How It Works
This medication combines two synthetic hormones: norgestimate, which is a progestin, and ethinyl estradiol, which is an estrogen. Tri-Sprintec works to prevent pregnancy by:
- Stopping the ovaries from releasing an egg during the menstrual cycle
- Thickening the cervical mucus, which makes it harder for sperm to travel into the uterus and reach an egg
- Changing the uterine lining (endometrium) so that it’s harder for a fertilized egg to implant
When used to treat acne, Tri-Sprintec works by lowering testosterone levels, which is assumed to lead to reduced oil production and fewer clogged pores.
| Quick Facts | |
|---|---|
| Common Brands | Tri-Sprintec, Ortho Tri-Cyclen, Tri-Estarylla, Tri-Linyah, Tri-Mili |
| Drug Class | Estrogen/progestin combined oral contraceptive |
| Generic Status | Generic is available |
| Availability | Prescription only |
Dosing
Tri-Sprintec comes in a 28-day blister pack consisting of 21 “active” pills that contain hormones, followed by 7 “inactive” (or placebo) pills that do not contain hormones. You’ll take one tablet by mouth every day in the order presented, ideally around the same time each day.
Taking the pills in the exact order specified on the blister pack is critical because the hormone levels change depending on the week. Each week is color-coded to make it easier to stay on track:
- Week 1: 7 gray pills containing 0.18 mg norgestimate and 35 mcg ethinyl estradiol
- Week 2: 7 light blue pills containing 0.215 mg norgestimate and 35 mcg ethinyl estradiol
- Week 3: 7 blue pills containing 0.25 mg norgestimate and 35 mcg ethinyl estradiol
- Week 4: 7 white pills containing no hormones (placebo pills)
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
Tri-Sprintec is FDA-approved to:
- Prevent pregnancy in women
- Treat moderate acne vulgaris in women who want to use birth control pills for contraception
Off-Label Uses
You may see Tri-Sprintec 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.
Tri-Sprintec may be used off-label to reduce menstrual pain, regulate menstrual cycles, and reduce the risk of developing ovarian cysts.
Side Effects
Like all medications, Tri-Sprintec 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
- Headache or migraine
- Breast pain, tenderness, discharge, or enlargement
- Vaginal infection or discharge
- Stomach pain
- Mood changes or depression
- Weight gain or bloating
- Painful or irregular periods or spotting
- Acne
- Tiredness
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using Tri-Sprintec and call your doctor immediately if you experience:
- Severe allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; racing heart; severe rash or itching; and/or fever.
- Blood clots: Taking Tri-Sprintec can cause blood clots in the veins, arteries, or the lungs. The risk may be higher in people who smoke cigarettes, those over 35 years old, or with a history of blood clots or heart problems. Symptoms include chest pain or pressure; abnormal heartbeat; difficulty breathing; sweating; vomiting; dizziness; pain in the back, jaw, throat, or arm; severe headache; slurred speech; sudden weakness on one side of the body; and vision loss or bulging eyes.
- High blood pressure (hypertension): Tri-Sprintec may dangerously increase blood pressure. Symptoms include severe headaches, vision changes, chest pain, dizziness, confusion, difficulty breathing, buzzing in the ears, anxiety, nosebleed, and abnormal heartbeat.
- Jaundice: Tri-Sprintec can affect liver function, leading to symptoms like jaundice (a yellowing of the skin or eyes).
- Headache or Migraine: Tri-Sprintec may cause or worsen migraines or headaches.
- Depression: Tri-Sprintec may cause or worsen depression or anxiety.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Take The Pill At The Same Time Each Day
This maximizes its effectiveness at preventing pregnancy. Set a daily alarm to help you remember.
Practice Safe Sex
Remember that while Tri-Sprintec helps prevent pregnancy, it does not offer any protection against HIV or other sexually transmitted infections (STIs). It is recommended to use a barrier method like a condom.
Use Sun Protection
Tri-Sprintec can cause chloasma (dark patches of skin on the face), especially in people with a history of the condition. It’s recommended to avoid sun exposure and ultraviolet radiation while taking the medication.
Avoid Smoking Cigarettes
Smoking significantly increases the risk of severe heart problems while taking Tri-Sprintec, especially in people who are over 35 years old.
Avoid Grapefruit Or Grapefruit Juice
Grapefruit can affect Tri-Sprintec levels in the body.
Store At Room Temperature
Tri-Sprintec should be stored at 68°F to 77°F (20°C to 25°C) in a cool, dry place away from light.
Tell Your Provider If You’re Pregnant Or Breastfeeding
Tri-Sprintec should not be taken anymore once you become pregnant. The medication can also affect breast milk. Tell your healthcare provider if you are breastfeeding, so they can recommend an appropriate option.
Call Your Provider If You Vomit After Taking A Pill
If vomiting or severe diarrhea occurs shortly after taking a dose, the medication may not be fully absorbed. It is recommended to treat it as a missed dose and use a backup birth control method like condoms until consulting a healthcare provider.
Try To Avoid Missing A Dose
If you miss one dose of Tri-Sprintec, take it as soon as you remember and take the next pill at your regular time, even if it means you are taking two pills in one day. If you miss multiple pills, your next steps may depend on what week of your cycle you’re in and how many pills you missed. Refer to your prescription packet or contact your provider.
Drug Interactions
Certain medications and substances can interact with Tri-Sprintec, potentially altering how it works or increasing the risk of side effects. For example:
- Acetaminophen (Tylenol): This over-the-counter pain reliever can interact with Tri-Sprintec and increase hormone levels.
