How It Works
Blisovi-Fe 1/20 works by using a multi-faceted approach to prevent pregnancy. By maintaining a steady level of synthetic hormones, it interferes with the processes that lead to pregnancy.
- Prevention of ovulation: The primary mechanism is the suppression of the mid-cycle surge of luteinizing hormone. This stops the ovaries from releasing a mature egg, meaning there is no egg available to be fertilized.
- Changes in cervical mucus: The progestin component increases the thickness of the mucus within the cervix. This creates a physical barrier that makes it difficult for sperm to travel into the uterus.
- Alteration of the uterine lining: The medication modifies the endometrium, or the lining of the uterus. By making this lining thinner and less receptive, it becomes more difficult for a fertilized egg to attach or implant.
- Hormonal stabilization: By providing a consistent dose of estrogen and progestin, the pill prevents the sharp hormonal fluctuations that often trigger moderate acne and heavy menstrual symptoms.
- Cycle reinforcement: The iron-containing placebo pills at the end of the pack allow for a “withdrawal bleed.” This mimics a regular period while the iron helps replace minerals lost during bleeding.
| Quick Facts | |
|---|---|
| Common Brands | Aurovela Fe 1/20, Blisovi Fe 1/20, Gildess Fe 1/20, Hailey Fe 1/20, Junel Fe 1/20, Larin Fe 1/20, Loestrin Fe 1/20, Microgestin Fe 1/20, Tarina Fe 1/20 |
| Drug Class | Combined oral contraceptive |
| Generic Status | Generic for Loestrin Fe 1/20 |
| Availability | Prescription only |
Dosing
Blisovi-Fe 1/20 comes in one dosage strength:
- Active pill composition: Each of the 21 active white tablets contains 1 mg of norethindrone acetate and 20 mcg of ethinyl estradiol.
- Placebo pill composition: Each of the 7 inactive brown tablets contains 75 mg of ferrous fumarate (iron).
The recommended dose is one tablet taken by mouth once daily in the exact order directed on the blister pack. To ensure effectiveness, you should take the medication at the same time every day. Once a pack is finished, a new pack should be started the next day with no break between months.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Blisovi-Fe 1/20 is FDA-approved for the prevention of pregnancy in women and the treatment of moderate acne vulgaris in women who also desire an oral contraceptive.
Off-Label Uses
You may see Blisovi-Fe 1/20 prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
Providers may prescribe Blisovi-Fe 1/20 off-label to help manage symptoms of polycystic ovary syndrome (PCOS) or to reduce the pain associated with endometriosis. It is also used to treat heavy menstrual bleeding and alleviate physical and emotional symptoms of premenstrual dysphoric disorder (PMDD).
Side Effects
Like all hormonal medications, Blisovi-Fe 1/20 can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Common Side Effects
- Nausea and vomiting
- Stomach cramps or bloating
- Breast tenderness or enlargement
- Spotting or breakthrough bleeding
- Changes in weight or appetite
- Headache or migraine
- Mood changes
- Vaginal yeast infections
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Contact your doctor if you experience any of the following:
- Blood clots: Pain, swelling, or warmth in the leg, or sudden shortness of breath and chest pain.
- Stroke or heart attack: Sudden numbness or weakness, slurred speech, confusion, or severe chest pressure.
- Liver problems: Yellowing of the eyes or skin, dark urine, or upper stomach pain.
- Gallbladder disease: Severe stomach pain accompanied by fever and nausea.
- High blood pressure: Significant increases in blood pressure readings.
- Severe allergic reactions: Swelling of the face, lips, or throat, or difficulty breathing.
- Vision changes: Sudden loss of vision, bulging eyes, or double vision.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Maintain a Routine
Take your pill at the same time each day to maintain steady hormone levels and ensure maximum effectiveness.
Manage Nausea
If the medication upsets your stomach, try taking it with your largest meal or shortly before you go to sleep.
Use Backups
Keep a backup method of birth control, such as condoms, available in case you miss multiple pills or experience severe vomiting or diarrhea.
Avoid Smoking
Do not smoke while taking this medication, as it increases the risk of serious cardiovascular side effects, especially if you are over 35.
Watch Your Vision
If you wear contact lenses and notice changes in your vision or how the lenses fit, consult your eye doctor.
Protect From Sun
This medication can cause dark patches on the skin; use sunscreen and avoid tanning beds to prevent skin discoloration.
