethinylestradiol may interact with Pulse Frequency

There are 20 known major drug interactions with Twirla.

Common Twirla Drug Interactions

Drug Name

Risk Level

Description

Anastrozole

Major

The therapeutic efficacy of Anastrozole can be decreased when used in combination with Ethinylestradiol.

Astemizole

Major

The metabolism of Astemizole can be decreased when combined with Ethinylestradiol.

Axitinib

Major

The metabolism of Axitinib can be decreased when combined with Ethinylestradiol.

Belinostat

Major

The metabolism of Belinostat can be increased when combined with Ethinylestradiol.

Binimetinib

Major

The metabolism of Binimetinib can be increased when combined with Ethinylestradiol.

Twirla Toxicity & Overdose Risk

Women who overdose on this drug may experience abnormal vaginal bleeding, nausea, vomiting, breast tenderness, abdominal pain, drowsiness, and fatigue. Treatment should focus on providing supportive care and monitoring potassium, sodium, and signs of metabolic acidosis.

image of a doctor in a lab doing drug, clinical research

Twirla Novel Uses: Which Conditions Have a Clinical Trial Featuring Twirla?

38 active clinical trials are assessing the potential of Twirla to provide Folate supplementation therapy, ameliorate Premenstrual Dysphoric Disorder and alleviate Menopause symptoms.

Condition

Clinical Trials

Trial Phases

Birth Control

19 Actively Recruiting

Not Applicable, Phase 3, Phase 4, Early Phase 1, Phase 2

Hormonal Contraception

0 Actively Recruiting

Folate supplementation therapy

0 Actively Recruiting

Patient desires oral contraception for birth control

0 Actively Recruiting

Osteoporosis

0 Actively Recruiting

Acne Vulgaris

0 Actively Recruiting

Acne Vulgaris

0 Actively Recruiting

Menopause

0 Actively Recruiting

Twirla Reviews: What are patients saying about Twirla?

5

Patient Review

3/26/2021

Twirla for Birth Control

I really like this new patch from Agile Therapeutics. It's called Twirla and it's much safer than my other patch. A few of my girlfriends have switched from the pill as well because they always forget to take it. Safe, effective, donâ??t have to worry about taking a pill everyday.

5

Patient Review

6/21/2021

Twirla for Birth Control

This patch is excellent for helping with cramps. It's also helped clear my acne and made my mood swings disappear. Plus, it doesn't cause weight gain like some other treatments can.

5

Patient Review

6/21/2021

Twirla for Birth Control

Switched from Xulane to Zafemy to Twirla and Twirla is the best by a landslide. Sticks great and you dont even feel it. Best on the market if you are like me and hate having to take a pill everyday.

5

Patient Review

7/21/2021

Twirla for Birth Control

I was looking for a way to avoid taking the pill, which was messing with my hormones. My doctor recommended Twirla, and I'm really glad I tried it. It's been keeping me much more balanced.

5

Patient Review

8/16/2022

Twirla for Birth Control

This is the best birth control I've used in my five months of using it.

5

Patient Review

6/7/2021

Twirla for Birth Control

This is such an easy method that I'll never go back to taking pills again.

5

Patient Review

3/7/2022

Twirla for Birth Control

I switched from Xulane to Twirla because it has a lower estrogen dose and I'm glad I did. The lower estrogen dose means less side effects and it's also easier to remove when it's time to take off.

5

Patient Review

2/24/2021

Twirla for Birth Control

5

Patient Review

7/9/2021

Twirla for Birth Control

This IUD is a huge improvement over the pill. No more cramps or mood swings for me!

5

Patient Review

7/9/2021

Twirla for Birth Control

This treatment is easy to use and works great.

4.7

Patient Review

6/1/2021

Twirla for Birth Control

I really enjoy using Twirla. It's been working great for me and it's so much easier to use than other methods like pills or more invasive treatments.

4.7

Patient Review

10/29/2022

Twirla for Birth Control

I was recommended Twirla by a friend and I'm really glad I tried it. It works great and I prefer it to the pill.

3.3

Patient Review

6/6/2022

Twirla for Birth Control

At first, this treatment worked great for me. My periods were really bad before, but then they stopped coming altogether for a month. When I started getting them again, they were longer than before-- lasting 9 days instead of 4.

