This last disadvantage does seem to decrease with longer use but can be as long as 20 full days of spotting mid cycle with the first cycle. (Paulo Alto Medical Foundation Website "Seasonale" 2003)
Cost of Seasonale, brand medication runs between 160 and 180 dollars per 91 day packet, which works out to be about twice as expensive as typical COCs that are formulated on a 28 day cycle, though one must remember that you are also getting 14 additional therapeutic doses per 91 day cycle. Generic Seasonale has also recently been released on the market the most commonly used brand being Quasense, which costs between 120-130 per cycle, more comparable to 28 day cycle pills but still slightly higher in price. (Online Price Comparison)
Patient teaching about Seasonale must include all the general warnings about any COCs, including common side effects, missed pill complication, rare serious side effects, increased with smoking and the fact that OCs do not protect against STIs as well as detailed descriptions of the cycle difference and bleeding irregularities and what to do if a pill(s) is missed, if one or two is missed and the patient doubles the dosage for one or two days 7 days following restarting the cycle the is risk of unintended pregnancy. If three or more pills...
(DuraMed, 2003, Seasonale Insert)
Side effects of the medication are comparable to those of all COCPs and include nausea, vomiting, abdominal cramping and bleeding, spotting, amenorrhea, infertility temporarily after discontinued use, edema, breast tenderness, weight gain, rash, headache, mood changes, vaginitis, vision changes, contact lens intolerance, decreased folate levels, lupus, porphyria or chorea exacerbation, aggravation of varicose veins, allergic reactions as well as the serious warnings, such as thrombophlebitis, arterial thromboembolism, pulmonary embolism, cerebral thrombosis, hypertension, gallbladder disease, heart attack, stroke and rare liver tumors. (DuraMed, 2003, Seasonale Insert)
References
DuraMed (2003) "Seasonale Patient Insert"
Paulo Alto Medical Foundation Website (2003):Birth Control: Seasonale" at http://www.pamf.org/teen/sex/birthcontrol/seasonale.html#What%20are%20the%20advantages%20to%20women%20using%20Seasonale%C2%AE?
Online Price Comparison at http://www.pharmacywebsearch.com/search.php?aid=3457&sid=2&keyword=Seasonale