Drug Interactions
Certain medications, supplements, and foods can make Blisovi-Fe 1/20 less effective, increasing the risk of pregnancy. For example:
- Antibiotics: While most common antibiotics do not interfere, rifampin and rifabutin are known to reduce the pill’s effectiveness.
- Anticonvulsants: Medications used for seizures, such as carbamazepine, phenytoin, and topiramate, can cause the pill to break down faster.
- St. John’s wort: This herbal supplement is documented to decrease the effectiveness of oral contraceptives.
- Antiviral medications: Certain medications for HIV and Hepatitis C can interact with the hormones in Blisovi-Fe 1/20.
- Grapefruit products: Consuming grapefruit can increase the levels of estrogen in your blood, which may increase the risk of side effects.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
How long does it take for Blisovi-Fe 1/20 to become fully effective at preventing pregnancy?
If you start the medication on the first day of your period, it is effective immediately. If started at any other time, it is accepted that you should use a backup method of birth control for the first seven days.
What is the actual purpose of the brown pills at the end of the monthly pack?
The brown pills are placebos that contain iron. They serve as reminders to keep you in the daily habit of taking a pill and help prevent iron deficiency during your withdrawal bleed.
Can I skip the brown pills and start a new pack to avoid having a period?
While some women use active pills continuously to skip a period, you should discuss this with your provider first to ensure it is a safe option for you.
If I miss one active pill, do I need to take two the next day?
Guidelines suggest if you miss one active pill to take the missed dose as soon as you remember, even if it means taking two pills on the same day.
Is it normal to experience irregular spotting during the first few months?
Spotting or breakthrough bleeding is a common side effect during the first three months as your body adjusts to the hormones.
How does Blisovi-Fe 1/20 differ from higher-dose birth control pills?
It contains 20 mcg of estrogen, whereas higher-dose pills contain 30 mcg. It is designed to provide effective protection with a lower hormonal impact.
Does this combination of hormones commonly cause weight gain?
While some people report weight changes, clinical studies show that significant weight gain is not a standard effect for most people, though mild fluid retention can occur.
Can this birth control pill help manage hormonal acne?
Blisovi-Fe 1/20 is FDA-approved to treat moderate acne in patients who also desire an oral contraceptive. By regulating the hormones that trigger oil production in the skin, this medication is frequently used to help clear moderate acne.
Do I need to use a backup method like condoms if I am taking antibiotics?
Discuss this question with your prescribing doctor. Standard guidelines suggest most common antibiotics do not interfere with the pill. However, rifampin is a notable exception that requires a backup method.
Why do placebo pills contain iron?
The iron is included to help replace the iron lost during the monthly withdrawal bleed, as maintaining healthy iron levels can help prevent anemia in some women.
Can taking Blisovi-Fe 1/20 make my heavy bleeding lighter?
One of the common benefits of this medication is that it often results in shorter, lighter, and less painful periods.
Are there any specific vitamins or herbal supplements that interfere with this pill?
St. John’s wort is the most common herbal supplement that reduces effectiveness. Large doses of vitamin C may also affect how estrogen is processed.
What is the difference between Blisovi-Fe 1/20 and the brand names Loestrin Fe 1/20 or Junel Fe 1/20?
These are all different brand names for the same combination of hormones and iron. They are bioequivalent and work in the same way.
Can this medication cause mood changes?
Mood swings and depression are reported side effects. If you have a history of depression, you should monitor your symptoms closely.
Comparable Medications
Junel Fe 1/20, Blisovi-Fe 1.5/30, Levonorgestrel and Ethinyl Estradiol, or Norethindrone 0.35mg (Errin / Camila)?
There are several medications that your doctor can prescribe in place of Blisovi-Fe 1/20. Here are a few possible alternatives below.
Junel Fe 1/20
A combination oral contraceptive that contains the exact same active hormones and iron as Blisovi-Fe 1/20. It is used to prevent pregnancy and manage moderate acne.
Blisovi-Fe 1.5/30
A higher-dose version of the same hormonal combination. It contains 30 mcg of estrogen and is often used if a patient experiences persistent breakthrough bleeding on a lower-dose pill.
Levonorgestrel and ethinyl estradiol
A combination birth control pill that uses a different type of progestin. It is used to prevent pregnancy and may be preferred for patients with different side effect sensitivities.
Norethindrone 0.35mg
A progestin-only "mini-pill" that does not contain estrogen. It is typically used by those who are breastfeeding or who have health risks that prevent the use of estrogen.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.