Ethinyl estradiol and norethindrone

To make using oral contraceptives as safe and reliable as possible, you should understand how and when to take them and what effects may be expected.

ethinyl estradiol and norethindrone comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

ethinyl estradiol and norethindrone is available in blister packs with a Dialpak® tablet dispenser. Each blister pack contains 28 tablets with different colors that need to be taken in the same order as directed on the blister pack.

When you begin using ethinyl estradiol and norethindrone, your body will require at least 7 days to adjust before a pregnancy will be prevented. Use a second form of contraception, such as a condom, spermicide, or diaphragm, for the first 7 days of your first cycle of pills.

Take ethinyl estradiol and norethindrone at the same time each day. Birth control pills work best when no more than 24 hours pass between doses.

Do not skip or delay taking your pill by more than 24 hours. If you miss a dose, you could get pregnant. Ask your doctor for ways to help you remember to take your pills or about using another method of birth control.

You may feel sick or nauseated, especially during the first few months that you take ethinyl estradiol and norethindrone. If your nausea is continuous and does not go away, call your doctor.

Dosing

The dose of ethinyl estradiol and norethindrone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ethinyl estradiol and norethindrone. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Your doctor may ask you to begin your dose on the first day of your menstrual period (called Day 1 start) or on the first Sunday after your menstrual period starts (called Sunday start). When you begin on a certain day it is important that you follow that schedule, even if you miss a dose. Do not change your schedule on your own. If the schedule that you use is not convenient, check with your doctor about changing it. For a Sunday start, you need to use another form of birth control (eg, condom, diaphragm, spermicide) for the first 7 days.

You should begin your next and all subsequent 28-day regimens of therapy on the same day of the week as the first regimen began and follow the same schedule.

• For oral dosage form (tablets):
  • For contraception (to prevent pregnancy):
    • Adults and teenagers—
      • Modicon®: One white tablet taken at the same time each day for 21 consecutive days followed by one green (inert) tablet daily for 7 days per menstrual cycle.
      • Ortho-novum®: One white or peach tablet taken at the same time each day for 21 consecutive days followed by one green (inert) tablet daily for 7 days per menstrual cycle.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

ethinyl estradiol and norethindrone has specific patient instructions on what to do if you miss a dose. Read and follow these instructions carefully and call your doctor if you have any questions.

Use a second form of birth control for 7 days after you miss a dose, to prevent pregnancy.

Make sure your doctor knows if you miss your period 2 months in a row, because this could mean that you are pregnant.

You may not have a period for that month if you miss more than one dose or change your schedule.

You could have light bleeding or spotting if you do not take a pill on time. The more pills you miss, the more likely you are to have bleeding.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Abdominal or stomach pain
• absent, missed, or irregular menstrual periods
• anxiety
• change in vision
• changes in skin color
• chest pain or discomfort
• chills
• clay-colored stools
• constipation
• cough
• dark urine
• diarrhea
• dizziness or lightheadedness
• fainting
• fast heartbeat
• fever
• headache
• hives or welts
• itching skin
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of appetite
• medium to heavy, irregular vaginal bleeding between regular monthly periods, which may require the use of a pad or a tampon
• nausea and vomiting
• pain or discomfort in the arms, jaw, back, or neck
• pain, tenderness, or swelling of the foot or leg
• pains in the chest, groin, or legs, especially in the calves of the legs
• pounding in the ears
• rash
• redness of the skin
• severe headaches of sudden onset
• slow or fast heartbeat
• sudden loss of coordination or slurred speech
• sudden onset of shortness of breath for no apparent reason
• sudden shortness of breath or troubled breathing
• sweating
• unusual tiredness or weakness
• vomiting of blood

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Abdominal or stomach cramps
• bloating
• blotchy spots on the exposed skin
• breast enlargement or tenderness
• discouragement
• feeling sad or empty
• irritability
• itching of the vagina or outside genitals
• loss of interest or pleasure
• pain during sexual intercourse
• thick, white curd-like vaginal discharge without odor or with mild odor
• tiredness
• trouble concentrating
• trouble sleeping
• trouble wearing contact lenses