- Antibiotics: Tri-Sprintec can interact with medicines like rifabutin or rifampin, potentially reducing the effectiveness of Tri-Sprintec.
- Antifungals: Medications for fungal infections, such as griseofulvin, itraconazole, and ketoconazole, can interact with Tri-Sprintec.
- Aprepitant: This medication can lower the effectiveness of Tri-Sprintec.
- Bosentan: This medication can decrease the effectiveness of Tri-Sprintec.
- Cholesterol medications: Medications like atorvastatin, rosuvastatin, and colesevelam can interact with Tri-Sprintec.
- Cyclosporine: Tri-Sprintec can affect the levels of this medicine in your system.
- Grapefruit or grapefruit juice: Consuming grapefruit or grapefruit juice can increase the levels of Tri-Sprintec in your bloodstream.
- Medications for HIV, AIDS, or hepatitis C: Tri-Sprintec should not be taken with ombitasvir, paritaprevir, or ritonavir due to an increased risk of liver problems.
- Medications for seizures or migraines: Barbiturates such as phenobarbital and butalbital and drugs such as phenytoin, carbamazepine, topiramate, and oxcarbazepine can reduce the effectiveness of Tri-Sprintec.
- Lamotrigine: Tri-Sprintec can significantly decrease lamotrigine effectiveness, which may require dose adjustments for adequate seizure control.
- Prednisolone: Tri-Sprintec can interact with this corticosteroid.
- St. John’s wort: Taking this supplement may reduce Tri-Sprintec’s effectiveness at preventing pregnancy.
- Temazepam: Tri-Sprintec can affect levels of this medication in your body.
- Thyroid medications: A dosage adjustment of the thyroid medication may be required when taking Tri-Sprintec.
- Tizanidine: Tri-Sprintec can affect how your body metabolizes this medication.
- Vitamin C (ascorbic acid): This over-the-counter supplement for low vitamin C levels can affect levels of Tri-Sprintec in the bloodstream.
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 Tri-Sprintec to become fully effective at preventing pregnancy?
Standard guidelines suggest that the initial effects begin within days. To be safe, healthcare providers often advise using a backup contraceptive method (such as a condom) during the first cycle or first week to prevent pregnancy.
What is the difference between Tri-Sprintec and Sprintec?
Tri-Sprintec is a triphasic pill, meaning the amount of progestin changes three times over the course of the 21 active pills to mimic natural hormonal shifts. Sprintec is a monophasic pill, delivering a consistent, unchanging dose of hormones in every active pill.
Why do the active pills in the blister pack change colors three times throughout the month?
The color changes indicate the three different dosage phases of Tri-Sprintec. Each color represents a specific combination of hormone levels designed for that particular week of the cycle.
Can I skip the seven white placebo pills and start a new pack to avoid having a period?
The standard prescription involves taking the 7 placebo pills to allow for a withdrawal bleed. However, some providers may recommend skipping the placebos and starting a new pack immediately to safely skip a period. This is considered an off-label use and should be discussed with a medical professional.
Is it common to experience nausea when starting this medication?
Yes, nausea is one of the possible side effects of starting Tri-Sprintec. Nausea usually goes away after the first few months once your body adjusts to the medication.
Can this medication affect overall mental health?
Yes, mood changes and feelings of depression are known potential side effects of hormonal contraceptives like Tri-Sprintec. People with a history of depression should monitor their mental health closely and contact their provider if symptoms worsen.
How does Tri-Sprintec differ from the lower-dose version, Tri-Lo-Sprintec?
Tri-Lo-Sprintec contains a lower dose of estrogen than Tri-Sprintec. Specifically, Tri-Sprintec has 35 mcg of ethinyl estradiol, whereas Tri-Lo-Sprintec contains 25 mcg.
What should I do if I vomit within a few hours of taking my daily pill?
If vomiting occurs shortly after taking a pill, your body may not have fully absorbed the hormones. Providers typically recommend treating this scenario as a missed dose and taking an extra pill of the same color from your extra tablet dispenser (or taking the next pill in your regular blister pack). If you are still vomiting after one day, it’s recommended to use a backup contraceptive method, such as condoms, until you can connect with your healthcare provider.
Is it safe to use this medication if I smoke cigarettes?
It is strongly advised against. Smoking while using combined oral contraceptives significantly increases the risk of serious cardiovascular events, including strokes, blood clots, and heart attacks. This risk is considerably higher for people who are 35 years of age or older.
How long after stopping Tri-Sprintec does it generally take for a normal menstrual cycle to return?
Medical professionals generally note that it can take a few months or longer for a natural, regular menstrual cycle to fully re-establish itself after discontinuing hormonal birth control.
Is Tri-Estarylla the same as Tri-Sprintec?
Yes, Tri-Estarylla and Tri-Sprintec are both common brand names for the same generic medication: norgestimate and ethinyl estradiol.
Comparable Medications
Tri-Sprintec, Sprintec, Tri-Lo-Sprintec, Tri-Estarylla, or levonorgestrel and ethinyl estradiol?
There are several medications that your doctor can prescribe in place of Tri-Sprintec. Here are a few possible alternatives below.
Sprintec
A combination daily birth control pill that contains the same amount of hormones throughout the menstrual cycle.
Tri-Lo-Sprintec
A combination daily birth control pill that contains a lower amount of estrogen than Tri-Sprintec.
Tri-Estarylla
Another brand name for the same medication as Tri-Sprintec.
Levonorgestrel and ethinyl estradiol
A combination contraceptive available as a daily birth control pill or a weekly transdermal patch.
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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.