Can I Take Qlaira Birth Control Pills Instead Of Loestrin ?
First let me just go what these medications contain.
1. 'Loestrin Fe' contains a combination of Low dose Ethinyl Estradiol (Estrogen) and Norethindone (Progesterone)
2. 'Ortho Micronor' is progesterone only pill and contains low dose of Norethindrone. It does not contain the estrogen component.
3. 'Qlaira' is marketed as natural anti-coagulant. In this context, it contains a combination of estradiol valerate (which is same as out human body estrogen) and Dienogest (a synthetic progesterone)
The majority of side effects due to the contraceptive pills is due to estrogen component. Therefore, most of the commercially available OCPs contain low dose of estrogen.
When you take progesterone only pills i.e Ortho Micronor, there is more tendency for heavy and prolonged periods. Since you already have history of autoimmune hemolytic anemia, you must avoid such situations where you have heavy periods.
Now your elevated blood pressure was most likely elevated due to side effect of the earlier medication (Loestrin Fe). However, if it a mild elevation, ths could be managed with appropriate medications.
Biochemically, Qlaira and Loestrin would be similar and chances of hypertension would be lees with Qlaira as it contains the natural estrogen.
So according to me, the preferred option for you is to go with Qlaira as its a safer alternative to Loestrin.
Second option will be to restart Loestin Fe and monitor BP. If Blood pressure becomes elevated, you can take medications to bring it under control instead of stopping Loestrin.
Adding Estrogen to Micronor will not be a good idea. The pill burden will increase. Also the appropriate dosage will not be available.
Hope this answers your query. Please get back if you need any further information
Regards
Dr Kiran