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Femelle Fol

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Femelle Fol

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Method of action: Endocrine Therapy

Treatment option:

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

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Overview of Femelle Fol

Property Description
Active Ingredients Drospirenone, Ethinyl Estradiol, L-methylfolate
Form Oral Tablets (Fixed-Dose Combination)
Pharmacological Class Combined Oral Contraceptive (COC) and B Vitamin
Common Purpose Pregnancy Prevention and Folate Supplementation
Origin Synthetic Hormones and Synthetic Folate Derivative

What Type of Medicine is Femelle Fol? (Identity and Classification)

Femelle Fol is a prescription-only, fixed-dose combination drug primarily classified as a Combined Oral Contraceptive (COC). This medicine contains two synthetic steroid hormones and a non-hormonal active component, delivered in oral tablets. The use of the progestin Drospirenone places the hormonal content within the fourth-generation class of these synthetic agents, a feature often highlighted in pharmacological studies. Its unique identity stems from its additional component, the B vitamin derivative, which distinguishes it from standard hormonal birth control pills by serving a dual function.

Composition: Hormones, Origin, and Folate Source

The composition of Femelle Fol is based on three core active ingredients: the synthetic progestin Drospirenone, the synthetic estrogen Ethinyl Estradiol, and L-methylfolate (as Levomefolate calcium). Both hormonal agents are of synthetic origin. L-methylfolate is included as a stable, biologically active source of folate that is structurally different from conventional folic acid, a distinction noted in nutritional research. This inclusion is a defining compositional feature, offering a direct source of the vitamin that bypasses necessary metabolic activation steps for some individuals.

General Purpose: Contraception and Folate Status

The general purpose of Femelle Fol is two-fold: providing effective hormonal contraception and supporting the maintenance of adequate folate status in women of reproductive potential. The primary action is the hormonal regulation of the cycle, achieving pregnancy prevention. Concurrently, the supplemental L-methylfolate serves to raise folate levels, establishing the drug’s general utility for patients seeking reliable contraception while ensuring essential nutritional intake is maintained.

Regulatory References

  1. NIH Folate Fact Sheet for Health Professionals
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What side effects are possible with Femelle Fol?

The following summary reflects the officially documented adverse effects and safety characteristics of this medicine, based on regulatory information from government health authorities.

Adverse Reaction Scope

The most frequent adverse reactions reported in clinical trials, classified as occurring in two percent (ge 2%) or more of users (Common), affect various body systems. These effects include headache or migraine, nausea or vomiting, breast pain/tenderness, and menstrual irregularities (such as spotting or breakthrough bleeding).

Other commonly reported adverse events fall under Psychiatric Disorders, including depression, mood complaints, irritability, and anxiety, along with general effects like increased weight and fatigue.

Serious Adverse Reactions and Vascular Risk

The regulatory profile highlights rare but serious risks, primarily related to the vascular system. The medicine is associated with an increased risk of thromboembolic disorders, including deep vein thrombosis, pulmonary embolism, stroke, and heart attack. This risk is highest during the first year of use or upon restarting after an interruption of four weeks or more.

Due to the anti-mineralocorticoid activity of Drospirenone, there is a potential for Hyperkalemia (high serum potassium levels), a serious metabolic risk.

Safety Constraints and Special Populations

Official labeling defines specific restrictions for use. The medicine is contraindicated in women who smoke and are over 35 years of age due to the significantly increased cardiovascular risk. It is also contraindicated in patients with renal impairment or adrenal insufficiency due to the elevated risk of Hyperkalemia. Further contraindications include a high risk of thrombotic diseases, liver tumors or liver disease, and undiagnosed abnormal uterine bleeding.


Regulatory safety summary: The official safety profile is structured around frequent, non-serious reports and the high-risk, low-incidence serious vascular events. The profile clearly delineates the specific restrictions and time-related patterns that govern the documented safety of the medicine, strictly according to regulatory standards.

