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Overview:  Norethindrone is a birth control medicine that is used to prevent pregnancy. You must take this medicine each day at the same time each day for it to work well. Common side effects include irregular periods, headache, and nausea. Before taking norethindrone, make sure to tell your health care provider about any health conditions or medicines you are taking. Tell your health care provider right away if you get sudden or severe pain in your stomach area. Get emergency help if you have trouble breathing, chest pain, vision changes, or trouble speaking.

Uses

What is norethindrone used for?

Norethindrone is a birth control pill used to prevent pregnancy.

Norethindrone may also be used for other conditions as determined by your health care provider.

How does norethindrone work (mechanism of action)?

Norethindrone works for pregnancy prevention in a few ways. Norethindrone works mainly by stopping the release of an egg from your ovaries. Norethindrone also works by thickening the mucus in your cervix to block sperm from reaching the uterus and by changing the lining of your uterus to make it less likely for a pregnancy to happen.

How is norethindrone supplied (dosage forms)?

Brands and other names

  • Camila
  • Emzahn
  • Errin
  • Heather
  • Incassia
  • Jencycla
  • Nor-QD

Dosage forms and strengths

  • 0.35 mg oral tablets

How should I store norethindrone?

Norethindrone 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.

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 norethindrone?

The most common side effects of norethindrone 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)
  • Headache (see below)
  • Tender breasts
  • Nausea
  • Dizziness

There may be other side effects of norethindrone 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 norethindrone?

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

Severe Allergic Reactions. Norethindrone may cause allergic reactions, which can be serious. Stop taking norethindrone 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

Changes in Menstrual Bleeding. Norethindrone can cause you to have frequent or irregular periods, including bleeding between your periods. Do not stop taking norethindrone if this happens. Take this medicine at the same time every day. 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 norethindrone. If you miss a period, check to see if you are pregnant.

Ectopic Pregnancy. Norethindrone may cause an ectopic pregnancy, which is a pregnancy that occurs outside your uterus (womb). Stop taking norethindrone and call your health care provider right away if you get sudden or severe stomach pain while taking norethindrone or if you become pregnant.

Ovarian Cyst. Norethindrone may cause an ovarian cyst, which is a fluid-filled sac in your ovary. These cysts can disappear without any symptoms or treatment. In some cases, the cyst may twist or rupture. Call your health care provider right away if you have sudden or severe pain in your stomach area.

Headache. Norethindrone may cause headaches or migraine. Call your health care provider right away if you get new headaches or migraine attacks that keep coming back, do not go away, or cause you a lot of pain.

Warnings & Precautions

Who should not use norethindrone?

Allergies to Ingredients. People who are allergic to any of the following should not take norethindrone.

  • Camila
  • Emzahn
  • Errin
  • Heather
  • Incassia
  • Jencycla
  • Norethindrone
  • Nor-QD
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific norethindrone products they stock.

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

Breast Cancer. Norethindrone should not be taken if you have breast cancer.

Unusual Vaginal Bleeding. Norethindrone 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.

Liver Problems. Norethindrone should not be used if you have a liver tumor (benign or cancerous) or if your liver is not working as well as it should be. 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.

What should I know about norethindrone before using it?

Do not take norethindrone unless it has been prescribed to you by a health care provider. Take it as prescribed.

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

Keep norethindrone out of the reach of children.

Norethindrone does not protect against human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), or other sexually transmitted diseases (STDs).

Take tablets in order (from left to right) at the same time every day until the pack is finished and swallow the tablets whole. Consider using a calendar or app to help you remember to take norethindrone at the same time each day. The medicine may not work well if you are just 3 hours late taking any given pill.

After taking the last tablet in the blister pack, start with the first tablet in a new blister pack. There is no break between packs. Talk to your health care provider about backup birth control (such as condoms or spermicide) if you miss tablets or  you have diarrhea or vomiting.

What should I tell my health care provider before using norethindrone?

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 norethindrone 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.

Other Medicines and Supplements. Norethindrone may interact with other medicines and supplements. Before taking norethindrone, 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.

Smoking. Tell your health care provider if you smoke. Smoking while taking norethindrone can increase your risk of having a heart attack or stroke.

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

Breastfeeding. Norethindrone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take norethindrone while breastfeeding.

Interactions

Does norethindrone interact with foods or drinks?

Eating grapefruit or drinking grapefruit juice while taking norethindrone 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.

There are no known interactions between norethindrone and alcohol.

Does norethindrone 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 norethindrone.

  • Aprepitant (Emend), which is a medicine used to prevent nausea and vomiting caused by chemotherapy
  • Bosentan, which is a medicine used to treat a condition called pulmonary arterial hypertension (PAH)
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Griseofulvin, fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, or voriconazole (Vfend), which is a medicine used to treat certain types of fungal infections
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Rifampin (Rifadin) or rifabutin (Mycobutin), which is a medicine commonly used to treat an infection called tuberculosis
  • St. John’s wort, which is a supplement that may be used to treat depression
  • Ulipristal (Ella, Logilia), which is an emergency contraceptive pill
  • An antibiotic, which is a medicine used for bacterial infections
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • A medicine for HIV, AIDS, or hepatitis C

Some other medicines may alter the blood levels of norethindrone, 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 norethindrone. 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 norethindrone?

If you or someone else has used too much norethindrone, 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 norethindrone?

If it has been 3 hours or less from the time you were supposed to take norethindrone, take the missed pill as soon as you remember.

If it has been more than 3 hours from the time you were supposed to take norethindrone, take the missed pill as soon as you remember and use backup birth control (condoms, spermicide) for the next 48 hours.

Norethindrone may not work well if you miss tablets. If you are not sure what to do about the pills you have missed, keep taking norethindrone and keep using backup birth control (condoms, spermicide) until you can talk to your health care provider. If you miss your period and have not taken norethindrone as directed, call your health care provider right away.

If you vomit soon after taking norethindrone, use backup birth control (condoms, spermicide) for the next 48 hours.

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