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Overview: Norgestrel/ethinyl estradiol is a hormonal birth control medicine that is used to prevent pregnancy. Common side effects include changes in menstrual bleeding, nausea, headache, or changes in weight.  Before taking norgestrel/ethinyl estradiol, make sure to tell your health care provider about any health conditions you have or medicines you are taking. Get emergency help if you have trouble breathing, chest pain, vision changes, or trouble speaking.

Uses

What is norgestrel/ethinyl estradiol used for?

Norgestrel/ethinyl estradiol is a combination birth control pill that is commonly used to prevent pregnancy.

Norgestrel/ethinyl estradiol may also be used for other conditions as determined by your health care provider.

How does norgestrel/ethinyl estradiol work (mechanism of action)?

Norgestrel/ethinyl estradiol contains two types of hormones, norgestrel (a progestin) and ethinyl estradiol (an estrogen). It prevents pregnancy by stopping the release of an egg from your ovaries.

How is norgestrel/ethinyl estradiol supplied (dosage forms)?

28-Day Monophasic (one phase)

Cryselle, Elinest, Low-Ogestrel, Turqoz

  • Days 1-21: norgestrel/ethinyl estradiol oral tablets (0.3 mg/0.03 mg)
  • Days 22-28:  inactive oral tablets

How should I store norgestrel/ethinyl estradiol?

Norgestrel/ethinyl estradiol should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place away from light.

Only remove a tablet from the blister pack when you are ready to take it.

Side Effects

What are the most common side effects of norgestrel/ethinyl estradiol?

The most common side effects of norgestrel/ethinyl estradiol are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Changes in menstrual bleeding (see below)
  • Nausea
  • Headache or migraine (see below)
  • Increase or decrease in weight 
  • Acne
  • Painful periods
  • Vaginal discharge
  • Stomach pain, cramping, or bloating
  • Increase in appetite
  • Depression (see below)
  • Nervousness
  • Skin darkening on face
  • Tiredness
  • Worsening of varicose veins 

There may be other side effects of norgestrel/ethinyl estradiol that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of norgestrel/ethinyl estradiol?

While less common, the most serious side effects of norgestrel/ethinyl estradiol are described below, along with what to do if they happen.

Severe Allergic Reactions. Norgestrel/ethinyl estradiol may cause allergic reactions, which can be serious. Stop taking norgestrel/ethinyl estradiol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Clots. Norgestrel/ethinyl estradiol may cause a blood clot in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism (VTE), including a blood clot in the lungs (pulmonary embolism), in the back of your eye (retinal vein occlusion), or in your legs or arms (deep venous thrombosis). Stop taking norgestrel/ethinyl estradiol and get emergency help if you have any of the following signs of a blood clot.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Pain, swelling, or tenderness in your arm or leg
  • Vision loss
  • Bulging eyes
  • Double vision

Liver Problems. Norgestrel/ethinyl estradiol may cause changes to your liver function, including an increase in your liver enzymes or possibly liver tumors. Call your health care provider if you have any of the following symptoms of liver problems.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Norgestrel/ethinyl estradiol may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Gallbladder Problems. Taking norgestrel/ethinyl estradiol may increase the risk of gallbladder problems, including cholecystitis and cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Fever
  • Pain in your upper stomach area
  • Stool (poop) that is clay-colored

Headache or Migraine. Norgestrel/ethinyl estradiol may cause headaches or migraine. Call your health care provider right away if you develop new headaches or migraine attacks that keep coming back, do not go away, or cause you a lot of pain.

Changes in Menstrual Bleeding. Norgestrel/ethinyl estradiol can cause irregular bleeding, spotting, or light bleeding between periods, especially during the first three months of use. For some people, periods may stop. Call your health care provider right away if you continue to have spotting or breakthrough bleeding between periods or if you have spotting after having regular cycles while taking norgestrel/ethinyl estradiol.

Depression. Norgestrel/ethinyl estradiol may cause changes in mood, including depression or nervousness. Call your health care provider right away if you have new or increased depression or other unusual changes in mood or behavior.

Cancer. Norgestrel/ethinyl estradiol is a combination birth control pill that contains two hormones. Certain cancers, including breast cancer and cervical cancer, may be sensitive to hormones. Make sure you keep all appointments with your health care provider.

Warnings & Precautions

Who should not use norgestrel/ethinyl estradiol?

Allergies to Ingredients. People who are allergic to any of the following should not take norgestrel/ethinyl estradiol.

