Norethindrone/Ethinyl EstradiolGeneric Name:
Norethindrone/Ethinyl Estradiol (nor-eth-IN-drone/ETH-in-il ess-tra-DYE-ole/FER-uhs FYOO-mar-rate)Brand Name:
Examples include Loestrin Fe 1/20 and Microgestin Fe 1/20
Cigarette smoking increases the risk of serious heart and blood vessel side effects from birth control pill use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite significant in women older than 35 years of age. Women who use birth control pills are strongly advised not to smoke.
Norethindrone/Ethinyl Estradiol are used for:
Prevention of pregnancy. It may also be used to regulate the menstrual cycle. It does NOT protect against HIV infection (AIDS) and other sexually transmitted diseases (STDs). It may be used to treat certain conditions as determined by your doctor.
Norethindrone/Ethinyl Estradiol are a combination of 2 female sex hormones, estrogen and progestin. Norethindrone/Ethinyl Estradiol works by preventing the ovaries from releasing eggs. When there is no egg to be fertilized, pregnancy cannot occur. It also thickens the cervical mucus, making it difficult for sperm to enter the uterus.
Do NOT use Norethindrone/Ethinyl Estradiol if:
- you are allergic to any ingredient in Norethindrone/Ethinyl Estradiol
- you are pregnant or think you may be pregnant
- you have or have ever had abnormal growth or cancer of the breast, cervical or uterine cancer, or unexplained vaginal bleeding
- you have or have ever had stoppage or rupture of blood vessels in the brain (stroke); blockage of blood vessels (blood clots) in the legs, lungs, heart (heart attack or angina/chest pain), or other parts of the body; heart valve problems; or severe high blood pressure
- you have liver disease, liver tumors, or yellowing of the eyes or skin during pregnancy or during previous use of Norethindrone/Ethinyl Estradiol or a similar medicine
- you are currently taking acitretin, aprepitant, barbiturates (eg, phenobarbital), bosentan, carbamazepine, felbamate, griseofulvin, hydantoins (eg, phenytoin), modafinil, nevirapine, penicillins (eg, amoxicillin), protease inhibitors (eg, indinavir), rifamycins (eg, rifampin), St. John's wort, tetracyclines (eg, doxycycline), topiramate, or troglitazone
Contact your doctor or health care provider right away if any of these apply to you.
Before using Norethindrone/Ethinyl Estradiol:
Some medical conditions may interact with Norethindrone/Ethinyl Estradiol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines or other substances
- if you smoke cigarettes or are in your 35 years of age or older
- if you have breast nodules, disease of the breast, an abnormal breast x-ray or mammogram, or a strong family history of breast cancer
- if you have vision problems, depression, diabetes, epilepsy (seizures), gallbladder or liver disease, heart problems, high blood pressure, kidney disease, or migraine headaches
- if you have high cholesterol, triglycerides, or calcium in the blood; pancreas disease; obesity; or uterine fibroids or endometriosis
- if you are going to have surgery or you will be on bed rest
Some MEDICINES MAY INTERACT with Norethindrone/Ethinyl Estradiol. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Acitretin, aprepitant, azole antifungals (eg, ketoconazole), barbiturates (eg, phenobarbital), bosentan, carbamazepine, felbamate, griseofulvin, hydantoins (eg, phenytoin), modafinil, nevirapine, penicillins (eg, amoxicillin), protease inhibitors (eg, indinavir), rifamycins (eg, rifampin), St. John's wort, tetracyclines (eg, doxycycline), topiramate, or troglitazone because they may decrease Norethindrone/Ethinyl Estradiol's effectiveness. While on these medicines, you will need an alternative form of birth control (eg, condoms) until your next period after stopping these medicines.
- Beta-blockers (eg, metoprolol), cyclosporine, theophyllines, or troleandomycin because the risk of their side effects or toxicity may be increased by Norethindrone/Ethinyl Estradiol
- Corticosteroids (eg, prednisone) because their side effects, including rounding of the face, weight gain, fluid retention, elevated blood pressure, elevated blood sugar, or skin changes, may be increased by Norethindrone/Ethinyl Estradiol
- Oral anticoagulants (eg, warfarin) because their side effects, including risk of bleeding, may be increased by Norethindrone/Ethinyl Estradiol; however, it is also possible that the effectiveness may also be decreased by Norethindrone/Ethinyl Estradiol
- Lamotrigine because its effectiveness may be decreased by Norethindrone/Ethinyl Estradiol; stopping Norethindrone/Ethinyl Estradiol may lead to severe side effects
This may not be a complete list of all interactions that may occur. Ask your health care provider if Norethindrone/Ethinyl Estradiol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Norethindrone/Ethinyl Estradiol:
Use Norethindrone/Ethinyl Estradiol as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Norethindrone/Ethinyl Estradiol. Talk to your pharmacist if you have questions about this information.
- Take Norethindrone/Ethinyl Estradiol by mouth with food.
- If you have trouble remembering to take Norethindrone/Ethinyl Estradiol, talk to your doctor about how to make pill-taking easier or about using another method of birth control.
- Always have another kind of birth control (eg, condoms) to use as a backup in case you miss pills. Also, always have an extra, full pack of pills.
- Decide what time of day you want to take your medicine. It is important that you take it at about the same time every day.