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

• Estrostep 21
• Eth Estradiol/Norethindr/Iron
• Ethinyl Estradiol/Norethindr
• Norethind Ac/Ethinyl Estradiol
• Norethindrone Acetate and Ethinyl Estradiol
• Ortho Novum
• Ovcon-50

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, oral:

Taytulla: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 pale pink capsules] and ferrous fumarate 75 mg [4 maroon capsules] (28s)

Tablet, oral:

femhrt: Ethinyl estradiol 0.0025 mg and norethindrone acetate 0.5 mg [white tablets] (28s)

Fyavolv:

0.5/2.5: Ethinyl estradiol 0.0025 mg and norethindrone acetate 0.5 mg [white-off-white tablets] (28s, 90s)

1/5: Ethinyl estradiol 0.005 mg and norethindrone acetate 1 mg [blue tablets] (28s, 90s)

Jevantique Lo: Ethinyl estradiol 0.0025 mg and norethindrone acetate 0.5 mg [white tablets] (28s)

Jinteli: Ethinyl estradiol 0.005 mg and norethindrone acetate 1 mg [white tablets] (28s, 90s)

Generic: Ethinyl estradiol 0.0025 mg and norethindrone acetate 0.5 mg (28s); Ethinyl estradiol 0.005 mg and norethindrone acetate 1 mg (28s, 90s)

Tablet, oral [monophasic formulation]:

Alyacen 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 peach tablets and 7 light green inactive tablets] (28s)

Balziva: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light peach tablets and 7 white inactive tablets] (28s)

Blisovi 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Blisovi Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 yellow tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Brevicon: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [21 blue tablets and 7 orange inactive tablets] (28s)

Briellyn: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light peach tablets and 7 white-off-white inactive tablets] (28s)

Cyclafem 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 pink tablets and 7 light green inactive tablets] (28s)

Dasetta 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 orange tablets and 7 white inactive tablets] (28s) [contains soya lecithin, tartrazine]

Gildagia: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 peach tablets and 7 light green inactive tablets] (28s)

Gildess 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [white tablets] [DSC]

Gildess 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [light green tablets] [DSC]

Gildess FE 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 white tablets] and ferrous fumarate 75 mg [7 white-speckled brown tablets] (28s)

Gildess FE 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 light green tablets] and ferrous fumarate 75 mg [7 white-speckled brown tablets] (28s)

Gildess 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 white-speckled brown tablets] (28s) [DSC]

Junel 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [yellow tablets] (21s)

Junel 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [pink tablets] (21s)

Junel Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 yellow tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Junel Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 pink tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Junel Fe 24: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 pale yellow tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Larin 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 pale yellow tablets] (21s) [contains soya lecithin]

Larin 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 green tablets] (21s) [contains soya lecithin]

Larin Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 pale yellow tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s) [contains soya lecithin]

Larin Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 green tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s) [contains soya lecithin]

Larin 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 pale yellow tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Loestrin 21 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [light yellow tablets] (21s)

Loestrin 21 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [pink tablets] (21s)

Loestrin 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Loestrin Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 light yellow tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Loestrin Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 pink tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Lomedia 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Microgestin 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [white tablets] (21s)

Microgestin 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [green tablets] (21s)

Microgestin 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s [DSC])

Microgestin Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Microgestin Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate 1.5 mg [21 green tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Modicon: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [21 white tablets and 7 green inactive tablets] (28s) [DSC]

Necon 0.5/35: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [21 light yellow tablets and 7 white inactive tablets] (28s)

Necon 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 dark yellow tablets and 7 white inactive tablets] (28s)

Norinyl 1+35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 yellow-green tablets and 7 orange inactive tablets] (28s)

Nortrel 0.5/35: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [21 light yellow tablets and 7 white inactive tablets] (28s)

Nortrel 1/35:

Ethinyl estradiol 0.035 mg and norethindrone 1 mg [yellow tablets] (21s)

Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 yellow tablets and 7 white inactive tablets] (28s)