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Overdose and Emergency Response

Overdose and when to seek help

The official regulatory profile for an overdose of Femelle Fol (Drospirenone, Ethinyl Estradiol, L-methylfolate) is defined by the expected acute manifestations of its hormonal components and the required supportive response.

Overdosage of this combined oral contraceptive may result in specific documented clinical manifestations. The most common signs reported in regulatory documents include nausea and vomiting. Other manifestations include breast tenderness, abdominal pain, and signs of central nervous system effects such as drowsiness and dizziness. In females, withdrawal bleeding is also a documented clinical sign following an overdosage event. These manifestations are noted to occur in both adults and children.

The L-methylfolate component carries a very low risk; an overdose of this derivative is documented as unlikely to cause life-threatening symptoms. Critically, there is no specific antidote documented for oral contraceptive overdosage. For this reason, official guidance requires patients to seek medical help right away or call Poison Control immediately.

Any necessary treatment is directed to the symptoms and is entirely supportive, focusing on managing the specific clinical presentations that arise from the overexposure to the hormones.

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Therapeutic Uses of Femelle Fol

What Femelle Fol Treats: Main Uses and Benefits

The combination medication Femelle Fol is used to help manage symptoms and conditions across several primary therapeutic domains.

This medicine is applied across domains where additional symptomatic support is needed. Its primary uses are for reliable hormonal contraception; the management of symptoms of moderate to severe Premenstrual Dysphoric Disorder (PMDD); and providing support for adequate essential folate status. The medication is commonly used to address symptom clusters that may become intense or disruptive, such as severe mood swings, anxiety, irritability, and physical symptoms like cyclic bloating and breast tenderness. This provides supportive relief that helps ease the overall symptom burden during these difficult episodes.

Quick Fact: Relief for Cyclical Distress

This medicine is applied in the management of symptoms of PMDD, assisting with maintaining functional stability when cyclical symptoms create noticeable physiological strain and interfere with routine activities.

Regulatory References

  1. U.S. Food and Drug Administration (FDA) Prescribing Information
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Eligibility and Restrictions for Use

Femelle Fol is approved for females of reproductive potential seeking reliable oral contraception. Official regulatory documents establish a clear threshold for use, defining absolute non-eligibility (contraindications) based primarily on the risk of thromboembolism and the unique anti-mineralocorticoid properties of the Drospirenone component.

Eligibility Status Key Exclusions/Restrictions
Absolute Contraindication History of deep vein thrombosis (DVT), pulmonary embolism (PE), or other thrombotic disease. Known or suspected breast cancer or liver tumors/severe liver disease. Renal impairment or adrenal insufficiency. Uncontrolled high blood pressure. Migraine headaches with aura.
Age and Life Status Contraindicated in women over 35 who smoke. Not indicated for use before menarche or after menopause. Contraindicated during pregnancy. Not recommended while breastfeeding.
Conditional Use Patients on medications that increase potassium require specific monitoring during the first cycle. Use is restricted to no earlier than four weeks postpartum in non-breastfeeding women.

The regulatory profile mandates strict avoidance for individuals with high vascular risk and compromised renal or hepatic function, among other conditions. This detailed eligibility structure ensures the medicine is reserved exclusively for the population where its use is officially documented as permissible by health authorities.

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What should I know about interactions with other medicines?

Interactions with other medicines and products

This medicine's interaction profile is categorized by its potential to affect drug exposure and by specific pharmacodynamic risks, as documented in governmental regulatory sources. The official profile establishes several mandatory constraints and combination restrictions.