- Do not skip pills even if you are spotting or bleeding between monthly periods or feel sick to your stomach (nausea).
- Do not skip pills even if you do not have sex very often.
- If you miss 1 dose of Norethindrone/Ethinyl Estradiol, take it as soon as your remember. Take your next dose at the regular time. This means you may take 2 doses on the same day. You do not need to use a backup method of birth control if you only miss 1 pill. If you miss more than 1 dose of Norethindrone/Ethinyl Estradiol, read the extra patient information leaflet that comes with Norethindrone/Ethinyl Estradiol or contact your doctor for instructions. You must use a backup method of birth control if you miss more than 1 dose of Norethindrone/Ethinyl Estradiol. If you are not sure about how to handle missed doses, use an extra form of birth control (eg, condoms) until you talk with your doctor.
Ask your health care provider any questions you may have about how to use Norethindrone/Ethinyl Estradiol.
Important safety information:
- Norethindrone/Ethinyl Estradiol may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Norethindrone/Ethinyl Estradiol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Norethindrone/Ethinyl Estradiol may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke.
- There may be times when you may not have regular menstrual periods after you have taken a pack of Norethindrone/Ethinyl Estradiol for a cycle. If you have taken Norethindrone/Ethinyl Estradiol regularly and missed 1 period, keep taking Norethindrone/Ethinyl Estradiol for the next cycle but be sure to tell your doctor first.
- If you have not taken Norethindrone/Ethinyl Estradiol daily as instructed and missed a period, or if you missed 2 consecutive periods, you may be pregnant. You could get pregnant if you have sex in the 7 days after you miss pills. Do not continue to take Norethindrone/Ethinyl Estradiol until you are sure that you are not pregnant, but continue to use another method of birth control (eg, condoms).
- Contact your doctor if you miss any menstrual periods so that the cause may be determined.
- Follow your doctor's instructions to examine your breasts, and report any lumps to your doctor immediately.
- Tell your doctor or dentist that you take Norethindrone/Ethinyl Estradiol before you receive any medical or dental care, emergency care, or surgery.
- If you will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor 3 to 4 weeks in advance. Special precautions may be needed.
- Norethindrone/Ethinyl Estradiol does not stop the spread of HIV or sexually transmitted diseases (STDs) to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have an HIV infection or an STD. Do not share needles, injection supplies, or items like toothbrushes or razors.
- Taking certain antibiotics or anticonvulsants while you are using Norethindrone/Ethinyl Estradiol may decrease the effectiveness of Norethindrone/Ethinyl Estradiol. To prevent pregnancy, use an additional form of birth control (eg, condoms) until your next menstrual period.
- If you wear contact lenses and you develop problems with them, contact your doctor.
- Norethindrone/Ethinyl Estradiol may cause dark skin patches on your face. Avoid the sun, sunlamps, or tanning booths until you know how you react to Norethindrone/Ethinyl Estradiol. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Diabetes patients - Norethindrone/Ethinyl Estradiol may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Norethindrone/Ethinyl Estradiol may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Norethindrone/Ethinyl Estradiol.
- Lab tests, including PAP tests, may be performed while you use Norethindrone/Ethinyl Estradiol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Norethindrone/Ethinyl Estradiol should not be used in CHILDREN or before the patient's first menstrual period; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Do not use Norethindrone/Ethinyl Estradiol if you are pregnant. If you think you may be pregnant, contact your doctor right away. Norethindrone/Ethinyl Estradiol are found in breast milk. Do not breast-feed while taking Norethindrone/Ethinyl Estradiol.
Possible side effects of Norethindrone/Ethinyl Estradiol:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Breast tenderness or enlargement; changes in appetite; changes in weight; dizziness; headache; mild hair loss; nausea; nervousness; stomach cramps or bloating; vaginal spotting or breakthrough bleeding.Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); absent menstrual period; breast discharge; breast lumps; calf or leg pain, swelling, or tenderness; change in amount of urine produced; chest pain or heaviness; confusion; coughing of blood; dark urine; fainting; mental or mood changes (eg, depression); migraines; numbness of an arm or leg; one-sided weakness; pale stools; persistent vaginal spotting; persistent, severe, or recurring headache or dizziness; severe pain or tenderness in the stomach; shortness of breath; slurred speech; sudden severe headache or vomiting; swelling of the fingers, hands, legs, or ankles; unusual or severe vaginal bleeding; unusual tiredness or weakness; vaginal irritation, discharge, or change in secretions; vision changes (eg, sudden vision loss, double vision); yellowing of the skin or eyes (with or without fever).
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include nausea; vaginal bleeding.Proper storage of Norethindrone/Ethinyl Estradiol:
Store Norethindrone/Ethinyl Estradiol at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store Norethindrone/Ethinyl Estradiol in the container it came in, tightly closed, away from heat, moisture, and light. Do not store in the bathroom. Keep Norethindrone/Ethinyl Estradiol out of the reach of children and away from pets.
- If you have any questions about Norethindrone/Ethinyl Estradiol, please talk with your doctor, pharmacist, or other health care provider.
- Norethindrone/Ethinyl Estradiol are to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
This information is a summary only. It does not contain all information about Norethindrone/Ethinyl Estradiol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.