Estrogen Receptor Agonists

Estrogen

Progestin

Progestin-containing Intrauterine System

Breast Neoplasms

Hypogonadism

Menopause, Premature

Menorrhagia

Prostatic Neoplasms

Primary Ovarian Insufficiency

Hot Flashes

<section class="Section" data-sectioncode="34089-3"><a name="Lb9e93adf-2eda-458d-a783-4404bd7c98ad"></a><a name="section-10"></a><h1>11 DESCRIPTION</h1>TWIRLA (levonorgestrel and ethinyl estradiol) transdermal system (TDS) contains 2.60 mg levonorgestrel (LNG) (17α)-(–) [13-ethyl-17¬hydroxy-18, 19-dinorpregn-4-en-20-yn-3-one], a progestin, and 2.30 mg ethinyl estradiol (EE), [(17α)-19-norpregna-1, 3, 5(10)-trien-20-yne-3, 17-diol] an estrogen (Figure 3).Figure 3. Structural Formulas<img alt="figure-2" src="figure-2.jpg"/>TWIRLA is designed to provide daily exposure of 120 mcg LNG and 30 mcg EE. TWIRLA is a matrix type TDS consisting of a 15 cm2 active adhesive laminate center, surrounded by a peripheral inactive adhesive laminate. The entire area of TWIRLA is 28 cm2.TWIRLA consists of 5 layers and a release liner which is removed and discarded prior to application. The two innermost layers contain the active ingredients (LNG and EE), as well as inactive components. Proceeding from the outer surface toward the surface adhering to the skin, the layers are (1) a woven peripheral backing layer, which is etched with “TWIRLA Levonorgestrel 120 mcg/day Ethinyl Estradiol 30 mcg/day”; (2) an inactive peripheral acrylic adhesive layer; (3) an inactive peripheral polyisobutylene adhesive layer; (4) an internal membrane to separate the active adhesive matrix from the inactive adhesive laminate; (5) the active adhesive matrix (Figure 4).Figure 4. Schematic Depiction of the TWIRLA TDS<img alt="figure-3" src="figure-3.jpg"/>The inactive components are acrylic adhesives, capric acid, copovidone, crospovidone, dimethyl sulfoxide, ethyl lactate, lauryl lactate, polybutene, polyester internal membrane, polyester release liner, polyisobutylene adhesives, and woven polyester backing membrane. TWIRLA is not made with latex.</section>

Twirla

ethinyl estradiol / levonorgestrel

168 HR ethinyl estradiol 0.00125 MG/HR / levonorgestrel 0.005 MG/HR Transdermal System

168 HR ethinyl estradiol 0.00125 MG/HR / levonorgestrel 0.005 MG/HR Transdermal System [Twirla]

ethinyl estradiol

levonorgestrel

Psoriasis (PsO)

Psoriatic Arthritis (PsA)

Ankylosing Spondylitis (AS)

Nonradiographic Axial Spondyloarthritis

Taltz

Juvenile Idiopathic Arthritis

Hidradenitis Suppurativa (HS)

Cosentyx

Siliq

Tremfya

Crohn's Disease (CD)

Ulcerative Colitis (UC)

Stelara

Skyrizi

Ilumya

Migraine

Cluster Headache

Migraine Prevention

Emgality

Qulipta

Acute Migraine

Ubrelvy

Nurtec ODT

Vyepti

Aimovig

Ajovy

Breast Cancer: HR+ (HER2-)

Verzenio

Ibrance

Kisqali

Atopic Dermatitis (Eczema)

Cibinqo

Eucrisa

Asthma (injectable)

Asthma OCS Dependent

Nasal Polyposis

Eosinophilic Esophagitis (EoE)

Prurigo Nodularis

Dupixent

Opzelura

Adbry

NSCLC ALK+ OR ROS1+ Disease

Lorbrena

Alecensa

Alunbrig

NSCLC cMET Mutation

Xalkori

Rheumatoid Arthritis (RA)

Xeljanz

Uveitis

Graft Versus Host Disease (GVHD)

Orencia

COVID-19 Treatment

Alopecia Areata

Olumiant

Multiple Sclerosis (MS)

Secondary Progressive Multiple Sclerosis

Zeposia

Rinvoq

Entyvio

Report Adverse Event

Prescribing Information

Medication Guide 

Submit MSL Request 

Pharmacy List 

Coverage Authorization Request 

Coverage Authorization Appeals 

Letter of Medical Necessity 

Enroll in Patient Savings Program 

Patch Replacement 

About Twirla 

Patient Resources 

Instructions For Use: Pregnancy Prevention