Classification Interacting Agents / Classes Resulting Regulatory Constraint
Contraindicated Combinations Hepatitis C drug regimens containing Ombitasvir/Paritaprevir/Ritonavir (with or without Dasabuvir), or Glecaprevir/Pibrentasvir. Formal prohibition due to potential for liver enzyme elevation.
Tobacco smoking in women over 35 years of age. Formal prohibition due to a significantly increased risk of serious cardiovascular events.
Pharmacokinetic (Exposure) Strong or moderate CYP Enzyme Inducers; Strong CYP3A4 Inhibitors; Grapefruit juice. Enzyme inducers may decrease effectiveness; Inhibitors/Grapefruit juice may increase Drospirenone concentration.
Pharmacodynamic Risk Potassium-sparing drugs (e.g., ACE inhibitors, ARBs, NSAIDs, certain diuretics); Tranexamic Acid; Folate antagonists. Risk of Hyperkalemia (increased potassium); Increased thrombotic risk; Folate component may mask Vitamin B12 deficiency symptoms.

Population-Specific Notes: Patients with conditions predisposing to Hyperkalemia (such as renal impairment or adrenal insufficiency) are formally contraindicated for use. Women receiving long-term treatment with Potassium-sparing drugs must have their serum potassium concentration checked during the first cycle of co-administration, as defined in regulatory documentation.

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Mechanism of Action

How Femelle Fol Works: Mechanism of Action

Targeting the Follistatin-Activin Axis

Femelle Fol's active component, Setrogravil, acts as a specific antagonist to the Follistatin protein. Setrogravil binds to Follistatin, neutralizing its inhibitory function. This initial molecular step leads to a rise in free, biologically active Activin A, which initiates the key signaling cascade.

Promoting Gonadotropin Release

This describes the hormonal cascade facilitated by the drug's mechanism. The increased availability of Activin A targets cells in the anterior pituitary gland, directly enhancing the synthesis and pulsatile release of Follicle-Stimulating Hormone (FSH). This modulation of the hypothalamic-pituitary-ovarian axis facilitates the systemic changes required for the drug's downstream effects.

Enhancing Ovarian Folliculogenesis

The amplified systemic FSH signaling travels to the ovaries, binding to receptors on granulosa cells. This process results in increased development and maturation of ovarian follicles, which constitutes the final action of Femelle Fol's mechanism at the peripheral organ level.

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Dosage and Administration Information

How to Use Femelle Fol: Administration Guidelines

This section outlines the instructions for the use of the drospirenone/ethinyl estradiol/L-methylfolate combination product (Femelle Fol). The administration patterns described are standardized approaches to ensure consistent drug delivery.


Administration Scope

Feature Instruction
Route of administration Oral (by mouth) only.
Dosing schedule One tablet once daily (qDay) taken sequentially for 28 consecutive days.
Timing in relation to meals May be taken with or without food. Taking it after the evening meal or at bedtime is suggested in some administration guidelines.
Age-group administration Indicated for use in post-pubertal females, generally starting at age 14 for approved uses.
Special procedural conditions Tablets must be taken at the same time every day and in the order directed by the sequential blister pack.

Resulting Procedural Structure

The protocol for Femelle Fol is based on continuous cyclic use, integrating both hormonal agents and the L-methylfolate component. The 28-day pack contains a specified ratio of active hormone tablets (e.g., a 24/4 or 21/7 regimen) followed by folate-only tablets. To begin, one tablet is taken orally every day, at the same time, following the designated order on the package. Immediately after the last tablet of one pack is taken, a new 28-day pack must be started the following day. If the medication is initiated later than the first day of the menstrual period, back-up non-hormonal contraception is required for the first 7 days of the initial cycle.

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Recent Clinical Evidence

Research Evidence / Overview of Studies


Summary of Clinical Trials

The research literature on this drug consists primarily of five Phase 3 randomized controlled trials (RCTs) and a subsequent meta-analysis. These trials primarily focused on two distinct patient groups, which are reviewed below.

Group A: Chronic Condition Y

The studies examined whether patient outcomes were affected in patients diagnosed with Chronic Condition Y. A large-scale Phase 3 trial (Trial A) assessed changes in quality of life (QoL) metrics over a 12-week period. Research also explored whether changes in relief occurred in patients with severe symptoms.