  • Cryselle
  • Elinest
  • Ethinyl estradiol
  • Lo-Ovral
  • Low-Ogestrel
  • Norgestrel
  • Ogestrel
  • Ovral
  • Turqoz
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific norgestrel/ethinyl estradiol products they stock.

Smoking. Norgestrel/ethinyl estradiol should not be used if you smoke and are over age 35, as this can increase your chances of having a heart attack, stroke, or blood clots.

Blood Clots. Norgestrel/ethinyl estradiol should not be used if you have or have had blood clots, including a blood clot in the lungs (pulmonary embolism) or deep vein thrombosis (DVT). This medicine should also not be used if you have a condition that makes your blood more prone to getting blood clots (thrombophilia). Norgestrel/ethinyl estradiol can increase the risk of developing a blood clot that could be dangerous or even deadly.

Heart Attack or Stroke. Norgestrel/ethinyl estradiol should not be used if you have had a stroke or heart attack. Norgestrel/ethinyl estradiol can increase the risk of having a heart attack or stroke that could be dangerous or even deadly.

Blood Vessel Problems. Norgestrel/ethinyl estradiol should not be used if you have or have had a history of plaque buildup in your blood vessels (coronary artery disease) or if you have or have had a condition that affects blood flow to your brain (cerebrovascular disease). Norgestrel/ethinyl estradiol could increase your chances of having a heart attack, stroke, or blood clots.

Heart Problems. Norgestrel/ethinyl estradiol should not be used if you have heart rhythm problems (such as atrial fibrillation) or heart valve problems, as this may increase your chances of having a blood clot.

Increased Blood Pressure (Hypertension). Norgestrel/ethinyl estradiol should not be used if you have high blood pressure that is not managed or high blood pressure with a condition that affects your blood vessels (vascular disease). Norgestrel/ethinyl estradiol could increase your chances of having a heart attack, stroke, or blood clots.

Diabetes. Norgestrel/ethinyl estradiol should not be used if you have diabetes with kidney, eye, nerve, or blood vessel damage. This can increase your chance of having a heart attack, stroke, or blood clots.

Headaches or Migraine. Norgestrel/ethinyl estradiol shuld not be used if you have migraine with vision or hearing changes, muscle weakness, tingling, or trouble speaking (known as migraine with aura) or certain other types of headaches. This can increase your risk of having a stroke. Norgestrel/ethinyl estradiol also should not be used if you are over age 35 and have any type of migraine headaches (with or without aura).

Liver Problems. Norgestrel/ethinyl estradiol should not be taken if your liver is not working as well as it should be or if you have liver tumors. If there is a concern about the health of your liver, your health care provider may do tests to see if it is working well enough to take this medicine.

Unusual Vaginal Bleeding. Norgestrel/ethinyl estradiol should not be used if you have bleeding from the uterus or vagina that is not part of your menstrual cycle or is abnormal. Any unusual uterine bleeding needs to be checked out by your health care provider.

Pregnancy. Do not take norgestrel/ethinyl estradiol if you are pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Breast Cancer. Norgestrel/ethinyl estradiol should not be used if you have or have had breast cancer. Some breast cancers are sensitive to hormones and could get worse if you use norgestrel/ethinyl estradiol.

Drug Interactions. Norgestrel/ethinyl estradiol should not be taken while you are using certain other medicines. Before taking norgestrel/ethinyl estradiol, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about norgestrel/ethinyl estradiol before using it?

Do not take norgestrel/ethinyl estradiol unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share norgestrel/ethinyl estradiol with other people, even if they have the same condition as you. It may harm them.

Keep norgestrel/ethinyl estradiol out of the reach of children.

Norgestrel/ethinyl estradiol does not protect you from HIV, AIDS, or other sexually transmitted diseases (STDs).

Expect to start norgestrel/ethinyl estradiol during a specific time of your menstrual period or within a certain time after having a baby or abortion. The timing will determine whether and for how long you need to use backup birth control (such as condoms or spermicide) after starting norgestrel/ethinyl estradiol. Ask your health care provider if you are not sure how or when to start norgestrel/ethinyl estradiol.

Take tablets in order (from left to right) at the same time every day until the pack is finished and swallow the tablets whole. After taking the last tablet in the blister pack, start with the first tablet in a new blister pack.

Consider using a calendar or app to help you remember to take norgestrel/ethinyl estradiol at the same time each day.

If you miss a period, check for pregnancy. The risk of pregnancy increases with missed pills.

