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norelgestromin - ethinyl estradiol
How does this medication work? What will it do for me?
This is a contraceptive (birth control) patch that is worn on the skin. The medication is continuously absorbed through the skin into the bloodstream. It is a combination contraceptive that contains 2 hormones (norelgestromin and ethinyl estradiol) to alter the female reproductive cycle. This medication prevents eggs from being released by the ovaries and changes the cervical mucus, making it harder for sperm to swim. This medication is used to prevent pregnancy.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white-to-off-white tablet contains 0.18 mg norgestimate plus 0.035 mg ethinyl estradiol. Nonmedicinal ingredients: lactose monohydrate, povidone K-30, pregelatinized starch, colloidal silicon dioxide, magnesium stearate, purified water, and talc.
Each light blue tablet contains 0.215 mg norgestimate plus 0.035 mg ethinyl estradiol. Nonmedicinal ingredients: FD&C Blue No. 2-5625 Aluminum Lake, lactose monohydrate, povidone K-30, pregelatinized starch, colloidal silicon dioxide, magnesium stearate, purified water, and talc.
Each blue tablet contains 0.25 mg norgestimate plus 0.035 mg ethinyl estradiol. Nonmedicinal ingredients: FD&C Blue No. 2 -5625 Aluminum Lake, lactose monohydrate, povidone K-30, pregelatinized starch, colloidal silicon dioxide, magnesium stearate, purified water, and talc.
Each light green tablet contains inert ingredients FD&C Blue No. 2 -5625 Aluminum Lake, D & C Yellow No. 10, lactose monohydrate, microcrystalline cellulose, magnesium stearate, pregelatinized starch, purified water, and talc.
How should I use this medication?
21-day pack: Take one tablet daily for 21 days, then take no pills for 7 days.
28-day pack: Take one tablet daily for 21 days, then one "reminder" pill daily for 7 days.
See the package insert for information on when to start and what to do if you forget to take a pill.
Talk with your doctor about the best time to start your pills. The first day of your menstrual period (bleeding) is known as "Day 1." Your doctor may have you start your pills on the first Sunday after your period starts or on Day 1 of your period. The pills should be taken approximately the same time every day.
It may be advisable to use a second method of birth control (e.g., latex condoms and spermicidal foam or gel) for the first 7 days of the first cycle of pill use.
Many women have spotting or light bleeding or may feel sick to their stomach during the first 3 months taking the pill. If you do feel sick, do not stop taking the pill. The problem will usually go away. If it does not go away, check with your doctor or clinic.
If you experience vomiting or diarrhea, or if you take certain medications (such as antibiotics), your pills may not work as well. If your doctor prescribes other medications, ask your doctor or pharmacist whether these medications could reduce the effectiveness of your birth control pills. Until you can check with your doctor or clinic to make certain that these things will not reduce the effectiveness of your birth control pills, use a backup method, such as latex condoms and spermicidal foam or gel.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is very important to take this medication exactly as prescribed by your doctor. If you miss pills at any time, the risk of becoming pregnant increases.
If you miss one pill, take it as soon as you remember, and take the next pill at the usual time. This means that you might take two pills in one day.
If you miss 2 pills in a row during the first 2 weeks of your cycle, take two pills the day you remember and 2 pills the next day, then take one pill a day until you finish the pack. Use a second method of birth control if you have sex in the 7 days after you miss the pills.
If you miss 2 pills in a row during the third week of your cycle or 3 or more pills in a row anytime in your cycle and you start your pills on Sunday, keep taking one pill a day until Sunday. On Sunday, safely discard the rest of the pack and start a new pack that day. You may not have a period this month. If you miss 2 periods in a row, call your doctor or clinic.
If you miss 2 pills in a row during the third week of your cycle or 3 or more pills at any time during your cycle and you start your pills on Day 1, safely dispose of the rest of the pill pack and start a new pack that same day. Use another method of birth control if you have sex in the 7 days after you miss the pills. You may not have a period this month. If you miss 2 periods in a row, call your doctor or clinic.
