How It Works
Norgestimate-ethinyl estradiol works in three ways to prevent pregnancy:
- Stopping the egg: The pill prevents the ovaries from releasing an egg.
- Changing the mucus: The hormone norgestimate thickens the mucus at the bottom of the womb (the cervix). This creates a barrier to prevent sperm from entering the uterus.
- Thinning the lining: Norgestimate-ethinyl estradiol thins the uterine lining, making it difficult for a fertilized egg to attach to the wall of the uterus.
Norgestimate-ethinyl estradiol often comes in a blister pack of 28 pills for 4 weeks of treatment. In a standard pack, there are 21 “active” pills that contain active ingredients. The last 7 pills are “placebo” pills, which do not have any hormones in them.
The inactive pills help to maintain a habit of taking the medication daily. During the placebo week, patients typically experience a menstrual period.
For patients taking norgestimate-ethinyl estradiol for acne, the pill may help by lowering certain hormones in the body that cause oily skin. These lower hormone levels may help keep pores clear and reduce breakouts.
| Quick Facts | |
|---|---|
| Common Brands | Sprintec, Tri-Sprintec, Estarylla, Mono-Linyah, Mili, Tri-Lo-Mili, Ortho-Cyclen, Ortho Tri-Cyclen, Previfem, Femynor |
| Drug Class | Combined Hormonal Contraceptive (Estrogen and Progestin) |
| Generic Status | Generic version available |
| Availability | Prescription only |
Dosing
The standard recommendation is to take norgestimate-ethinyl estradiol by mouth once daily, ideally at the same time each day.
Many doctors suggest a “Day 1 Start.” This means taking the first pill on the first day of your period. It is recommended to use a backup contraception method, like a condom, for the first 7 days of treatment.
Here are tips related to norgestimate-ethinyl estradiol dosing:
- Avoiding side effects: To help avoid an upset stomach, take the pill with a meal or right before bed.
- Avoiding gaps in protection: Doctors recommend taking the pills in package sequence. When the package is finished, begin a new package the next day.
- Addressing a skipped pill: If you forget to take an active pill, take it as soon as you remember. This might mean taking two pills in one day. Missing two or more pills in a row can reduce the efficacy of the contraception. When this happens, doctors recommend using a back-up contraception, like a condom, for 7 days.
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
Norgestimate-ethinyl estradiol is FDA-approved to prevent pregnancy (contraception). It is also approved to treat moderate acne in females.
Off-Label Uses
You may see norgestimate-ethinyl estradiol prescribed for uses that are not “FDA-approved.” This is a 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.
Health providers may prescribe norgestimate-ethinyl estradiol for the following off-label uses:
- Period regulation: To make periods come at the same time every month.
- Painful periods: To help with painful menstrual cramps.
- Endometriosis: To help with pelvic pain caused by this condition.
- PCOS: To help balance hormones for those with polycystic ovary syndrome.
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Side Effects
After beginning norgestimate-ethinyl estradiol, your body may need time to get used to the new hormones. Most side effects are mild. They often lessen after you have taken the medication regularly for around three months.
Common Side Effects
- Nausea
- Spotting, or light bleeding between periods
- Breast soreness or tenderness
- Mild headaches
- Mood changes, like feeling nervous, sad, or irritable
- Minor weight gain from water retention
- Development of dark spots on the skin after sun exposure
Serious Side Effects
Serious side effects from norgestimate-ethinyl estradiol are rare, but it’s important to know what to look for if they do occur. The risk of serious side effects, particularly blood clots, is higher if you smoke or if you are over 35 years old.
- Blood clot in the leg: Symptoms include pain, swelling, or redness in one leg.
- Blood clot in the lung: Common symptoms are sudden chest pain or trouble breathing.
- Stroke: This serious side effect may involve sudden numbness on one side of the body, a very bad headache, or trouble seeing.
- Liver problems: Jaundice may cause yellowing of the skin or eyes.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Use an Alarm
Scheduling a daily alarm on your phone may help remind you to take your pill. Taking the pill at the same time every day helps keep hormone levels stable.
Protect Your Skin
Norgestimate-ethinyl estradiol can make your skin more sensitive to the sun. Wearing sunscreen and protective clothing can help you avoid sun-related side effects like the development of dark spots on the face.
Make Adjustments When Sick
If you throw up or have severe diarrhea within 3 hours of taking your pill, the medication’s efficacy may be reduced. Experts recommend treating this situation like a missed dose.
Tell Your Doctor Everything
Make sure your doctor knows about the other medicines you take to avoid interactions. This includes vitamins, herbal supplements, and over-the-counter medications.
Consider Time Zone Changes
If you travel to a different time zone, keep taking your pill at the same time you would have at home. You may need to take it earlier or later in the day in the new time zone to stay on schedule.
Drug Interactions
Some medicines and foods can affect the norgestimate-ethinyl estradiol birth control pill from working effectively, which can lead to an unplanned pregnancy. For example:
- Specific antibiotics: Most common antibiotics do not impact norgestimate-ethinyl estradiol, but drugs used for tuberculosis (like Rifampin) can lessen the pill’s efficacy.