2.3

Patient Review

10/4/2022

Twirla for Birth Control

I failed to use this medication correctly and as a result got pregnant. I want to be clear that it wasn't the medication's fault, but rather my own irresponsible usage. Please be careful if you decide to use this treatment.

1.3

Patient Review

10/4/2022

Twirla for Birth Control

I have never left a review before, but I feel compelled to warn others about this product. Within two hours of using it, I felt incredibly sick and experienced wild mood swings. I don't know what was in it, but whatever hormones it released were totally out of whack.

1

Patient Review

10/4/2022

Twirla for Birth Control

I would not recommend this product to anyone. I felt an intense burning and stinging sensation less than 30 minutes after inserting it, and had to struggle to remove it due to the strength of the adhesive.
image of drug pills surrounding a glass of water symbolizing drug consumption

Patient Q&A Section about twirla

These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

How fast does Twirla work?

"If you start using Twirla within the first 24 hours of your period, you will not need to use any other form of contraception for the first 7 days. If you start using Twirla after the first 24 hours of your period, you will need to use a non-hormonal form of contraception, such as condoms or spermicide, for the first 7 days."

Answered by AI

Does Twirla patch make you gain weight?

"The most common side effects of using the Twirla patch are skin reactions at the application site and weight gain. Other possible side effects include menstrual cramps."

Answered by AI

How effective is the Twirla patch?

"The SECURE Trail found that Twirla was 95% effective in preventing pregnancy, which is the same as other combined hormonal contraceptives."

Answered by AI

Is Twirla better than Xulane?

"The findings of a study showed that Twirla was more effective in contraceiving women with a lower body mass index (BMI). The pregnancy rate per 100 woman-years of Xulane use was 1.07 (95% CI 0.6-, 1.76). Xulane is said to be less effective in women with a higher BMI. In a year-long phase 3 trial, 5% of all the Twirla patches (55,900) worn fully detached."

Answered by AI

Clinical Trials for Twirla

Image of University of California, San Diego in La Jolla, United States.

Lidocaine for Pain Control in Birth Control

18 - 50
Female
La Jolla, CA

The goal of this research study is to learn more about how different uses of a numbing medication might affect pain levels while getting an IUD placed. The investigators are also studying participants opinions of their clinicians' empathy. The investigators are inviting patients who arrive at their clinic visit seeking an IUD. Usually, at University of California, San Diego (UCSD), for patients who have never delivered a baby, clinicians use a buffered paracervical block for before IUD placement. The purpose of this research study is to investigate whether a "buffered" (2 cc of sodium bicarbonate, 18 cc of 1% lidocaine) paracervical block (numbing medication given on both sides of the cervix) is effective in reducing pain during IUD placement in individuals with prior C-sections, the difference between buffered and unbuffered for nulliparous patients, and whether a medicated gel reduces pain with the paracervical block.

Recruiting
Paid Trial

University of California, San Diego

Sheila K Mody, MD, MPH

Image of EmpoweRx, Inc in Del Mar, United States.

HAPPI Software for Birth Control Access

18+
All Sexes
Del Mar, CA

The goal of this clinical trial is to learn if use of the HAPPI software can improve pharmacist-provided birth control services. The main questions it aims to answer are: 1. Does the HAPPI software make it easier for pharmacists to provide birth control services in their pharmacy? 2. Does the HAPPI software make it easier for patients to access birth control? Researchers will compare pharmacists' implementation and patients' access when using the HAPPI software and when not using the HAPPI software to see if the software improves implementation and access. Participants will include pharmacists and patients. Pharmacists will be asked to provide birth control services as normal while using the HAPPI software. Patients will be asked to receive birth control services from a pharmacist as normal, while using the HAPPI software.

Recruiting
Has No Placebo

EmpoweRx, Inc

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Image of University of Colorado Anschutz Medical Campus in Aurora, United States.