If you are not sure what to do after missing pills, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use norelgestromin – ethinyl estradiol if you:
- are allergic to norelgestromin or ethinyl estradiol or any other ingredients of the medication
- are immobilized for prolonged periods
- are known or suspected to be pregnant
- have or have had blood clots (in the legs, lungs, eyes, or anywhere else) or have severe or multiple risk factors for them
- have or have had a stroke or TIA ("mini-stroke")
- have or have had a heart attack or chest pain (angina)
- have or have had valvular heart disease with complications
- have severe high blood pressure (always >160/100 mmHg)
- have diabetes with blood vessel involvement
- have very high cholesterol
- have health conditions that increase the risk of blood clots (such as certain inherited blood clotting diseases; talk to your doctor for more information)
- smoke and are over the age of 35
- have active liver disease
- have or have had liver tumours (benign or malignant)
- have or are suspected to have breast cancer
- have or are suspected to have cancer of the reproductive organs (e.g., endometrium)
- have undiagnosed abnormal vaginal bleeding
- have yellowing of the skin (jaundice) due to steroids or blocked bile ducts
- have yellowing of the eyes or skin during pregnancy
- have vision problems due to vascular eye disease
- have migraine with focal aura
- have had major surgery associated with an increased risk of blood clots
- are taking the following medication combination used to treat Hepatitis C: paritaprevir, ritonavir, ombitasvir with or without dasabuvir
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- breast discomfort
- changes in skin pigmentation
- gain or loss of body or facial hair
- flu-like illness
- headache (unless it is sudden, severe, or worsening)
- painful menstrual periods
- skin irritation, redness, or rash where the patch was applied
- weight gain
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal swelling of arms or legs
- breast lumps
- headaches or migraines
- muscle pain
- severe pain or a lump in the abdomen
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- swelling of the feet, ankles, or lower leg
- symptoms of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
- vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge
- unexpected vaginal bleeding
Stop using the medication and seek immediate medical attention if any of the following occur:
- loss of vision or change in vision (sudden)
- pains in chest, groin, or leg (especially in calf of leg)
- signs of a blood clot in the lung (e.g., coughing up blood, sudden/unexplained shortness of breath)
- signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
- signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
The information provided here results from studies of combination oral contraceptives; the patch contraceptive is thought to have similar risks. Oral combination contraceptives increase the risk of the following serious conditions:
- blood clots
- gallbladder disease
- heart attack
- liver tumours
The risk of disease or death from these conditions greatly increases if a woman has other risk factors such as high blood pressure, high cholesterol, obesity, or diabetes.
Smoking while taking oral contraceptives increases the risk of side effects that affect the heart and blood vessels (e.g., blood clots). This risk is greatest for women 35 years and older. You should not take this medication if you smoke and are 35 years or older.
You should stop using the patch immediately if you develop any of the following:
- blood clot disorders and cardiovascular disorders (e.g., inflammation of a vein due to blood clot, blood clot in your lung)
- a condition that makes you immobile for a long period of time (e.g., recovering from major surgery, being bedridden due to a long-term illness)
- vision or eye problems (e.g., double vision, certain eye conditions) – check with your doctor
- severe headache without known cause, or worsening of preexisting migraine
Body weight: For women weighing 90 kg (198 lbs.) or more, the patch may be less effective. Check with your doctor for more information.
Breast self-exam and physical exams: Women taking this medication should do regular breast self-exams and have yearly physical exams done by their doctor.
Depression: Hormones, such as estrogen, have been known to cause mood swings and symptoms of depression. If you have had clinical depression in the past, you may be more likely to experience it again while taking this medication. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Heat sources: Do not expose the patch area to heat sources such as heating pads, electric blankets, saunas, hot tubs, or heat lamps. This may increase the amount of medication that enters your body through the skin.
Sexually transmitted infections: Birth control patches do not protect against sexually transmitted infections, including HIV/AIDS. For protection against these, use latex condoms.
Pregnancy: This medication should not be taken during pregnancy. You should stop using this medication if you become pregnant and contact your doctor.
Breast-feeding: This medication passes into breast milk and may affect your baby. Adverse effects on the baby, such as jaundice and breast enlargement, have been reported. Talk to your doctor about whether you should continue breast-feeding.
Children: This medication is not recommended for use before the start of menstruation in puberty.
What other drugs could interact with this medication?
There may be an interaction between norelgestromin – ethinyl estradiol patch and any of the following:
- antibiotics (e.g., ampicillin, metronidazole, penicillin, rifampin, neomycin, tetracyclines)
- anticonvulsants (e.g., carbamazepine, , phenobarbital, phenytoin, primidone, topiramate, lamotrigine)
- "azole" antifungals (e.g., fluconazole, ketoconazole, voriconazole)
- barbiturates (e.g., phenobarbital)
- benzodiazepines (e.g., lorazepam, clonazepam, diazepam)
- blood pressure medications (e.g., metoprolol, , methyldopa)
- corticosteroids (e.g., dexamethasone, prednisone)
- diabetes medications (e.g., glyburide, gliclazide, insulin)
- folic acid
- grapefruit juice
- Hepatitis C antivirals (e.g., dasabuvir, ombitasvir, paritaprevir, ritonavir)
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
- HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
- low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
- St. John’s wort
- theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
- tranexamic acid
- vitamin B12
- vitamin C (ascorbic acid)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Tri-Jordyna