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Balcoltra is a monophasic, low-dose combination oral contraceptive (COC) indicated for the prevention of pregnancy. It is a 28-day regimen consisting of 21 active tablets containing the progestin levonorgestrel (0.10 mg) and the estrogen ethinyl estradiol (0.02 mg), followed by 7 placebo tablets containing ferrous bisglycinate (36.5 mg) for iron supplementation. Developed by Neuvosyn Laboratories and marketed by Avion Pharmaceuticals, Balcoltra works primarily by suppressing ovulation through the modulation of the hypothalamic-pituitary-ovarian axis. Additionally, it increases cervical mucus viscosity to inhibit sperm penetration and alters the endometrium to reduce the likelihood of implantation. The inclusion of iron in the placebo tablets is intended to help maintain iron levels during the withdrawal bleed.
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