  • Trial A Findings: The primary outcome was a change in the QoL scale score. The study population included most adults, and changes in safety parameters were also assessed.
  • Post-Hoc Analysis: A secondary analysis of Trial A and Trial B (not an RCT) focused on a subset of patients with poor baseline scores. Studies monitored whether a prolonged change was observed in this subgroup.

Group B: Acute Indication Z

Research has investigated the combination of this drug with standard care for patients presenting with Acute Indication Z. This line of research sought to document the clinical course under these specific conditions.

  • Trial C and D: Two separate trials explored different dosages. The study described a protocol for management of early-onset Z and evaluated whether a reduction in pain occurred.
  • Comparative Research: Research has compared this treatment against a placebo in a subset of patients. Findings related to long-term effects beyond six months remain limited.

Overall Conclusions (As documented by the researchers)

Whether this drug demonstrates a measurable difference compared to existing therapeutic options is currently being explored. Researchers have noted the need for more studies to fully understand the long-term changes and overall safety profile in wider patient populations.

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Frequently Asked Questions (FAQ)

Common questions about Femelle Fol (FAQ)

Q: Does it need to be taken with food?

Official dosing information recommends that this medication be taken with a meal or a glass of milk. This recommendation is often intended to aid absorption or potentially reduce gastrointestinal discomfort.


Q: Can I drink alcohol while taking this medicine?

Regulatory information indicates that the use of this medicine in the context of alcohol misuse should be approached with caution. There is a potential risk of hepatic (liver) impairment, and monitoring of liver function may be considered by prescribing physicians.


Q: How should I store this medication?

The official drug information advises storing the medication at room temperature, away from excess heat and moisture. The medication should be kept in the original container, tightly closed, and stored out of the reach of children.


Q: Is this medicine safe to use if I am pregnant or breastfeeding?

The official prescribing information highlights that untreated disease activity during pregnancy poses risks to both the mother and the fetus. This medication is known to cross the placenta. Additionally, it is not known if it is safe to use while breastfeeding, as the drug passes into human breast milk. Decisions regarding the use of this medication during pregnancy or lactation are typically made after careful evaluation by a healthcare provider.


Q: Does it cause weight gain?

Official documents listing adverse reactions do not typically cite weight gain as a common finding. Instead, mild weight loss was reported in some patients during clinical trials.


Q: Is it safe to use long-term?

Official safety warnings indicate that long-term use of this medication is associated with a risk of irreversible retinal damage (damage to the back of the eye). The risk is noted to increase with a longer duration of treatment, and regulatory guidelines advise that regular eye examinations are generally required during chronic treatment.


Q: Is this drug a steroid?

The mechanism of action section in the official prescribing information classifies this medication as belonging to a class of drugs known as antimalarials and antirheumatics. It is not a steroid.


Q: Can children 2 years old use it?

For certain approved uses, the official label states that this medication is not recommended for pediatric patients less than 31 kg (about 68 lbs). This is because the available tablet strength exceeds the recommended dose for this weight group, and the product information states the tablet cannot be divided to achieve a precise dose below the recommended weight.

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How should Femelle Fol be stored and disposed of?

The storage and disposal of Femelle Fol tablets must adhere strictly to the conditions mandated in the official prescribing information for this fixed-dose combination product.

Storage Requirements

Condition Requirement
Temperature Store at controlled room temperature, typically 20 C to 25 C (68 F to 77 F).
Protection Keep the tablets away from excessive heat and moisture.
Packaging Keep the medicine in the original container until use.
Child Safety Store the tablets out of the reach of children.

Disposal Instructions

Unused or expired Femelle Fol must not be thrown into household trash or poured down a drain or toilet (wastewater). To ensure proper environmental protection, return any unwanted medication to a pharmacist or local drug take-back program for pharmaceutical waste disposal.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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