Ortho-Novum 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 peach tablets and 7 green inactive tablets] (28s)

Ovcon 35: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light peach tablets and 7 green inactive tablets] (28s [DSC])

Philith: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 tan tablets and 7 white inactive tablets] (28s)

Pirmella 1/35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 peach tablets and 7 green inactive tablets] (28s)

Tarina FE 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Vyfemla: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light peach tablets and 7 white inactive tablets] (28s)

Wera: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [21 light peach tablets and 7 white inactive tablets] (28s)

Zenchent: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light peach tablets and 7 white inactive tablets] (28s)

Tablet, chewable, oral [monophasic formulation]:

Femcon Fe: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets] [spearmint flavor] (28s [DSC])

Generess Fe: Ethinyl estradiol 0.025 mg and norethindrone 0.8 mg [24 light green tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Kaitlib Fe: Ethinyl estradiol 0.025 mg and norethindrone 0.8 mg [24 light green tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Layolis Fe: Ethinyl estradiol 0.025 mg and norethindrone 0.8 mg [24 light green tablets] and ferrous fumarate 75 mg [4 brown tablets] [spearmint flavor] (28s)

Mibelas 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] (28s)

Minastrin 24 Fe: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [24 white tablets] and ferrous fumarate 75 mg [4 brown tablets] [spearmint flavor] (28s)

Wymzya Fe: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Zenchent Fe: Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 light yellow tablets] and ferrous fumarate 75 mg [7 brown tablets] [spearmint flavor] (28s)

Generic: Ethinyl estradiol 0.025 mg and norethindrone 0.8 mg [24 tablets] and ferrous fumarate 75 mg [4 tablets] (28s); Ethinyl estradiol 0.035 mg and norethindrone 0.4 mg [21 tablets] and ferrous fumarate 75 mg [7 tablets] (28s)

Tablet, oral [biphasic formulation]:

Lo Loestrin Fe:

Day 1-24: Ethinyl estradiol 0.01 mg and norethindrone acetate 1 mg [24 blue tablets]

Day 25-26: Ethinyl estradiol 0.01 mg [2 white tablets]

Day 27-28: Ferrous fumarate 75 mg [2 brown tablets] (28s)

Lo Minastrin Fe:

Day 1-24: Ethinyl estradiol 0.01 mg and norethindrone acetate 1 mg [24 blue chewable tablets]

Day 25-26: Ethinyl estradiol 0.01 mg [2 white tablets]

Day 27-28: Ferrous fumarate 75 mg [2 brown tablets] (28s) [DSC]

Necon 10/11:

Day 1-10: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [10 light yellow tablets]

Day 11-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [11 dark yellow tablets]

Day 22-28: 7 white inactive tablets (28s) [DSC]

Tablet, oral [triphasic formulation]:

Alyacen 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 white-off-white tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 light peach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peach tablets]

Day 22-28: 7 light green inactive tablets (28s)

Aranelle:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 light yellow tablets]

Day 8-16: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [9 white tablets]

Day 17-21: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [5 light yellow tablets]

Day 22-28: 7 peach inactive tablets (28s)

Cyclafem 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 white tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 light pink tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 pink tablets]

Day 22-28: 7 light green inactive tablets (28s)

Dasetta 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 light peach tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 peach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 orange tablets]

Day 22-28: 7 white inactive tablets (28s)

Estrostep Fe:

Day 1-5: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [5 white triangular tablets]

Day 6-12: Ethinyl estradiol 0.03 mg and norethindrone acetate 1 mg [7 white square tablets]

Day 13-21: Ethinyl estradiol 0.035 mg and norethindrone acetate 1 mg [9 white round tablets]

Day 22-28: Ferrous fumarate 75 mg [7 brown tablets] (28s)

Leena:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 light blue tablets]

Day 8-16: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [9 light yellow-green tablets]

Day 17-21: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [5 light blue tablets]

Day 22-28: 7 orange inactive tablets (28s)

Necon 7/7/7, Ortho-Novum 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 white tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 light peach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peach tablets]