- Seizure medicine: Some medicines used for seizures or nerve pain can interfere with norgestimate-ethinyl estradiol.
- St. John’s wort: This herbal supplement is known to reduce the contraceptive effects of the pill.
- Grapefruit: Grapefruit juice can affect how your body processes estrogen.
- Vitamin C: High doses of vitamin C can affect the level of hormones in your blood.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
What is the difference between Tri-Sprintec and the regular version, Sprintec?
Sprintec is monophasic, meaning every active pill has the same amount of hormones. Tri-Sprintec is triphasic, meaning the amount of hormones changes week over week. Research suggests both are effective at preventing pregnancy.
What should I do if I forget to take a pill in my pack?
Experts suggest taking the missed pill as soon as you remember. If you missed more than one, you may need to use back-up contraception, like a condom, for a week. Check the paper that came with your pills or contact your doctor for the exact steps to follow.
Can I skip the inactive “sugar pills” at the end of the pack and start a new pack to skip my period?
Some people do this to avoid having a period. It is usually safe, but ask your doctor first. You may experience spotting if you skip the placebo week.
Do antibiotics actually make this birth control stop working?
Most antibiotics do not affect the pill, but some types used for serious infections can reduce its efficacy.
Why am I spotting or bleeding while taking the active pills every day?
This is called “breakthrough bleeding.” It is common when you first start the pill and does not mean the pill is not working. Spotting is a side effect that usually stops after a few months.
Will norgestimate-ethinyl estradiol help alleviate my severe menstrual cramps?
Norgestimate-ethinyl estradiol is commonly used off-label to treat severe menstrual cramps.
Does norgestimate-ethinyl estradiol cause anxiety?
Hormones can affect how you feel. Some people may feel more nervous while on norgestimate-ethinyl estradiol, while others feel more balanced. If you feel very anxious, talk to your doctor.
How many days do I need to take this pill before it fully protects me from getting pregnant?
If you start taking norgestimate-ethinyl estradiol on the first day of your period, experts suggest you are protected right away. If you start on any other day, it’s generally accepted that you must take the pill for 7 days before you are considered protected from unplanned pregnancy.
Is it safe to take this medication if I have severe migraines?
If you see flashing lights or feel numb before a headache (aura), your doctor may recommend that you do not take this pill. Some research suggests estrogen can increase the risk of a stroke for people with this type of migraine. Talk with your doctor to determine what is best for you.
Can I take this birth control while I am breastfeeding?
Estrogen can sometimes reduce milk production while breastfeeding. Many doctors suggest waiting until your baby is no longer breastfeeding or to use a progestin-only pill.
Does the time of day I take norgestimate-ethinyl estradiol matter?
You can take norgestimate-ethinyl estradiol at any time of day, but taking it at the same time every day is ideal.
Will taking this birth control pill make it harder for me to get pregnant once I stop?
Research suggests that taking norgestimate-ethinyl estradiol only reduces your chance of getting pregnant while you are actively taking it. Experts say it should not cause long-term problems with future pregnancies once you stop taking the medication.
Can I safely take over-the-counter painkillers like acetaminophen (Tylenol) while on norgestimate-ethinyl estradiol?
Experts suggest that most people can safely take over-the-counter painkillers while on norgestimate-ethinyl estradiol. If you take prescription-strength acetaminophen, discuss potential interactions with a provider.
Why do my pills have three different colors of active pills before the placebo week?
These different colors mean you have a “triphasic” pack. Each color has a different amount of hormones to mimic the natural changes in a menstrual cycle.
Does norgestimate-ethinyl estradiol cause weight gain?
Studies show that norgestimate-ethinyl estradiol does not cause much long-term weight gain.
What is the 7-day rule for the pill?
This “rule” means you must take the active pill for 7 consecutive days before you experience the full contraceptive effects of the medication. Because of this rule, it is advised to use an alternative means of birth control, such as a condom, for 7 days if you start the pill mid-cycle or miss multiple doses.
Comparable Medications
Tri-Sprintec, Yaz/Yasmin, Norethindrone (The Mini-Pill), Drospirenone (Slynd), or NuvaRing?
There are several medications that your doctor can prescribe in place of norgestimate-ethinyl estradiol. Here are a few possible alternatives below.
Tri-Sprintec
From $32.99
A birth control pill that uses the same hormones as the regular version, but the dose of progestin changes slightly every seven days to mimic a natural menstrual cycle.
Yaz/Yasmin
A combination birth control pill that uses a different progestin called drospirenone. It is used to treat premenstrual dysphoric disorder (PMDD) and can help reduce water retention and bloating.
Norethindrone
From $24.99
A progestin-only pill (POP) that contains no estrogen. It is used to prevent pregnancy and is often prescribed to those who are breastfeeding or cannot take estrogen due to certain health risks.
Drospirenone
A newer progestin-only pill. It is used to prevent pregnancy and offers a more flexible 24-hour daily dosing window.
NuvaRing
A small, flexible vaginal ring that provides a continuous low dose of hormones over three weeks. It is used to prevent pregnancy and offers an alternative to taking a daily pill.
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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 board-certified 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.