If you have vomiting or diarrhea within a few hours of taking norgestrel/ethinyl estradiol, it may not work as well.  Follow the Patient Labeling on how to take norgestrel/ethinyl estradiol when you miss a dose. If vomiting or diarrhea lasts more than one day, use backup birth control (such as condoms or spermicide) until you talk with your health care provider.

Norgestrel/ethinyl estradiol may affect your blood sugar or cholesterol levels. Make sure to keep all follow-up appointments, including for blood work and blood pressure checks, with your health care provider.

What should I tell my health care provider before using norgestrel/ethinyl estradiol?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if norgestrel/ethinyl estradiol is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Diabetes
  • High blood pressure
  • High cholesterol or triglycerides
  • Depression 
  • Had yellowing of the skin or eyes during pregnancy
  • A condition called hereditary angioedema
  • Gave birth within the last month
  • Recent abortion
  • Heart problems
  • Gallbladder or liver problems

Upcoming Surgery or Bed Rest. You may be at increased risk for some side effects of norgestrel/ethinyl estradiol if you do not move around normally for an extended period of time. Tell your health care provider if you have any upcoming surgeries or need to be on bed rest. Your health care provider can tell you if or when you need to stop norgestrel/ethinyl estradiol.

Smoking. Smoking can increase your risk of getting heart disease, which increases your risk of having a heart attack, stroke, or blood clots. Tell your health care provider if you smoke before starting norgestrel/ethinyl estradiol.

Skin Darkening. Talk to your health care provider if you have had a condition that led to dark patches of skin around your forehead, nose, cheeks, and around your mouth (chloasma) during pregnancy because you may have an increased chance of having chloasma while taking norgestrel/ethinyl estradiol. If you have had chloasma, avoid exposure to the sun and to ultraviolet (UV) rays from tanning booths or sun lamps.

Pregnancy. Do not take norgestrel/ethinyl estradiol and tell your health care provider if you are pregnant or plan to become pregnant. If you become pregnant, stop taking norgestrel/ethinyl estradiol right away and contact your health care provider.

Breastfeeding. Norgestrel/ethinyl estradiol passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Norgestrel/ethinyl estradiol may decrease the amount of breast milk you make. Your health care provider will let you know if you should take norgestrel/ethinyl estradiol while breastfeeding.

Interactions

Does norgestrel/ethinyl estradiol interact with foods or drinks?

Eating grapefruit or drinking grapefruit juice while taking norgestrel/ethinyl estradiol can increase the levels of medicine in your body and increase the risk of side effects. Talk to your health care provider if you eat grapefruit or drink grapefruit juice.

It is unknown if drinking alcohol will affect norgestrel/ethinyl estradiol.

Does norgestrel/ethinyl estradiol interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking norgestrel/ethinyl estradiol.

  • A medicine for HIV, AIDS, or hepatitis C
  • Any medicine that may be used to treat seizures, such as carbamazepine (Carbatrol, Tegretol, and others), phenytoin (Dilantin, Phenytek, and others), felbamate, lamotrigine (Lamictal), oxcarbazepine (Trileptal, Oxtellar XR), or topiramate (Topamax, Trokendi XR, Qudexy XR)
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent mycobacterium avium complex infection
  • A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraine, or seizures
  • Bosentan, which is a medicine used to treat a condition called pulmonary arterial hypertension (PAH)
  • Aprepitant, which is a medicine used to prevent nausea and vomiting caused by chemotherapy 
  • St. John’s wort, which is a supplement that may be used to treat depression
  • Colesevelam (Welchol), which is a medicine for high cholesterol and high blood sugar from type 2 diabetes
  • Fluconazole (Diflucan), griseofulvin, itraconazole (Sporanox, Tolsura), ketoconazole, or voriconazole (Vfend), which are medicines used for fungal infections
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Prednisolone, which is a medicine for certain inflammatory conditions
  • Theophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problems
  • Tizanidine (Zanaflex), which is a muscle relaxant
  • A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels

Some other medicines may alter the blood levels of norgestrel/ethinyl estradiol, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with norgestrel/ethinyl estradiol. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much norgestrel/ethinyl estradiol?

If you or someone else has used too much norgestrel/ethinyl estradiol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of norgestrel/ethinyl estradiol?

Norgestrel/ethinyl estradiol may not work well if you miss tablets. Follow the Patient Labeling on how to take norgestrel/ethinyl estradiol when you miss a dose, as this can change depending on how many tablets you have missed and which weeks they were missed on. In some cases, you may need to avoid sexual intercourse or use backup birth control (such as condoms or spermicide)

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