Day 22-28: 7 green inactive tablets (28s)

Nortrel 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 light yellow tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 blue tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peach tablets]

Day 22-28: 7 white inactive tablets (28s)

Pirmella 7/7/7:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 white tablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 light peach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peach tablets]

Day 22-28: 7 green inactive tablets (28s)

Tilia Fe:

Day 1-5: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [5 white triangular tablets]

Day 6-12: Ethinyl estradiol 0.03 mg and norethindrone acetate 1 mg [7 white square tablets]

Day 13-21: Ethinyl estradiol 0.035 mg and norethindrone acetate 1 mg [9 white round tablets]

Day 22-28: Ferrous fumarate 75 mg [7 brown tablets] (28s)

Tri-Legest Fe:

Day 1-5: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg [5 light pink tablets]

Day 6-12: Ethinyl estradiol 0.03 mg and norethindrone acetate 1 mg [7 light yellow tablets]

Day 13-21: Ethinyl estradiol 0.035 mg and norethindrone acetate 1 mg [9 light blue tablets]

Day 22-28: Ferrous fumarate 75 mg [7 brown tablets] (28s)

Tri-Norinyl:

Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 blue tablets]

Day 8-16: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [9 yellow-green tablets]

Day 17-21: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [5 blue tablets]

Day 22-28: 7 orange inactive tablets (28s)

• Alyacen 1/35
• Alyacen 7/7/7
• Aranelle
• Balziva
• Blisovi 24 Fe
• Blisovi Fe 1/20
• Brevicon
• Briellyn
• Cyclafem 1/35
• Cyclafem 7/7/7
• Dasetta 1/35
• Dasetta 7/7/7
• Estrostep Fe
• Femcon Fe [DSC]
• femhrt
• Fyavolv
• Generess Fe
• Gildagia
• Gildess 1.5/30 [DSC]
• Gildess 1/20 [DSC]
• Gildess 24 Fe [DSC]
• Gildess FE 1.5/30
• Gildess FE 1/20
• Jevantique Lo
• Jinteli
• Junel 1.5/30
• Junel 1/20
• Junel Fe 1.5/30
• Junel Fe 1/20
• Junel Fe 24
• Kaitlib Fe
• Larin 1.5/30
• Larin 1/20
• Larin 24 Fe
• Larin Fe 1.5/30
• Larin Fe 1/20
• Layolis Fe
• Leena
• Lo Loestrin Fe
• Lo Minastrin Fe [DSC]
• Loestrin 21 1.5/30
• Loestrin 21 1/20
• Loestrin 24 Fe
• Loestrin Fe 1.5/30
• Loestrin Fe 1/20
• Lomedia 24 Fe
• Mibelas 24 Fe
• Microgestin 1.5/30
• Microgestin 1/20
• Microgestin 24 Fe [DSC]
• Microgestin Fe 1.5/30
• Microgestin Fe 1/20
• Minastrin 24 Fe
• Modicon [DSC]
• Necon 0.5/35
• Necon 1/35
• Necon 10/11 [DSC]
• Necon 7/7/7
• Norinyl 1+35
• Nortrel 0.5/35
• Nortrel 1/35
• Nortrel 7/7/7
• Ortho-Novum 1/35
• Ortho-Novum 7/7/7
• Ovcon 35 [DSC]
• Philith
• Pirmella 1/35
• Pirmella 7/7/7
• Tarina FE 1/20
• Taytulla
• Tilia Fe
• Tri-Legest Fe
• Tri-Norinyl
• Vyfemla
• Wera
• Wymzya Fe
• Zenchent
• Zenchent Fe

Acne: Adolescents ≥15 years and Adults: Females: Oral (Estrostep Fe, Tilia Fe, Tri-Legest Fe): Refer to dosing for contraception

Contraception: Females: One tablet once daily

Schedule 1 (Sunday starter): Dose begins on first Sunday after onset of menstruation; if the menstrual period starts on Sunday, take first tablet that very same day. (This schedule is not preferred for all products [eg, Generess Fe, Lo Loestrin Fe, Lo Minastrin Fe]). With a Sunday start, an additional method of contraception should be used until after the first 7 days of consecutive administration (all products).