Birth Control Pills and DNA Interaction

18 - 45
Female
Aurora, CO

The goal of this clinical trial is to evaluate how differences in specific parts of our DNA can influence how individual bodies break down the hormones contained within oral contraceptive pills, which could affect how well these birth control pills work to prevent pregnancy. The investigators are also interested in exploring how these differences in our DNA can also explain why patients taking the exact same formulation of birth control pill will experience very different side effects. The main questions it aims to answer are: * Do individuals with the CYP3A7\*1C variant have increased metabolism of both desogestrel and ethinyl estradiol when taking a combined oral contraceptive pill? * Do individuals with the CYP3A7\*1C variant experience higher rates of breakthrough ovulation while taking a desogestrel/ethinyl estradiol combined oral contraceptive pill? * What novel genetic loci are associated with alterations in steroid hormone pharmacokinetics and pharmacodynamics among a larger cohort of combined oral contraceptive pill users? Participants will take a specific formulation of combined oral contraceptive pill (desogestrel/ethinyl estradiol) and undergo the following procedures: * Blood draw to measure the amount of progestin and estrogen in their system from the combined oral contraceptive pill * Questionnaires to assess side effects possibly caused by the combined oral contraceptive pill * Blood draw to measure endogenous hormone levels and biomarkers that may be affected by the combined oral contraceptive pill * A transvaginal ultrasound to measure any ovarian follicles (optional procedure)

Phase 4
Recruiting

University of Colorado Anschutz Medical Campus (+2 Sites)

Aaron M Lazorwitz, MD, PhD

Image of HYPE in Bryan, United States.

Game-Based Learning Intervention for Health Behaviors

9 - 15
All Sexes
Bryan, TX

The study aims to implement Using the Connect (UTC), an innovative, game-based intervention designed to increase protective factors and decrease adolescent pregnancies. This intervention will be implemented in Texas middle schools and community-based organizations. The long-term goal is to promote optimal health in youth and prevent adolescent pregnancy in populations disproportionately impacted by adolescent pregnancy and sexually transmitted infection (STI) rates. The short-term objective is to conduct a robust, multi-site clustered randomized controlled trial to evaluate implementation outcomes and the impact of UTC, a novel theory-based game developed using powerful and effective human-centered design (HCD) strategies, on intention to delay sexual activity.

Waitlist Available
Has No Placebo

HYPE (+2 Sites)

Brittany Rosen, PhD, MEd

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Progestin Contraceptives for Birth Control Effects

18 - 40
Female
Portland, OR

The purpose of the study is to learn more about menstrual changes in progestin contraception users. The investigators are hoping to find out what changes in the endometrium lead to different bleeding patterns during the first year of progestin contraception use. Participants will choose to receive the contraceptive implant (Etonogestrel implant also called Nexplanon) or the contraceptive injectable (Depo-medroxyprogesterone acetate (DMPA) also called Depo-Provera) for up to 12 months. They will be asked to have 4 endometrial biopsies over the course of the study, as well as blood draws, physical exams, and pregnancy tests. Participants will also use a daily text message or email diary to report bleeding patterns. This study's plan is to comprehensively phenotype bleeding patterns and profile the entire endometrium using single-cell RNA seq data (sCRNAseq).

Phase < 1
Recruiting

OHSU

Alison Edelman, MD

Image of University of Colorado Denver in Aurora, United States.

Etonogestrel Implant for Emergency Birth Control

18 - 40
Female
Aurora, CO

The investigators propose a single site, single arm, open label mechanism of action pharmacodynamic pilot study of etonogestrel implant insertion prior to an luteinizing hormone (LH) surge. The investigators will evaluate ovulation rates via serum levels of reproductive hormones and transvaginal ultrasound findings following placement of an etonogestrel implant once the dominant follicle reaches a size of 15mm or greater, but prior to an LH surge, in persons with prior documented regular cycles and confirmed ovulation. The researchers' hypothesis is that ovulation will be inhibited if the etonogestrel implant is placed prior to an LH surge. Based on data from the Food and Drug Administration label for Nexplanon, etonogestrel rises to levels associated with ovulation suppression within 8 hours of placement. Given this rapid increase, it is therefore plausible to assume that ovulation can be inhibited by the implant if placed prior to an LH surge. This study is novel as there have been no published studies evaluating an etonogestrel implant for this indication. The contribution of this proposed research to the literature is significant because current recommendations from the Center for Disease Control (CDC) regarding timing of etonogestrel implant placement are stringent and not patient-centered. Any day insertion of the etonogestrel implant is supported by retrospective data and this pharmacodynamic data would further support the literature for any day insertion without the need for additional emergency contraception. If results support the investigators' hypothesis, it could increase access to contraception and decrease duplicative therapy.

Phase 4
Recruiting

University of Colorado Denver

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