Schedule 2 (Day 1 starter): Dose starts on first day of menstrual cycle taking 1 tablet daily.

Additional contraceptive dosing considerations:

Switching from a different contraceptive:

Oral contraceptive: Start on the same day that a new pack of the previous oral contraceptive would have been taken.

Transdermal patch, vaginal ring, injection: Start on the day the next dose would have been due.

IUD or implant: Start on the day of removal. A backup method of contraception should be used for the first 7 days if IUD is not removed on the first day of the menstrual cycle.

Use after first trimester abortion or miscarriage: Therapy may be started immediately. If not started within 5 days, a back-up method of contraception should be used for the first 7 days.

Use after childbirth (in women who are not breastfeeding) or after second trimester abortion or miscarriage: Therapy may be started ≥4 weeks postpartum. Pregnancy should be ruled out prior to treatment if menstrual periods have not restarted. An additional method of contraception (nonhormonal) should be used until after the first 7 days of consecutive administration.

Also refer to prescribing information for product specific information (or Curtis 2016a) for general guidance.

Missed or late doses (Curtis 2016a):

If one dose is late (<24 hours since dose should have been taken) or if one dose is missed (24 to <48 hours since dose should have been taken): Take dose as soon as possible. Continue remaining doses at the usual time (even if that means 2 doses on the same day).

If ≥2 consecutive doses are missed (≥48 hours since dose should have been taken): Take the most recently missed dose as soon as possible, discard any other missed doses. Continue remaining doses at the usual time (even if that means taking 2 doses on the same day); use back-up contraception until hormonal pills have been taken for 7 consecutive days. If doses were missed during the last week of hormonal (active) tablets (eg, days 15 to 21 of a 28 day pack), omit the hormone free interval by finishing the current pack and starting a new pack. If unable to start a new pack immediately, back up contraception is needed until hormonal pills from a new pack have been taken for 7 consecutive days. Consider use of emergency contraception in some situations (refer to guidelines for details).

Also refer to prescribing information for product specific information.

Postmenopausal indications: General dosing guidelines: When treating postmenopausal women, use estrogens for the shortest duration possible at the lowest effective dose consistent with treatment goals. Reevaluate patients as clinically appropriate to determine if treatment is still necessary. Consider use of an estrogen with a progestin in postmenopausal women with a uterus. Women who have had a hysterectomy generally do not need a progestin; however one may be needed if there is a history of endometriosis. Dosage needs to be adjusted based upon the patient's response.

Osteoporosis prevention: Females: Oral (femhrt, Jevantique Lo, Jinteli): One tablet daily

Vasomotor symptoms associated with menopause: Females: Oral (femhrt, Jevantique Lo, Jinteli): Initial: One tablet daily; patient should be re-evaluated at 3- to 6-month intervals to determine if treatment is still necessary.

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution and monitor blood pressure closely.

Use is contraindicated in pregnant women. Combination hormonal contraceptives are used to prevent pregnancy; treatment should be discontinued if pregnancy occurs. In general, the use of combination hormonal contraceptives, when inadvertently used early in pregnancy, have not been associated adverse fetal or maternal effects (Curtis 2016b).

The manufacturer states that combination hormonal contraceptives should not be started until ≥4 weeks after delivery in women who choose not to breastfeed. Due to the increased risk of venous thromboembolism (VTE) postpartum, combination hormonal contraceptives should not be started in any woman <21 days following delivery. The risk decreases to baseline by postpartum day 42. Use of combination hormonal contraceptives in women between 21 and 42 days after delivery should take into consideration the individual woman's risk factors for VTE (eg, age ≥35 years, previous VTE, thrombophilia, immobility, preeclampsia, transfusion at delivery, cesarean delivery, peripartum cardiomyopathy, BMI ≥30 kg/m2, postpartum hemorrhage, smoking) (Curtis 2016b).